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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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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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Sklivanioti Greenfield M, Wang Y, Msghina M. Similarities and differences in the induction and regulation of the negative emotions fear and disgust: A functional near infrared spectroscopy study. Scand J Psychol 2022; 63:581-593. [PMID: 35634652 PMCID: PMC9796661 DOI: 10.1111/sjop.12836] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 05/09/2022] [Indexed: 01/07/2023]
Abstract
Affective processing, including induction and regulation of emotion, activates neural networks, induces physiological responses, and generates subjective experience. Dysregulation of these processes can lead to maladaptive behavior and even psychiatric morbidity. Multimodal studies of emotion thus not only help elucidate the nature of emotion, but also contribute to important clinical insights. In the present study, we compared the induction (EI) and effortful regulation (ER) with reappraisal of fear and disgust in healthy subjects using functional near infrared spectroscopy (fNIRS) in conjunction with electrodermal activity (EDA). During EI, there was significant activation in medial prefrontal cortex (PFC) for fear and more widespread activation for disgust, with right lateral PFC significantly more active during disgust compared to fear. ER was equally effective for fear and disgust reducing subjective emotion rating by roughly 45%. Compared to baseline, there was no increased PFC activity for fear during ER, while for disgust lateral PFC was significantly more active. Significant differences between the two negative emotions were also observed in sympathetic nerve activity as reflected in EDA during EI, but not during ER. Lastly, compared to men, women had higher emotion rating for both fear and disgust without corresponding differences in EDA. In conclusion, in the present study we show that emotion induction was associated with differential activation in both PFC and sympathetic nerve activity for fear and disgust. These differences were however less prominent during emotion regulation. We discuss the potential interpretation of our results and their implications regarding our understanding of negative emotion processing.
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Affiliation(s)
| | - Yanlu Wang
- Department of Clinical ScienceIntervention, and Technology, Karolinska InstituteStockholmSweden,MR Physics, Medical Radiation Physics and Nuclear MedicineKarolinska University HospitalStockholmSweden
| | - Mussie Msghina
- Department of Clinical Neuroscience (CNS)Karolinska InstituteStockholmSweden,Faculty of Medicine and HealthÖrebro UniversityÖrebroSweden
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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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Sklivanioti Greenfield M, Wang Y, Msghina M. Behavioral, cortical and autonomic effects of single-dose escitalopram on the induction and regulation of fear and disgust: Comparison with single-session psychological emotion regulation with reappraisal. Front Psychiatry 2022; 13:988893. [PMID: 36684004 PMCID: PMC9845894 DOI: 10.3389/fpsyt.2022.988893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 12/05/2022] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Adaptive and successful emotion regulation, the ability to flexibly exert voluntary control over emotional experience and the ensuing behavior, is vital for optimal daily functioning and good mental health. In clinical settings, pharmacological and psychological interventions are widely employed to modify pathological emotion processing and ameliorate its deleterious consequences. METHODS In this study, we investigated the acute effects of single-dose escitalopram on the induction and regulation of fear and disgust in healthy subjects. Furthermore, we compared these pharmacological effects with psychological emotion regulation that utilized a cognitive strategy with reappraisal. Emotion induction and regulation tasks were performed before and 4 h after ingestion of placebo or 10 mg escitalopram in a randomized, double-blind design. The International Affective Picture System (IAPS) was used as a source of images, with threat-related pictures selected for fear and disease and contamination-related pictures for disgust. Behavioral data, electrodermal activity (EDA), and functional near-infrared spectroscopy (fNIRS) recordings were collected. RESULTS Escitalopram significantly reduced emotion intensity for both fear and disgust during emotion induction, albeit with differing electrodermal and hemodynamic activity patterns for the two negative emotions. At rest, i.e., in the absence of emotive stimuli, escitalopram increased sympathetic activity during the fear but not during the disgust experiments. For both fear and disgust, emotion regulation with reappraisal was more effective in reducing emotion intensity compared to pharmacological intervention with escitalopram or placebo. DISCUSSION We concluded that emotion regulation with reappraisal and acute administration of escitalopram, but not placebo, reduce emotion intensity for both fear and disgust, with cognitive regulation being significantly more efficient compared to pharmacological regulation under the conditions of this study. Results from the fNIRS and EDA recordings support the concept of differential mechanisms of emotion regulation that could be emotion-specific.
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Affiliation(s)
| | - Yanlu Wang
- Department of Clinical Science, Intervention, and Technology, Karolinska Institute, Stockholm, Sweden.,MR Physics, Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Mussie Msghina
- Department of Clinical Neuroscience (CNS), Karolinska Institute, Stockholm, Sweden.,Department of Psychiatry, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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Eyal T, Dar R, Liberman N. Is disgust in obsessive-compulsive disorder mediated by fear of pathogens? J Anxiety Disord 2021; 77:102340. [PMID: 33302175 DOI: 10.1016/j.janxdis.2020.102340] [Citation(s) in RCA: 3] [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: 05/09/2020] [Revised: 11/09/2020] [Accepted: 11/23/2020] [Indexed: 11/15/2022]
Abstract
Individuals with obsessive-compulsive disorder (OCD) tend to report higher levels of disgust, but not much is known about factors that might underlie this relationship. The present study was motivated by the behavioral immune theory, which suggests that disgust has evolved as a protective reaction to potential presence of disease agents in the immediate environment. We examined the relationships between the intensity of experienced physical disgust, perceived vulnerability to disease, and OCD symptoms. The intensity of experienced disgust was assessed with a recent procedure whereby participants rate how disgusted they feel in response to color versus black-and-white pictures that evoke physical disgust. In addition to this procedure, participants (N = 403) completed measures of perceived vulnerability to disease, OCD symptoms, depression and anxiety. OCD symptoms were positively related to the physical disgust evoked by the pictures, and this relationship was mediated by reported emotional discomfort in contexts that connote a potential for pathogen transmission. Replicating previous findings, color pictures were rated as more disgusting than black-and-white pictures overall, and this effect was especially pronounced among people with higher OCD tendencies. These results suggest that, consistent with behavioral immune theory, disgust in OCD is a basic, concrete emotion that is at least partly mediated by fear of pathogens.
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Affiliation(s)
- Tal Eyal
- Ben Gurion University of the Negev, Israel
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The relation between normative rituals/routines and obsessive-compulsive symptoms at a young age: A systematic review. DEVELOPMENTAL REVIEW 2020. [DOI: 10.1016/j.dr.2020.100913] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Examining the functional activity of different obsessive-compulsive symptom dimensions in Tourette syndrome. NEUROIMAGE-CLINICAL 2020; 26:102198. [PMID: 32062563 PMCID: PMC7025096 DOI: 10.1016/j.nicl.2020.102198] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 01/22/2020] [Accepted: 01/24/2020] [Indexed: 11/21/2022]
Abstract
Patients with Tourette Syndrome completed an obsessive–compulsive provocation task. Patients reported higher anxiety for the provocation conditions than did controls. Group differences found in the insula, sensorimotor cortex and supramarginal gyri. Obsessive–compulsive severity associated with frontal and parietal lobe activity. Tic severity associated with anterior cingulate activity for the symmetry condition.
Objectives Tourette syndrome (TS) is commonly comorbid with obsessive–compulsive disorder (OCD) and many phenomenological similarities exist between tics and obsessive–compulsive symptoms (OCS). Therefore, due to the clinical importance of comorbid OCD, the goal of this study was to investigate the neural substrates of OCS in TS using functional magnetic resonance imaging. Methods Forty patients with TS and 20 healthy controls underwent functional magnetic resonance imaging while viewing blocks of OCS-provoking pictures relating to washing, checking and symmetry symptoms, as well as generally disgusting and neutral scenes. Statistical comparisons were made between patients with moderate/severe OCS, absent/mild OCS and healthy controls. As well, within the entire TS patient group, significant associations with clinical measures were assessed for each of the provocation conditions. Results Group differences in the insula, sensorimotor cortex, supramarginal gyrus and visual processing regions were common among the checking, washing and disgust conditions. In the patient group, negative associations between OCS severity and activity in the supramarginal gyrus, inferior frontal gyrus, sensorimotor cortex, precuneus and visual processing regions were common among the provocation conditions. Tic severity was only associated with activity in the anterior cingulate cortex for the symmetry condition. Conclusion Our findings implicate areas previously reported to be involved in OCD, as well as areas not typically implicated in OCD, suggesting that the neurobiological profile of TS+OCD is intermediate to pure TS and pure OCD.
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Ojserkis R, McKay D, Kim SK. Obsessive-compulsive symptom profiles in individuals exposed to interpersonal versus noninterpersonal trauma. Bull Menninger Clin 2020; 84:53-78. [PMID: 31967510 DOI: 10.1521/bumc_2020_84_04] [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] [Indexed: 12/23/2022]
Abstract
Obsessive-compulsive (OC) symptoms have been associated with trauma exposure. Although no studies have specified relations between type of trauma and OC symptom presentations, this information may inform personalized care for this complex population. Thus, this study used profile analysis via multidimensional scaling to characterize typical OC symptom profiles in individuals exposed to interpersonal versus noninterpersonal traumas. Profiles were also correlated with self-reported disgust and mental contamination, which have been related to OC symptoms and interpersonal trauma in prior research. The interpersonal trauma group revealed two profiles: (1) Obsessing (high obsessing, low neutralizing), and (2) Ordering (high ordering, low obsessing). The noninterpersonal trauma group showed two profiles: (1) Hoarding/Ordering (high hoarding and ordering, low washing), and (2) Hoarding Only (high hoarding, low ordering). No significant correlations were found between OC profiles and disgust-related constructs. Clinical implications, limitations, and future directions are explored.
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Affiliation(s)
- Rachel Ojserkis
- Rhode Island Hospital, Providence, Rhode Island, and a Clinical Instructor in the Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, Rhode Island
| | - Dean McKay
- Professor of Psychology at Fordham University, Bronx, New York
| | - Se-Kang Kim
- Associate Professor of Psychometrics and Quantitative Psychology at Fordham University, Bronx, New York
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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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12
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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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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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Knowles KA, Jessup SC, Olatunji BO. Disgust in Anxiety and Obsessive-Compulsive Disorders: Recent Findings and Future Directions. Curr Psychiatry Rep 2018; 20:68. [PMID: 30094516 PMCID: PMC6422162 DOI: 10.1007/s11920-018-0936-5] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
PURPOSE OF REVIEW In the past 20 years, the role of disgust in anxiety disorders and obsessive-compulsive disorder (OCD) has been investigated with increasing precision. In this review, we examine recent evidence implicating disgust in anxiety and OCD, highlighting recent measurement and methodological improvements. Specific emphasis is placed on understanding the mechanisms that may account for the role of disgust in OCD and related disorders. RECENT FINDINGS Recent developments include clarification of the role of distinct disgust-relevant vulnerabilities in the etiology of anxiety and OCD, an improved understanding of the neurobiology of disgust processing in OCD, and an increased focus on disgust-related mechanisms that contribute to psychopathology, such as disgust-based learning and emotion regulation. Disgust proneness is increasingly linked with symptoms of anxiety and OCD. However, further examination of the mechanisms that account for the roles of distinct disgust-relevant vulnerabilities is needed, and studies that directly examine disgust during the course of treatment are limited. Increasingly, the field has moved toward experimental investigation of specific disgust-relevant mechanisms that influence the etiology and treatment of OCD and related anxiety disorders.
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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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Osmundsen M, Petersen MB. Political Ideology and Precautionary Reasoning: Testing the Palliative Function of Right-Wing Ideology on Obsessive-Compulsive Symptoms. SOCIAL COGNITION 2017. [DOI: 10.1521/soco.2017.35.4.450] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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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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Berle D, Starcevic V, Milicevic D, Hannan A, Dale E, Skepper B, Viswasam K, Brakoulias V. The structure and intensity of self-reported autonomic arousal symptoms across anxiety disorders and obsessive-compulsive disorder. J Affect Disord 2016; 199:81-6. [PMID: 27093491 DOI: 10.1016/j.jad.2016.04.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 03/10/2016] [Accepted: 04/11/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND Heightened autonomic arousal symptoms (AAS) are assumed to be a central feature of anxiety disorders. However, it is unclear whether the magnitude and profile of AAS vary across anxiety disorders and whether heightened AAS characterises obsessive-compulsive disorder (OCD). AIMS We sought to determine whether the intensity and structure of AAS varied across anxiety disorders and OCD. METHOD A sample of 459 individuals with a primary anxiety disorder or OCD were administered the Symptom Checklist-90R. Nine items referring to prototypic AAS were included in a latent class analysis. RESULTS A 2-class solution (high and low AAS classes) best fitted the data. Participants comprising the high AAS class scored uniformly high across all assessed AAS symptoms. Older age and the presence of panic disorder, social anxiety disorder and generalized anxiety disorder predicted membership in the high AAS class. No OCD symptom dimension was significantly associated with membership in the high AAS class. LIMITATION AAS were assessed using a self-report measure and replication is needed using other methodologies. CONCLUSIONS These findings suggest that OCD may be sufficiently distinct from anxiety disorders and do not support subtyping of anxiety disorders on the basis of the predominant type of AAS. Therapeutic approaches that target AAS might best be applied in the treatment of panic disorder, social anxiety disorder and generalized anxiety disorder.
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Affiliation(s)
- David Berle
- School of Psychiatry, UNSW, Australia; St John of God Health Care, Richmond Hospital, Australia.
| | - Vladan Starcevic
- Discipline of Psychiatry, Sydney Medical School - Nepean, University of Sydney, Australia
| | - Denise Milicevic
- Nepean Anxiety Disorders Clinic, Nepean Blue Mountains Local Health District, Australia
| | - Anthony Hannan
- Nepean Anxiety Disorders Clinic, Nepean Blue Mountains Local Health District, Australia
| | - Erin Dale
- Nepean Anxiety Disorders Clinic, Nepean Blue Mountains Local Health District, Australia
| | - Brian Skepper
- Nepean Anxiety Disorders Clinic, Nepean Blue Mountains Local Health District, Australia
| | | | - Vlasios Brakoulias
- Discipline of Psychiatry, Sydney Medical School - Nepean, University of Sydney, Australia
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Gonçalves ÓF, Carvalho S, Leite J, Fernandes-Gonçalves A, Carracedo A, Sampaio A. Cognitive and emotional impairments in obsessive-compulsive disorder: Evidence from functional brain alterations. Porto Biomed J 2016; 1:92-105. [PMID: 32258557 DOI: 10.1016/j.pbj.2016.07.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
There is a common agreement on the existence of dysfunctional cortico-striatal-thalamus-cortical pathways in OCD. Despite this consensus, recent studies showed that brain regions other than the CSTC loops are needed to understand the complexity and diversity of cognitive and emotional deficits in OCD. This review presents examples of research using functional neuroimaging, reporting abnormal brain processes in OCD that may underlie specific cognitive/executive (inhibitory control, cognitive flexibility, working memory), and emotional impairments (fear/defensive, disgust, guilt, shame). Studies during resting state conditions show that OCD patients have alterations in connectivity not only within the CSTC pathways but also in more extended resting state networks, particularly the default mode network and the fronto-parietal network. Additionally, abnormalities in brain functioning have been found in several cognitive and emotionally task conditions, namely: inhibitory control (e.g., CSTC loops, fronto-parietal networks, anterior cingulate); cognitive flexibility (e.g., CSTC loops, extended temporal, parietal, and occipital regions); working memory (e.g., CSTC loops, frontal parietal networks, dorsal anterior cingulate); fear/defensive (e.g., amygdala, additional brain regions associated with perceptual - parietal, occipital - and higher level cognitive processing - prefrontal, temporal); disgust (e.g., insula); shame (e.g., decrease activity in middle frontal gyrus and increase in frontal, limbic, temporal regions); and guilt (e.g., decrease activity anterior cingulate and increase in frontal, limbic, temporal regions). These findings may contribute to the understanding of OCD as both an emotional (i.e., anxiety) and cognitive (i.e., executive control) disorder.
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Affiliation(s)
- Óscar F Gonçalves
- Neuropsychophysiology Lab, CIPsi, School of Psychology, University of Minho, Braga, Portugal.,Spaulding Center of Neuromodulation, Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Department of Applied Psychology, Bouvé College of Health Sciences, Northeastern University, Boston, USA
| | - Sandra Carvalho
- Neuropsychophysiology Lab, CIPsi, School of Psychology, University of Minho, Braga, Portugal.,Spaulding Center of Neuromodulation, Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jorge Leite
- Neuropsychophysiology Lab, CIPsi, School of Psychology, University of Minho, Braga, Portugal.,Spaulding Center of Neuromodulation, Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Angel Carracedo
- Forensic Genetics Unit, Institute of Legal Medicine, Faculty of Medicine, University of Santiago de Compostela, Galicia, Spain
| | - Adriana Sampaio
- Neuropsychophysiology Lab, CIPsi, School of Psychology, University of Minho, Braga, Portugal
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Shaw AM, Llabre MM, Timpano KR. Affect Intolerance and Hoarding Symptoms: A Structural Equation Modeling Approach. Int J Cogn Ther 2015. [DOI: 10.1521/ijct_2015_8_05] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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21
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Change in disgust reactions following cognitive-behavioral therapy for childhood anxiety disorders. Int J Clin Health Psychol 2014; 15:1-7. [PMID: 30487816 PMCID: PMC6224794 DOI: 10.1016/j.ijchp.2014.06.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 06/16/2014] [Indexed: 11/20/2022] Open
Abstract
Disgust, in addition to fear, is a prominent emotional state associated with avoidance of distressing stimuli. While most of the research in disgust has been conducted in relation to Obsessive-Compulsive Disorder (OCD), recent data has also implicated disgust in the etiology of anxiety disorders in general. Studies have shown that decreases in disgust are key to symptom reduction in individuals with OCD. However, there has been little empirical work exploring whether these interventions are efficacious for childhood anxiety disorders that present with prominent disgust components. This study examined how disgust propensity in children with anxiety disorders responds to cognitive-behavioral therapy (CBT) with an emphasis on exposure. Forty-one children, ages 7 to 17, with anxiety disorders were evaluated for disgust propensity and were treated with intensive, weekly, CBT. It was found that disgust levels decreased following treatment across all anxiety disorder diagnoses, where children with primary OCD exhibited significantly greater reductions. Clinical implications and suggestions for further research of the treatment of disgust in relation to childhood anxiety disorders are discussed.
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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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Whitton AE, Henry JD, Grisham JR. Moral rigidity in obsessive-compulsive disorder: do abnormalities in inhibitory control, cognitive flexibility and disgust play a role? J Behav Ther Exp Psychiatry 2014; 45:152-9. [PMID: 24161700 DOI: 10.1016/j.jbtep.2013.10.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Revised: 08/20/2013] [Accepted: 10/02/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND AND OBJECTIVES Abnormalities in cognitive control and disgust responding are well-documented in obsessive-compulsive disorder (OCD), and also interfere with flexible, outcome-driven utilitarian moral reasoning. The current study examined whether individuals with OCD differ from healthy and anxious individuals in their use of utilitarian moral reasoning, and whether abnormalities in inhibitory control, cognitive flexibility and disgust contribute to moral rigidity. METHODS Individuals with OCD (n = 23), non-OCD anxiety (n = 21) and healthy participants (n = 24) gave forced-choice responses to three types of moral dilemmas: benign, impersonal, personal. Scores on measures of cognitive flexibility, inhibitory control and trait disgust were also examined. RESULTS Individuals with OCD gave fewer utilitarian responses to impersonal moral dilemmas compared to healthy, but not anxious, individuals. Poorer cognitive flexibility was associated with fewer utilitarian responses to impersonal dilemmas in the OCD group. Furthermore, greater trait disgust was associated with increased utilitarian responding to personal dilemmas in the OCD group, but decreased utilitarian responding to impersonal dilemmas in the anxious group. LIMITATIONS Although we did not find an association between inhibitory control and moral reasoning, smaller associations may be evident in a larger sample. CONCLUSION These data indicate that individuals with OCD use more rigid moral reasoning in response to impersonal moral dilemmas compared to healthy individuals, and that this may be associated with reduced cognitive flexibility. Furthermore, these data suggest that trait disgust may exert opposing effects on moral reasoning in individuals with OCD compared to those with other forms of anxiety.
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Affiliation(s)
- Alexis E Whitton
- School of Psychology, University of New South Wales, Kensington, NSW 2031, Australia.
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Nicholson E, Barnes-Holmes D. Developing an implicit measure of disgust propensity and disgust sensitivity: examining the role of implicit disgust propensity and sensitivity in obsessive-compulsive tendencies. J Behav Ther Exp Psychiatry 2012; 43:922-30. [PMID: 22387628 DOI: 10.1016/j.jbtep.2012.02.001] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2011] [Revised: 01/27/2012] [Accepted: 02/08/2012] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND OBJECTIVES There is increasing evidence that disgust responding occurs at both a primary and secondary level in the form of disgust propensity and disgust sensitivity. The unique contributions of anxiety and disgust need to be established if disgust is to be implicated in the etiology of anxiety disorders such as obsessive-compulsive disorder (OCD). The primary objective of the current study was to develop two separate implicit measures of disgust propensity and sensitivity and to explicate the role of implicit disgust propensity and sensitivity in avoidance behavior and OC tendencies. METHODS The current study (N = 33 undergraduate students) utilized a measure of implicit cognition, the Implicit Relational Assessment Procedure (IRAP), to independently analyze disgust propensity and disgust sensitivity. In addition, a series of behavioral approach tasks (BAT) and questionnaires measuring general disgust, obsessive-compulsive (OC) tendencies and general psychopathology were implemented to validate the implicit measures. RESULTS Disgust sensitivity predicted avoidance behavior on the BATs independent of disgust propensity and anxiety, while disgust propensity did not. Both disgust propensity and sensitivity predicted self-reported OC tendencies and individually predicted obsessing and washing concerns, respectively. LIMITATIONS Our findings are based on a non-clinical student sample and further research is required for generalization to OCD. CONCLUSIONS The implicit measures appeared to be measuring two separate constructs and had differential relationships with behavior and OC tendencies. Overall, the results support current theories relating to pathological disgust and OCD.
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Affiliation(s)
- Emma Nicholson
- Department of Psychology, National University of Ireland, Maynooth, Co. Kildare, Ireland.
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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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