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Fink-Lamotte J, Bieber H, Jordan H, Exner C. Once in Contact, Forever Contaminated! Introducing a Clinically Validated Imagery- and Video-Based Chain of Contagion Task for the Measurement of Disgust and Contamination Change in Experimental Research and Clinical Practice. Behav Ther 2024; 55:1043-1058. [PMID: 39174264 DOI: 10.1016/j.beth.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 12/05/2023] [Accepted: 03/04/2024] [Indexed: 08/24/2024]
Abstract
Tolin et al. (2004) developed the Chain of Contagion Task (CCT) to experimentally test the law of contagion and looming vulnerability (LV). In the CCT, contaminated pencils are brought into contact with clean pencils. The degree of contamination transferred to further new pencils refers to the level of biased contagious beliefs. Although this could be an important transdiagnostic tool, the usability of the original paradigm has been very laborious. Therefore, an imagery- and video-based CCT is introduced and validated in Study 1 in a nonclinical sample with 85 participants. In Study 2, the imagery-based CCT was validated in a clinical study with 15 participants diagnosed with contamination-related obsessive-compulsive disorder (C-OCD), 15 participants suffering from an anxiety disorder, and 15 nonclinical controls. The number of participants is consistent with those in Tolin's original sample and the statistical evaluation of Study 2 was preregistered. Both CCT could be validated and the results could be replicated. In the imagery-based CCT, the C-OCD group displayed significantly higher contamination ratings, avoidance tendencies and LV than the two control groups. We argue that this open access diagnostic instrument can be applied in research as well as in therapeutic practice (Download CCT videos and imagery: https://doi.org/10.5281/zenodo.7730459).
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Wang J, Becker B, Wang Y, Ming X, Lei Y, Wikgren J. Conceptual-level disgust conditioning in contamination-based obsessive-compulsive disorder. Psychophysiology 2024:e14637. [PMID: 38923525 DOI: 10.1111/psyp.14637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 05/13/2024] [Accepted: 06/10/2024] [Indexed: 06/28/2024]
Abstract
Pavlovian fear conditioning and extinction represent learning mechanisms underlying exposure-based interventions. While increasing evidence indicates a pivotal role of disgust in the development of contamination-based obsessive-compulsive disorder (C-OCD), dysregulations in conditioned disgust acquisition and maintenance, in particular driven by higher-order conceptual processes, have not been examined. Here, we address this gap by exposing individuals with high (HCC, n = 41) or low (LCC, n = 41) contamination concern to a conceptual-level disgust conditioning and extinction paradigm. Conditioned stimuli (CS+) were images from one conceptual category partially reinforced by unconditioned disgust-eliciting stimuli (US), while images from another category served as non-reinforced conditioned stimuli (CS-). Skin conductance responses (SCRs), US expectancy and CS valence ratings served as primary outcomes to quantify conditioned disgust responses. Relative to LCC, HCC individuals exhibited increased US expectancy and CS+ disgust experience, but comparable SCR levels following disgust acquisition. Despite a decrease in conditioned responses from the acquisition phase to the extinction phase, both groups did not fully extinguish the learned disgust. Importantly, the extinction resilience of acquired disgust was more pronounced in HCC individuals. Together, our findings suggest that individuals with high self-reported contamination concern exhibit increased disgust acquisition and resistance to extinction. The findings provide preliminary evidence on how dysregulated disgust learning mechanism across semantically related concepts may contribute to C-OCD.
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Affiliation(s)
- Jinxia Wang
- Institute for Brain and Psychological Sciences, Sichuan Normal University, Chengdu, China
- Department of Psychology, Centre for Interdisciplinary Brain Research, University of Jyvaskyla, Jyvaskyla, Finland
| | - Benjamin Becker
- State Key Laboratory of Brain and Cognitive Sciences, Department of Psychology, The University of Hong Kong, Hong Kong, China
| | - Yizhen Wang
- School of Psychology, South China Normal University, Guangzhou, China
| | - Xianchao Ming
- School of Psychology, South China Normal University, Guangzhou, China
| | - Yi Lei
- Institute for Brain and Psychological Sciences, Sichuan Normal University, Chengdu, China
| | - Jan Wikgren
- Department of Psychology, Centre for Interdisciplinary Brain Research, University of Jyvaskyla, Jyvaskyla, Finland
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von Spreckelsen P, Wessel I, Glashouwer KA, de Jong PJ. Repeated exposure to body-related memories in women with high body-related self-disgust: Impact on disgust, avoidance, and acceptance. Behav Res Ther 2024; 175:104496. [PMID: 38401244 DOI: 10.1016/j.brat.2024.104496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 01/31/2024] [Accepted: 02/07/2024] [Indexed: 02/26/2024]
Abstract
Disgust-based body image concerns can bias autobiographical memory towards the recall and avoidant processing of disgust-related memories of the own body. Repeated exposure to such memories may help breaking avoidance and promote the habituation of disgust, thereby lowering body concerns. Using a pre-post within-participant experimental design, we tested if repeatedly exposing women with high self-disgust (N = 61) to disgust-focused body memories vs. neutral memories led to changes in disgust, body acceptance, and reactive avoidance. Contrary to expectations, state disgust towards the body itself only decreased following exposure to neutral memories. Yet, disgust elicited by body-related memories decreased following both repeated exposure to neutral and body memories. Although acceptance was not found to significantly change in either exposure session, pre-post decreases in state disgust were associated with increases in acceptance following the disgust-focused exposure. In contrast to expectations, reactive avoidance increased from pre to post in the disgust-focused exposure. Overall, the results indicate that repeated exposure to disgust-focused body memories may help reduce disgust elicited by these memories and promote body acceptance. Yet, the effect of this repeated exposure to body memories did not extend to changing state disgust towards the body, possibly due to reactive avoidance.
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Affiliation(s)
- Paula von Spreckelsen
- University of Groningen, Department of Psychology (Expertise Group: Clinical Psychology and Experimental Psychopathology), Groningen, the Netherlands.
| | - Ineke Wessel
- University of Groningen, Department of Psychology (Expertise Group: Clinical Psychology and Experimental Psychopathology), Groningen, the Netherlands.
| | - Klaske A Glashouwer
- University of Groningen, Department of Psychology (Expertise Group: Clinical Psychology and Experimental Psychopathology), Groningen, the Netherlands; Department of Eating Disorders, Accare Child and Adolescent Psychiatry, Groningen, the Netherlands.
| | - Peter J de Jong
- University of Groningen, Department of Psychology (Expertise Group: Clinical Psychology and Experimental Psychopathology), Groningen, the Netherlands.
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Karch S, Maywald M, Schwartz C, Heil C, Neumüller J, Keeser D, Garcia S, Tschentscher N, Pogarell O, Paolini M, Voderholzer U. Neuronal correlates of intensification and acceptance of symptoms during exposure therapy in patients with obsessive-compulsive disorder. Front Psychol 2024; 15:1256046. [PMID: 38375106 PMCID: PMC10875107 DOI: 10.3389/fpsyg.2024.1256046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 01/15/2024] [Indexed: 02/21/2024] Open
Abstract
Introduction Cognitive behaviour therapy with exposure and response prevention is efficient in treating patients with obsessive-compulsive disorder (OCD). Nevertheless, it would be helpful for many patients to complement the therapeutic treatment with acceptance strategies to further increase the therapeutic benefit. The aim of the present study was to examine neurobiological responses to acceptance and intensification strategies during symptom provocation alongside the psychotherapeutic process. Method A total of 23 patients diagnosed with OCD (subtype: washing/contamination fear) was instructed to utilise either an acceptance strategy (ACS) or an intensification strategy (INS) to cope with their emotional and cognitive reactions to personalised symptom-triggering and neutral pictures. Fourteen patients participated twice: at the beginning [T1] and at the end [T2] of an inpatient multimodal treatment including cognitive behaviour therapy with response prevention to assess functional variations. Results For the contrast of T1 and T2, ACS showed increased brain activity in the left inferior frontal gyrus (IFG), left caudate body, and posterior cingulate gyrus (PCC). They also showed decreased activity in the left anterior insula. INS showed decreased activation in right lingual gyrus and right caudate body. At T2, ACS showed increased activation compared to INS in the left cerebrum: IFG, caudate nucleus, middle and superior temporal gyrus, and PCC/cuneus. For the comparison of T1 and T2, the ACS revealed increased brain activity in the left IFG, left caudate body, and right inferior parietal lobe. It showed decreased activity in the left anterior insula. The INS revealed decreased activity in right lingual gyrus and right caudate body.The psychometric questionnaires suggested that patients were able to reduce obsession, compulsion, and depression symptoms. Furthermore, patients rated the ACS as more useful for themselves compared with the INS. Conclusion The increased left IFG activity using ACS (T1 vs. T2) could be interpreted as a better inhibitory top-down process, while the increased PCC response might be due to a better reappraisal strategy after therapy. ACS seems to mobilise neuronal activations under therapy, especially in the left hemisphere. Both strategies showed reductions in emotional networks as a neuronal correlate of therapy success. Overall, ACS may be more efficient than INS, as rated by the patients and as in accordance with neurobiological findings.
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Affiliation(s)
- Susanne Karch
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany
| | - Maximilian Maywald
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany
| | | | - Clara Heil
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany
| | | | - Daniel Keeser
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany
- Department of Radiology, University Hospital LMU, Munich, Germany
| | - Sarah Garcia
- Schoen Clinic Roseneck, Prien am Chiemsee, Germany
| | - Nadja Tschentscher
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany
| | - Oliver Pogarell
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany
| | - Marco Paolini
- Department of Radiology, University Hospital LMU, Munich, Germany
| | - Ulrich Voderholzer
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany
- Schoen Clinic Roseneck, Prien am Chiemsee, Germany
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Efe A, Tok A. Obsessive-Compulsive Symptomatology and Disgust Propensity in Disordered Eating Behaviors of Adolescents with Celiac Disease. Int J Behav Med 2024; 31:85-96. [PMID: 36781574 DOI: 10.1007/s12529-023-10163-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2023] [Indexed: 02/15/2023]
Abstract
BACKGROUND Considering the importance of underlying psychopathological mechanisms that mediate maladaptive eating behaviors in celiac disease (CD) in the determination of cognitive-behavioral therapeutic approaches, we investigated the impact of obsessive-compulsive symptomatology and disgust propensity on disordered eating attitudes (DEA) and poor gluten-free diet (GFD) compliance in adolescents with CD. METHOD Adolescents with biopsy-proven CD (n = 148, aged 12-18 years) were compared with age- and sex-matched controls (n = 104) in terms of eating attitudes/behaviors, obsessive-compulsive symptoms, and disgust propensity, as well as depression and anxiety to rule out depression- and anxiety-related covariates. The clinical implications associated with poor GFD compliance were determined using between-subgroup analysis. Multivariate linear regression and multiple logistic regression were used to identify predictors of DEA and GFD noncompliance, respectively. RESULTS In adolescents with CD, DEA was remarkably associated with obsessive-compulsive symptom severity and disgust propensity, especially in contamination and core disgust sub-dimensions. Obsessionality and disgust propensity were independent predictors of DEA, of which the obsessive-compulsive symptom severity was the most decisive predictor of DEA. Higher DEA severity and lower body mass index were independent predictors of poor GFD compliance. CONCLUSION Higher obsessionality, accompanied by disgust-related evaluative conditioning processes, may contribute to constructing a cognitive network consisting of hypervigilance and catastrophic interpretations towards benign somatic stimulations, food-related preoccupations, and avoidant behaviors in the disordered eating of adolescents with CD. The reciprocal relationship between lifelong GFD and DEA, mediated by obsessionality and disgust propensity, was supported by current findings that could guide clinicians in the management of maladaptive eating behaviors in adolescents with CD.
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Affiliation(s)
- Ayşegül Efe
- Department of Child and Adolescent Psychiatry, University of Health Sciences, Dr. Sami Ulus Maternity, Children's Health and Diseases Training and Research Hospital, Babür Cd., No: 41, Altındağ, 06080, Ankara, Turkey.
| | - Ayşegül Tok
- Department of Child Hepatology, Gastroenterology and Nutrition, University of Health Sciences, Dr. Sami Ulus Maternity, Children's Health and Diseases Training and Research Hospital, Ankara, Turkey
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Himle JA, Grogan-Kaylor A, Hiller MA, Mannella KA, Norman LJ, Abelson JL, Prout A, Shunnarah AA, Becker HC, Russman Block SR, Taylor SF, Fitzgerald KD. Exposure and response prevention versus stress management training for adults and adolescents with obsessive compulsive disorder: A randomized clinical trial. Behav Res Ther 2024; 172:104458. [PMID: 38103359 DOI: 10.1016/j.brat.2023.104458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 11/24/2023] [Accepted: 12/06/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVE Though exposure and response prevention (ERP) is a well-proven treatment for OCD across the lifespan, prior RCTs have not studied adolescent and adult patients with the same ERP protocol relative to an active comparator that controls for non-specific effects of treatment. This approach assesses differences in the effect of OCD-specific exposures in affected adolescents and adults and in response to ERP compared to a stress-management control therapy (SMT). METHODS This assessor-blinded, parallel, 2-arm, randomized, ambulatory clinical superiority trial randomized adolescents (aged 12-18) and adults (24-46) with OCD (N = 126) to 12 weekly sessions of ERP or SMT. OCD severity was measured before, during and after treatment using the child or adult version of the Yale-Brown Obsessive Compulsive Scale (C/Y-BOCS), depending on participant age. We predicted that ERP would produce greater improvement in OCD symptoms than SMT and that there would be no significant post-treatment differences across age groups. RESULTS ERP (n = 63) produced significantly greater improvements on C/Y-BOCS scores at post-treatment than SMT (n = 63) (Effect size = -0.72, CI = -0.52 to -0.91, p < .001). ERP also produced more treatment responders (ERP = 86%, SMT = 32%; χ2 = 46.37, p < .001) and remitters than SMT (ERP = 39%, SMT = 7%; χ2 = 16.14, p < .001). Finally, there were no statistically significant post-treatment differences in C/Y-BOCS scores between adolescents and adults assigned to ERP. CONCLUSION A single ERP protocol is superior to SMT in treating both adolescents and adults with OCD. OCD-specific therapy is necessary across the lifespan for optimal outcomes in this highly disabling disorder, though non-specific treatments like SMT are still all-too-commonly provided.
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Affiliation(s)
- Joseph A Himle
- School of Social Work, University of Michigan, 1080 South University Ave, Ann Arbor, MI, 48109, USA; Department of Psychiatry, Medical School, University of Michigan, 1500 East Medical Center Dr., Ann Arbor, MI, 48109, USA.
| | - Andrew Grogan-Kaylor
- School of Social Work, University of Michigan, 1080 South University Ave, Ann Arbor, MI, 48109, USA
| | - Matthew A Hiller
- School of Social Work, University of Michigan, 1080 South University Ave, Ann Arbor, MI, 48109, USA
| | - Kristin A Mannella
- Department of Psychiatry, Medical School, University of Michigan, 1500 East Medical Center Dr., Ann Arbor, MI, 48109, USA
| | - Luke J Norman
- Department of Psychiatry, Medical School, University of Michigan, 1500 East Medical Center Dr., Ann Arbor, MI, 48109, USA
| | - James L Abelson
- Department of Psychiatry, Medical School, University of Michigan, 1500 East Medical Center Dr., Ann Arbor, MI, 48109, USA
| | - Aileen Prout
- Department of Psychiatry, Medical School, University of Michigan, 1500 East Medical Center Dr., Ann Arbor, MI, 48109, USA
| | - Angela A Shunnarah
- Department of Psychiatry, Medical School, University of Michigan, 1500 East Medical Center Dr., Ann Arbor, MI, 48109, USA
| | - Hannah C Becker
- Department of Psychiatry, Medical School, University of Michigan, 1500 East Medical Center Dr., Ann Arbor, MI, 48109, USA
| | - Stefanie R Russman Block
- Department of Psychiatry, Medical School, University of Michigan, 1500 East Medical Center Dr., Ann Arbor, MI, 48109, USA
| | - Stephan F Taylor
- Department of Psychiatry, Medical School, University of Michigan, 1500 East Medical Center Dr., Ann Arbor, MI, 48109, USA
| | - Kate D Fitzgerald
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, 630 W 168th St, New York, NY, 10032, USA
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Chua J, Sündermann O. Attenuating experimentally acquired disgust: Comparing counterconditioning, exposure and unconditioned stimulus revaluation. J Behav Ther Exp Psychiatry 2023; 79:101813. [PMID: 36496272 DOI: 10.1016/j.jbtep.2022.101813] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 07/31/2022] [Accepted: 11/16/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND OBJECTIVES Disgust is implicated in the aetiology and maintenance of various psychopathologies such as anxiety disorders and obsessive-compulsive disorders. Despite its prominent role in psychopathology, little is known about how to effectively attenuate disgust. The study examined strategies to modify an experimentally acquired disgust response in a sample of undergraduate students. METHODS A conditioning paradigm was used where participants (N = 175) first underwent acquisition of disgust via repeated presentations of a neutral picture (functioning as conditioned stimulus + [CS+]) paired with a disgusting picture (functioning as unconditioned stimulus [US]). Participants were then randomly assigned to either an exposure (repeated presentation of CS-only trials), counterconditioning (pairing CS+ with pleasant pictures), US revaluation (pairing disgusting US with pleasant pictures) or a control (filler task) condition. We hypothesised that counterconditioning would attenuate evaluative learned disgust to the greatest extent, relative to exposure and US revaluation. Participants' evaluations of the pictures were attained with a disgust-pleasantness visual analogue scale. RESULTS Exposure, counterconditioning and US revaluation reduced disgusting US expectancies. However, experimental and control conditions did not differ in terms of attenuating disgust towards CS+. LIMITATIONS Measures of psychopathology and implicit evaluations of disgust were not collected. Modest power might have limited significance of the results. CONCLUSIONS No statistical support for the effectiveness of disgust attenuation following exposure nor counterconditioning were found. Findings for US revaluation are inconclusive. Implications for future research are discussed.
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Affiliation(s)
- Jiajie Chua
- Department of Psychology, National University of Singapore, Singapore.
| | - Oliver Sündermann
- Department of Psychology, National University of Singapore, Singapore
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Matson LA, Moeck EK, Takarangi MKT. Disgust and fear reactions uniquely affect intrusions and posttraumatic stress symptoms. J Anxiety Disord 2023; 95:102683. [PMID: 36870275 DOI: 10.1016/j.janxdis.2023.102683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 12/23/2022] [Accepted: 02/16/2023] [Indexed: 03/06/2023]
Abstract
Disgust reactions commonly occur during/following trauma and predict posttraumatic stress (PTS) symptoms. Yet, disgust is not mentioned in DSM-5 PTSD criteria. To investigate disgust's clinical significance in PTSD, we measured the relationship between disgust (and fear) reactions to a personal trauma, and problematic intrusion characteristics (e.g., distress) and intrusion symptom severity. We focused on intrusions because they are a transdiagnostic PTSD symptom, though we also measured overall PTS symptoms to replicate prior work. Participants (N = 471) recalled their most traumatic/stressful event from the past six months. They then rated disgust and fear reactions to this event and completed the Posttraumatic Stress Disorder Checklist-5. Participants who had experienced intrusions about their event in the past month (n = 261) rated these intrusions on several characteristics (e.g., distress, vividness). We found stronger traumatic event-related disgust reactions were associated with more problematic intrusion characteristics, higher intrusion symptom severity, and higher overall PTS symptom severity. Notably, disgust reactions uniquely predicted these variables after statistically controlling for fear reactions. We conclude disgust reactions to trauma may be similarly pathological to fear reactions for intrusion and broader PTS symptoms. Therefore, PTSD diagnostic manuals and treatments should recognize disgust as a trauma-relevant emotion.
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Affiliation(s)
- Lucy A Matson
- College of Education, Psychology and Social Work, Flinders University, Adelaide, South Australia, Australia
| | - Ella K Moeck
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Melanie K T Takarangi
- College of Education, Psychology and Social Work, Flinders University, Adelaide, South Australia, Australia.
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Olatunji BO, Tomarken A. Pavlovian Disgust Conditioning and Generalization: Specificity and Associations With Individual Differences. Behav Ther 2023; 54:1-13. [PMID: 36608967 DOI: 10.1016/j.beth.2022.06.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 06/17/2022] [Accepted: 06/17/2022] [Indexed: 01/11/2023]
Abstract
Although studies have identified differences between fear and disgust conditioning, much less is known about the generalization of conditioned disgust. This is an important gap in the literature given that overgeneralization of conditioned disgust to neutral stimuli may have clinical implications. To address this knowledge gap, female participants (n = 80) completed a Pavlovian conditioning procedure in which one neutral food item (conditioned stimulus; CS+) was followed by disgusting videos of individuals vomiting (unconditioned stimulus; US) and another neutral food item (CS-) was not reinforced with the disgusting video. Following this acquisition phase, there was an extinction phase in which both CSs were presented unreinforced. Importantly, participants also evaluated generalization stimuli (GS+, GS-) that resembled, but were distinct from, the CS after each conditioning phase. As predicted, the CS+ was rated as significantly more disgusting and fear inducing than the CS- after acquisition and this pattern persisted after extinction. However, disgust ratings of the CS+ after acquisition were significantly larger than fear ratings. Participants also rated the GS+ as significantly more disgusting, but not fear inducing, than the GS- after acquisition. However, this effect was not observed after extinction. Disgust proneness did predict a greater increase in disgust and fear ratings of the CS+ relative to the CS- after acquisition and extinction. In contrast, trait anxiety predicted only higher fear ratings to the CS+ relative to the CS- after acquisition and extinction. Disgust proneness nor trait anxiety predicted the greater increase in disgust to the GS+ relative to the GS- after acquisition. These findings suggest that while conditioned disgust can generalize, individual difference variables that predict generalization remain unclear. The implications of these findings for disorders of disgust are discussed.
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Knowles KA, Jessup SC, Olatunji BO. Facing Uncertainty: A Comparison of Hierarchical and Variable Exposure Interventions for Contamination Fear. J Obsessive Compuls Relat Disord 2023; 36:100777. [PMID: 36582425 PMCID: PMC9794192 DOI: 10.1016/j.jocrd.2022.100777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
Abstract
Consistent with the inhibitory retrieval approach, one proposed modification to improve the effectiveness of exposure-based interventions is to maximize variability by not proceeding linearly up an exposure hierarchy. Accordingly, the present study compares hierarchical and variable exposure interventions for contamination-fearful individuals and examines the role of uncertainty to predict intervention outcomes. Participants (N=73) were randomly assigned to complete a single-session exposure intervention using a standard hierarchy or a variable exposure intervention in which hierarchy items were randomly presented. Participants completed a behavioral approach task (BAT) at baseline and two follow-up visits over a two-week period. Both interventions resulted in a significant decrease in anxiety and disgust as well as more BAT steps completed but did not differ from one another. However, individuals in the variable exposure condition reported less variability in uncertainty during exposure compared to those in the standard condition, d=.78. Furthermore, lower levels of variability in uncertainty predicted greater reductions in anxiety and disgust post-intervention. Consistent with previous studies, variable exposure did not convey additional benefit over standard, hierarchical exposure. The experience of uncertainty during exposure is an important yet understudied process that warrants additional investigation.
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How much are they predictive for obsessive-compulsive symptom dimensions: beliefs, emotions, emotional schemas? CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03969-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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12
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D'Mello RJ, Kumar A. Experience of Disgust and Symptom Severity in Contamination Subtype of Obsessive-Compulsive Disorder: Role of Experiential Avoidance. Indian J Psychol Med 2022; 44:580-585. [PMID: 36339694 PMCID: PMC9615452 DOI: 10.1177/02537176221116267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The emotion of disgust has been linked with the underlying nature of the contamination subtype of obsessive-compulsive disorder (C-OCD). Prior studies show that disgust contributes to the development of C-OCD by reinforcing avoidance strategies. Therefore, experiential avoidance (EA) may influence the effect between disgust sensitivity (DS) and C-OCD symptom severity. This study aimed to investigate the mediational role of EA between DS and C-OCD severity. METHODS A cross-sectional design was adopted with 45 patients of OCD and 45 healthy controls. Both the groups were assessed on the Obsessive-Compulsive Inventory, the Disgust Scale (Revised), and Acceptance and Action Questionnaire-II. Yale-Brown Obsessive Compulsive Scale (Y-BOCS) checklist and symptom severity scale were additionally administered to the patients with OCD. Independent t-tests, Pearson's product-moment correlation, regression analysis, and mediation analysis were used. RESULTS DS and EA were positively associated with contamination-washing symptoms and symptom severity. Regression analysis indicated that DS and EA were highly associated with contamination/washing severity scores among both the patients with C-OCD and the healthy controls. CONCLUSION The study implicates that disgust is a central emotion underlying the presentation of obsessions and compulsions, which are of contamination concerns. Further, EA has a role in the maintenance of OCD through avoidance learning; however, it may not be interacting with DS to cause OCD.
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Affiliation(s)
- Raina Jane D'Mello
- Dept. of Clinical Psychology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Ajay Kumar
- Dept. of Clinical Psychology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
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Kiss BL, Birkás B, Zilahi L, Zsidó AN. The role of fear, disgust, and relevant experience in the assessment of stimuli associated with blood-injury-injection phobia. Heliyon 2022; 8:e11839. [DOI: 10.1016/j.heliyon.2022.e11839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 10/05/2022] [Accepted: 11/16/2022] [Indexed: 11/28/2022] Open
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14
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Petersen JM, Twohig MP. Acceptance and Commitment Therapy for a Child With Misophonia: A Case Study. Clin Case Stud 2022. [DOI: 10.1177/15346501221126136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Misophonia, a condition involving hypersensitivity, anger, and/or disgust in response to specific noises (e.g., chewing, tapping), is highly underresearched in children. Several case studies point towards the utility of cognitive behavioral therapy and related treatments (e.g., acceptance and commitment therapy [ACT]). ACT presents a particularly promising option, as it focuses on building psychological flexibility in response to difficult internal experiences, rather than trying to remove or change them (e.g., responding effectively to irritation provoked by chewing). The present case study describes “Kelly” (pseudonym), a 12-year-old girl with moderately severe misophonia symptoms, who received a 16-session course of ACT for misophonia. At post-treatment, Kelly reported a decline to the mild range of misophonia, as well as re-engagement in activities that were important to her and clinically significant reductions in depressive symptoms. These results suggest that ACT may be an appropriate treatment for children with misophonia; however, much more research is warranted.
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Naumann E, Werthmann J, Vocks S, Svaldi J, Hartmann AS. Die Spiegelkonfrontationstherapie zur Behandlung von Körperbildstörungen bei Essstörungen – Evidenz, Wirkmechanismen und Vorgehensweise. PSYCHOLOGISCHE RUNDSCHAU 2022. [DOI: 10.1026/0033-3042/a000558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Körperbildprobleme sind ein Kernmerkmal von Essstörungen. Daher gilt eine Verbesserung des Körperbildes bei der Behandlung von Essstörungen als zentrales Therapieziel. Verschiedene empirische Befunde weisen auf die Spiegelkonfrontation als wirksame Methode zur Reduktion von Körperbildstörungen hin. Ziel dieses Übersichtsartikels ist es, den aktuellen Stand der wissenschaftlichen Literatur zum Thema Spiegelkonfrontationstherapie bei Essstörungen darzulegen. Insbesondere sollen die Wirksamkeitsstudien getrennt für nicht-klinische, körperunzufriedene Gruppen mit und ohne Übergewicht sowie die verschiedenen Essstörungsgruppen systematisiert und unterschiedliche Vorgehensweisen beschrieben werden. Der Übersichtsartikel liefert Hinweise dafür, dass die Spiegelkonfrontationstherapie bei Hochrisikogruppen mit erhöhter Körperunzufriedenheit sowie bei Essstörungen zu positiven Veränderungen hinsichtlich der kognitiv-affektiven und behavioralen Komponente des Körperbildes führt. Jedoch mangelt es insgesamt an randomisiert-kontrollierten Studien, die die Wirksamkeit der Spiegelkonfrontationstherapie mit ausreichend großen Stichproben gezielt untersuchen – vor allem bei der Anorexia nervosa. Der Übersichtsartikel schließt mit einer Diskussion über mögliche Wirkmechanismen, (Kontra–)Indikationen und einem Ausblick für zukünftige Forschung ab.
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Affiliation(s)
- Eva Naumann
- Abteilung Klinische Psychologie und Psychologie, Institut für Psychologie, Eberhard Karls Universität Tübingen, Deutschland
| | - Jessica Werthmann
- Abteilung Klinische Psychologie und Psychologie, Institut für Psychologie, Albert-Ludwigs-Universität Freiburg, Deutschland
| | - Silja Vocks
- Fachgebiet Klinische Psychologie und Psychologie, Institut für Psychologie, Universität Osnabrück, Deutschland
| | - Jennifer Svaldi
- Abteilung Klinische Psychologie und Psychologie, Institut für Psychologie, Eberhard Karls Universität Tübingen, Deutschland
| | - Andrea S. Hartmann
- Fachgebiet Klinische Psychologie und Psychologie, Institut für Psychologie, Universität Osnabrück, Deutschland
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Miegel F, Bücker L, Kühn S, Mostajeran F, Moritz S, Baumeister A, Lohse L, Blömer J, Grzella K, Jelinek L. Exposure and Response Prevention in Virtual Reality for Patients with Contamination-Related Obsessive-Compulsive Disorder: a Case Series. Psychiatr Q 2022; 93:861-882. [PMID: 35779165 DOI: 10.1007/s11126-022-09992-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/05/2022] [Indexed: 11/27/2022]
Abstract
Exposure therapy in virtual reality is successful in treating anxiety disorders. Studies on exposure and response prevention in virtual reality (VERP) in obsessive-compulsive disorder (OCD) are rare, and it is unclear whether distress associated with other emotions than anxiety (e.g., disgust) can be evoked. The present study aimed to investigate whether distress can be induced during VERP in patients with contamination-related OCD (C-OCD) and a primary feeling of disgust. We treated eight female patients with C-OCD with the primary emotion of disgust over six weeks with VERP and assessed their OC symptoms before and after the intervention period with the Y-BOCS. We measured subjective units of distress (SUD), heart rate and skin conductivity (arousal), sense of presence, and simulator sickness during four consecutive exposure sessions. VERP was able to induce distress and arousal. The qualitative feedback was heterogeneous and sense of presence moderate. Patients' OC symptoms reduced over the treatment period with medium to large effect sizes, but only two patients were considered responders; two patients discontinued treatment due to lack of treatment success. Although VERP was able to induce distress and arousal associated with disgust and evoked a moderate sense of presence, the low rate of symptom reduction diminishes the positive results. Possible reasons for the heterogeneous results and implications are discussed. Trial registration: German Registry for Clinical Studies (DRKS00016929), 10.04.2019.
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Affiliation(s)
- Franziska Miegel
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
| | - Lara Bücker
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Simone Kühn
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
- Lise Meitner Group for Environmental Neuroscience, Max Planck Institute for Human Development, Lentzeallee 94, 14195, Berlin, Germany
| | - Fariba Mostajeran
- Department of Informatics, University of Hamburg, Vogt-Kölln-Strasse 30, 22527, Hamburg, Germany
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Anna Baumeister
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Luzie Lohse
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Jannik Blömer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Karsten Grzella
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Lena Jelinek
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
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Peters J, Visser RM, Kindt M. More than just fear: Development and psychometric evaluation of the Spider Distress Scale to assess spider fear and spider-related disgust. J Anxiety Disord 2022; 90:102602. [PMID: 35841782 DOI: 10.1016/j.janxdis.2022.102602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 05/20/2022] [Accepted: 07/02/2022] [Indexed: 11/19/2022]
Abstract
Spider fear is an excellent model to experimentally study processes in the maintenance and treatment of long-lasting fears. A valid, reliable, and practical tool to assess spider-related distress dimensionally, and to differentiate between spider-related fear and disgust in a time-sensitive manner, may help to better understand individual differences in these two emotions and to tailor treatments accordingly. We developed a concise self-report questionnaire, the Spider Distress Scale (SDS), that combines the strengths of established spider fear questionnaires and addresses their shortcomings. We explored (study 1 and 2) and confirmed (study 3) a two-factor structure of the SDS in samples from the general population (n = 370; n = 360; n = 423), recruited online via Prolific Academic from the United Kingdom, the Netherlands, and the United States. The fear and disgust factors of the SDS are highly internally consistent and the SDS has excellent test-retest reliability. We found good convergent and discriminant validity, based on self-report measures and spider behavioural approach tasks, and the SDS successfully differentiated between individuals with and without spider fear (study 4, n = 75). Our series of studies suggests that fear and disgust are functionally related, but that disgust towards spiders can be differentially assessed when focussing on unique elements of disgust-related information.
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Affiliation(s)
- Jacqueline Peters
- Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands.
| | - Renee M Visser
- Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands
| | - Merel Kindt
- Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands
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18
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Ferrante D, D'Olimpio F. Who guards over obsessive fear of guilt? The case of Not Just Right Experiences and disgust. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022. [DOI: 10.1016/j.jadr.2022.100364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Wang J, Sun X, Becker B, Lei Y. Common and separable behavioral and neural mechanisms underlie the generalization of fear and disgust. Prog Neuropsychopharmacol Biol Psychiatry 2022; 116:110519. [PMID: 35101603 DOI: 10.1016/j.pnpbp.2022.110519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 01/21/2022] [Accepted: 01/22/2022] [Indexed: 11/29/2022]
Abstract
Generalization represents the transfer of a conditioned responses to stimuli that resemble the conditioned stimulus (CS). Previous studies on generalization of defensive avoidance responses have primarily focused on fear and have neglected disgust generalization, which represents a key pathological mechanism in some anxiety disorders. In the present study we examined common and distinct mechanisms of fear and disgust generalization by means of a fear or disgust multi-CS conditioning and generalization paradigm with concomitant event-related potential (ERPs) acquisition in n = 62 subjects. We demonstrate that compared to fear, disgust-relevant generalized stimuli (GS) elicited larger expectancy ratings and longer reaction times (RTs) reflecting stronger ratings of 'risk'. On the electrophysiological level, increased P2 amplitudes were found in response to conditioned CS+ versus CS- across both domains, possibly reflecting higher motivational and attentional salience of aversive conditioned stimuli per se. Contingent negative variation (CNV) amplitude was significantly larger for disgust-CS+ than disgust-CS-, reflecting a stronger preparation of the disgust US. Additionally, we found that the contingent negative variation (CNV) fear generalization gradient, and CNV amplitude were increased with similarity to CS+. In contrast the CNV to disgust-GS did not differ and did not reflect disgust generalization. Together this may indicate that the CNV represents a highly fear-specific index for generalization learning. This study provides the first neurobiological evidence for common and distinct generalization learning in fear versus disgust suggesting that dysregulations in separable defensive avoidance mechanisms may underly different anxiety disorder subtypes.
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Affiliation(s)
- Jinxia Wang
- Institute for Brain and Psychological Sciences, Sichuan Normal University, Chengdu 610066, China; Faculty of Education and Psychology, University of Jyvaskyla, Finland
| | - Xiaoying Sun
- Ningxia College of Construction, Ningxia 750021, China
| | - Benjamin Becker
- Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China.
| | - Yi Lei
- Institute for Brain and Psychological Sciences, Sichuan Normal University, Chengdu 610066, China.
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20
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Effects of body ownership illusion during exposure to disgusting stimuli. Conscious Cogn 2022; 99:103285. [PMID: 35180445 DOI: 10.1016/j.concog.2022.103285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 01/18/2022] [Accepted: 01/23/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND The Rubber Hand Illusion (RHI) refers to the feeling of ownership of a rubber hand by synchronously stroking the rubber hand and the own hand of a person. Previous research has shown that RHI can be used to simulate skin contact with a disgust-eliciting stimulus. We used a primary disgust elicitor (a living maggot) to replicate this finding and to gather data on disgust habituation during RHI, and effects on in-vivo exposure. METHODS A total of 82 healthy participants (25 males, 57 females) were randomly assigned to one of two conditions; synchronous stroking or asynchronous stroking (control condition) of the rubber/own hand. Subsequently, a maggot was placed on the rubber hand for five minutes. Participants rated experienced disgust at the beginning and end of the exposure. They were also asked if the maggot could be placed on their own hand. RESULTS Synchronous stroking successfully elicited RHI, which was associated with higher disgust ratings for the maggot at the beginning of exposure compared to asynchronous stroking. The two conditions did not differ in disgust habituation and the willingness to expose the own hand to the maggot. CONCLUSION RHI successfully simulated skin contact with a disgust stimulus. Future studies should apply longer exposure intervals and test individuals with higher disgust propensity to detect possible RHI effects on disgust habituation.
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21
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Visvalingam S, Crone C, Street S, Oar EL, Gilchrist P, Norberg MM. The causes and consequences of shame in obsessive-compulsive disorder. Behav Res Ther 2022; 151:104064. [DOI: 10.1016/j.brat.2022.104064] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/01/2022] [Accepted: 02/11/2022] [Indexed: 11/02/2022]
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22
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Body exposure, its forms of delivery and potentially associated working mechanisms: How to move the field forward. CLINICAL PSYCHOLOGY IN EUROPE 2021; 3:e3813. [DOI: 10.32872/cpe.3813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 05/18/2021] [Indexed: 11/25/2022] Open
Abstract
Background
Body image disturbance (BID) is a hallmark feature of eating disorders (EDs) and has proven to be involved in their etiology and maintenance. Therefore, the targeting of BID in treatment is crucial, and has been incorporated in various treatment manuals. One of the most common techniques in the treatment of BID is body exposure (BE), the confrontation with one’s own body. BE has been found to be effective in individuals with EDs or high body dissatisfaction. However, BE is applied in a multitude of ways, most of which are based on one or a combination of the hypothesized underlying working mechanisms, with no differential effectiveness known so far.
Method
The aim of this paper is to selectively review the main hypothesized working mechanisms of BE and their translation into therapeutic approaches.
Results and Conclusion
Specifically, we underline that studies are needed to pinpoint the proposed mechanisms and to develop an empirically informed theoretical model of BE. We provide a framework for future studies in order to identify working mechanisms and increase effectiveness of BE.
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23
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Miłkowska K, Galbarczyk A, Klimek M, Zabłocka-Słowińska K, Jasienska G. Pathogen disgust, but not moral disgust, changes across the menstrual cycle. EVOL HUM BEHAV 2021. [DOI: 10.1016/j.evolhumbehav.2021.03.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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24
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Sookman D, Phillips KA, Anholt GE, Bhar S, Bream V, Challacombe FL, Coughtrey A, Craske MG, Foa E, Gagné JP, Huppert JD, Jacobi D, Lovell K, McLean CP, Neziroglu F, Pedley R, Perrin S, Pinto A, Pollard CA, Radomsky AS, Riemann BC, Shafran R, Simos G, Söchting I, Summerfeldt LJ, Szymanski J, Treanor M, Van Noppen B, van Oppen P, Whittal M, Williams MT, Williams T, Yadin E, Veale D. Knowledge and competency standards for specialized cognitive behavior therapy for adult obsessive-compulsive disorder. Psychiatry Res 2021; 303:113752. [PMID: 34273818 DOI: 10.1016/j.psychres.2021.113752] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 01/21/2021] [Indexed: 12/19/2022]
Abstract
Obsessive-Compulsive Disorder (OCD) is a leading cause of disability world-wide (World Health Organization, 2008). Treatment of OCD is a specialized field whose aim is recovery from illness for as many patients as possible. The evidence-based psychotherapeutic treatment for OCD is specialized cognitive behavior therapy (CBT, NICE, 2005, Koran and Simpson, 2013). However, these treatments are not accessible to many sufferers around the world. Currently available guidelines for care are deemed to be essential but insufficient because of highly variable clinician knowledge and competencies specific to OCD. The phase two mandate of the 14 nation International OCD Accreditation Task Force (ATF) created by the Canadian Institute for Obsessive Compulsive Disorders is development of knowledge and competency standards for specialized treatments for OCD through the lifespan deemed by experts to be foundational to transformative change in this field. This paper presents knowledge and competency standards for specialized CBT for adult OCD developed to inform, advance, and offer a model for clinical practice and training for OCD. During upcoming ATF phases three and four criteria and processes for training in specialized treatments for OCD through the lifespan for certification (individuals) and accreditation (sites) will be developed based on the ATF standards.
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Affiliation(s)
- Debbie Sookman
- Department of Psychology, McGill University Health Center, 1025 Pine Ave W, Montreal, Quebec, H3A 1A1, Canada; Department of Psychiatry, McGill University, 845 Sherbrooke St W, Montreal, Quebec, H3A 0G4, Canada.
| | - Katharine A Phillips
- Department of Psychiatry, Weill Cornell Medicine, 1300 York Ave, New York, NY 10065, United States.
| | - Gideon E Anholt
- Department of Psychology, Marcus Family Campus, Ben-Gurion University of the Negev, Beer Sheva, P.O.B. 653 Beer-Sheva, 8410501, Israel.
| | - Sunil Bhar
- Department of Psychological Sciences, Faculty of Health, Arts and Design, Swinburne University of Technology, 1 John St, Hawthorn, Victoria, 3122, Australia.
| | - Victoria Bream
- Oxford Health Specialist Psychological Interventions Clinic and Oxford Cognitive Therapy Centre, Warneford Hospital, Oxford, OX3 7JX, United Kingdom.
| | - Fiona L Challacombe
- Institute of Psychiatry, Psychology and Neuroscience, Kings College London, De Crespigny Park, London, SE5 8AF, United Kingdom.
| | - Anna Coughtrey
- Great Ormond Street Hospital for Children, London WC1N 3JH, United Kingdom; UCL Great Ormond Street Institute of Child Health, 30 Guilford St, Holborn, London, WC1N 1EH, United Kingdom.
| | - Michelle G Craske
- Anxiety and Depression Research Center, Depression Grant Challenge, Innovative Treatment Network, Staglin Family Music Center for Behavioral and Brain Health, UCLA Department of Psychology and Department of Psychiatry and Biobehavioral Sciences, Box 951563, 1285 Franz Hall, Los Angeles, CA, United States.
| | - Edna Foa
- Center for the Treatment and Study of Anxiety, University of Pennsylvania Perelman SOM, 3535 Market Street, Philadelphia, PA 19104, United States.
| | - Jean-Philippe Gagné
- Department of Psychology, Concordia University, 7141 Sherbrooke St, West, Montreal, Quebec H4B 1R6, Canada.
| | - Jonathan D Huppert
- Department of Psychology, The Hebrew University of Jerusalem, Mt. Scopus, Jerusalem, 91905, Israel.
| | - David Jacobi
- Rogers Behavioral Health, 34700 Valley Road, Oconomowoc, WI, 53066, United States.
| | - Karina Lovell
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Oxford Rd, Manchester, M13 9PL, United Kingdom; Manchester Academic Health Science Centre, Greater Manchester Mental Health NHS Foundation Trust, Manchester, M13 9PL, United Kingdom.
| | - Carmen P McLean
- National Center for PTSD, Dissemination and Training Division, VA Palo Alto Healthcare System, 795 Willow Road, Menlo Park, CA, 94025, United States; Department of Psychiatry and Behavioral Sciences, Stanford University, 450 Serra Mall, Stanford, CA, 94305, United States.
| | - Fugen Neziroglu
- Bio-Behavioral Institute, 935 Northern Boulevard, Suite 102, Great Neck, NY, 11021, United States.
| | - Rebecca Pedley
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PL, United Kingdom.
| | - Sean Perrin
- Department of Psychology, Lund University, Box 213, 22100, Lund, Sweden.
| | - Anthony Pinto
- Zucker School of Medicine at Hofstra/Northwell, Zucker Hillside Hospital - Northwell Health, 265-16 74th Avenue, Glen Oaks, NY, 11004, United States.
| | - C Alec Pollard
- Center for OCD and Anxiety-Related Disorders, Saint Louis Behavioral Medicine Institute, 1129 Macklind Ave, St. Louis, MO, 63110, United States; Department of Family and Community Medicine, Saint Louis University School of Medicine, Saint Louis, MO, 63110, United States.
| | - Adam S Radomsky
- Department of Psychology, Concordia University, 7141 Sherbrooke St, West, Montreal, Quebec H4B 1R6, Canada.
| | - Bradley C Riemann
- 34700 Valley Road, Rogers Behavioral Health, Oconomowoc, WI, 53066, United States.
| | - Roz Shafran
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Hospital Institute of Child Health, Holborn, London, WC1N 1EH, United Kingdom.
| | - Gregoris Simos
- Department of Educational and Social Policy, University of Macedonia, 156 Egnatia Street, 54636 Thessaloniki, Greece.
| | - Ingrid Söchting
- Departments of Psychology, University of British Columbia, 2136 West Mall, Vancouver, British Columbia, V6T 1Z4, Canada.
| | - Laura J Summerfeldt
- Department of Psychology, Trent University, 1600 West Bank Drive, Peterborough, K9L 0G2 Ontario, Canada.
| | - Jeff Szymanski
- International OCD Foundation, 18 Tremont Street, #308, Boston MA, 02108, United States.
| | - Michael Treanor
- Anxiety and Depression Research Center, University of California, Los Angeles, Box 951563, 1285 Franz Hall, Los Angeles, CA, United States.
| | - Barbara Van Noppen
- Clinical Psychiatry and Behavioral Sciences, OCD Southern California, 2514 Jamacha Road Ste, 502-35 El Cajon, CA, 92019, United States; Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, University of Southern California, 2250 Alcazar Street, Suite 2200, Los Angeles, CA, 90033, United States.
| | - Patricia van Oppen
- Department of Psychiatry, Amsterdam UMC, location VUmc, Netherlands; Amsterdam Public Health Research Institute - Mental Health, Netherlands; GGZ inGeest Specialized Mental Health Care, Netherlands.
| | - Maureen Whittal
- Vancouver CBT Centre, 302-1765 W8th Avenue, Vancouver, British Columbia, V6J5C6, Canada; Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.
| | - Monnica T Williams
- School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier Pvt, Ottawa, K1N 6N5, Ontario, Canada.
| | - Timothy Williams
- Department of Psychology, University of Reading, PO Box 217, Reading, Berkshire, RG6 6AH, United Kingdom.
| | - Elna Yadin
- Department of Psychiatry, University of Pennsylvania, 3535 Market Street, 2nd Floor, Philadelphia, PA 19104, United States.
| | - David Veale
- South London and the Maudsley NHS Foundation Trust & King's College London, Denmark Hill, London, SE5 8 AZ, United Kingdom.
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Bragdon LB, Eng GK, Belanger A, Collins KA, Stern ER. Interoception and Obsessive-Compulsive Disorder: A Review of Current Evidence and Future Directions. Front Psychiatry 2021; 12:686482. [PMID: 34512412 PMCID: PMC8424053 DOI: 10.3389/fpsyt.2021.686482] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 07/31/2021] [Indexed: 01/04/2023] Open
Abstract
Disrupted interoceptive processes are present in a range of psychiatric conditions, and there is a small but growing body of research on the role of interoception in obsessive-compulsive disorder (OCD). In this review, we outline dimensions of interoception and review current literature on the processing of internal bodily sensations within OCD. Investigations in OCD utilizing objective measures of interoception are limited and results mixed, however, the subjective experience of internal bodily sensations appears to be atypical and relate to specific patterns of symptom dimensions. Further, neuroimaging investigations suggest that interoception is related to core features of OCD, particularly sensory phenomena and disgust. Interoception is discussed in the context of treatment by presenting an overview of existing interventions and suggesting how modifications aimed at better targeting interoceptive processes could serve to optimize outcomes. Interoception represents a promising direction for multi-method research in OCD, which we expect, will prove useful for improving current interventions and identifying new treatment targets.
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Affiliation(s)
- Laura B. Bragdon
- Department of Psychiatry, New York University School of Medicine, New York, NY, United States
- Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, United States
| | - Goi Khia Eng
- Department of Psychiatry, New York University School of Medicine, New York, NY, United States
- Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, United States
| | - Amanda Belanger
- Department of Psychiatry, New York University School of Medicine, New York, NY, United States
- Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, United States
| | - Katherine A. Collins
- Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, United States
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Emily R. Stern
- Department of Psychiatry, New York University School of Medicine, New York, NY, United States
- Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, United States
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26
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Mertens G, van Dis EAM, Krypotos AM, Engelhard IM. Does an unconditioned stimulus memory devaluation procedure decrease disgust memories and conditioned disgust? Results of two laboratory studies. J Anxiety Disord 2021; 82:102447. [PMID: 34271332 DOI: 10.1016/j.janxdis.2021.102447] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 01/30/2021] [Accepted: 07/06/2021] [Indexed: 11/29/2022]
Abstract
Research has demonstrated that disgust can be installed through classical conditioning by pairing neutral conditioned stimuli (CSs) with disgusting unconditioned stimuli (USs). Disgust has been argued to play an important role in maintaining fear-related disorders. This maintaining role may be explained by conditioned disgust being less sensitive to extinction (i.e., experiencing the CS in the absence of the US). Promising alternatives to extinction training are procedures that focus on the devaluation of US memory representations. In the current study, we investigated whether such devaluation procedures can be successful to counter conditioned disgust. We conducted two laboratory studies (N = 120 and N = 51) in which disgust was conditioned using audio-visual USs. Memory representations of the USs were devalued by having participants recall these USs while they performed a taxing eye-movement task or executed one of several control tasks. The results showed successful conditioned disgust acquisition. However, no strong evidence was obtained that an US memory devaluation procedure modulates disgust memory and diminishes conditioned disgust as indicated by subjective, behavioral, or psychophysiological measures. We discuss the relevance of our results for methodological improvements regarding US memory devaluation procedures and disgust conditioning.
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Affiliation(s)
- Gaëtan Mertens
- Department of Clinical Psychology, Utrecht University, Utrecht, the Netherlands; Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
| | | | - Angelos-Miltiadis Krypotos
- Department of Clinical Psychology, Utrecht University, Utrecht, the Netherlands; Research Group on Health Psychology, KU Leuven, Leuven, Belgium
| | - Iris M Engelhard
- Department of Clinical Psychology, Utrecht University, Utrecht, the Netherlands.
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27
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Wang J, Sun X, Lu J, Dou H, Lei Y. Generalization gradients for fear and disgust in human associative learning. Sci Rep 2021; 11:14210. [PMID: 34244571 PMCID: PMC8270915 DOI: 10.1038/s41598-021-93544-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 06/14/2021] [Indexed: 11/29/2022] Open
Abstract
Previous research indicates that excessive fear is a critical feature in anxiety disorders; however, recent studies suggest that disgust may also contribute to the etiology and maintenance of some anxiety disorders. It remains unclear if differences exist between these two threat-related emotions in conditioning and generalization. Evaluating different patterns of fear and disgust learning would facilitate a deeper understanding of how anxiety disorders develop. In this study, 32 college students completed threat conditioning tasks, including conditioned stimuli paired with frightening or disgusting images. Fear and disgust were divided into two randomly ordered blocks to examine differences by recording subjective US expectancy ratings and eye movements in the conditioning and generalization process. During conditioning, differing US expectancy ratings (fear vs. disgust) were found only on CS-, which may demonstrated that fear is associated with inferior discrimination learning. During the generalization test, participants exhibited greater US expectancy ratings to fear-related GS1 (generalized stimulus) and GS2 relative to disgust GS1 and GS2. Fear led to longer reaction times than disgust in both phases, and the pupil size and fixation duration for fear stimuli were larger than for disgust stimuli, suggesting that disgust generalization has a steeper gradient than fear generalization. These findings provide preliminary evidence for differences between fear- and disgust-related stimuli in conditioning and generalization, and suggest insights into treatment for anxiety and other fear- or disgust-related disorders.
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Affiliation(s)
- Jinxia Wang
- Institute for Brain and Psychological Sciences, Sichuan Normal University, Chengdu, 610066, China.,Faculty of Education and Psychology, University of Jyvaskyla, Jyväskylä, Finland
| | - Xiaoying Sun
- Ningxia College of Construction, Ningxia, 750021, China
| | - Jiachen Lu
- School of Psychology, South China Normal University, Guangzhou, 510631, China
| | - HaoRan Dou
- Institute for Brain and Psychological Sciences, Sichuan Normal University, Chengdu, 610066, China.,Faculty of Education and Psychology, University of Jyvaskyla, Jyväskylä, Finland
| | - Yi Lei
- Institute for Brain and Psychological Sciences, Sichuan Normal University, Chengdu, 610066, China. .,Center for Neurogenetics, Shenzhen Institute of Neuroscience, Shenzhen, 518057, China.
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Mancini F, Gangemi A. Deontological and Altruistic Guilt Feelings: A Dualistic Thesis. Front Psychol 2021; 12:651937. [PMID: 34239480 PMCID: PMC8258242 DOI: 10.3389/fpsyg.2021.651937] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 05/10/2021] [Indexed: 11/21/2022] Open
Abstract
In this paper we argue in favor of the existence of two different guilt feelings: altruistic guilt (AG) and deontological guilt (DG). AG arises from having harmed, through one's own action or omission, an innocent victim, while DG arises from the transgression of an internalized norm. In most daily experiences of guilt feelings both types are present, but we argue that they are not traceable to each other and that each can be present without the other. We show that the two guilt feelings can be distinguished with reference to behavioral, cognitive, and neurophysiological aspects. Moreover, we demonstrate that they are differently related to other processes and emotions. AG is connected with pain, empathy and ToM. DG is strongly related to disgust. We briefly illustrate some implications for moral psychology and clinical psychology.
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Affiliation(s)
- Francesco Mancini
- Scuola di Specializzazione in Psicoterapia Cognitiva (SPC), Rome, Italy.,Department of Human Sciences, Guglielmo Marconi University, Rome, Italy
| | - Amelia Gangemi
- Department of Cognitive Science, University of Messina, Messina, Italy
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von Spreckelsen P, Jonker NC, Vugteveen J, Wessel I, Glashouwer KA, de Jong PJ. Individual differences in avoiding feelings of disgust: Development and construct validity of the disgust avoidance questionnaire. PLoS One 2021; 16:e0248219. [PMID: 33690707 PMCID: PMC7946286 DOI: 10.1371/journal.pone.0248219] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 02/22/2021] [Indexed: 11/18/2022] Open
Abstract
We developed and examined the construct validity of the Disgust Avoidance Questionnaire (DAQ) as a measure of people’s inclination to prevent experiencing disgust (disgust prevention) and to escape from the experience of disgust (disgust escape). In a stepwise item-reduction (Study 1; N = 417) using Exploratory Factor Analysis (EFA) based on a 4-subscale distinction (behavioral prevention, cognitive prevention, behavioral escape, cognitive escape), we selected 17 items from a pool of potential items. In order to incorporate the conceptual overlap between dimensions of disgust avoidance, focus (prevention vs. escape), and strategy (behavioral avoidance vs. cognitive avoidance), we specified an adapted model. In this model, we allowed each item to load on one type of dimension and one type of strategy, resulting in four overlapping factors (prevention, escape, behavioral avoidance, cognitive avoidance). Evaluation of this overlapping 4-factor model (Study 2; N = 513) using Exploratory Structural Equation Modeling (ESEM) and Confirmatory Factor Analysis (CFA) showed promising model fit indices, factor loadings, factor correlations, and reliability estimates for three of the four factors (prevention, behavioral avoidance, cognitive avoidance). Those three subscales also showed good convergent validity. In contrast, the results related to the escape factor may call the suitability of self-report to assess disgust escape into question. In light of the exploratory nature of the project, future examinations of the DAQ’s validity and applicability to more diverse samples are essential. A critical next step for future research would be to examine the DAQ’s criterion validity and the distinctive roles of the DAQ subscales in (clinical) psychological constructs and processes.
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Affiliation(s)
- Paula von Spreckelsen
- Department of Psychology (Expertise Group: Clinical Psychology and Experimental Psychopathology), University of Groningen, Groningen, The Netherlands
- * E-mail:
| | - Nienke C. Jonker
- Department of Psychology (Expertise Group: Clinical Psychology and Experimental Psychopathology), University of Groningen, Groningen, The Netherlands
| | - Jorien Vugteveen
- Department of Psychology (Expertise Group: Psychometrics and Statistics), University of Groningen, Groningen, The Netherlands
| | - Ineke Wessel
- Department of Psychology (Expertise Group: Clinical Psychology and Experimental Psychopathology), University of Groningen, Groningen, The Netherlands
| | - Klaske A. Glashouwer
- Department of Psychology (Expertise Group: Clinical Psychology and Experimental Psychopathology), University of Groningen, Groningen, The Netherlands
- Department of Eating Disorders, Accare Child and Adolescent Psychiatry, Groningen, The Netherlands
| | - Peter J. de Jong
- Department of Psychology (Expertise Group: Clinical Psychology and Experimental Psychopathology), University of Groningen, Groningen, The Netherlands
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30
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The role of disgust proneness and contamination-related thought-action fusion in mental contamination-related washing urges. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01401-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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31
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Anderson LM, Berg H, Brown TA, Menzel J, Reilly EE. The Role of Disgust in Eating Disorders. Curr Psychiatry Rep 2021; 23:4. [PMID: 33404776 PMCID: PMC7895454 DOI: 10.1007/s11920-020-01217-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/16/2020] [Indexed: 12/25/2022]
Abstract
PURPOSE OF REVIEW In current review, we evaluate the current literature examining the role of disgust in eating disorders (EDs), and provide a theoretical model designed to inform the study and treatment of disgust-based symptoms in EDs. RECENT FINDINGS Findings from this review suggest that aberrant disgust-conditioning processes represent promising but understudied mechanisms that may contribute to the risk and maintenance of core eating disorder (ED) psychopathology. In addition, preliminary evidence supports the use of interventions designed to target aversive disgust cues and disrupt maladaptive disgust-based conditioning that may maintain eating pathology. However, experimental studies designed to elucidate the role of disgust and aversive learning processes remain limited. Disgust is a promising risk and maintenance factor in EDs. Future systematic investigation is needed to examine disgust-based processes at a mechanistic level in order to better understand the links between disgust, avoidance behaviors, and EDs. Further investigation of the mechanistic role of disgust in EDs is warranted.
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Affiliation(s)
- Lisa M. Anderson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, 2450 Riverside Avenue South, F229, Minneapolis, MN 55454, USA
| | - Hannah Berg
- Department of Psychology, University of Minnesota, N218 Elliott Hall, 75 East River Road, Minneapolis, MN 55455, USA
| | - Tiffany A. Brown
- Department of Psychiatry, University of California - San Diego, 4510 Executive Drive, Suite 315, San Diego, CA 92121, USA
| | - Jessie Menzel
- Department of Psychiatry, University of California - San Diego, 4510 Executive Drive, Suite 315, San Diego, CA 92121, USA
| | - Erin E. Reilly
- Department of Psychology, Hofstra University, 210 Hauser Hall, Hempstead, NY 11549, USA
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Fink-Lamotte J, Widmann A, Sering K, Schröger E, Exner C. Attentional Processing of Disgust and Fear and Its Relationship With Contamination-Based Obsessive-Compulsive Symptoms: Stronger Response Urgency to Disgusting Stimuli in Disgust-Prone Individuals. Front Psychiatry 2021; 12:596557. [PMID: 34163378 PMCID: PMC8215551 DOI: 10.3389/fpsyt.2021.596557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 04/22/2021] [Indexed: 12/05/2022] Open
Abstract
Disgust has recently been characterized as a low-urgency emotion, particularly compared to fear. The aim of the present study is to clarify whether behavioral inhibition during disgust engagement is characteristic of a low-urgency emotion and thus indicates self-imposed attentional avoidance in comparison to fear. Therefore, 54 healthy participants performed an emotional go/no-go task with disgust- and fear-relevant as well as neutral pictures. Furthermore, heart rate activity and facial muscle activity on the fear-specific m. corrugator supercilli and the disgust-specific m. levator labii were assessed. The results partially support the temporal urgency hypothesis of disgust. The emotion conditions significantly differed in emotional engagement and in the facial muscle activity of the m. levator labii as expected. However, contrary to our expectations, no differences between the emotion conditions regarding behavioral inhibition as well as heart rate change could be found. Furthermore, individuals with a higher-trait disgust proneness showed faster reactions and higher activity of the m. levator labii in response to disgust stimuli. The results show that different trait levels influence attentional engagement and physiological parameters but have only a small effect on behavioral inhibition.
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Affiliation(s)
- Jakob Fink-Lamotte
- University of Leipzig, Clinical Psychology and Psychotherapy, Leipzig, Germany
| | - Andreas Widmann
- University of Leipzig, Cognitive and Biological Psychology, Leipzig, Germany.,Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - Konstantin Sering
- University of Tuebingen, Quantitative Linguistics, Tübingen, Germany
| | - Erich Schröger
- University of Leipzig, Cognitive and Biological Psychology, Leipzig, Germany
| | - Cornelia Exner
- University of Leipzig, Clinical Psychology and Psychotherapy, Leipzig, Germany
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Georgiadis C, Schreck M, Gervasio M, Kemp J, Freeman J, Garcia A, Case B. Disgust propensity and sensitivity in childhood anxiety and obsessive-compulsive disorder: Two constructs differentially related to obsessional content. J Anxiety Disord 2020; 76:102294. [PMID: 32916505 DOI: 10.1016/j.janxdis.2020.102294] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/06/2020] [Accepted: 08/10/2020] [Indexed: 11/25/2022]
Abstract
The role of disgust in anxiety and related disorders has been extensively studied in adults, however its role in childhood psychopathology is in need of further investigation. The adult literature has suggested that two distinct sub-constructs within "disgust proneness" may differentially predict anxiety-related disorders. Namely, disgust propensity (DP) has been defined as the likelihood an individual will experience a disgust reaction, and disgust sensitivity (DS) as the degree to which an individual is distressed by their experience of disgust. The current study aimed to validate the Disgust Propensity and Sensitivity Scale-Revised (DPSS-R) in a sample of youth receiving intensive services for OCD and anxiety, examine the relationship between disgust sub-constructs and obsessional content in a sample of youth with OCD, and examine the relationship between disgust change and symptom severity at discharge. A confirmatory factor analysis supported a two-factor structure of the DPSS-R. DP was found to be uniquely predictive of contamination obsessions, and DS was found to be uniquely predictive of moral obsessions. Lastly, change in DP, but not DS, predicted overall change in OCD symptom severity. The present study provides a valid measure of DS and DP in youth with anxiety and related disorders, and suggests that subconstructs of disgust may serve as distinct risk factors for obsessional content in youth with OCD. Future research should examine the predictive validity of DP and DS longitudinally, as well as examine effective ways to more effectively target DP with exposure therapy.
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Affiliation(s)
| | - Meghan Schreck
- McLean Hospital, Harvard Medical School, Boston, MA, USA
| | - Maddi Gervasio
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Pediatric Anxiety Research Center, Bradley Hospital, USA
| | - Joshua Kemp
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Pediatric Anxiety Research Center, Bradley Hospital, USA
| | - Jennifer Freeman
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Pediatric Anxiety Research Center, Bradley Hospital, USA
| | - Abbe Garcia
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Pediatric Anxiety Research Center, Bradley Hospital, USA
| | - Brady Case
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Pediatric Anxiety Research Center, Bradley Hospital, USA
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Olatunji BO, Cox RC, Li I. Disgust regulation between menstrual cycle phases: Differential effects of emotional suppression and reappraisal. J Behav Ther Exp Psychiatry 2020; 68:101543. [PMID: 31874370 DOI: 10.1016/j.jbtep.2019.101543] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 12/08/2019] [Accepted: 12/15/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND OBJECTIVE Immunosuppression is characteristic of the luteal phase of the menstrual cycle and is accompanied by an adaptive disgust response to reduce contact with pathogens. However, research has not examined the effects of emotion regulation on disgust during the menstrual cycle. Accordingly, the present study examines the effect of suppression and reappraisal on disgust during the luteal and follicular phases of the menstrual cycle. METHOD Menstrual cycle phase was estimated in a sample of naturally cycling women (n = 73), and those in the follicular or luteal phase were assigned to suppress or reappraise disgust while watching a disgust-inducing video. Physiological arousal during the video and avoidance of disgust cues in a public restroom after the video were also assessed. RESULTS No differences were observed in self-reported disgust to the video between those who suppressed and those who reappraised in the luteal phase. However, women in the follicular phase who suppressed reported less disgust than those who reappraised. The emotion regulation strategies did not influence physiology during the video or avoidance after the video as a function of menstrual cycle phase. LIMITATIONS Hormone assay data was not collected to confirm menstrual cycle phase and a relatively small sample of naturally cycling women was used. CONCLUSIONS Suppression may be a more effective strategy than reappraisal for reducing verbal disgust in the follicular phase but not in the luteal phase. The implications of these findings for the treatment of disgust-based disorders among women are discussed.
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Affiliation(s)
| | | | - Irene Li
- Vanderbilt University, United States
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35
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Mathes BM, Day TN, Wilver NL, Redden SA, Cougle JR. Indices of change in exposure and response prevention for contamination-based OCD. Behav Res Ther 2020; 133:103707. [PMID: 32758679 DOI: 10.1016/j.brat.2020.103707] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 06/04/2020] [Accepted: 07/29/2020] [Indexed: 01/29/2023]
Abstract
Few studies have examined indices of change in treatment for obsessive compulsive disorder (OCD). The current study evaluated within- and between-session trajectories of fear, disgust, and urge to wash in exposure and response prevention (ERP) for contamination-based OCD and tested whether change in these indices were associated with treatment outcomes. Forty-one participants (75.6% female) engaged in three sessions of ERP for contamination OCD. Participants provided ratings of fear, disgust, and urge to wash during each session, and contamination symptoms were assessed at pre- and post-treatment and two-week follow-up. Fear, disgust, and urge to wash all significantly decreased both within and between sessions. Both fear and disgust declined significantly faster than urge to wash within session, though declines in fear and disgust did not significantly differ from each other. Within-session changes in fear were significantly associated with reduced symptoms at post-treatment, whereas within-session changes in disgust were associated with symptoms at two-week follow-up. The current study highlights the roles of fear and disgust in the context of ERP as unique indicators of treatment outcome for contamination-based OCD. Only within-session fear was uniquely associated with treatment outcome at post, while within-session disgust predicted outcome at follow-up. Theoretical and clinical implications are discussed.
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Affiliation(s)
- Brittany M Mathes
- Florida State University, 1107 West Call Street, Tallahassee, FL, 32304, USA
| | - Taylor N Day
- Florida State University, 1107 West Call Street, Tallahassee, FL, 32304, USA
| | - Natalie L Wilver
- Florida State University, 1107 West Call Street, Tallahassee, FL, 32304, USA
| | - Sarah A Redden
- Florida State University, 1107 West Call Street, Tallahassee, FL, 32304, USA
| | - Jesse R Cougle
- Florida State University, 1107 West Call Street, Tallahassee, FL, 32304, USA.
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36
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Novara C, Vivet B, Raffard S. Le dégoût dans le trouble obsessionnel compulsif, mécanismes, évaluation, implications pour des pistes thérapeutiques. PRAT PSYCHOL 2020. [DOI: 10.1016/j.prps.2019.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Effects of "Dirty" Information on Disgust Responding to an Unknown Animal in Children: The Moderating Role of Maternal Disgust Proneness. Behav Ther 2020; 51:634-645. [PMID: 32586435 DOI: 10.1016/j.beth.2019.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 10/03/2019] [Accepted: 10/05/2019] [Indexed: 11/21/2022]
Abstract
Although research has shown that disgust facilitates avoidance of small animals among adults, much less is known about disgust appraisals of small animals in children as well as the predictors of such appraisals. To address this gap, children (ages 5-13) were exposed to dirt-related and cleanliness-related information about unknown animals. The extent to which these types of information influenced children's feelings of fear, disgust, positivity, and avoidance behavior in relation to the animals was examined. The present study then examined the extent to which child and maternal disgust proneness predicted feelings of disgust to the 'dirty' animal. The findings show that providing dirt-related information resulted in a significant increase in disgust, but not fear, responding to the animal. Dirt-related information also resulted in a significant decrease in positive feelings toward the animal. Conversely, providing cleanliness-related information resulted in a significant decrease in disgust, but not fear, responding to the animal. In addition, providing cleanliness-related information resulted in a significant increase in positive feelings toward the animal. Children also engage in more avoidance of the animal described as dirty compared to the animal described as clean. In addition, subsequent analysis revealed an interaction between child and maternal disgust propensity in predicting learned disgust to the dirty animal such that the highest levels of feelings of disgust to the dirty animal were observed among children with high disgust proneness who also have mothers with high disgust proneness. The implications of these findings for conceptualizing the role of disgust in animal phobias among youth will be discussed.
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Fink-Lamotte J, Widmann A, Fader J, Exner C. Interpretation bias and contamination-based obsessive-compulsive symptoms influence emotional intensity related to disgust and fear. PLoS One 2020; 15:e0232362. [PMID: 32353055 PMCID: PMC7192464 DOI: 10.1371/journal.pone.0232362] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 04/13/2020] [Indexed: 11/25/2022] Open
Abstract
Biased processing of disgust-related stimuli is increasingly discussed in addition to fear-related processing as a maintenance factor for contamination-based obsessive-compulsive disorder (C-OCD). However, the differential impact of fear and disgust on biased processing in C-OCD is not yet completely understood. Because it is difficult to distinguish the two emotions in self-report assessment by directly addressing the specific emotions, a text paragraph-based interpretation bias paradigm was applied to more implicitly assess emotions. For the text-based interpretation bias paradigm, disgust-related, fear-related, disgust-fear-ambiguous and neutral text paragraphs describing everyday life situations were developed and validated in a pre-study (N = 205). Fifty-nine healthy participants watched either disgust- or fear-inducing movies and afterwards rated their experienced emotional response to the text paragraphs. The results show that fear and disgust components of an emotional response to mixed-emotional situations are strongly influenced by the situational context, and across the levels of trait contamination fear people did not differ in their fear experiences to everyday situations (which was overall strong), but in their disgust experiences. These findings highlight the strength of situational context on interpretation bias for mixed-emotional disorders and the important role of disgust for C-OCD.
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Affiliation(s)
- Jakob Fink-Lamotte
- Clinical Psychology and Psychotherapy, University of Leipzig, Leipzig, Germany
- * E-mail:
| | - Andreas Widmann
- Cognitive and Biological Psychology, University of Leipzig, Leipzig, Germany
- Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - Judith Fader
- Clinical Psychology and Psychotherapy, University of Leipzig, Leipzig, Germany
| | - Cornelia Exner
- Clinical Psychology and Psychotherapy, University of Leipzig, Leipzig, Germany
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40
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Harada Y, Mitsudo H, Ohyama J. The effect of unusualness on the functional field of view in unsafe scenes. VISUAL COGNITION 2020. [DOI: 10.1080/13506285.2020.1718817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Yuki Harada
- Faculty of Human-Environment Studies, Kyushu University, Fukuoka, Japan
- Human Augmentation Research Center, National Institute of Advanced Industrial Science and Technology, Tsukuba City, Japan
| | - Hiroyuki Mitsudo
- Faculty of Human-Environment Studies, Kyushu University, Fukuoka, Japan
| | - Junji Ohyama
- Human Augmentation Research Center, National Institute of Advanced Industrial Science and Technology, Tsukuba City, Japan
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Fink J, Exner C. Does Transcranial Direct Current Stimulation (tDCS) Improve Disgust Regulation Through Imagery Rescripting? Front Hum Neurosci 2019; 13:192. [PMID: 31275125 PMCID: PMC6593270 DOI: 10.3389/fnhum.2019.00192] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 05/23/2019] [Indexed: 11/13/2022] Open
Abstract
The first pilot studies have shown the potential of imagery rescripting (ImR) for reducing contamination-related pathological disgust, although the effects were rather small. The aim of the present study is to investigate whether the effects of ImR in reducing disgust can be further increased by transcranial direct current stimulation (tDCS). tDCS is a non-invasive method of brain stimulation that has been successfully used multiple times to support emotion-regulation strategies. In the present study, disgust was induced via images related to individualized sources of disgust. Fifty-eight healthy volunteers took part in two parallel experiments. The two groups were matched by age, highest educational level and gender, and were tested under two emotion-regulation conditions, namely an ImR condition and a control condition. Participants performed three trials on the first day and three trials on the second day. Across both days they performed three trials under each of the two emotion-regulation conditions in a randomized order. On one day active stimulation was applied, while on the other day participants were sham stimulated. The combination of emotion-regulation and stimulation condition was balanced across subjects. The only difference between the two groups was the localization of tDCS stimulation: one group was stimulated over the dorsolateral prefrontal cortex and the other group was stimulated over the visual cortex (VC). This experimental manipulation was implemented to gain further insights into the underlying neuropsychological mechanisms of imagery. ImR was conducted via a previously-recorded audio file. The results confirm the effect of ImR on the reduction of disgust. However, with the present experimental design we were not able to show that supplementary tDCS of the VC or the dorsolateral prefrontal cortex lead to improvement.
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Affiliation(s)
- Jakob Fink
- Department of Clinical Psychology and Psychotherapy, University of Leipzig, Leipzig, Germany
| | - Cornelia Exner
- Department of Clinical Psychology and Psychotherapy, University of Leipzig, Leipzig, Germany
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He J, Ellis JM, Zickgraf HF, Fan X. Translating, modifying, and validating the Adult Picky Eating Questionnaire for use in China. Eat Behav 2019; 33:78-84. [PMID: 31005684 PMCID: PMC7061871 DOI: 10.1016/j.eatbeh.2019.04.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Revised: 03/01/2019] [Accepted: 04/10/2019] [Indexed: 01/16/2023]
Abstract
OBJECTIVE The aim of this study was to translate, modify, and validate the Adult Picky Eating Questionnaire (APEQ) for use in China. METHODS Based on standard procedures, the APEQ was translated into Chinese. Four items were added in the final Chinese version of the APEQ (C-APEQ). For testing the psychometric properties of the C-APEQ, a total of 1069 participants (17-24 years; 52.57% women) were recruited from two universities in mainland China. RESULTS Exploratory factor analysis and confirmatory factor analysis supported the previous four-factor structure of the APEQ. Findings also showed that the C-APEQ had adequate internal consistency (α = 0.874) and test-retest reliability (ICC = 0.778). The C-APEQ demonstrated strong measurement invariance across gender. Furthermore, the C-APEQ composite score presented positive and significant correlations with eating disturbance, psychological distress, and psychological inflexibility. It also showed a negative and significant correlation with food-related life satisfaction. CONCLUSION Findings suggested that the Chinese version of the APEQ demonstrated sound psychometric properties. Thus, the C-APEQ can be a useful tool in future studies to accurately assess picky eating among adult population and explore the relationships between picky eating and other physical and psychological outcomes in a Chinese context.
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Affiliation(s)
- Jinbo He
- School of Humanities and Social Science, Chinese University of Hong Kong (Shenzhen), Shenzhen, Guangdong, China.
| | - Jordan M. Ellis
- Psychology Department, East Carolina University, Greenville, NC, United States
| | - Hana F. Zickgraf
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, United States
| | - Xitao Fan
- School of Humanities and Social Science, Chinese University of Hong Kong (Shenzhen), Shenzhen, Guangdong, China.
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Menzel JE, Reilly EE, Luo TJ, Kaye WH. Conceptualizing the role of disgust in avoidant/restrictive food intake disorder: Implications for the etiology and treatment of selective eating. Int J Eat Disord 2019; 52:462-465. [PMID: 30628116 DOI: 10.1002/eat.23006] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 12/05/2018] [Accepted: 12/07/2018] [Indexed: 11/07/2022]
Abstract
Selective eating is a common presenting problem in Avoidant/Restrictive Food Intake Disorder (ARFID). Understanding the etiology of selective eating will lead to the creation of more effective treatments for this problem. Recent reports have linked disgust sensitivity to picky eating, and the field has yet to conceptualize the role that disgust might play in ARFID. Disgust has long been tied to formation of taste aversions and is considered at its core to be a food-related emotion. A brief review of the literature on disgust reveals that disgust has a unique psychophysiological profile compared to other emotions, like anxiety, and that disgust is resistant to extinction procedures. If disgust is implicated in the etiology of selective eating, its presence would have a significant impact on treatment approaches. This article provides an overview of the research on disgust and eating, a clinical example of the treatment challenges that disgust may pose, and an overview of the unique clinical features of disgust as they apply to psychopathology. We pose several research questions related to disgust and selective eating and discuss initial hypotheses for pursing this line of inquiry. Finally, we discuss the possible implications of this line of research for treatment.
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Affiliation(s)
- Jessie E Menzel
- Department of Psychiatry, University of California San Diego, San Diego, California, USA
| | - Erin E Reilly
- Department of Psychiatry, University of California San Diego, San Diego, California, USA
| | - Tana J Luo
- Department of Psychiatry, University of California San Diego, San Diego, California, USA
| | - Walter H Kaye
- Department of Psychiatry, University of California San Diego, San Diego, California, USA
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Wilver NL, Summers BJ, Garratt GH, Carlton CN, Cougle JR. An initial investigation of the unique relationship between disgust propensity and body dysmorphic disorder. Psychiatry Res 2018; 269:237-243. [PMID: 30153602 DOI: 10.1016/j.psychres.2018.08.056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 06/19/2018] [Accepted: 08/16/2018] [Indexed: 10/28/2022]
Abstract
Disgust is a universal emotion that has received recent empirical attention for its potential role in various forms of psychopathology. We conducted two studies using varying methods to explore the relationship between disgust propensity, a construct related to obsessive-compulsive symptomatology, and symptoms of body dysmorphic disorder (BDD). Study 1 found a significant and unique (i.e., above and beyond co-occurring depression and anxiety) relationship between higher disgust propensity and more severe BDD symptoms, as measured by a standardized self-report and via an in-vivo task aimed at eliciting BDD-related concerns (N = 200). In Study 2, a clinical sample of individuals with BDD (N = 50) reported higher disgust propensity compared to mentally healthy controls (N = 36). This finding remained significant when controlling for depression and anxiety. Findings are the first to our knowledge to demonstrate a relationship between disgust propensity and BDD symptoms and provide directions for future research exploring the role of disgust in BDD.
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Affiliation(s)
- Natalie L Wilver
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL 32306, USA.
| | - Berta J Summers
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL 32306, USA; Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, 185 Cambridge Street, Suite 2000, Boston, MA 02114, USA.
| | - Grace H Garratt
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL 32306, USA.
| | - Corinne N Carlton
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL 32306, USA.
| | - Jesse R Cougle
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL 32306, USA.
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A Structural Model of Relationship Between Disgust Propensity and Fear of Contamination: The Mediating Role of Mental Contamination. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2018. [DOI: 10.5812/ijpbs.11442] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Knowles KA, Cox RC, Armstrong T, Olatunji BO. Cognitive mechanisms of disgust in the development and maintenance of psychopathology: A qualitative review and synthesis. Clin Psychol Rev 2018; 69:30-50. [PMID: 29909923 DOI: 10.1016/j.cpr.2018.06.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 05/23/2018] [Accepted: 06/06/2018] [Indexed: 12/21/2022]
Abstract
A growing body of research has implicated disgust in various psychopathologies, especially anxiety-related disorders. Although the observed role of disgust in many disorders is robust, the mechanisms that may explain this role are unclear. Cutting-edge research in cognitive science has the potential to elucidate such mechanisms and consequently improve our understanding of how disgust contributes to the etiology and maintenance of psychopathology. In this qualitative review, we systematically assess cognitive bias mechanisms that have been linked to disgust and its disorders. This review suggests that disgust-related biases may be observed in memory, interpretation, judgment of expectancies, and attention, as well as at implicit levels. Of these cognitive domains, the most robust bias appears to be observed at the level of attention. However, reliable moderators of attentional biases for disgust have not yet been identified, and this bias has not been systematically linked to other levels of analysis. Despite these limitations, the available research indicates that attentional avoidance rather than orienting or maintenance may be the most characteristic of disgust. Attentional avoidance of disgust may have important implications for etiological and treatment models of disorders characterized by excessive disgust reactions. The implications for advancing such models are discussed in the context of a combined cognitive bias hypothesis.
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Ching THW, Williams MT, Siev J, Olatunji BO. Responsibility/Threat Overestimation Moderates the Relationship Between Contamination-Based Disgust and Obsessive-Compulsive Concerns About Sexual Orientation. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:1109-1117. [PMID: 29476409 DOI: 10.1007/s10508-018-1165-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Revised: 06/03/2017] [Accepted: 01/29/2018] [Indexed: 06/08/2023]
Abstract
Disgust has been shown to perform a "disease-avoidance" function in contamination fears. However, no studies have examined the relevance of disgust to obsessive-compulsive (OC) concerns about sexual orientation (e.g., fear of one's sexual orientation transforming against one's will, and compulsive avoidance of same-sex and/or gay or lesbian individuals to prevent that from happening). Therefore, we investigated whether the specific domain of contamination-based disgust (i.e., evoked by the perceived threat of transmission of essences between individuals) predicted OC concerns about sexual orientation, and whether this effect was moderated/amplified by obsessive beliefs, in evaluation of a "sexual orientation transformation-avoidance" function. We recruited 283 self-identified heterosexual college students (152 females, 131 males; mean age = 20.88 years, SD = 3.19) who completed three measures assessing disgust, obsessive beliefs, and OC concerns about sexual orientation. Results showed that contamination-based disgust (β = .17), responsibility/threat overestimation beliefs (β = .15), and their interaction (β = .17) each uniquely predicted OC concerns about sexual orientation, ts = 2.22, 2.50, and 2.90, ps < .05. Post hoc probing indicated that high contamination-based disgust accompanied by strong responsibility/threat overestimation beliefs predicted more severe OC concerns about sexual orientation, β = .48, t = 3.24, p < .001. The present study, therefore, provided preliminary evidence for a "sexual orientation transformation-avoidance" process underlying OC concerns about sexual orientation in heterosexual college students, which is facilitated by contamination-based disgust, and exacerbated by responsibility/threat overestimation beliefs. Treatment for OC concerns about sexual orientation should target such beliefs.
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Affiliation(s)
- Terence H W Ching
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, 06269, USA.
| | - Monnica T Williams
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, 06269, USA
| | - Jedidiah Siev
- Department of Psychology, Swarthmore College, Swarthmore, PA, USA
| | - Bunmi O Olatunji
- Department of Psychological Sciences, Vanderbilt University, Nashville, TN, USA
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Fink J, Pflugradt E, Stierle C, Exner C. Changing disgust through imagery rescripting and cognitive reappraisal in contamination-based obsessive-compulsive disorder. J Anxiety Disord 2018; 54:36-48. [PMID: 29421371 DOI: 10.1016/j.janxdis.2018.01.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 01/05/2018] [Accepted: 01/07/2018] [Indexed: 01/16/2023]
Abstract
Contamination-related obsessive-compulsive disorder (C-OCD) is characterized by strongly experienced disgust and fear, in response to potentially contaminating stimuli. Both emotions differ in their susceptibility for change by habituation and extinction, which are important processes for the success of exposure therapy. Even though the response rates for exposure therapy for C-OCD are very good, it seems promising to test additional therapeutic techniques which target disgust more directly. Therefore, imagery rescripting and cognitive reappraisal were evaluated for their potential to change levels of disgust (within-subject), in the two-session laboratory study with 30 participants, with diagnosed C-OCD, and 30 matched, healthy controls (between-subject), presented. The results show that both emotion-regulation strategies reduced disgust better than a non-intervention control task (counting fishes), across all the participants. Therefore, both strategies seem to be applicable and effective for reducing disgust, in the short term, in participants with diagnosed C-OCD. The implications of these findings for the experimental approach and for the clinical treatment of C-OCD, are discussed.
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Affiliation(s)
- Jakob Fink
- University of Leipzig, Clinical Psychology and Psychotherapy, Neumarkt 9-19, 04081 Leipzig, Germany.
| | - Elisa Pflugradt
- University of Leipzig, Clinical Psychology and Psychotherapy, Neumarkt 9-19, 04081 Leipzig, Germany.
| | - Christian Stierle
- Schön Klinik Bad Bramstedt, Birkenweg 10, 24576 Bad Bramstedt, Germany.
| | - Cornelia Exner
- University of Leipzig, Clinical Psychology and Psychotherapy, Neumarkt 9-19, 04081 Leipzig, Germany.
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Abstract
In the present study, attentional bias was investigated as a potential predisposing mechanism for the contamination-related subtype of obsessive-compulsive disorder (C-OC disorder). Fifty healthy participants with varying degrees of subclinical C-OC symptoms performed a visual search task to measure differential attentional biases elicited by neutral, disgust-, and fear-specific pictorial material. Participants had to find a target picture within five neutral distractor pictures randomly presented on different locations in an array. The task was to decide whether the array contained an unpleasant target picture or not. In randomly-selected emotional trials, participants were further asked about the content of the picture and the confidence of their answer. The results show that the reaction times significantly differed between the emotional and neutral pictures. Participants were significantly more confident in answering questions referring to fear compared to disgust pictures. This effect was marginally amplified in participants with higher C-OC symptoms. We discuss the results within the framework of the cost and benefit hypothesis, which postulates that disgust evolutionarily elicits stronger uncertainty compared to fear, owing to the ambiguous nature of the stimuli. Increased uncertainty might be an important but underestimated factor for pathological disgust experience, such as in obsessive-compulsive disorder.
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Affiliation(s)
- Jakob Fink
- a Department of Clinical Psychology and Psychotherapy , University of Leipzig , Leipzig , Germany
| | - Frederike Buchta
- a Department of Clinical Psychology and Psychotherapy , University of Leipzig , Leipzig , Germany
| | - Cornelia Exner
- a Department of Clinical Psychology and Psychotherapy , University of Leipzig , Leipzig , Germany
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Complexity in obsessive-compulsive and body dysmorphic disorder – a functional approach to complex difficulties. COGNITIVE BEHAVIOUR THERAPIST 2017. [DOI: 10.1017/s1754470x17000113] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObsessive-compulsive disorder (OCD) and related disorders such as body dysmorphic disorder (BDD) can take many different forms of presentations. The term ‘complex’ is common and inconsistently used in both OCD and BDD. Practitioners often refer to complex OCD or BDD when patients present with severe co-morbid problems, often in the context of personality difficulties, dissociation, difficult early relationships and trauma; or when the illness is chronic and debilitating with previous multiple treatment failures. Current best-evidence treatment protocols for both disorders focus heavily on exposure and response prevention (E/RP) but with moderate success, particularly in patients who are deemed ‘complex’, and often those with relevant shame and/or disgust-based past experiences. The aim of the present paper is to (a) describe factors that contribute to complexity in OCD and BDD, and (b) link these with theory and practice. We emphasize the importance of understanding both the function of OCD and BDD-related behaviours (rather than the content of obsessions or compulsion), and the context in which they occur such as the family. We illustrate complexity in OCD and BDD using real case material, using a functional and contextual approach to formulate the client's difficulties, and demonstrate how E/RP can be enhanced successfully with imagery rescripting, family work, and compassion-focused therapy.
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