Individual differences in disgust sensitivity and health-related avoidance: Examination of specific associations

In masks we trust: explicit and implicit reactions to masked faces vary by political orientation

Previous studies in the context of the COVID-19 pandemic indicated that wearing a medical-style mask affects whether a stranger's face is judged as more trustworthy, socially desirable, or likely to be ill. However, given political controversies around mask use, these effects might vary by political orientation. In a pre-registered online experiment, we measured evaluations of trustworthiness, social desirability and perceived illness in masked and unmasked faces by 1241 British and US participants. We included questions on political orientation, along with the implicit online-VAAST approach/avoid task to test reaction times to masked/unmasked faces. There was a medium-sized effect of masks on trustworthiness and a significant interaction with political orientation, in that conservatives found masked faces less trustworthy than did liberals. Participants were quicker to approach masked than unmasked faces, but conservatives were relatively slower than liberals. The effects on trustworthiness suggest that differential moralization of novel social norms can affect how their adherents are evaluated in terms of their suitability for social interactions. Furthermore, the congruence between implicit and explicit methods implies that such differences can have deep-seated effects on reactions.

Discriminating between sick and healthy faces based on early sickness cues: an exploratory analysis of sex differences

Background and objectives

It has been argued that sex and disease-related traits should influence how observers respond to sensory sickness cues. In fact, there is evidence that humans can detect sensory cues related to infection in others, but lack of power from earlier studies prevents any firm conclusion regarding whether perception of sickness cues is associated with sex and disease-related personality traits. Here, we tested whether women (relative to men), individuals with poorer self-reported health, and who are more sensitive to disgust, vulnerable to disease, and concerned about their health, overestimate the presence of, and/or are better at detecting sickness cues.

Methodology

In a large online study, 343 women and 340 men were instructed to identify the sick faces from a series of sick and healthy photographs of volunteers with an induced acute experimental inflammation. Participants also completed several disease-related questionnaires.

Results

While both men and women could discriminate between sick and healthy individuals above chance level, exploratory analyses revealed that women outperformed men in accuracy and speed of discrimination. Furthermore, we demonstrated that higher disgust sensitivity to body odors is associated with a more liberal decision criterion for categorizing faces as sick.

Conclusion

Our findings give strong support for the human ability to discriminate between sick and healthy individuals based on early facial cues of sickness and suggest that women are significantly, although only slightly, better at this task. If this finding is replicated, future studies should determine whether women's better performance is related to increased avoidance of sick individuals.

Pandemic elevates sensitivity to moral disgust but not pathogen disgust

The behavioral immune system, with disgust as its motivational part, serves as the first line of defense in organisms' protection against pathogens. Laboratory studies indicate that disgust sensitivity adaptively adjusts to simulated environmental threat, but whether disgust levels similarly change in response to real-life threats, such as a pandemic, remains largely unknown. In a preregistered within-subject study, we tested whether the threat posed by the Covid-19 pandemic would lead to increased perceived disgust. The perception of threat was induced by testing during two phases of the Covid-19 pandemic (periods of high vs. low pathogen threat). We found heightened levels of moral disgust during a "wave" of the pandemic, but the effect was not observed in the domain of pathogen or sexual disgust. Moreover, the age of respondents and levels of trait anxiety were positively associated with pathogen and moral disgust, suggesting that variation in disgust sensitivity may be based chiefly on stable characteristics.

Disgust sensitivity and support for immigration across five nations

Immigration has become a focal debate in politics across the world. Recent research suggests that anti-immigration attitudes may have deep psychological roots in implicit disease avoidance motivations. A key implication of this theory is that individual differences in disease avoidance should be related to opposition to immigration across a wide variety of cultural and political contexts. However, existing evidence on the topic has come almost entirely from the United States and Canada. In this article, we test the disease avoidance hypothesis using nationally representative samples from Norway, Sweden, Turkey, and Mexico, as well as two diverse samples from the United States. We find consistent and robust evidence that disgust sensitivity is associated with anti-immigration attitudes and that the relationship is similar in magnitude to education. Overall, our findings support the disease avoidance hypothesis and provide new insights into the nature of anti-immigration attitudes.

Behavioral avoidance of contagious and non-contagious adults

Evolutionary theories of disease avoidance propose that humans have a set of universal psychological processes to detect environmental cues indicative of infectious disease. These processes then initiate cognitive, emotional, and behavioral responses that function to limit contact with harmful pathogens. Here, we study the conditions under which people exhibit behavioral avoidance of others with a contagious illness or a physical injury (i.e., a broken leg), and the potential mechanisms that underlie this behavior. Across three studies, participants were given the option of sitting at one of two workstations previously occupied by two confederates, one of whom either showed visible symptoms of a cold (contagion condition), wore a lower-leg orthopedic boot and used crutches (broken leg condition), or showed no signs of illness or physical injury (control). We found strong evidence that adults explicitly avoid contact with individuals who show symptoms of a contagious illness. Further, we provide some evidence that adults also avoid individuals with a physical injury, but that this behavior might be driven by implicit, unconscious processes. The findings are discussed in terms of implications for the healthy avoidance of contagion, and the risk for potential stigmatization of non-contagious groups.

Pathogen disgust sensitivity: Individual differences in pathogen perception or pathogen avoidance?

The emotion disgust motivates the avoidance of pathogens and contaminants. Individuals differ in their tendency to experience disgust and this is referred to as pathogen disgust sensitivity. Yet, it remains unclear which differences in psychological processes are captured by pathogen disgust sensitivity. We tested two hypotheses about how the information processing structure underlying pathogen avoidance might give rise to individual differences in pathogen disgust sensitivity. Participants (n = 998) rated the perceived health of individuals with or without facial blemishes and indicated how comfortable they would feel about having physical contact with them. For participants with high disgust sensitivity, facial blemishes were more indicative of poor health and perceived health was more strongly related to comfort with physical contact. These findings suggest that pathogen disgust sensitivity reflects individual differences in the tendency to interpret stimuli as an infection risk and the weight given to estimated infection risk when deciding who should be approached or avoided.

Disease Avoidance Model Explains the Acceptance of Cohabitation With Bats During the COVID-19 Pandemic

Bats and humans have a close relationship based on cohabitation, with bats taking roost in buildings. It has been suggested that bats function as a reservoir of the SARS-CoV-2 virus that causes the COVID-19 disease in humans. A misconception that bats can spread SARS-CoV-2 to humans may have increased negative emotions toward bats and reduced individuals' acceptance of cohabitation with bats during the COVID-19 pandemic. By applying the disease avoidance model, we tested whether knowledge about bats would be associated with reduced negative emotions toward bats, which in turn would be associated with increased acceptance of cohabitation with bats. Moreover, we tested whether previous experiences of bats, perceived COVID-19 risk, age, gender and level of education would be associated with negative emotions and acceptance of bats. A quantitative survey (N = 577) collected during the COVID-19 pandemic in Finland was analyzed with multiple linear regression. The results supported the disease avoidance model. Negative emotions toward bats reduced the acceptance of cohabitation with bats. However, knowledge about bats was associated with increased acceptance of bats both directly, as well as indirectly, via reduced negative emotions. Moreover, perceived COVID-19 risk was associated with increased negative emotions toward bats, and reduced acceptance of bats. Females were more likely than other respondents to report negative emotions, and reduced acceptance of cohabitation with bats. Prior experience of bats was associated with increased acceptance of bats as neighbors. These findings suggest that COVID-19 pandemic may threaten the existence of bats if no action is taken. The findings highlight the importance of correcting misunderstandings about non-human species as transmitters of diseases to humans.

Large Gatherings? No, Thank You. Devaluation of Crowded Social Scenes During the COVID-19 Pandemic

In most European countries, the first wave of the COVID-19 pandemic (spring 2020) led to the imposition of physical distancing rules, resulting in a drastic and sudden reduction of real-life social interactions. Even people not directly affected by the virus itself were impacted in their physical and/or mental health, as well as in their financial security, by governmental lockdown measures. We investigated whether the combination of these events had changed people's appraisal of social scenes by testing 241 participants recruited mainly in Italy, Austria, and Germany in an online, preregistered study conducted about 50 days after the beginning of the COVID-19 outbreak in Europe. Images depicting individuals alone, in small groups (up to four people), and in large groups (more than seven people) were rated in terms of valence, arousal, and perceived physical distance. Pre-pandemic normative ratings were obtained from a validated database (OASIS). Several self-report measures were also taken, and condensed into four factors through factor analysis. All images were rated as more arousing compared to the pre-pandemic period, and the greater the decrease in real-life physical interactions reported by participants, the higher the ratings of arousal. As expected, only images depicting large gatherings of people were rated less positively during, compared to before, the pandemic. These ratings of valence were, however, moderated by a factor that included participants' number of days in isolation, relationship closeness, and perceived COVID-19 threat. Higher scores on this factor were associated with more positive ratings of images of individuals alone and in small groups, suggesting an increased appreciation of safer social situations, such as intimate and small-group contacts. The same factor was inversely related to the perceived physical distance between individuals in images of small and large groups, suggesting an impact of lockdown measures and contagion-related worries on the representation of interpersonal space. These findings point to rapid and compelling psychological and social consequences of the lockdown measures imposed during the COVID-19 pandemic on the perception of social groups. Further studies should assess the long-term impact of such events as typical everyday life is restored.

Evaluating the mediating effects of perceived vulnerability to disease in the relation between disgust and contamination-based OCD

Contamination-based obsessive-compulsive disorder (OCD) is thought to develop and be maintained by excessive propensity to experience disgust, particularly in response to perceived contaminants, and dysfunctional threat appraisals pertaining to illness. The present studies attempted to integrate these lines of research by testing the degree to which contamination-based OCD is associated with individual differences in disgust propensity and sensitivity, affective distress in response to perceived contaminants, and perceived threat of illness. In Study 1, a convenience sample of 185 adults completed self-report scales assessing obsessive-compulsive symptoms, disgust propensity and sensitivity, germ aversion, and perceived infectability. Multivariate regression showed that disgust propensity and germ aversion were the only significant predictors of contamination-based obsessions and compulsions. Exploratory analyses suggested that there was a significant indirect effect of disgust propensity on contamination-based obsessions and compulsions via germ aversion. Findings from Study 1 were replicated using a sample of twenty-six obsessive-compulsive participants. Despite the substantially smaller sample, the proportion of the total effects attributable to the mediating effect of germ aversion was comparable, consistent with a significant partial mediation in both samples. These results together suggest that contamination-based OCD symptoms are likely maintained and motivated by basic affective processes.

Disgust Sensitivity Among Women During the COVID-19 Outbreak

The emotion of disgust is suggested to be an adaptation that evolved to keep us away from sources of infection. Therefore, individuals from populations with greater pathogen stress should have a greater disgust sensitivity. However, current evidence for a positive relationship between disgust sensitivity and the intensity of infectious diseases in the environment is limited. We tested whether disgust and contamination sensitivity changed in response to the COVID-19 pandemic. Disgust was assessed in 984 women in 2017 (before pandemic) and 633 women in 2020 (during pandemic) by a set of photographs depicting sources of infection and Pathogen and Moral of Three-Domain Disgust Scale. Further, contamination sensitivity among participants in two waves was measured by Contamination Obsessions and Washing Compulsions Subscale of Padua Inventory. State anxiety was measured with the Polish adaptation of the State-Trait Anxiety Inventory (STAI) only during the second wave of data collection. Women from the COVID-19 pandemic group assessed the photographs depicting sources of infection as more disgusting, scoring higher on Padua Inventory, but lower on Moral Disgust Domain as compared to women from before the pandemic. In addition, anxiety levels during pandemic positively correlated with scores from Pathogen Disgust Domain, Padua Inventory, and the ratings of the photographs. The participants of the study scored higher in state anxiety than the norms determined for the Polish population. Summarizing, we present evidence for differences in individual levels of disgust sensitivity in relation to pathogen stress, supporting the idea that disgust evolved to serve as protection from pathogens.

Individual differences in avoiding feelings of disgust: Development and construct validity of the disgust avoidance questionnaire

We developed and examined the construct validity of the Disgust Avoidance Questionnaire (DAQ) as a measure of people’s inclination to prevent experiencing disgust (disgust prevention) and to escape from the experience of disgust (disgust escape). In a stepwise item-reduction (Study 1; N = 417) using Exploratory Factor Analysis (EFA) based on a 4-subscale distinction (behavioral prevention, cognitive prevention, behavioral escape, cognitive escape), we selected 17 items from a pool of potential items. In order to incorporate the conceptual overlap between dimensions of disgust avoidance, focus (prevention vs. escape), and strategy (behavioral avoidance vs. cognitive avoidance), we specified an adapted model. In this model, we allowed each item to load on one type of dimension and one type of strategy, resulting in four overlapping factors (prevention, escape, behavioral avoidance, cognitive avoidance). Evaluation of this overlapping 4-factor model (Study 2; N = 513) using Exploratory Structural Equation Modeling (ESEM) and Confirmatory Factor Analysis (CFA) showed promising model fit indices, factor loadings, factor correlations, and reliability estimates for three of the four factors (prevention, behavioral avoidance, cognitive avoidance). Those three subscales also showed good convergent validity. In contrast, the results related to the escape factor may call the suitability of self-report to assess disgust escape into question. In light of the exploratory nature of the project, future examinations of the DAQ’s validity and applicability to more diverse samples are essential. A critical next step for future research would be to examine the DAQ’s criterion validity and the distinctive roles of the DAQ subscales in (clinical) psychological constructs and processes.

The Role of Disgust and Threat in Contamination-Related Obsessive–Compulsive Disorder

Theoretical models suggest that the emotion disgust or threat overestimates are important in the aetiology and maintenance of contamination-based obsessive–compulsive disorder. In the current study, both threat and disgust were manipulated and 115 non-clinical participants (mean age 20.46 years, 94 females) were randomly allocated to one of four conditions: high-disgust/low-threat (n = 29), high-disgust/high-threat (n = 29), low-disgust/low-threat (n = 27), and low-disgust/high-threat (n = 30). Participants completed a hierarchical Behavioural Avoidance Task (BAT). Those in the high-threat and high-disgust conditions completed less BAT steps and showed more latency to begin each step than those in the low-threat and low-disgust conditions. A significant interaction effect was observed for the high-disgust/high-threat condition as significantly more task avoidance was found. However, handwashing duration was not significantly different between the high and low-disgust conditions or the high and low-threat conditions. The overall low mean washing duration of 30 s possibly due to the testing conditions and/or the ethnic heterogeneity of the sample may account for these results. There were also no significant differences in the level of anxiety for participants in the high-threat compared with the low-threat conditions. It is possible that anxiety remained relatively low across conditions as a result of the graduated BAT. Future research and theoretical and clinical implications are discussed.

The Impact of the Covid-19 Pandemic on Disgust Sensitivity

There have been few tests of whether exposure to naturalistic or experimental disease-threat inductions alter disgust sensitivity, although it has been hypothesized that this should occur as part of disgust's disease avoidance function. In the current study, we asked Macquarie university students to complete measures of disgust sensitivity, perceived vulnerability to disease (PVD), hand hygiene behavior and impulsivity, during Australia's Covid-19 pandemic self-quarantine (lockdown) period, in March/April 2020. These data were then compared to earlier Macquarie university, and other local, and overseas student cohorts, to determine if disgust sensitivity and the other measures, were different in the lockdown sample. The most consistent finding in the lockdown sample was of higher core disgust sensitivity (Cohen's d = 0.4), with some evidence of greater germ aversion on the PVD, and an increase in hand and food-related hygiene, but with little change in impulsivity. The consistency with which greater core disgust sensitivity was observed, suggests exposure to a highly naturalistic disease threat is a plausible cause. Greater disgust sensitivity may have several functional benefits (e.g., hand and food-related hygiene) and may arise implicitly from the threat posed by the Covid-19 pandemic.

Pre-pandemic disgust proneness predicts increased coronavirus anxiety and safety behaviors: Evidence for a diathesis-stress model

Although health anxiety and corresponding safety behaviors can facilitate disease transmission avoidance, they can be maladaptive in excess, including during the coronavirus pandemic. Disgust proneness (i.e., tendency to experience and be sensitive to disgust) is one factor that may predict elevated coronavirus anxiety and safety behaviors during the pandemic, given the role of disgust in avoiding disease transmission. The present study examined the relations between pre-pandemic disgust proneness and coronavirus anxiety and safety behaviors in community adults who completed a 2016 study and were re-contacted on 4/1/2020 (N = 360). Interactions between pre-pandemic disgust proneness and current perceived stress were tested to examine a diathesis-stress model of the role of disgust proneness in anxiety response to the pandemic. Increased pre-pandemic disgust proneness predicted increased coronavirus anxiety and safety behaviors, controlling for number of COVID-19 cases by state. Consistent with a diathesis-stress model, current perceived stress moderated this effect, such that highest coronavirus anxiety and safety behaviors were reported by those with high disgust proneness and high stress. Trait disgust proneness may be a vulnerability factor for anxiety responses to the coronavirus pandemic, particularly among individuals experiencing high stress. Assessing disgust proneness and current stress may facilitate targeted anxiety intervention during the pandemic.

Keep your (social) distance: Pathogen concerns and social perception in the time of COVID-19

Previous research suggests that individual differences in pathogen disgust sensitivity and social anxiety predict avoidance behavior, especially of pathogen cues, and reduced tolerance for social ambiguity. Conversely, generalized social trust is associated with approach behavior and a greater tolerance for social ambiguity. We conducted an online study (N = 1078) to test these predictions in the context of the COVID-19 global pandemic. Specifically, we assessed whether individual differences in pathogen disgust sensitivity, social anxiety and generalized social trust predicted judgments of trustworthiness, desired social distance and perceptions of sickness of target faces wearing surgical masks. Our results showed that (a) high sensitivity to pathogen disgust predicted lower judgments of trustworthiness and lower social desirability; (b) high social anxiety predicted higher perceptions of illness and lower judgments of trustworthiness; and (c) generalized social trust predicted higher judgments of trustworthiness and lower perceptions of illness of target faces. Further, we found that mask wearers were perceived as more likely to be ill, more trustworthy and more socially desirable than the same faces presented to a control group, without the surgical mask superimposed. Results are discussed in terms of perceived compliance with an emerging social norm overriding the intrinsic untrustworthiness of masked faces.

Olfactory Communication of Sickness Cues in Respiratory Infection

Animals detect sick conspecifics by way of body odor that enables the receiver to avoid potential infectious transmission. Human observational studies also indicate that different types of disease are associated with more or less aversive smells. In addition, body odors from otherwise healthy human individuals smell more aversive as a function of experimentally induced systemic inflammation. To investigate if naturally occurring immune activation also gives rise to perceivable olfactory changes, we collected body odor samples during two nights from individuals with a respiratory infection as well as when they were healthy. We hypothesized that independent raters would rate the body odor originating from sick individuals as smelling more aversive than when the same individuals were healthy. Even though body odor samples from sick individuals nominally smelled more intense, more disgusting, and less pleasant and healthy than the body odor from the same individuals when healthy, these effects were not statistically significant. Moreover, raters filled out three questionnaires, Perceived Vulnerability to Disease, Disgust Scale, and Health Anxiety, to assess potential associations between sickness-related personality traits and body odor perception. No such association was found. Since experimentally induced inflammation have made body odors more aversive in previous studies, we discuss whether this difference between studies is due to the level of sickness or to the type of trigger of the sickness response.

People expressing olfactory and visual cues of disease are less liked

For humans, like other social animals, behaviour acts as a first line of defence against pathogens. A key component is the ability to detect subtle perceptual cues of sick conspecifics. The present study assessed the effects of endotoxin-induced olfactory and visual sickness cues on liking, as well as potential involved mechanisms. Seventy-seven participants were exposed to sick and healthy facial pictures and body odours from the same individual in a 2 × 2 factorial design while disgust-related facial electromyography (EMG) was recorded. Following exposure, participants rated their liking of the person presented. In another session, participants also answered questionnaires on perceived vulnerability to disease, disgust sensitivity and health anxiety. Lower ratings of liking were linked to both facial and body odour disease cues as main effects. Disgust, as measured by EMG, did not seem to be the mediating mechanism, but participants who perceived themselves as more prone to disgust, and as more vulnerable to disease, liked presented persons less irrespectively of their health status. Concluding, olfactory and visual sickness cues that appear already a few hours after the experimental induction of systemic inflammation have implications for human sociality and may as such be a part of a behavioural defence against disease. This article is part of the Theo Murphy meeting issue 'Olfactory communication in humans'.

A Proximal Perspective on Disgust

The functional basis of disgust in disease avoidance is widely accepted; however, there is disagreement over what disgust is. This is a significant problem, as basic questions about disgust require knowing if single/multiple forms/processes exist. We address this issue with a new model with one form of disgust generated by multiple processes: (a) pure disgust experienced during gastrointestinal illness; (b) somatosensory disgust elicited by specific cues that activate the pure disgust state; (c) anticipatory disgust elicited by associations between distance cues for somatosensory disgust and requiring threat evaluation; (d) simulated disgusts elicited by imagining somatosensory and anticipatory disgust and frequently involving other emotions. Different contamination processes interlink (a–d). The implications of our model for fundamental questions about disgust (e.g., emotion status; continuation into animals) are examined.

Disgust in Anxiety and Obsessive-Compulsive Disorders: Recent Findings and Future Directions

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.

Emotional predictors of bowel screening: the avoidance-promoting role of fear, embarrassment, and disgust

Background

Despite considerable efforts to address practical barriers, colorectal cancer screening numbers are often low. People do not always act rationally, and investigating emotions may offer insight into the avoidance of screening. The current work assessed whether fear, embarrassment, and disgust predicted colorectal cancer screening avoidance.

Methods

A community sample (N = 306) aged 45+ completed a questionnaire assessing colorectal cancer screening history and the extent that perceptions of cancer risk, colorectal cancer knowledge, doctor discussions, and a specifically developed scale, the Emotional Barriers to Bowel Screening (EBBS), were associated with previous screening behaviours and anticipated bowel health decision-making.

Results

Step-wise logistic regression models revealed that a decision to delay seeking healthcare in the hypothetical presence of bowel symptoms was less likely in people who had discussed risk with their doctor, whereas greater colorectal cancer knowledge and greater fear of a negative outcome predicted greater likelihood of delay. Having previously provided a faecal sample was predicted by discussions about risk with a doctor, older age, and greater embarrassment, whereas perceptions of lower risk predicted a lower likelihood. Likewise, greater insertion disgust predicted a lower likelihood of having had an invasive bowel screening test in the previous 5 years.

Conclusions

Alongside medical and demographic factors, fear, embarrassment and disgust are worthy of consideration in colorectal cancer screening. Understanding how specific emotions impact screening decisions and behaviour is an important direction for future work and has potential to inform screening development and communications in bowel health.

Psychological Predictors of Health Anxiety in Response to the Zika Virus

The threat of a United States (U.S.) Zika virus pandemic during 2015-2016 was associated with public anxiety. Such threats represent opportunities to examine hypotheses about health anxiety. The present study investigated psychological predictors of Zika-related anxiety during the 2015-2016 outbreak. U.S. adults (N = 216) completed a battery of measures assessing Zika-related anxiety as well as psychological variables hypothesized to predict anxious responding to the threat of a domestic Zika outbreak. Contrary to hypotheses, regression analyses indicated that only contamination severity overestimates and greater Zika knowledge significantly predicted Zika-related anxiety. Study limitations and clinical implications are discussed.

Is Disgust Proneness Associated With Anxiety and Related Disorders? A Qualitative Review and Meta-Analysis of Group Comparison and Correlational Studies

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.

Moral and Sexual Disgust Suppress Sexual Risk Behaviors among Men Who Have Sex with Men in China

Increasingly more men who have sex with men (MSM) are engaging in sexual risk taking in China in recent years. Given the high rates of HIV infection among MSM in China, it is urgent that we understand the factors that influence MSM's practice of sexual risk taking. Disgust sensitivity, which elicits a behavioral avoidance response, has the potential to influence risky sexual behavior. The present study examined the relationship between disgust sensitivity and sexual risk behavior among MSM in China. Men (n = 584) who reported having anal intercourse in the previous 6 months were recruited from the Internet. Two indicators of sexual risk behaviors were measured: condom use and the number of sex partners. The results indicated that moral disgust was positively associated with condom use, with MSM who had higher moral disgust being more likely to use condoms than others did. Sexual disgust was positively associated with the number of sex partners, with MSM who had higher sexual disgust having fewer male sex partners than others did. Sexual and moral disgust sensitivity significantly predicted HIV testing. Our study verified that sexual and moral disgust suppressed sexual risk behaviors and promoted HIV testing. Moral and sexual education should be incorporated in future strategies for HIV prevention and encouragement of safe sex behaviors among MSM in China.

Contamination Appraisals, Pollution Beliefs, and the Role of Cultural Inheritance in Shaping Disease Avoidance Behavior

Despite the upsurge of research on disgust, the implications of this research for the investigation of cultural pollution beliefs has yet to be adequately explored. In particular, the sensitivity of both disgust and pollution to a common set of elicitors (e.g., bodily emissions, disease, and death) suggests a common psychological basis, though several obstacles have prevented an integrative account, including methodological differences between the relevant disciplines. Employing a conciliatory framework that embraces both naturalistic (evolutionary) and humanistic levels of explanation, this article examines the dynamic reciprocal process by which contamination/contagion appraisals in individuals serve to shape-and are in turn shaped by-culture-specific pollution beliefs. This complex interrelationship is illustrated by examining ancient Near Eastern and modern ethnographic documentation of pollution beliefs, highlighting the underappreciated function of these pollution beliefs as folk theories for the spread of infectious disease. By evaluating how pollution beliefs (as also modern germ theory) shape contamination appraisals in individuals, it will be argued that cultural inheritance has played a much larger role in guiding disease avoidance behavior than has been previously recognized.

Predicting the patients who will struggle with anal incontinence: sensitivity to disgust matters

AIM

Quality of life varies in patients with anal incontinence. The severity of symptoms is a surprisingly modest predictor, but they reliably elicit disgust. The current work assessed prospectively whether dispositional sensitivity to disgust predicted the quality of life in patients with anal incontinence.

METHOD

Seventy-five patients with anal incontinence identified from the waiting list for the pelvic floor clinic at the Greenlane Clinical Centre, Auckland, New Zealand, completed questionnaires assessing symptom severity (Fecal Incontinence Severity Index) and disgust sensitivity (Disgust Sensitivity-Revised scale) prior to a first appointment. Three months later incontinence-specific (Fecal Incontinence Quality of Life Scale, FI QLS) and general quality of life (World Health Organization Quality of Life-BREF, WHOQOL-BREF) were assessed.

RESULTS

Greater severity of symptoms prospectively predicted lower incontinence-specific quality of life (FI QLS lifestyle domain) and lower general quality of life (WHOQOL-BREF environmental domain). Greater disgust sensitivity predicted poorer psychological and environmental well-being, and moderated the link between symptom severity and outcome. Persons low in disgust sensitivity reported a higher quality of life when symptom severity was low, but those with a high disgust sensitivity had a low quality of life regardless of symptom severity.

CONCLUSION

The functional status of patients with anal incontinence explains some but not all of the variation in quality of life. Emotional factors such as disgust appear to have a role. Disgust sensitivity warrants further attention.

Specificity of disgust domains in the prediction of contamination anxiety and avoidance: a multimodal examination

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.