Does the measure matter? On the association between disgust proneness and OCD symptoms

Involvement of fear, incompleteness, and disgust during symptoms of pediatric obsessive-compulsive disorder

Fear has been assigned a central role in models of obsessive-compulsive disorder (OCD), but empirical investigations into the emotions that underpin OCD symptoms are few, especially in pediatric samples. Using validated, clinician-led structured interviews, 124 youth with OCD reported on the presence and severity of symptoms across the main symptom dimensions of OCD (aggressive, symmetry, contamination) and the degree to which fear, incompleteness, and disgust accompanied these symptoms. For comparison purposes, the degree of fear, incompleteness, and disgust during symptoms was obtained also from youth with social anxiety disorder (SAD; n = 27) and generalized anxiety disorder (GAD; n = 28). Participants with OCD reported that all three emotions were involved in their symptoms; however, fear was most strongly linked to aggressive symptoms, incompleteness to symmetry symptoms, and disgust to contamination symptoms. Incompleteness differentiated youth with OCD from those with SAD and GAD. No differences for these emotions were found for youth with OCD with versus without the tic-disorder subtype or comorbid autism. A positive association between incompleteness and self-reported hoarding emerged among youth with OCD. Further studies of the emotional architecture of pediatric OCD, and its relationship to etiology and treatment, are warranted.

Incompleteness, harm avoidance, and disgust: A comparison of youth with OCD, anxiety disorders, and no psychiatric disorder

Psychological models of pediatric obsessive-compulsive disorder (OCD) place a heavy emphasis on harm avoidance as a maintaining factor and target for treatment. Incompleteness and disgust may also play a role in pediatric OCD but remain understudied. Youth with OCD (n = 100), anxiety disorders (n = 96), and no impairing psychiatric symptoms (n = 25) completed self-report measures of trait-level incompleteness, harm avoidance, and disgust and current symptoms of OCD, anxiety, and depression. Group differences and associations between emotions, symptoms, and pre- to post-treatment change in overall OCD severity were examined. Youth with OCD and anxiety disorders scored higher on harm avoidance and disgust than youth with no psychiatric disorder. Youth with OCD scored higher on incompleteness than youth with anxiety disorders and youth with no psychiatric disorder. Harm avoidance showed unique associations to self-reported symptoms of OCD, anxiety, and depression while incompleteness was uniquely related to OCD and disgust to anxiety. Within the OCD sample, incompleteness and harm avoidance were differentially related to the major OCD symptom dimensions, and change in incompleteness was uniquely related to pre- to post-treatment change in OCD severity. Trait-level incompleteness appears to play a central role in pediatric OCD and studies investigating its direct involvement in symptoms and associations with treatment outcome are needed. The role of disgust in relation to pediatric OCD remains unclear.

Anger Rumination is not Uniquely Characteristic of Obsessive-Compulsive Disorder

Although anger has been observed in obsessive-compulsive disorder (OCD), it remains unclear if rumination about anger is characteristic and/or unique to OCD. The present study examines whether types of anger rumination are endorsed more strongly by OCD patients compared to clinical and nonclinical controls. Patients with OCD (n = 30), generalized anxiety disorder (GAD; n = 29), and non-clinical controls (NCC; n = 30) completed measures of OCD symptoms, anger rumination, and trait anxiety. Patients with OCD and GAD significantly differed from NCC's (all ps < .001), but not each other (all ps > .10), in anger afterthoughts, thoughts of revenge, angry memories, and understanding causes of anger. However, the group differences were no longer significant when controlling for trait anxiety. A dimensional approach revealed that OCD symptoms were correlated with anger rumination domains overall. However, these associations were also no longer significant after controlling for trait anxiety. These findings suggest that anger rumination may emerge in OCD largely as an artifact of trait anxiety/negative affect that is associated with but not unique to the disorder. The implications of these findings for conceptualizing emotion and its regulation in OCD are discussed.

The source effect as a natural function of disgust in interpersonal context and its impairment in mental disorders

Disgust affects interpersonal relationships and regulates hygienic, sexual and distance behaviour. Its intensity in the interpersonal context depends on the character of the relationship. Strangers normally evoke more disgust than intimates (known as the source effect). General disgust sensitivity is increased in various mental diseases. It is unclear how disgust in the interpersonal context is affected and whether the source effect is preserved. 460 inpatients with mental disorders and 463 healthy subjects answered a newly developed Questionnaire (DIRQ) that covers disgust in the interpersonal context on content categories (hygiene, physical proximity, sexuality) and on source categories (self, partner, parent, stranger). Mental disorders were diagnosed with structured interviews. Healthy controls exhibited a pronounced source effect, with strangers evoking more disgust than intimates. In patients, this source effect was reduced (Cohen's d = 0.3), especially for sexual disgust, while general disgust sensitivity was increased (d = 0.5). High disgust in patients was best predicted by a history of sexual abuse and by the presence of post-traumatic stress disorder. In conclusion, mentally impaired patients show increased and trauma-associated disgust sensitivity. Their downregulation of sexual disgust in intimate relationships is hindered, which may have a boundary protective function but might also fuel difficulties engaging in relationships or intimacy.

Disgust assessment: Factorial structure and psychometric properties of the French version of the Disgust Propension and Sensibility Scale Revised-12

The present study examined the internal and external validity of the French version of the 12-item Disgust Propensity and Sensitivity Scale-Revised (DPSS-12) in a nonclinical sample from the general population. Two hundred and eighty-two participants completed the DPSSf-12 questionnaire as well as the Anxiety Sensitivity Index (ASI), Anxiety Trait (STAI B), Obsessional Belief Questionnaire 44 items (OBQ 44), Obsessive Compulsive Inventory-Revised (OCI-R) and Positive and Negative Affect Schedule (PANAS). Confirmatory Factor Analysis supported a 2-factor structure after two sensitivity items were removed. The 10-item scale showed good internal consistency, construct validity and test-retest reliability. These adequate psychometric properties make the DPSSf-10 appropriate for use by researchers and practitioners.