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Hain S, Stevenson RJ. Contamination in Trypophobia: investigating the role of disgust. Cogn Emot 2024:1-14. [PMID: 39120561 DOI: 10.1080/02699931.2024.2389388] [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: 06/11/2023] [Revised: 07/30/2024] [Accepted: 07/31/2024] [Indexed: 08/10/2024]
Abstract
Trypophobia is a relatively common aversion to clusters of holes. There is no consensus yet on which emotions are involved in Trypophobia nor in its functional utility. This report investigates the role of disgust using contamination tasks in two studies, which contrast people with an aversion to trypophobic stimuli to those without. In Study 1, participants reported their emotional reactions to imagined contamination of trypophobic images. In Study 2, participants evaluated physically present trypophobic, disgust, fear, and control stimuli. The capacity of these stimuli to contaminate other objects was established using a chain of contagion task. Across both studies, contamination was present, however, only those with an aversion to trypophobic stimuli evidenced contamination on the chain of contagion task, a hallmark of disgust responding. Elevated levels were not only reported for disgust, but also alongside fear/anxiety. Participant reports suggest an underlying disease avoidance mechanism in Trypophobia, with trypophobic participants demonstrating an exaggerated response to such stimuli involving disgust and fear/anxiety, which is also seen in small animal phobia, BII, and C-OCD. Implications, particularly for treatment are discussed.
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Affiliation(s)
- Simone Hain
- Department of Psychology, Macquarie University, Sydney, Australia
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2
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Kaňková Š, Dlouhá D, Ullmann J, Velíková M, Včelák J, Hill M. Association between Disgust Sensitivity during Pregnancy and Endogenous Steroids: A Longitudinal Study. Int J Mol Sci 2024; 25:6857. [PMID: 38999978 PMCID: PMC11241696 DOI: 10.3390/ijms25136857] [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: 04/07/2024] [Revised: 06/18/2024] [Accepted: 06/20/2024] [Indexed: 07/14/2024] Open
Abstract
The emotion of disgust protects individuals against pathogens, and it has been found to be elevated during pregnancy. Physiological mechanisms discussed in relation to these changes include immune markers and progesterone levels. This study aimed to assess the association between steroids and disgust sensitivity in pregnancy. Using a prospective longitudinal design, we analyzed blood serum steroid concentrations and measured disgust sensitivity via text-based questionnaires in a sample of 179 pregnant women during their first and third trimesters. We found positive correlations between disgust sensitivity and the levels of C19 steroids (including testosterone) and its precursors in the Δ5 pathway (androstenediol, DHEA, and their sulfates) and the Δ4 pathway (androstenedione). Additionally, positive correlations were observed with 5α/β-reduced C19 steroid metabolites in both trimesters. In the first trimester, disgust sensitivity was positively associated with 17-hydroxypregnanolone and with some estrogens. In the third trimester, positive associations were observed with cortisol and immunoprotective Δ5 C19 7α/β-hydroxy-steroids. Our findings show that disgust sensitivity is positively correlated with immunomodulatory steroids, and in the third trimester, with steroids which may be related to potential maternal-anxiety-related symptoms. This study highlights the complex relationship between hormonal changes and disgust sensitivity during pregnancy.
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Affiliation(s)
- Šárka Kaňková
- Department of Philosophy and History of Science, Faculty of Science, Charles University, Viničná 7, 128 44 Prague, Czech Republic; (Š.K.); (D.D.); (J.U.)
| | - Daniela Dlouhá
- Department of Philosophy and History of Science, Faculty of Science, Charles University, Viničná 7, 128 44 Prague, Czech Republic; (Š.K.); (D.D.); (J.U.)
| | - Jana Ullmann
- Department of Philosophy and History of Science, Faculty of Science, Charles University, Viničná 7, 128 44 Prague, Czech Republic; (Š.K.); (D.D.); (J.U.)
| | - Marta Velíková
- Department of Steroids and Proteofactors, Institute of Endocrinology, Národní 8, 116 94 Prague, Czech Republic;
| | - Josef Včelák
- Department of Molecular Endocrinology, Institute of Endocrinology, Národní 8, 116 94 Prague, Czech Republic;
| | - Martin Hill
- Department of Steroids and Proteofactors, Institute of Endocrinology, Národní 8, 116 94 Prague, Czech Republic;
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3
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Corkish B, Yap K. Does mental contamination mediate the association between childhood trauma and obsessive-compulsive symptoms in adults? CHILD ABUSE & NEGLECT 2024; 152:106789. [PMID: 38608420 DOI: 10.1016/j.chiabu.2024.106789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 03/15/2024] [Accepted: 04/01/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND Previous research has shown that individuals with obsessive-compulsive disorder (OCD) and OCD symptoms have higher rates of childhood trauma. Although it has been suggested that this relationship is due to mental contamination that developed in response to trauma, no studies have investigated the associations between childhood trauma, mental contamination, and OCD, and none have examined whether the relationship between childhood trauma and OCD is mediated by mental contamination. OBJECTIVE We hypothesized that OCD, childhood trauma, and mental contamination are positively correlated, and that mental contamination would mediate the association between childhood trauma and OCD symptoms PARTICIPANTS AND SETTING: We tested these hypotheses in a sample of 245 individuals, which comprised 158 MTurk workers recruited via CloudResearch.com and 87 individuals recruited through social media with OCD diagnoses or OCD symptoms above the clinical cutoff on the Obsessive-Compulsive Inventory-Revised. METHODS Participants completed online self-report questionnaires on childhood trauma, mental contamination, and OCD symptoms. RESULTS The results revealed statistically significant positive correlations between childhood trauma, mental contamination, and OCD, and statistically significant total and indirect effects for the simple mediational model. Exploratory re-analyses with participants who had high OCD symptoms (n = 87) showed similar results. CONCLUSIONS Our research shows that the association between childhood trauma and OCD may be explained by mental contamination. We recommend that mental contamination should be assessed and addressed in OCD patients with a history of childhood trauma.
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Affiliation(s)
- Brittany Corkish
- School of Behavioural and Health Sciences, Australian Catholic University, Australia
| | - Keong Yap
- School of Behavioural and Health Sciences, Australian Catholic University, Australia.
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4
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Olatunji BO, Kim J. Examining reciprocal relations between disgust proneness and OCD symptoms: A four-wave longitudinal study. J Behav Ther Exp Psychiatry 2024; 82:101907. [PMID: 37690887 DOI: 10.1016/j.jbtep.2023.101907] [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: 01/08/2023] [Revised: 06/26/2023] [Accepted: 08/26/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND AND OBJECTIVES Although disgust proneness has been implicated in the development of obsessive-compulsive disorder (OCD), available studies have largely employed cross-sectional designs and the prospective and potentially reciprocal association between disgust proneness and OCD symptoms remains unclear. The present study employs cross lagged panel analysis to examine the prospective and reciprocal association between disgust proneness and OCD symptoms. METHOD A community sample of adults (N = 307) completed symptom measures of disgust proneness and OCD symptoms at four time points with 1 month intervals. RESULTS The results showed that the cross-lagged paths from disgust proneness to OCD symptoms were significant (average β = 0.07, p's < 0.001) when controlling for depression. However, the paths from total OCD symptoms to disgust proneness were not significant. In contrast, the cross-lagged paths from disgust proneness to washing OCD symptoms were not significant. However, the paths from washing OCD symptoms to disgust proneness were significant (average β = 0.05, p's < 0.01) when controlling for depression. LIMITATIONS The study is limited is limited by exclusive reliance on self-report in a nonclinical sample. CONCLUSIONS The findings offer preliminary evidence suggesting that disgust proneness may be a cause and consequence of OCD depending on the nature of the symptoms. Thus, the longitudinal relation between disgust proneness and OCD may be transactional where one influences the effect of the other.
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Affiliation(s)
| | - Jingu Kim
- Busan National University of Education, South Korea; Radboud University, the Netherlands.
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5
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Ouellet-Courtois C, Radomsky AS. Can immorality be contracted? Appraisals of moral disgust and contamination fear. Behav Res Ther 2023; 166:104336. [PMID: 37270955 DOI: 10.1016/j.brat.2023.104336] [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: 12/20/2022] [Revised: 04/05/2023] [Accepted: 05/19/2023] [Indexed: 06/06/2023]
Abstract
While extant research underlines the role of disgust in obsessive-compulsive disorder (OCD) with contamination fear, less research attention has been devoted to moral disgust. This study endeavored to examine the types of appraisals that are elicited by moral disgust in comparison to core disgust, and to examine their associations with both contact and mental contamination symptoms. In a within-participants design, 148 undergraduate students were exposed to core disgust, moral disgust, and anxiety control elicitors via vignettes, and provided appraisal ratings of sympathetic magic, thought-action fusion and mental contamination, as well as compulsive urges. Measures of both contact and mental contamination symptoms were administered. Mixed modeling analyses indicated that core disgust and moral disgust elicitors both provoked greater appraisals of sympathetic magic and compulsive urges than anxiety control elicitors. Further, moral disgust elicitors elicited greater thought-action fusion and mental contamination appraisals than all other elicitors. Overall, these effects were greater in those with higher contamination fear. This study demonstrates how a range of contagion beliefs are evoked by the presence of 'moral contaminants', and that such beliefs are positively associated with contamination concerns. These results shed light on moral disgust as an important target in the treatment of contamination fear.
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Affiliation(s)
- Catherine Ouellet-Courtois
- Concordia University, Department of Psychology, 7141 Rue Sherbrooke Ouest, Montreal, Quebec, H4B 1R6, Canada
| | - Adam S Radomsky
- Concordia University, Department of Psychology, 7141 Rue Sherbrooke Ouest, Montreal, Quebec, H4B 1R6, Canada.
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6
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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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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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Anti-Disgust Cognitive Behavioral Therapy for Contamination-Based Obsessive Compulsive Disorder: A Randomized Controlled Clinical Trial. J Clin Med 2022; 11:jcm11102875. [PMID: 35629000 PMCID: PMC9145879 DOI: 10.3390/jcm11102875] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 05/15/2022] [Accepted: 05/18/2022] [Indexed: 02/01/2023] Open
Abstract
Background: Disgust is a strong and persistent emotion that frequently occurs during exposure-based treatments for contamination-based obsessive compulsive disorder (C-OCD). This study aimed to examine the efficacy of augmenting cognitive behavioral therapy (CBT) with a novel type of anti-disgust cognitive intervention in reducing the severity of OCD, disgust propensity/sensitivity, and refusal rate of exposure and response prevention, while simultaneously increasing acceptance of disgust. Materials and Methods: Fifty-five individuals with C-OCD (mean age 28.1 years, SD = 3.52; 77% female) were randomly assigned to 15 weekly sessions of anti-disgust plus CBT (AD-CBT) or CBT alone. They were evaluated for outcomes four times (pretreatment, prior to exposure and response prevention (ERP) sessions, posttreatment, and three-month follow-up), and mixed-design ANOVAs were used to analyze the data. Results: The findings indicated that when compared to CBT alone, AD-CBT significantly reduced OCD severity, disgust propensity/sensitivity, and concurrently increased disgust acceptance (p < 0.001). Additionally, engaging in an anti-disgust cognitive intervention was associated with lower ERP refusal rate (4% vs. 16%). The superiority of AD-CBT over CBT persisted through the three-month follow-up period. Conclusions: The current study suggests that supplementing CBT for C-OCD with an anti-disgust cognitive intervention significantly increased acceptance of disgust and decreased the refusal rate of ERP, OCD severity, and disgust-related factors.
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Üzümcü E, Evliyaoğlu ES, Inozu M. The role of gender, fear of self and disgust propensity in mental contamination: A model test using mental contamination induction. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02285-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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10
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Emotion generation and regulation following an intrusion induction: Implications for taboo or autogenous obsessions. J Behav Ther Exp Psychiatry 2020; 69:101593. [PMID: 32574801 DOI: 10.1016/j.jbtep.2020.101593] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 04/26/2020] [Accepted: 06/05/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND OBJECTIVES Research demonstrates that autogenous (AO) and reactive obsessions (RO) differ in obsessional content; however, no experimental research has examined differences in emotion generation and regulation. Characterizing this taxonomy with respect to emotion generation and regulation could refine conceptualizations of obsessionality and optimize clinical interventions. METHODS Seventy undergraduates were randomly assigned to imagine a personally-relevant AO or RO. Subsequently, emotional reactivity was assessed. Participants then rated their emotion regulation efforts and the degree to which the intrusion violated their values. RESULTS Broadly aligning with expectations, bootstrapped linear regression models indicated that AOs led to a significant increase in self-conscious emotions (guilt, shame, and embarrassment), and these effects were stronger for those whose values were more severely threatened by the intrusion. A conditional process analysis revealed that the relationship between the AO condition and emotion regulation difficulties was explained by an increase in negative emotional reactivity, and the strength of this effect depended upon the degree of conflict with participants' values. LIMITATIONS The use of an analogue sample, and minimal emotional reactivity in the RO condition, threaten the ecological and external validity of the study. CONCLUSIONS The current study employed a novel experimental design demonstrating a meaningful relationship between AOs and both emotional activation and regulation. Results highlight the relevance of self-conscious emotions to the conceptualization of AOs and the utility of addressing them in the context of exposure therapy.
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11
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Dev V, Consedine NS, Reynolds LM. The “Ick” Factor: An Unrecognized Affective Predictor of Physical Symptoms During Chemotherapy. Ann Behav Med 2020; 55:345-355. [DOI: 10.1093/abm/kaaa055] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Patients undergoing chemotherapy experience a range of aversive symptoms. These symptoms vary across individuals and at least some of this variation can be predicted by psychological factors, such as distress. However, while psychological distress predicts some of the symptoms, it is limited in important ways.
Purpose
To (a) assess the viability of disgust—a discrete emotion that specifically evolved for health-related reasons—as a predictor of chemotherapy-related symptoms (particularly, taste- and smell-related changes) and (b) compare the predictive utility of disgust sensitivity and propensity against the most commonly used affective predictor, that is, psychological distress.
Methods
Patients with cancer (N = 63) about to initiate chemotherapy were recruited in a prospective observational study. Psychosocial predictor variables were assessed at baseline, and outcomes (i.e., physical symptoms, body mass index [BMI], and food-based sensory-processing changes) were assessed at both baseline and 6 week follow-up.
Results
Psychological distress did not predict any of the outcomes. Both disgust sensitivity (β = .53, p = .003) and propensity (β = −.56, p = .002) predicted greater food-based sensory-processing changes, while disgust sensitivity marginally predicted greater chemotherapy-related physical symptoms (β = .34, p = .060); neither of these two forms of disgust predicted BMI.
Conclusions
The study provides first evidence showing (a) associations between trait disgust and food sensory-processing changes that arise during chemotherapy and (b) disgust as being a more useful predictor of food- and digestion-related symptoms than psychological distress. In doing so, it opens new doors for better care to be provided to patients undergoing chemotherapy.
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Affiliation(s)
- Vinayak Dev
- Department of Psychological Medicine, University of Auckland, Grafton, Auckland, New Zealand
| | - Nathan S Consedine
- Department of Psychological Medicine, University of Auckland, Grafton, Auckland, New Zealand
| | - Lisa M Reynolds
- Department of Psychological Medicine, University of Auckland, Grafton, Auckland, New Zealand
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12
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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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13
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Olatunji BO, Kim J, Cox RC, Ebesutani C. Prospective associations between disgust proneness and OCD symptoms: Specificity to excessive washing compulsions. J Anxiety Disord 2019; 65:34-40. [PMID: 31158647 DOI: 10.1016/j.janxdis.2019.05.003] [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: 02/24/2019] [Revised: 04/12/2019] [Accepted: 05/19/2019] [Indexed: 10/26/2022]
Abstract
Although considerable evidence has linked disgust proneness (DP) to obsessive-compulsive disorder (OCD), few studies have examined the extent to which DP predicts OCD symptoms over time. Further, it remains unclear if DP is a risk factor for the contamination subtype of OCD specifically or if it is prospectively associated with other OCD symptom subtypes. The present study sought to address these gaps in the literature with a large sample of unselected community participants (n = 497) that completed measures of DP and OCD symptoms monthly over a 6-month period. Latent growth analysis revealed that initial levels of DP were associated with higher initial level of total OCD symptoms when controlling for depression, but not the slope of change in total OCD symptoms over time. Initial levels of total OCD symptoms were also associated with higher initial levels of DP when controlling depression, but not the slope of change in DP over time. Examination of symptom specificity revealed that initial levels of DP were associated with initial levels of washing, neutralizing, obsessing, ordering, and hoarding symptoms. However, initial levels of DP were associated only with the slope of change in the washing subtype when controlling for depression such that high initial levels of DP were associated with steeper increases in washing symptoms of OCD over the 6-month period. These findings suggest that although DP may have concurrent associations with symptoms of OCD more broadly, prospective associations are specific to the contamination/washing subtype of OCD. The implications of these findings for the etiology and treatment of contamination-based OCD are discussed.
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Affiliation(s)
| | - Jingu Kim
- Konkuk University, Republic of Korea
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14
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Melli G, Poli A, Chiorri C, Olatunji BO. Is Heightened Disgust Propensity Truly a Risk Factor for Contamination-Related Obsessive-Compulsive Disorder? Behav Ther 2019; 50:621-629. [PMID: 31030878 DOI: 10.1016/j.beth.2018.10.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 09/29/2018] [Accepted: 10/01/2018] [Indexed: 11/18/2022]
Abstract
Disgust propensity (DP) has been conceptualized as a stable personality trait that confers risk for contamination-related OCD (C-OCD). However, the extent to which DP leads to the subsequent development of C-OCD is unclear. In fact, the presence of C-OCD might lead to an increase in DP rather than the inverse. The present study was aimed to test this hypothesis in a large clinical sample of OCD patients (≥ 21 years of age) with (C-OCD; n = 56) and without (NC-OCD; n = 103) contamination-related symptoms that completed measures of OCD symptoms, depression, anxiety, and DP. DP was assessed twice, in reference to the present situation (T1) and to when the participant was 18 years old (T0). The two groups did not significantly differ in DP at T0. However, C-OCD participants reported higher DP scores than NC-OCD at T1. Furthermore, the T1 vs T0 difference in DP was significant only in the C-OCD group. Subsequent analyses also showed that T1 DP levels, but not T0 levels, significantly predicted contamination-related symptoms. Despite study limitations, these findings question the role of DP as a risk factor for C-OCD.
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Affiliation(s)
- Gabriele Melli
- Institute for Behavioral and Cognitive Psychology and Psychotherapy of Florence (IPSICO); University of Pisa.
| | - Andrea Poli
- Institute for Behavioral and Cognitive Psychology and Psychotherapy of Florence (IPSICO)
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15
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Mathes BM, McDermott KA, Okey SA, Vazquez A, Harvey AM, Cougle JR. Mental Contamination in Obsessive-Compulsive Disorder: Associations With Contamination Symptoms and Treatment Response. Behav Ther 2019; 50:15-24. [PMID: 30661555 DOI: 10.1016/j.beth.2018.03.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Revised: 02/26/2018] [Accepted: 03/12/2018] [Indexed: 01/16/2023]
Abstract
The most common symptom of obsessive-compulsive disorder (OCD) is contamination fear. Feelings of contamination can be provoked through contact with a physical contaminant, referred to as contact contamination (CC), as well as in the absence of one, referred to as mental contamination (MC). Prior research indicates that CC and MC are distinct, and MC may interfere with treatment for CC. However, no study to date has examined how MC may be associated with responses to physical contaminants and treatment response for CC. This study examined the relationships between CC and MC in a sample of individuals with elevated contamination symptoms (N = 88), half of whom met diagnostic criteria for OCD. Participants engaged in three sessions of exposure and response prevention (ERP) for CC and completed self-report measures and behavioral tasks assessing CC and MC at pretreatment, posttreatment, and follow-up. As hypothesized, at pretreatment, MC was positively associated with reactivity to physical contaminants, even after participants washed their hands. ERP for CC was associated with unique changes in CC and MC across self-report and behavioral measures, and greater pretreatment MC predicted greater posttreatment CC, though this effect was evident in only one of two CC measures. Additionally, specificity analyses indicated changes in MC were independent of changes in disgust propensity, a related construct. Pretreatment disgust propensity also predicted treatment outcome, though the addition of pretreatment disgust propensity as a covariate reduced the relationship between pretreatment MC and posttreatment CC to nonsignificance. Results suggest MC plays an important role in the manifestation and treatment of CC symptoms and may represent a manifestation of disgust proneness. Theoretical and clinical implications are discussed.
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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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17
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Miceli M, Castelfranchi C. Contempt and disgust: the emotions of disrespect. JOURNAL FOR THE THEORY OF SOCIAL BEHAVIOUR 2018. [DOI: 10.1111/jtsb.12159] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Maria Miceli
- Institute of Cognitive Sciences and Technologies; National Research Council of Italy; Roma Italy
| | - Cristiano Castelfranchi
- Institute of Cognitive Sciences and Technologies; National Research Council of Italy; Roma Italy
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18
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Olatunji BO, Berg H, Cox RC, Billingsley A. The effects of cognitive reappraisal on conditioned disgust in contamination-based OCD: An analogue study. J Anxiety Disord 2017; 51:86-93. [PMID: 28705679 DOI: 10.1016/j.janxdis.2017.06.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 06/14/2017] [Accepted: 06/23/2017] [Indexed: 10/19/2022]
Abstract
Experimental research has shown that conditioned disgust is resistant to extinction, which may account for the slower habituation to disgust relative to fear in contamination-based obsessive-compulsive disorder (OCD). However, few studies have examined the efficacy of interventions that may attenuate conditioned disgust responses. Studies of cognitive reappraisal have demonstrated that reinterpreting a stimulus can alter emotional responding. This technique is based on cognitive theories which suggest that anxiety disorders arise from biased cognitions; therefore, changing a person's thoughts will elicit durable changes in emotional responses. Given the demonstrated effectiveness of cognitive reappraisal, the present study examined whether cognitive reappraisal would attenuate conditioned disgust responses. We conditioned participants high in contamination fear (n=55) using images of neutral food items (conditioned stimuli; CS) paired with videos of individuals vomiting (unconditioned stimuli; US) while we obtained subjective disgust reports. After conditioning, half of the participants were randomly assigned to cognitive reappraisal training aimed at decreasing their emotional response to the US and CS, while the other half received no such training. The findings showed that cognitive reappraisal participants demonstrated a reduction in learned disgust across sessions and further benefited from extinction. These findings suggest that cognitive reappraisal may be an effective strategy for attenuating learned disgust.
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19
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Bhikram T, Abi-Jaoude E, Sandor P. OCD: obsessive-compulsive … disgust? The role of disgust in obsessive-compulsive disorder. J Psychiatry Neurosci 2017; 42:300-306. [PMID: 28375077 PMCID: PMC5573572 DOI: 10.1503/jpn.160079] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Recent research has identified the important role of disgust in the symptomatology of obsessive-compulsive disorder (OCD). Exaggerated and inappropriate disgust reactions may drive some of the symptoms of OCD, and in some cases, may even eclipse feelings of anxiety. This paper reviews behavioural and neuroimaging research that recognizes the prominent role of disgust in contributing to OCD symptoms, especially contamination-based symptoms. We discuss how elevated behavioural and biological markers of disgust reported in OCD populations support the need for alternative clinical treatment strategies and theoretical models of OCD.
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Affiliation(s)
- Tracy Bhikram
- Correspondence to: T. Bhikram, University Health Network, Tourette Syndrome Neurodevelopmental Clinic, 399 Bathurst St, Toronto, ON M5T 2S8;
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Olatunji BO, Armstrong T, Elwood L. Is Disgust Proneness Associated With Anxiety and Related Disorders? A Qualitative Review and Meta-Analysis of Group Comparison and Correlational Studies. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2017. [DOI: 10.1177/1745691616688879] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Research suggests that disgust may be linked to the etiology of some anxiety-related disorders. The present investigation reviews this literature and employs separate meta-analyses of clinical group comparison and correlational studies to examine the association between disgust proneness and anxiety-related disorder symptoms. Meta-analysis of 43 group comparison studies revealed those high in anxiety disorder symptoms reported significantly more disgust proneness than those low in anxiety symptoms. Although this effect was not moderated by clinical versus analogue studies or type of disorder, larger group differences were observed for those high in anxiety symptoms associated with contagion concerns compared to those high in anxiety symptoms not associated with contagion concerns. Similarly, meta-analysis of correlational data across 83 samples revealed moderate associations between disgust proneness and anxiety-related disorder symptoms. Moderator analysis revealed that the association between disgust proneness and anxiety-related disorder symptoms was especially robust for anxiety symptoms associated with contagion concerns. After controlling for measures of negative affect, disgust proneness continued to be moderately correlated with anxiety-related disorder symptoms. However, negative affect was no longer significantly associated with symptoms of anxiety-related disorders when controlling for disgust proneness. The implications of these findings are discussed in the context of a novel transdiagnostic model.
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Martoni RM, Rancoita PMV, Di Serio C, Brombin C. Validating the Italian Version of the Disgust and Propensity Scale-Revised. Front Psychol 2017; 8:765. [PMID: 28553252 PMCID: PMC5427091 DOI: 10.3389/fpsyg.2017.00765] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 04/26/2017] [Indexed: 12/31/2022] Open
Abstract
The aim of this work is to evaluate the factor structure and psychometric properties of the Italian version of the Disgust Propensity and Sensitivity Scale-Revised (DPSS-R, 16 items) in two samples taken from the general population. In the first study, 285 participants completed the DPSS-R questionnaire through a web-based survey. Exploratory factor analysis for ordinal Likert-type data supported the existence of four underlying factors, reflecting self-focused disgust, disgust propensity, somatic anxiety and disgust sensitivity. In the second study, an independent sample of 293 participants was enrolled as a test set to validate the factor structure obtained in the exploratory phase. The factor solution was confirmed, but showed quite highly correlated latent factors. We fitted the model and tested whether or not the bifactor structure was better than the previous one (four correlated factors). Actually, we had evidence supporting the presence of a general factor, providing a measure of disgust susceptibility, along with the four specific factors previously defined. This result could be useful also from the clinical perspective since the DPSS-R questionnaire will be used in clinical context, where underlying factors may be related to different and specific psychopathological profiles. Finally, we examined and visualized the interrelationships among the four DPSS-R factors and the external scales (Anxiety Sensitivity, Disgust Scale and Padua) using a graphical model approach.
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Affiliation(s)
- Riccardo M Martoni
- Department of Clinical Neurosciences, IRCCS San Raffaele TurroMilan, Italy
| | - Paola M V Rancoita
- University Center for Statistics in the Biomedical Sciences, Vita-Salute San Raffaele UniversityMilan, Italy
| | - Clelia Di Serio
- University Center for Statistics in the Biomedical Sciences, Vita-Salute San Raffaele UniversityMilan, Italy
| | - Chiara Brombin
- University Center for Statistics in the Biomedical Sciences, Vita-Salute San Raffaele UniversityMilan, Italy
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Melli G, Chiorri C, Stopani E, Bulli F, Carraresi C. Development and validation of a new Italian short measure of disgust propensity: The Disgust Propensity Questionnaire (DPQ). Clin Psychol Psychother 2017; 24:1189-1204. [DOI: 10.1002/cpp.2073] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 12/26/2016] [Accepted: 12/29/2016] [Indexed: 11/11/2022]
Affiliation(s)
- Gabriele Melli
- Institute for Behavioral and Cognitive Psychology and Psychotherapy of Florence (IPSICO); Florence Italy
- University of Pisa; Pisa Italy
| | | | - Eleonora Stopani
- Institute for Behavioral and Cognitive Psychology and Psychotherapy of Florence (IPSICO); Florence Italy
| | - Francesco Bulli
- Institute for Behavioral and Cognitive Psychology and Psychotherapy of Florence (IPSICO); Florence Italy
| | - Claudia Carraresi
- Institute for Behavioral and Cognitive Psychology and Psychotherapy of Florence (IPSICO); Florence Italy
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Melli G, Bulli F, Carraresi C, Tarantino F, Gelli S, Poli A. The differential relationship between mental contamination and the core dimensions of contact contamination fear. J Anxiety Disord 2017; 45:9-16. [PMID: 27886574 DOI: 10.1016/j.janxdis.2016.11.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 11/07/2016] [Accepted: 11/17/2016] [Indexed: 01/21/2023]
Abstract
Two types of contamination fear are recognized: contact and mental contamination. Contact contamination appears to be motivated both by harm avoidance and disgust avoidance. This study aimed to examine the relationships between disgust propensity, mental contamination and contact contamination while differentiating between harm avoidance and disgust avoidance in contact contamination. 169 OCD patients completed a set of questionnaires assessing mental contamination, contact contamination, disgust propensity, OCD, anxiety and depression. 1) Contact contamination based on disgust avoidance was more strongly associated with mental contamination and disgust propensity than contact contamination based on harm avoidance; 2) mental contamination significantly predicted contact contamination based on disgust avoidance, while it did not predict contact contamination based on harm avoidance; 3) mental contamination had a significant mediational role in the relationship between disgust propensity and contact contamination motivated by disgust avoidance. Mental contamination plays a role in contact contamination fear when disgust is primarily experienced.
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Affiliation(s)
- Gabriele Melli
- Institute for Behavioral and Cognitive Psychology and Psychotherapy of Florence (IPSICO), Italy; University of Pisa, Italy.
| | - Francesco Bulli
- Institute for Behavioral and Cognitive Psychology and Psychotherapy of Florence (IPSICO), Italy
| | - Claudia Carraresi
- Institute for Behavioral and Cognitive Psychology and Psychotherapy of Florence (IPSICO), Italy
| | | | - Simona Gelli
- Institute for Behavioral and Cognitive Psychology and Psychotherapy of Florence (IPSICO), Italy
| | - Andrea Poli
- Institute for Behavioral and Cognitive Psychology and Psychotherapy of Florence (IPSICO), Italy
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Duncko R, Veale D. Changes in disgust and heart rate during exposure for Obsessive Compulsive Disorder: A case series. J Behav Ther Exp Psychiatry 2016; 51:92-9. [PMID: 26803230 DOI: 10.1016/j.jbtep.2016.01.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 11/26/2015] [Accepted: 01/10/2016] [Indexed: 01/21/2023]
Abstract
BACKGROUND AND OBJECTIVES The emotion of disgust has been suggested as a factor contributing to a poor response to Cognitive Behaviour Therapy (CBT) in the treatment of Obsessive Compulsive Disorder (OCD). However, only limited information is available about the phenomenology of disgust in clinical OCD and the physiological mechanisms involved. This case series was designed to explore the phenomenology of OCD and the physiological activity associated with the emotion of disgust. METHODS State disgust and heart rate was measured in eleven participants attending treatment for OCD during exposure relevant to their individual formulation. RESULTS All participants with contamination and most patients with blood and injury related fears experienced a prominent increase in state disgust during exposure. These participants also had absent heart rate acceleration during exposure. Disgust response correlated with heart rate response (r = -0.63, p < 0.01) and Root Mean Square of Successive Differences (RMSSD) (r = 0.52, p < 0.01). LIMITATIONS The design using ecologically valid stimuli and the limited number of participants did not allow between subject comparisons or more detailed analysis of relationship between trait and state disgust and between disgust and severity of OCD. CONCLUSIONS Our findings show that a large proportion of our case series with OCD experience prominent disgust with signs of increased vagal tonus during their exposure. Such experiences differ from the concept of adrenergic activation used for psychoeducation in CBT and appraisals of harm and this may result in poorer therapeutic outcome.
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Affiliation(s)
- Roman Duncko
- South London and Maudsley NHS Foundation Trust, UK; Institute of Psychiatry, Psychology and Neuroscience, Kings College London, UK.
| | - David Veale
- South London and Maudsley NHS Foundation Trust, UK; Institute of Psychiatry, Psychology and Neuroscience, Kings College London, UK
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Emotional and Cognitive Variables Associated with Contamination-Related Obsessive-Compulsive Symptoms. THE SPANISH JOURNAL OF PSYCHOLOGY 2016; 19:E25. [PMID: 27210477 DOI: 10.1017/sjp.2016.27] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Different variables have been associated with the development/ maintenance of contamination-related obsessive-compulsive disorder (OCD), although the relevance of these factors has not been clearly established. The present study aimed to analyze the relevance and specificity of these variables. Forty-five women with high scores on obsessive-compulsive contamination symptoms (n = 16) or checking symptoms (n = 15), or non-clinical scores (n = 14) participated in a behavioral approach/avoidance task (BAT) with a contamination-OCD stimulus. Vulnerability variables and participants' emotional, cognitive, physiological and behavioral responses to the BAT were appraised. Results show that fear of illness was a relevant vulnerability variable specific to contamination participants (p = .001; η2 p = .291). Contamination participants responded with significantly higher subjective disgust (p =.001; η2 p = .269), anxiety (p = .001; η2 p = .297), urge to wash (p < .001; η2 p = 370), threat from emotion (p < .001; η2 p = .338) and contamination severity (p = .002; η2 p = .260) appraisals, and with lower behavioral approach (p = .008; η2 p = .208) than the other two groups. Moreover, contamination participants showed lower heart rate acceleration (p = .046; η2 p = .170) and higher contamination likelihood appraisals (p < .001; η2 p = .342) than the non-clinical group. Urge to wash was predicted by state disgust (R 2 change = .346) and threat from emotion (R 2 change = .088). These responses were predicted by general anxiety sensitivity (R 2 change = .161), disgust propensity (R 2 change = .255) and fear of illness (R 2 change = .116), but not by other vulnerability variables such as dysfunctional beliefs about thoughts (Responsibility and Overestimation of threat) or disgust sensitivity. State disgust, threat from disgust, anxiety sensitivity and fear of illness were found to be the most relevant variables in contamination symptoms.
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Melli G, Gremigni P, Elwood LS, Stopani E, Bulli F, Carraresi C. The Relationship Between Trait Guilt, Disgust Propensity, and Contamination Fear. Int J Cogn Ther 2015. [DOI: 10.1521/ijct_2015_8_01] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Ludvik D, Boschen MJ, Neumann DL. Effective behavioural strategies for reducing disgust in contamination-related OCD: A review. Clin Psychol Rev 2015; 42:116-29. [PMID: 26190372 DOI: 10.1016/j.cpr.2015.07.001] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 05/19/2015] [Accepted: 07/01/2015] [Indexed: 11/29/2022]
Abstract
Disgust is an understudied but important emotion in various psychological disorders. Over the last decade, increasing evidence suggests that disgust is also present in various subtypes of obsessive-compulsive disorder (OCD), especially in contamination-related OCD (C-OCD). The treatment of choice for C-OCD is exposure with response prevention, originally designed to reduce fear-associated emotions thought to be acquired through Pavlovian conditioning (PC). However, disgust has been proposed to be acquired through evaluative conditioning (EC) and according to the referential model of this form of learning, there are functional differences between PC and EC that need to be considered in the treatment of disgust-related responses. Alternative strategies suggested by EC-based models include counterconditioning (contingent presentation of the CS with a US of opposite valence) and US revaluation (contingent presentation of the US with US of opposite valence). Drawing on the referential model, this paper reviews evidence for the effectiveness of each strategy to identify the most theoretically sound and empirically valid intervention to reduce disgust in C-OCD.
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Affiliation(s)
- Dominika Ludvik
- School of Applied Psychology and Menzies Health Institute of Queensland, Griffith University, Gold Coast 4222, Australia.
| | - Mark J Boschen
- School of Applied Psychology and Menzies Health Institute of Queensland, Griffith University, Gold Coast 4222, Australia.
| | - David L Neumann
- School of Applied Psychology and Menzies Health Institute of Queensland, Griffith University, Gold Coast 4222, Australia.
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Athey AJ, Elias JA, Crosby JM, Jenike MA, Pope HG, Hudson JI, Brennan BP. REDUCED DISGUST PROPENSITY IS ASSOCIATED WITH IMPROVEMENT IN CONTAMINATION/WASHING SYMPTOMS IN OBSESSIVE-COMPULSIVE DISORDER. J Obsessive Compuls Relat Disord 2015; 4:20-24. [PMID: 25485229 PMCID: PMC4254727 DOI: 10.1016/j.jocrd.2014.11.001] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVES Disgust is a well-established phenomenon with known neurobiological correlates. However, it remains unclear how or whether disgust changes with clinical treatment, because few longitudinal studies have tracked the association of disgust vulnerability and clinical symptoms in patient populations. METHODS We assessed disgust propensity and symptoms of obsessive-compulsive disorder (OCD) in 134 patients receiving intensive residential treatment for OCD. Using linear regression with adjustment for age, sex, and depression severity, we tested the association between change in disgust propensity and change in OCD symptoms from admission to discharge. RESULTS Change in disgust propensity was significantly associated with improvement in contamination/washing symptoms (β = 0.25 [95% confidence interval: 0.11-0.39]; P = .001). No significant association was found between change in disgust propensity and change in other OCD symptom dimensions. CONCLUSIONS In patients with OCD undergoing intensive residential treatment, disgust propensity appears to improve in parallel with contamination/washing symptoms.
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Affiliation(s)
- Alison J Athey
- Biological Psychiatry Laboratory, McLean Hospital, Belmont, MA
| | - Jason A Elias
- Obsessive-Compulsive Disorder Institute, McLean Hospital, Belmont, MA ; Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Jesse M Crosby
- Obsessive-Compulsive Disorder Institute, McLean Hospital, Belmont, MA
| | - Michael A Jenike
- Obsessive-Compulsive Disorder Institute, McLean Hospital, Belmont, MA ; Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Harrison G Pope
- Biological Psychiatry Laboratory, McLean Hospital, Belmont, MA ; Department of Psychiatry, Harvard Medical School, Boston, MA
| | - James I Hudson
- Biological Psychiatry Laboratory, McLean Hospital, Belmont, MA ; Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Brian P Brennan
- Biological Psychiatry Laboratory, McLean Hospital, Belmont, MA ; Obsessive-Compulsive Disorder Institute, McLean Hospital, Belmont, MA ; Department of Psychiatry, Harvard Medical School, Boston, MA
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Olatunji BO, Ebesutani C, Haidt J, Sawchuk CN. Specificity of disgust domains in the prediction of contamination anxiety and avoidance: a multimodal examination. Behav Ther 2014; 45:469-81. [PMID: 24912460 DOI: 10.1016/j.beth.2014.02.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Revised: 02/07/2014] [Accepted: 02/07/2014] [Indexed: 11/13/2022]
Abstract
Although core, animal-reminder, and contamination disgust are viewed as distinct "types" of disgust vulnerabilities, the extent to which individual differences in the three disgust domains uniquely predict contamination-related anxiety and avoidance remains unclear. Three studies were conducted to fill this important gap in the literature. Study 1 was conducted to first determine if the three types of disgust could be replicated in a larger and more heterogeneous sample. Confirmatory factor analysis revealed that a bifactor model consisting of a "general disgust" dimension and the three distinct disgust dimensions yielded a better fit than a one-factor model. Structural equation modeling in Study 2 showed that while latent core, animal-reminder, and contamination disgust factors each uniquely predicted a latent "contamination anxiety" factor above and beyond general disgust, only animal-reminder uniquely predicted a latent "non-contamination anxiety" factor above and beyond general disgust. However, Study 3 found that only contamination disgust uniquely predicted behavioral avoidance in a public restroom where contamination concerns are salient. These findings suggest that although the three disgust domains are associated with contamination anxiety and avoidance, individual differences in contamination disgust sensitivity appear to be most uniquely predictive of contamination-related distress. The implications of these findings for the development and maintenance of anxiety-related disorders marked by excessive contamination concerns are discussed.
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Whitton AE, Henry JD, Grisham JR. Cognitive and psychophysiological correlates of disgust in obsessive-compulsive disorder. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2014; 54:16-33. [DOI: 10.1111/bjc.12058] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Revised: 04/16/2014] [Indexed: 11/27/2022]
Affiliation(s)
- Alexis E. Whitton
- School of Psychology; University of New South Wales; Randwick New South Wales Australia
| | - Julie D. Henry
- School of Psychology; University of Queensland; St Lucia Queensland Australia
| | - Jessica R. Grisham
- School of Psychology; University of New South Wales; Randwick New South Wales Australia
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Brakoulias V, Starcevic V, Berle D, Milicevic D, Hannan A, Martin A. The relationships between obsessive-compulsive symptom dimensions and cognitions in obsessive-compulsive disorder. Psychiatr Q 2014; 85:133-42. [PMID: 24142072 DOI: 10.1007/s11126-013-9278-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Several studies have linked obsessive-compulsive symptoms to specific obsessive-compulsive cognitions, however methodologies have varied, and no study has determined obsessive-compulsive symptoms using the most widely used clinician rating scale, the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Considering that almost all studies that used factor analysis to ascertain OCD symptom dimensions were based on the Y-BOCS and that self-report instruments assessing obsessive-compulsive symptoms correlate poorly with the Y-BOCS, there is a need to use the Y-BOCS to examine the relationship between obsessive-compulsive cognitions and obsessive-compulsive symptom dimensions. This study examined the relationship between five Y-BOCS-derived obsessive-compulsive symptom dimensions and the three obsessive-compulsive cognitive domains identified by the obsessive-beliefs questionnaire (OBQ). The symmetry/ordering symptom dimension was associated with increased perfectionism/intolerance of uncertainty, the unacceptable/taboo thoughts symptom dimension was associated with increased importance/control of thoughts and the doubt/checking symptom dimension was associated with increased responsibility/threat estimation. There was no statistical evidence of an association between any OBQ belief sub-scale and the hoarding symptom dimension nor the contamination/cleaning symptom dimension. The findings encourage symptom-based approaches to cognitive-behavioural therapy for some OCD symptoms and call for further research on cognitions associated with contamination/cleaning symptoms and hoarding.
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Affiliation(s)
- Vlasios Brakoulias
- Discipline of Psychiatry, Sydney Medical School - Nepean, University of Sydney, Sydney/Penrith, NSW, Australia,
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Béland M, O'Connor K. Evolution of Emotions, Obsessions, and Compulsions in People Recovering from Obsessional Compulsion during Inference-Based Therapy. Int J Cogn Ther 2014. [DOI: 10.1521/ijct.2014.7.1.29] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Olatunji BO, Tomarken A, Zhao M. Effects of Exposure to Stereotype Cues on Contamination Aversion and Avoidance in African Americans. JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2014. [DOI: 10.1521/jscp.2014.33.3.229] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Alonso P, Orbegozo A, Pujol J, López-Solà C, Fullana MÀ, Segalàs C, Real E, Subirà M, Martínez-Zalacaín I, Menchón JM, Harrison BJ, Cardoner N, Soriano-Mas C. Neural correlates of obsessive-compulsive related dysfunctional beliefs. Prog Neuropsychopharmacol Biol Psychiatry 2013; 47:25-32. [PMID: 23911440 DOI: 10.1016/j.pnpbp.2013.07.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Revised: 07/22/2013] [Accepted: 07/23/2013] [Indexed: 12/30/2022]
Abstract
There have been few attempts to integrate neurobiological and cognitive models of obsessive-compulsive disorder (OCD), although this might constitute a key approach to clarify the complex etiology of the disorder. Our study aimed to explore the neural correlates underlying dysfunctional beliefs hypothesized by cognitive models to be involved in the development and maintenance of OCD. We obtained a high-resolution magnetic resonance image from fifty OCD patients and 30 healthy controls, and correlated them, voxel-wise, with the severity of OC-related dysfunctional beliefs assessed by the Obsessive Beliefs Questionnaire-44. In healthy controls, significant negative correlations were observed between anterior temporal lobe (ATL) volume and scores on perfectionism/intolerance of uncertainty and overimportance/need to control thoughts. No significant correlations between OBQ-44 domains and regional gray matter volumes were observed in OCD patients. A post-hoc region-of-interest analysis detected that the ATLs was bilaterally smaller in OCD patients. On splitting subjects into high- and low-belief subgroups, we observed that such brain structural differences between OCD patients and healthy controls were explained by significantly larger ATL volumes among healthy subjects from the low-belief subgroup. Our results suggest a significant correlation between OC-related dysfunctional beliefs and morphometric variability in the anterior temporal lobe, a brain structure related to socio-emotional processing. Future studies should address the interaction of these correlations with environmental factors to fully characterize the bases of OC-related dysfunctional beliefs and to advance in the integration of biological and cognitive models of OCD.
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Affiliation(s)
- Pino Alonso
- OCD Clinical and Research Unit, Department of Psychiatry, Hospital de Bellvitge, Barcelona, Spain; Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Carlos III Health Institute, Spain; CRC-Hospital del Mar, Barcelona, Spain.
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Abstract
The cognitive model of OCD suggests that misinterpreting intrusive thoughts as unacceptable leads to increased anxiety and attempts to suppress or ignore the thoughts through avoidance or compulsive rituals. An insidious negative feedback loop develops as one's attention focuses on these thoughts and in turn the unwanted thoughts do not respond to efforts to avoid or suppress. This article is a current review of the research on cognitive processes in obsessive-compulsive disorder (OCD). We review research that has (1) empirically validated the theoretical underpinnings of the cognitive model, (2) altered maladaptive cognitive processes through state-of-the-art experimental procedures, (3) refined our understanding of the relationship between obsessive beliefs and OC symptoms and (4) examined how underlying traits (e.g., anxiety and disgust sensitivity) relate to the development and maintenance of OCD. We discuss the clinical implications of this research.
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Broderick J, Grisham JR, Weidemann G. Disgust and fear responding in contamination-based obsessive-compulsive disorder during pictorial exposure. Behav Ther 2013; 44:27-38. [PMID: 23312424 DOI: 10.1016/j.beth.2012.05.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2011] [Revised: 04/12/2012] [Accepted: 05/30/2012] [Indexed: 11/15/2022]
Abstract
The emotion of disgust has been implicated in the development and maintenance of contamination-based obsessive-compulsive disorder (OCD). In the present study nonclinical participants with high (n=26) and low (n=28) levels of OCD contamination symptoms were exposed to 2 categories of disgust stimuli (blood injury and body waste) across 4 blocks using standardized disgust images. Self-report disgust and fear were recorded, as well as cardiovascular heart rate. In both groups, an initial primary disgust reaction was observed. Self-report disgust and fear, but not heart rate deceleration, was greater in the high symptom group. The high symptom group showed reductions in heart rate deceleration, whereas the low symptom group did not. Significant differences in self-report changes across time were observed between the groups, with fear increasing to a greater extent for high contamination fearful individuals when viewing body waste images. The implications of these findings for theoretical models and clinical treatment of OCD with prominent contamination symptoms are discussed.
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Affiliation(s)
- Joshua Broderick
- School of Psychology, University of New South Wales, Sydney, NSW 2052 Australia.
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Badour CL, Bown S, Adams TG, Bunaciu L, Feldner MT. Specificity of fear and disgust experienced during traumatic interpersonal victimization in predicting posttraumatic stress and contamination-based obsessive-compulsive symptoms. J Anxiety Disord 2012; 26:590-8. [PMID: 22465821 PMCID: PMC3350597 DOI: 10.1016/j.janxdis.2012.03.001] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Revised: 02/07/2012] [Accepted: 03/06/2012] [Indexed: 11/16/2022]
Abstract
Emerging evidence has documented comorbidity between posttraumatic stress disorder (PTSD) and obsessive-compulsive disorder (OCD) among individuals with a history of traumatic events. There is growing recognition of the importance of disgust in each of these conditions independently. No study, however, has examined the potential role of disgust in these conditions following traumatic event exposure. The current study examined the unique role of peritraumatic fear, self-focused disgust, and other-focused disgust in predicting posttraumatic stress symptoms and contamination-based OC symptoms among 49 adult women (M(age)=28.37, SD=13.86) with a history of traumatic interpersonal victimization. Results demonstrated that intensity of peritraumatic self-focused disgust was significantly related to contamination-based OC symptoms while peritraumatic fear and other-focused disgust were related to posttraumatic stress symptoms. These results highlight the need for future research aimed at elucidating the nature of the association between disgust experienced during traumatic events and subsequent psychopathology.
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Affiliation(s)
- Christal L. Badour
- University of Arkansas, 216 Memorial Hall, Department of Psychology, Fayetteville, AR 72701
| | - Stephanie Bown
- University of Arkansas, 216 Memorial Hall, Department of Psychology, Fayetteville, AR 72701
| | - Thomas G. Adams
- University of Arkansas, 216 Memorial Hall, Department of Psychology, Fayetteville, AR 72701
| | - Liviu Bunaciu
- University of Arkansas, 216 Memorial Hall, Department of Psychology, Fayetteville, AR 72701
| | - Matthew T. Feldner
- University of Arkansas, 216 Memorial Hall, Department of Psychology, Fayetteville, AR 72701,Laureate Institute for Brain Research, 6655 S Yale Avenue, Tulsa, OK 74136
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Davey GCL. Disgust: the disease-avoidance emotion and its dysfunctions. Philos Trans R Soc Lond B Biol Sci 2012; 366:3453-65. [PMID: 22042921 DOI: 10.1098/rstb.2011.0039] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
This review analyses the accumulating evidence from psychological, psychophysiological, neurobiological and cognitive studies suggesting that the disease-avoidance emotion of disgust is a predominant emotion experienced in a number of psychopathologies. Current evidence suggests that disgust is significantly related to small animal phobias (particularly spider phobia), blood-injection-injury phobia and obsessive-compulsive disorder contamination fears, and these are all disorders that have primary disgust elicitors as a significant component of their psychopathology. Disgust propensity and sensitivity are also significantly associated with measures of a number of other psychopathologies, including eating disorders, sexual dysfunctions, hypochondriasis, height phobia, claustrophobia, separation anxiety, agoraphobia and symptoms of schizophrenia--even though many of these psychopathologies do not share the disease-avoidance functionality that characterizes disgust. There is accumulating evidence that disgust does represent an important vulnerability factor for many of these psychopathologies, but when disgust-relevant psychopathologies do meet the criteria required for clinical diagnosis, they are characterized by significant levels of both disgust and fear/anxiety. Finally, it has been argued that disgust may also facilitate anxiety and distress across a broad range of psychopathologies through its involvement in more complex human emotions such as shame and guilt, and through its effect as a negative affect emotion generating threat-interpretation biases.
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Affiliation(s)
- Graham C L Davey
- School of Psychology, University of Sussex, Brighton BN1 9QH, UK.
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Berle D, Starcevic V, Brakoulias V, Sammut P, Milicevic D, Hannan A, Moses K. Disgust propensity in obsessive-compulsive disorder: cross-sectional and prospective relationships. J Behav Ther Exp Psychiatry 2012; 43:656-63. [PMID: 21946297 DOI: 10.1016/j.jbtep.2011.09.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2011] [Revised: 09/01/2011] [Accepted: 09/01/2011] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND OBJECTIVES Findings from non-clinical samples suggest that disgust propensity is associated with contamination concerns in obsessive-compulsive disorder (OCD). However, studies of clinical samples have yielded conflicting results. We investigated the relationship between disgust propensity and OCD symptoms in a clinical sample and examined whether changes in disgust propensity are associated with changes in OCD symptoms. METHODS One hundred and nine OCD participants completed measures of disgust propensity and OCD symptoms. Sixty of these underwent a six-month follow-up assessment. RESULTS At the baseline assessment, disgust propensity was associated with all OCD symptom dimensions except hoarding. Changes in overall disgust propensity between baseline and the six-month follow-up assessment were associated with changes in overall self-reported OCD symptoms but not with changes in contamination-based OCD symptoms or changes in interviewer-assessed OCD symptoms. LIMITATIONS There was substantial participant attrition between the baseline and follow-up assessments. CONCLUSIONS Our study is the first to investigate prospective relationships between disgust propensity and OCD across a six-month interval. Our findings suggest that if there is an association between changes in disgust propensity and changes in contamination-based OCD symptoms its magnitude is likely to be small.
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Affiliation(s)
- David Berle
- Nepean Anxiety Disorders Clinic, Nepean Blue Mountains Local Health Network, Penrith, NSW, Australia.
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Rector NA, Daros AR, Bradbury CL, Richter MA. Disgust recognition in obsessive-compulsive disorder: diagnostic comparisons and posttreatment effects. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2012; 57:177-83. [PMID: 22398004 DOI: 10.1177/070674371205700307] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To examine whether disgust recognition deficits are present and specific to obsessive-compulsive disorder (OCD), and the extent to which this deficit, if present, can be reduced in cognitive-behavioural therapy (CBT). METHOD Responses to the Pictures of Facial Affect (POFA) were examined in patients with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, diagnosed OCD (n = 20), panic disorder with agoraphobia (PDA; n = 15), and generalized social phobia (GSP; n = 15) and a second, independent OCD sample of treatment responders to CBT (n = 11). RESULTS There were significant and statistically large disgust recognition differences between the OCD group and comparison PDA and GSP groups. However, patients with OCD treated with CBT showed disgust recognition scores that were equivalent to the PDA and GSP groups, significantly better than the untreated OCD sample, and equivalent to scores from the original POFA nonaffected standardization sample. CONCLUSIONS These results provide support for the presence of disgust recognition impairment in OCD, and provide preliminary evidence that disgust recognition impairments may improve with treatment.
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Affiliation(s)
- Neil A Rector
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario.
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Specificity of disgust vulnerability in the distinction and treatment of OCD. J Psychiatr Res 2011; 45:1236-42. [PMID: 21353249 PMCID: PMC3118257 DOI: 10.1016/j.jpsychires.2011.01.018] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2010] [Revised: 01/27/2011] [Accepted: 01/28/2011] [Indexed: 11/20/2022]
Abstract
A growing body of research has implicated disgust as a potential risk factor for the development and maintenance of obsessive-compulsive disorder (OCD). The first aim of the present study was to determine whether related, yet distinct, disgust vulnerabilities are endorsed more strongly by individuals with OCD than by those with another anxiety disorder. The second aim was to examine the unique contributions of changes in disgust to symptom improvement observed with exposure-based treatment for OCD. In study 1, individuals with OCD, generalized anxiety disorder (GAD), and nonclinical controls (NCCs) completed a measure of disgust propensity and disgust sensitivity. Compared to NCCs and individuals with GAD, those with OCD more strongly endorsed disgust propensity. However, individuals with OCD did not significantly differ from individuals with GAD in disgust sensitivity, although both groups reported significantly higher disgust sensitivity levels compared to NCCs. Study 2 comprised mediation analyses of symptom improvement among individuals with OCD and revealed that decreases in disgust propensity over time mediated improvement in OCD symptoms, even after controlling for improvements in negative affect. The implications of these findings for conceptualizing the role of disgust in the nature and treatment of OCD are discussed.
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Cisler JM, Adams TG, Brady RE, Bridges AJ, Lohr JM, Olatunji BO. Unique affective and cognitive processes in contamination appraisals: Implications for contamination fear. J Anxiety Disord 2011; 25:28-35. [PMID: 20691567 PMCID: PMC3066658 DOI: 10.1016/j.janxdis.2010.07.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2010] [Revised: 07/07/2010] [Accepted: 07/09/2010] [Indexed: 11/26/2022]
Abstract
A large body of evidence suggests an important role of disgust in contamination fear (CF). A separate line of research implicates various cognitive mechanisms in contamination fear, including obsessive beliefs, memory biases, and delayed attentional disengagement from threat. This study is an initial attempt to integrate these two lines of research and examines whether disgust and delayed attention disengagement from threat explain unique or overlapping processes within CF. Non-clinical undergraduate students (N = 108) completed a spatial cueing task, which provided measures of delayed disengagement from frightening and disgusting cues, and a self-report measure of disgust propensity (DP). Participants also completed a chain of contagion task, in which they provided contamination appraisals of an object as a function of degrees of removal from an initial contaminant. Results demonstrated that DP predicted greater initial contamination appraisals, but a sharper decline in estimations across further degrees of removal from the contaminant. Delayed disengagement from disgust cues uniquely predicted sustained elevations in contamination estimations across further degrees of removal from the contaminant. These results suggest that DP and delayed disengagement from disgust cues explain unique and complimentary processes in contamination appraisals, which suggests the utility of incorporating the disparate affective and cognitive lines of research on CF.
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Affiliation(s)
- Josh M. Cisler
- University of Arkansas
,University of Arkansas for Medical Sciences, Brain Imaging Research Center
,To whom correspondence should be directed: 216 Memorial Hall, Department of Psychology, University of Arkansas, Fayetteville, AR, 72701;
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