Why disgust matters

Emotional body representations: more pronounced effect of hands at a more explicit level of awareness

To understand conditions such as body dysmorphic disorder, we need to understand healthy individuals' perceptual, conceptual, and emotional representations of their bodies. Not much is known about the differences in these representations across body districts, for example, hands, feet, and whole-body, despite their differences at sensory and functional levels. To understand this, we developed more implicit and explicit measures of body satisfaction for these body districts. Sixty-seven participants (age M = 30.66, SD = 11.19) completed a series of online Implicit Association Tests (IAT) and a Body Image Satisfaction Visual Analogue Scale (BISVAS; explicit) for each body district (hands/feet/whole body). The results show no differences in the more implicit level of awareness in hands, feet and whole body, while differences are apparent at a more explicit level of awareness, with higher scores for body image satisfaction for the hands than the whole body and marginally significant lower scores for feet than hands. Those findings suggest that visual attention, level of concern attributed to a body district, and disgust drivers are possible factors affecting the experience of attitudinal body image satisfaction.

Is processing superiority a universal trait for all threats? Divergent impacts of fearful, angry, and disgusted faces on attentional capture

Fearful, angry, and disgusted facial expressions are evolutionarily salient and convey different types of threat signals. However, it remains unclear whether these three expressions impact sensory perception and attention in the same way. The present ERP study investigated the temporal dynamics underlying the processing of different types of threatening faces and the impact of attentional resources employed during a perceptual load task. Participants were asked to judge the length of bars superimposed over faces presented in the center of the screen. A mass univariate statistical approach was used to analyze the EEG data. Behaviorally, task accuracy was significantly reduced following exposure to fearful faces relative to neutral distractors, independent of perceptual load. The ERP results revealed that the P1 amplitude over the right hemisphere was found to be enhanced for fearful relative to disgusted faces, reflecting the rapid and coarse detection of fearful cues. The N170 responses elicited by fearful, angry, and disgusted faces were larger than those elicited by neutral faces, suggesting the largely automatic and preferential processing of threats. Furthermore, the early posterior negativity (EPN) component yielded increased responses to fearful and angry faces, indicating prioritized attention to stimuli representing acute threats. Additionally, perceptual load exerted a pronounced influence on the EPN and late positive potential (LPP), with larger responses observed in the low perceptual load condition, indicating goal-directed cognitive processing. Overall, the early sensory processing of fearful, angry, and disgusted faces is characterized by differential sensitivity in capturing attention automatically, despite the importance of these facial signals for survival. Fearful faces produce a strong interference effect and are processed with higher priority than angry and disgusted ones.

Disgust as a basic, sexual, and moral emotion

Disgust is a basic emotion that increases the organism's survival success by preventing the transfer of pathogens. In this regard, it directs cognitive processes and motivates avoidance behaviors that prevent pathogens from entering the body. Moreover, disgust has many specific characteristics that distinguish it from other basic emotions. Firstly, unlike other basic emotions, it contaminates neutral objects around it and causes difficult-to-change learning. Another specific characteristic of disgust is that it depends on ideational processes. Objects, situations, and behaviors that do not contain pathogens can also cause disgust. In this regard, disgust appears not only as a basic emotion but also as different adaptations in different fields. In this context, two distinct adaptations of disgust stand out: sexual and moral disgust. These two adaptations of disgust benefit from disgust-related behaviors and motivations in different ways. Sexual disgust works as a gene protection mechanism, while moral disgust helps maintain social rules. The specific characteristics of disgust and its effects on cognitive processes such as attention and memory interact. In conclusion, the multifaceted structure of disgust shows that it needs to be studied more in the subfields of psychology. (Strohminger, Philos Compass 9:478-493, 2014) defines disgust as a psychological nebula that needs to be discovered. However, it is observed that disgust has not been adequately addressed. This review aims to comprehensively explore unique characteristics and diverse aspects of disgust, shedding light on its significance from various perspectives. This study underscores the broader understanding of disgust and its pivotal role in psychological research.

Consumers' perception of novel foods and the impact of heuristics and biases: A systematic review

According to the definition adopted in the European Union, novel foods are foods that were not consumed to a significant degree within the Union before May 15, 1997. This includes cultivated meat and insects. Novel foods are meant to play a critical role in the transition towards sustainable food systems. However, their success depends on whether and to what extent they will be incorporated into the diets at the population level. This review investigates consumers' perception of novel food products by narratively synthesising results on the influence of heuristics and biases triggered by emotions, personality traits, and socio-cultural factors. Empirical studies conducted in Western countries and published in English after 1997 were eligible, which led to 182 studies being included. Notably, most included studies focused on insects and cultivated meat. Disgust and fear are shown to be the main emotions driving rejection of novel foods, together with food neophobia and specific cultural norms common across countries included in the scope of the review. Familiarity with novel foods and curiosity both led to higher acceptance. Despite being investigated directly in a minority of studies, heuristics and related biases mostly fell under the "affect," the "natural-is-better," and the "trust" heuristics. The review also discusses to what extent consumers' perception reflects in the regulatory framework applicable to novel foods in the European Union, how it influences the regulation of insects and cultivated meat and which lessons can be drawn for the future of the regulatory framework.

Stevenson R. Differential involvement of the senses in disgust memories

One prediction derived from the disease avoidance account of disgust is that proximal disgust cues (smells, tastes and touches) should elicit this emotion more intensely than distal disgust cues (sights and sounds). If correct, then memories of disgusting experiences should involve smelling, tasting or touching to a greater degree than seeing or hearing. Two surveys were conducted on university students to test this idea, drawing upon their naturalistic experiences. Survey 1 (N = 127) asked participants to detail their most memorable disgusting, fear-provoking, morally repulsive and yucky/gross experience, with each recollection self-rated for sensory involvement. Survey 2 (N = 89) employed the same task, but this time, participants recollected their most common disgusting, fear-provoking, morally repulsive and yucky/gross experience in the preceding week. The majority of disgusting experiences were core disgusts-i.e. related to disease/pathogen presence or stimuli. The proximal and distal sensory cues contributed equally to individuals' most memorable core disgust experiences, but the proximal senses were more involved than the distal senses in individuals' most common core disgust experiences. Further, the proximal sensory cues, as compared with the distal sensory cues, were signficantly more involved in core disgust experiences than in morally repulsive and fear-provoking experiences. The implications of these findings for a disease avoidance account of disgust, for multi-sensory disgust research, and core disgust's classification as an emotion or a drive, are discussed.

Neurobiology of Pathogen Avoidance and Mate Choice: Current and Future Directions

Animals are under constant threat of parasitic infection. This has influenced the evolution of social behaviour and has strong implications for sexual selection and mate choice. Animals assess the infection status of conspecifics based on various sensory cues, with odours/chemical signals and the olfactory system playing a particularly important role. The detection of chemical cues and subsequent processing of the infection threat that they pose facilitates the expression of disgust, fear, anxiety, and adaptive avoidance behaviours. In this selective review, drawing primarily from rodent studies, the neurobiological mechanisms underlying the detection and assessment of infection status and their relations to mate choice are briefly considered. Firstly, we offer a brief overview of the aspects of mate choice that are relevant to pathogen avoidance. Then, we specifically focus on the olfactory detection of and responses to conspecific cues of parasitic infection, followed by a brief overview of the neurobiological systems underlying the elicitation of disgust and the expression of avoidance of the pathogen threat. Throughout, we focus on current findings and provide suggestions for future directions and research.

Exposure to models' negative facial expressions whilst eating a vegetable decreases women's liking of the modelled vegetable, but not their desire to eat

Introduction

Food enjoyment can be conveyed through facial expressions. Observing others' enjoyment of food has been found to influence adults' desirability of liked and disliked food. Exposing adults to other eaters enjoying nutritious foods that are typically disliked (e.g., vegetables) could enhance the consumption of vegetables by young adults. However, this remains to be examined in young adult populations. This study examined the effect of models' facial expressions towards raw broccoli on young adult women's change in liking and change in desire to eat a modelled vegetable (raw broccoli) and a non-modelled vegetable (cucumber).

Methods

Young adult women (N = 205) were randomised to watch a video of unfamiliar adult models eating raw broccoli with a positive, negative, or neutral facial expression. Participants' change in liking and change in desire to eat the modelled and non-modelled vegetable was examined.

Results

Observing models conveying negative facial expressions whilst eating raw broccoli resulted in a statistically significant reduction in liking ratings of broccoli, but not cucumber. There was no effect of models' facial expressions on the change in desire to eat foods.

Discussion

These findings suggest that watching others express a negative facial expression whilst eating a raw vegetable reduces women's liking of the modelled vegetable, in the absence of a significant change to their desire to consume these foods. This highlights the power of others' negative facial expressions on food liking. Further work is needed to establish the effect of others' facial expressions on vegetable intake.

Disgust-reduction evaluative conditioning (DREC) and brain stimulation in patients with contamination-based obsessive-compulsive disorder: a protocol for a randomized control trial

BACKGROUND

The negative emotional valence of a stimulus can be altered if paired with a pleasant stimulus, a phenomenon referred to as evaluative conditioning. Disgust, as a central emotion in obsessive-compulsive disorder (OCD), particularly in the contamination subtype, may be an appropriate target for such a method. We know that disgust processing and OCD pathophysiology share in some brain areas, including the orbitofrontal cortex, as the neuromodulation techniques targeted in this area have been able to decrease OCD symptoms. We aim to conduct a randomized clinical trial to investigate the evaluative conditioning effect on disgust reduction in patients with contamination-based OCD when administered with or without neuromodulation targeted orbitofrontal cortex.

METHOD

In a single-blind randomized control trial (RCT), 55 patients with contamination-based OCD will be randomly assigned to four arms. In a factorial design, they will receive 10 sessions of evaluative conditioning training (either sham or real) plus cathodal transcranial direct current stimulation (tDCS) over the orbitofrontal cortex (either sham or real). The intensity of disgust experience and clinical symptoms will be investigated as primary outcomes and quantitative electroencephalogram and cognitive functions as secondary outcomes. The data will be collected at three assessment levels: baseline, after completing intervention sessions, and 2-month follow-up.

DISCUSSION

The present RCT is the first study that applies evaluative conditioning training in the OCD clinical sample. It will clarify the effect of the evaluative conditioning method alone and with tDCS on disgust reduction in patients with contamination-based OCD. It will provide initial evidence for such an emotion modulation method in the OCD population. The effect of this emotion-focused protocol on cognitive functions and electroencephalogram components is also of interest.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT05907369. Registered on 16 June 2023. Retrospectively registered.

A linguistic analysis of dehumanization toward substance use across three decades of news articles

Introduction

Substances and the people who use them have been dehumanized for decades. As a result, lawmakers and healthcare providers have implemented policies that subjected millions to criminalization, incarceration, and inadequate resources to support health and wellbeing. While there have been recent shifts in public opinion on issues such as legalization, in the case of marijuana in the U.S., or addiction as a disease, dehumanization and stigma are still leading barriers for individuals seeking treatment. Integral to the narrative of "substance users" as thoughtless zombies or violent criminals is their portrayal in popular media, such as films and news.

Methods

This study attempts to quantify the dehumanization of people who use substances (PWUS) across time using a large corpus of over 3 million news articles. We apply a computational linguistic framework for measuring dehumanization across three decades of New York Times articles.

Results

We show that (1) levels of dehumanization remain high and (2) while marijuana has become less dehumanized over time, attitudes toward other substances such as heroin and cocaine remain stable.

Discussion

This work highlights the importance of a holistic view of substance use that places all substances within the context of addiction as a disease, prioritizes the humanization of PWUS, and centers around harm reduction.

Evolutionary psychology of entomophobia and its implications for insect conservation

Many people, especially those living in developed countries, exhibit irrational negative feelings (e.g. fear, disgust, and aversion) toward insects. This so-called 'entomophobia' has often been suggested as a key contributing factor to the ongoing global decline in insects. However, this topic has not been well-investigated. From this point of view, we discuss the formation processes of entomophobia and its consequences from an evolutionary psychological perspective. Adopting the concept of the behavioral immune system, we suggest that the negative responses toward insects exhibited by modern people are driven by a series of emotional, cognitive, and behavioral traits that evolved to avoid infectious diseases. We then provide several strategic recommendations for mitigating the prevalence of entomophobia and a roadmap for better understanding how individual-level entomophobia can influence insect conservation. Understanding the human psychological dimension behind the ongoing decline of insects will provide useful insight on how best to mitigate this decline.

Disgust Processing and Potential Relationships with Behaviors in Autism

PURPOSE OF REVIEW

While there are reports of differences in emotion processing in autism, it is less understood whether the emotion of disgust, in particular, plays a significant role in these effects. Here, we review literature on potential disgust processing differences in autism and its possible associations with autistic traits.

RECENT FINDINGS

In autism, there is evidence for differences in physical disgust processing, pica behaviors, attention away from other's disgust facial expressions, and differences in neural activity related to disgust processing. In typically developing individuals, disgust processing is related to moral processing, but modulated by individual differences in interoception and alexithymia. Autistic individuals may experience atypical disgust, which may lead to difficulty avoiding contaminants and affect socio-emotional processing. In autism, such outcomes may lead to increased occurrences of illness, contribute to gastrointestinal issues, diminish vicarious learning of disgust expression and behaviors, and potentially contribute to differences in processes related to moral reasoning, though further research is needed.

Disgust in animals and the application of disease avoidance to wildlife management and conservation

Disgust is an adaptive system hypothesized to have evolved to reduce the risk of becoming sick. It is associated with behavioural, cognitive and physiological responses tuned to allow animals to avoid and/or get rid of parasites, pathogens and toxins. Little is known about the mechanisms and outcomes of disease avoidance in wild animals. Furthermore, given the escalation of negative human-wildlife interactions, the translation of such knowledge into the design of evolutionarily relevant conservation and wildlife management strategies is becoming urgent. Contemporary methods in animal ecology and related fields, using direct (sensory cues) or indirect (remote sensing technologies and machine learning) means, provide a flexible toolbox for testing and applying disgust at individual and collective levels. In this review/perspective paper, we provide an empirical framework for testing the adaptive function of disgust and its associated disease avoidance behaviours across species, from the least to the most social, in different habitats. We predict various trade-offs to be at play depending on the social system and ecology of the species. We propose five contexts in which disgust-related avoidance behaviours could be applied, including endangered species rehabilitation, invasive species, crop-raiding, urban pests and animal tourism. We highlight some of the perspectives and current challenges of testing disgust in the wild. In particular, we recommend future studies to consider together disease, predation and competition risks. We discuss the ethics associated with disgust experiments in the above contexts. Finally, we promote the creation of a database gathering disease avoidance evidence in animals and its applications.

Disgust and fear reactions uniquely affect intrusions and posttraumatic stress symptoms

Disgust reactions commonly occur during/following trauma and predict posttraumatic stress (PTS) symptoms. Yet, disgust is not mentioned in DSM-5 PTSD criteria. To investigate disgust's clinical significance in PTSD, we measured the relationship between disgust (and fear) reactions to a personal trauma, and problematic intrusion characteristics (e.g., distress) and intrusion symptom severity. We focused on intrusions because they are a transdiagnostic PTSD symptom, though we also measured overall PTS symptoms to replicate prior work. Participants (N = 471) recalled their most traumatic/stressful event from the past six months. They then rated disgust and fear reactions to this event and completed the Posttraumatic Stress Disorder Checklist-5. Participants who had experienced intrusions about their event in the past month (n = 261) rated these intrusions on several characteristics (e.g., distress, vividness). We found stronger traumatic event-related disgust reactions were associated with more problematic intrusion characteristics, higher intrusion symptom severity, and higher overall PTS symptom severity. Notably, disgust reactions uniquely predicted these variables after statistically controlling for fear reactions. We conclude disgust reactions to trauma may be similarly pathological to fear reactions for intrusion and broader PTS symptoms. Therefore, PTSD diagnostic manuals and treatments should recognize disgust as a trauma-relevant emotion.

A Study on How Food Colour May Determine the Categorization of a Dish: Predicting Meal Appeal from Colour Combinations

A person’s preference to select or reject certain meals is influenced by several aspects, including colour. In this paper, we study the relevance of food colour for such preferences. To this end, a set of images of meals is processed by an automatic method that associates mood adjectives that capture such meal preferences. These adjectives are obtained by analyzing the colour palettes in the image, using a method based in Kobayashi’s model of harmonic colour combinations. The paper also validates that the colour palettes calculated for each image are harmonic by developing a rating model to predict how much a user would like the colour palettes obtained. This rating is computed using a regression model based on the COLOURlovers dataset implemented to learn users’ preferences. Finally, the adjectives associated automatically with images of dishes are validated by a survey which was responded by 178 people and demonstrates that the labels are adequate. The results obtained in this paper have applications in tourism marketing, to help in the design of marketing multimedia material, especially for promoting restaurants and gastronomic destinations.

An experimental test of the effects of acute sleep deprivation on affect and avoidance

BACKGROUND AND OBJECTIVES

Avoidance and sleep have been identified as mechanisms involved in the development and maintenance of many mental health disorders. However, there has been little research into the relation between sleep and avoidance.

METHODS

To address this, a randomized controlled experiment using behavioral and self-report measures of affect and avoidance was conducted. Compared to a control group, we hypothesized that sleep-deprived individuals would demonstrate increased negative, and decreased positive, affectivity, more avoidance behavior toward a negatively valenced stimulus, as well as increased self-reported avoidance. Fifty-two healthy individuals ages 18-30 years old were randomly assigned to a full night of sleep deprivation or normal sleep. They completed a baseline and post-manipulation behavioral avoidance task (BAT) using a disgusting stimulus and self-reports of avoidance and state affect.

RESULTS

Repeated measures ANOVAs demonstrated negative affectivity and self-reported avoidance increased, and positive affectivity decreased, from pre-to post-manipulation in the sleep loss condition as expected. However, there were no effects of sleep deprivation on avoidance behaviors.

LIMITATIONS

This study emphasized internal validity over generalizability. Additionally, the at-home sleep deprivation limited researcher control over the overnight activities of participants.

CONCLUSIONS

Results replicate prior work on the affective consequences of sleep deprivation and highlight a discrepancy between the effect of sleep deprivation on behavioral avoidance toward a specific stimulus compared to self-reported cognitive and social avoidance behaviors.

COVIDisgust: Language processing through the lens of partisanship

Disgust is an aversive reaction protecting an organism from disease. People differ in how prone they are to experiencing it, and this fluctuates depending on how safe the environment is. Previous research has shown that the recognition and processing of disgusting words depends not on the word’s disgust per se but rather on individual sensitivity to disgust. However, the influence of dynamically changing disgust on language comprehension has not yet been researched. In a series of studies, we investigated whether the media’s portrayal of COVID-19 will affect subsequent language processing via changes in disgust. The participants were exposed to news headlines either depicting COVID-19 as a threat or downplaying it, and then rated single words for disgust and valence (Experiment 1; N = 83) or made a lexical decision (Experiment 2; N = 86). The headline type affected only word ratings and not lexical decisions, but political ideology and disgust proneness affected both. More liberal participants assigned higher disgust ratings after the headlines discounted the threat of COVID-19, whereas more conservative participants did so after the headlines emphasized it. We explain the results through the politicization and polarization of the pandemic. Further, political ideology was more predictive of reaction times in Experiment 2 than disgust proneness. High conservatism correlated with longer reaction times for disgusting and negative words, and the opposite was true for low conservatism. The results suggest that disgust proneness and political ideology dynamically interact with perceived environmental safety and have a measurable effect on language processing. Importantly, they also suggest that the media’s stance on the pandemic and the political framing of the issue may affect the public response by increasing or decreasing our disgust.

Common and separable behavioral and neural mechanisms underlie the generalization of fear and disgust

Generalization represents the transfer of a conditioned responses to stimuli that resemble the conditioned stimulus (CS). Previous studies on generalization of defensive avoidance responses have primarily focused on fear and have neglected disgust generalization, which represents a key pathological mechanism in some anxiety disorders. In the present study we examined common and distinct mechanisms of fear and disgust generalization by means of a fear or disgust multi-CS conditioning and generalization paradigm with concomitant event-related potential (ERPs) acquisition in n = 62 subjects. We demonstrate that compared to fear, disgust-relevant generalized stimuli (GS) elicited larger expectancy ratings and longer reaction times (RTs) reflecting stronger ratings of 'risk'. On the electrophysiological level, increased P2 amplitudes were found in response to conditioned CS+ versus CS- across both domains, possibly reflecting higher motivational and attentional salience of aversive conditioned stimuli per se. Contingent negative variation (CNV) amplitude was significantly larger for disgust-CS+ than disgust-CS-, reflecting a stronger preparation of the disgust US. Additionally, we found that the contingent negative variation (CNV) fear generalization gradient, and CNV amplitude were increased with similarity to CS+. In contrast the CNV to disgust-GS did not differ and did not reflect disgust generalization. Together this may indicate that the CNV represents a highly fear-specific index for generalization learning. This study provides the first neurobiological evidence for common and distinct generalization learning in fear versus disgust suggesting that dysregulations in separable defensive avoidance mechanisms may underly different anxiety disorder subtypes.

Design, delivery, and determinants of uptake: findings from a food hygiene behavior change intervention in rural Bangladesh

BACKGROUND

Microbial food contamination, although a known contributor to diarrheal disease and highly prevalent in low-income settings, has received relatively little attention in nutrition programs. Therefore, to address the critical pathway from food contamination to infection to child undernutrition, we adapted and integrated an innovative food hygiene intervention into a large-scale nutrition-sensitive agriculture trial in rural Bangladesh. In this article, we describe the intervention, analyze participation and uptake of the promoted food hygiene behaviors among intervention households, and examine the underlying determinants of behavior adoption.

METHODS

The food hygiene intervention employed emotional drivers, engaging group activities, and household visits to improve six feeding and food hygiene behaviors. The program centered on an 'ideal family' competition. Households' attendance in each food hygiene session was documented. Uptake of promoted behaviors was assessed by project staff on seven 'ideal family' indicators using direct observations of practices and spot checks of household hygiene conditions during household visits. We used descriptive analysis and mixed-effect logistic regression to examine changes in household food hygiene practices and to identify determinants of uptake.

RESULTS

Participation in the food hygiene intervention was high with more than 75% attendance at each session. Hygiene behavior practices increased from pre-intervention with success varying by behavior. Safe storage and fresh preparation or reheating of leftover foods were frequently practiced, while handwashing and cleaning of utensils was practiced by fewer participants. In total, 496 of 1275 participating households (39%) adopted at least 5 of 7 selected practices in all three assessment rounds and were awarded 'ideal family' titles at the end of the intervention. Being an 'ideal family' winner was associated with high participation in intervention activities [adjusted odds ratio (AOR): 11.4, 95% CI: 5.2-24.9], highest household wealth [AOR: 2.3, 95% CI: 1.4-3.6] and secondary education of participating women [AOR: 2.2, 95% CI: 1.4-3.4].

CONCLUSION

This intervention is an example of successful integration of a behavior change food hygiene component into an existing large-scale trial and achieved satisfactory coverage. Future analysis will show if the intervention was able to sustain improved behaviors over time and decrease food contamination and infection.

Epidemiology, Secondary School Curricula, and Preparing the Next Generation for Global Citizenship

Because COVID-19 and other emerging infectious diseases are likely to play an increasingly important role in shaping American and global society in years to come, there is a need to prepare young people to make informed decisions in this changing global context. One way to do so is teaching and learning about basic principles of epidemiology in secondary schools. Improved understanding about the agent of infection, mechanisms of transmission, factors that increase or decrease susceptibility, place variation and environmental factors that facilitate or hinder transmission, reservoirs of infection (where the agent lives and multiplies), and when the disease is more or less likely to occur comprise the main facts about an infectious disease relevant to prevention and control. Improved understanding of these basic concepts could help future generations make informed decisions in a changing global context with emerging infectious diseases and a plethora of widely disseminated misinformation and disinformation. This viewpoint considers why learning about epidemiology in secondary school would benefit population health using COVID-19 as an illustration.

Faecal microbiota transplants: towards a healthy disgust scepticism

This paper engages with the obstacle of disgust surrounding the use of faecal microbiota transplants (FMT). In discourse about the human microbiome and microbiota-based therapies (like FMT), disgust has become an unavoidable emotion for physicians, patients and caregivers interested in these therapies. Additionally, microbiota therapies and microbiomes are challenging our conception of an individual biological self. As these two discourses converge with FMT, it becomes necessary to understand how they are working together. To do this, this paper explores the way disgust functions in the formation of subjects. Scholarship about disgust can be categorised into two approaches: disgust as a deep wisdom or disgust scepticism. The former approach focuses on the physiological, embodied aspects of our disgust reactions as evidence of 'truth' in disgusting encounters, and the latter recognises the way disgust is culturally contingent and adapted for use in moral and social determinations of good and bad. However, both positions accept the use of disgust as a defence against 'toxins and diseases'. Yet, as this paper argues, we should take the sceptical approach further. The disgust sceptical approach, particularly as developed by Sarah Ahmed, does more than just challenge disgust's role in moral deliberations. It also demands sceptical reflection on disgust as a universal defence against 'toxins and diseases'. Much as disgust can be co-opted to support oppression, it too can be co-opted to reconstitute a false vision of human subjectivity-the coherent, contained and exceptional human subject situated above the natural world. The human microbiome, faecal therapeutics and being disgusted give us an opportunity to recognise ourselves as more-than-human subjects.

Zootherapeutic uses of animals excreta: the case of elephant dung and urine use in Sayaboury province, Laos

BACKGROUND

Despite a widespread aversion towards faeces and urine, animal excreta are used in traditional medicine in many countries since centuries, but records are scattered and few therapeutic uses have been accurately documented while in the current context of emerging zoonoses such records may be of major interest.

METHODOLOGY

In this study, we investigated the therapeutic uses that mahouts in Xayaboury province, Lao PDR make of elephant urine and faeces as well as of the brood chamber that beetles (Heliocopris dominus) fashion from elephant dung. Semi-structured interviews were conducted with mahouts on elephant diet, health problems and responses to disease, andwhether they use elephant products. Data were supplemented by interviews with traditional healers.

RESULTS

Seven respondents reported the use of elephant urine in ethnoveterinary care for elephants and in human medicine in case of diabetes and otitis. 25 respondents reported therapeutic use of elephant faeces (EF) and elephant dung beetle brood chambers. The major indications are gastrointestinal and skin problems. Macerations or decoctions are drunk or used externally as a lotion. The mahouts attribute the therapeutic effectiveness of EFs to their content which includes the remains of many species from the elephant diet which they consider to be medicinal.

DISCUSSION

The indications of these uses are consistent with pharmacological and clinical studies highlighting the properties of different animals' urine and faeces and their curative potential tested in vivo. The acknowledgement by the mahouts of medicinal properties of elephant faecal bolus contrasts with the rare justifications of animal material use recorded in zootherapeutic studies, which falls within the symbolic domain. However, numerous studies highlight the preponderant role of the microbiota in physiological processes, raising the hypothesis of a curative action of EF, by rebalancing the user's microbiota.

CONCLUSION

The therapeutic uses of EF preparations despite their possible curative properties are a potential source of zoonotic transmission from elephants to humans. In the current context of globalisation of trade which favours the emergence of zoonoses and in relation with the issue of One Health, it becomes crucial to further document the zootherapeutic practices to prevent emerging diseases. As elephants and local related ethnoethological knowledge are threatened, documenting them is urgent to contribute to their preservation.

The development and validation of the Misophonia response scale

OBJECTIVE

Most current Misophonia scales are not validated, do not include both emotional and physiological responses to triggers, and/or focus only on auditory triggers. This research aimed to develop and validate a measure of the magnitude of the Misophonic response that addressed these omissions.

METHOD

Three studies were carried out with individuals with self-diagnosed Misophonia. In study 1, expert opinion and participants commented on initial items to determine both face and content validity. In study 2, scale structure, reliability, and convergent and discriminant validity were determined using correlations, principal component analysis (PCA), and reliability analysis. In study 3, factor structure was confirmed in another sample of participants using confirmatory factor analysis (CFA).

RESULTS

The final 22-item scale assesses the magnitude of responses to triggers across any sensory modality. There are three subscales (emotional, physiological, and participation in life), with three additional items measuring frequency of triggers, avoidance of triggers, and time taken to recover from the triggers. The final scale showed suitable discriminant and convergent validity, with good internal consistency (Cronbach's alphas range 0.77 to 0.89). The three-component solution extracted using PCA explained 53.97% of variance, with all items loading between 0.45 and 0.84. The structure was confirmed with CFA (χ² = 269.01, p < .001; CFI = 0.96; TLI = 0.96 and RMSEA = 0.045 (CI 0.037-0.053).

CONCLUSION

The Misophonia Response Scale, which is valid and reliable, will facilitate understanding of Misophonia as it is short and easy to use for self-report in research.

Tactile disgust: Post-contact can be more disgusting than contact

Several studies have examined if disgust can be evoked by contacting an object-yet none have examined if reported disgust changes when the hand leaves the object. This is surprising given that post-contact tactile disgust is probably a driver of hand hygiene. We examined contact and post-contact tactile disgust and its sensory origins. Participants were asked to touch several objects, making sensory, disgust, and desire-to-handwash evaluations. These ratings were made at three stages-of-contact: object-contact (just touch), post-contact (just touch), and visual post-contact (touch, vision). Disgust was typically highest at post-contact (when the hand left the object). Stickiness and wetness were uniquely predictive of object-contact disgust. Only stickiness drove post-contact disgust, and only wetness visual post-contact disgust. Hand-washing desire was primarily driven by quantity of residue perceived on the hand. These findings suggest that tactile disgust is a multisensory and iterative process relating to object- and residue-adhesiveness.

Food disgust sensitivity predicts disease-preventing behaviour beyond the food domain in the COVID-19 pandemic in Germany

In the fight against the COVID-19 pandemic, personal hygiene behaviours such as proper handwashing have gained significantly more attention and interpersonal contact is performed with great care. Disgust, as a disease-avoidance mechanism, can play an important role in the promotion of hygiene behaviour. We know from previous research that pathogen disgust can be a predictor of an individual's behaviour in the pandemic. Given that the pandemic greatly affects our food and eating behaviour, the current study aims to add to the existing evidence and to complement it by investigating the role of food-specific disgust in the pandemic. For that, we conducted an online survey in Germany in April 2020, while the pandemic was spreading in Europe. A total of 519 participants completed the survey and provided information about their COVID-19-related attitudes and behaviours and about their food disgust sensitivity. The results show that food disgust sensitivity is an important predictor for an individual's feelings, shopping behaviour, and disease-preventive behaviour related to the COVID-19 pandemic. Given that the success of political measures to fight the pandemic critically depends on the population to support and follow the proposed measures, a better understanding of the factors driving individual behaviour is key. Implications for pandemic management are discussed.

Mechanisms underlying memory enhancement for disgust over fear

Disgust is remembered better than fear, despite both emotions being highly negative and arousing. But the mechanisms underlying this effect are not well-understood. Therefore, we compared two proposed mechanisms underlying superior memory for disgust. According to the memory consolidation mechanism, it is harder (but crucial) to remember potentially contaminating vs. threatening stimuli. Hence, disgust elicits additional memory consolidation processes to fear. According to the attention mechanism, it takes longer to establish if disgust (relative to fear) stimuli are dangerous. Hence, people pay more attention to disgust during encoding. Both mechanisms could boost memory for disgust. Ninety-eight participants encoded disgust, fear, and neutral images whilst completing a simple task to measure attention. After 10- or 45-min delay, participants freely recalled the images. We found enhanced memory for disgust relative to fear after 10- and 45-min delay, but this effect was larger after 45-min. Participants paid more attention to disgust than fear images during encoding. However, mixed effect models showed increased attention did not contribute to enhanced memory for disgust. Our results therefore support the memory consolidation mechanism.

Infectious diseases and social distancing in nature

Spread of contagious pathogens critically depends on the number and types of contacts between infectious and susceptible hosts. Changes in social behavior by susceptible, exposed, or sick individuals thus have far-reaching downstream consequences for infectious disease spread. Although "social distancing" is now an all too familiar strategy for managing COVID-19, nonhuman animals also exhibit pathogen-induced changes in social interactions. Here, we synthesize the effects of infectious pathogens on social interactions in animals (including humans), review what is known about underlying mechanisms, and consider implications for evolution and epidemiology.

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.

A cross-sectional survey to assess the risk factors associated with stigmatizing attitudes towards patients with podoconiosis among rural youth in southern Ethiopia

BACKGROUND

Many health conditions are associated with stigma due to beliefs about their causes and the physical changes experienced by patients. Among such conditions are several neglected tropical diseases (NTDs). Podoconiosis, classified as an NTD, is a form of lymphoedema caused by the co-influence of genetic and environmental factors. It is a major public health problem in Ethiopia and is associated with intense stigma. Despite this, little is known about the factors contributing to stigmatizing attitudes against patients with the disease.

METHODS

A cross-sectional survey was conducted in southern Ethiopia to analyse the attitudes of rural youth and associated risk factors for stigmatizing attitudes towards patients with podoconiosis, with the aim of informing stigma reduction strategies.

RESULTS

The survey included 336 randomly selected youth. Of the 177 (52.7%) youth who held more stigmatizing attitudes toward patients with podoconiosis, 105 (59.3%) were females and 171 (96.6%) did not have affected friends. Accurate knowledge about gene-environment influences and rejection of infectious causes of podoconiosis were associated with less stigmatizing attitudes.

CONCLUSIONS

Improving understanding of the gene-environment interaction and dispelling beliefs about infectious causes may reduce negative attitudes about podoconiosis. Affected youth may play an important role as agents of change to spread non-stigmatizing messages.

The Emotion of Disgust among Medical and Psychology Students

The emotion of disgust evolved as a way to protect oneself from illness and is associated with aspects of disease avoidance. Disgust Scale–Revised (DS-R) (Olatunji et al., 2008) measures the disgust propensity of three kinds of disgust (core, animal reminder, contamination). Contextual factors, such as academic background, might influence DS-R scoring, especially among medical students, where the notion of disease is central. We examined DS-R scoring and the choice of postgraduate studies in medical (n = 94) and psychology (n = 97) students. In an anonymous web-based survey, participants completed the DS-R and a questionnaire including plans for postgraduate studies. Females outnumbered males and scored higher in total DS-R score (p = 0.003). Psychology students scored higher in all three kinds of disgust (p < 0.001 for core disgust and animal reminder, p = 0.069 for contamination disgust), indicating a higher level of disease avoidance. Medical students willing to follow Internal Medicine scored higher in core disgust (p < 0.05), while psychology students willing to study Experimental Psychology scored lower in the animal reminder subscale (p = 0.019 and p < 0.001 for the association between these subscales and the orientation of Medical and Psychology Students, respectively). In conclusion, disgust propensity as rated by DS-R is related to academic background and orientation preferences in postgraduate studies.

Investigating the Effects of COVID-19 Quarantine in Migraine: An Observational Cross-Sectional Study From the Italian National Headache Registry (RICe)

Background: Previous studies during SARS and Ebola pandemics have shown that quarantine is associated with several negative psychological effects, such as post-traumatic stress symptoms, confusion, and anger. These conditions may affect the course of many diseases, including migraine. Although it is possible that the quarantine measures for the current COVID-19 pandemic affect migraine burden, no information is currently available on this issue. Aim: In this study, we aimed to: (1) explore the possible changes in migraine frequency, severity, and days with acute medication intake during quarantine period; (2) evaluate possible differences in migraine outcomes in consideration of lifestyle changes, emotions, pandemic diffusion, and COVID-19 infection. Methods: We interviewed patients who were included in the observational Italian Headache Registry (Registro Italiano Cefalee, RICE), retrospectively collecting information on main headache features, lifestyle factors, emotions, individual infection status, and perception of COVID-19 for 2 months before (pre-quarantine) and after the beginning of the quarantine (quarantine). Inclusion criteria were: age > 18, diagnosis of migraine without aura, migraine with aura and chronic migraine, last in-person visit more than 3 months preceding the beginning of quarantine. Results: A total of 433 migraine subjects agreed to be interviewed. We found an overall reduction in headache frequency (9.42 ± 0.43 days with headache vs. 8.28 ± 0.41) and intensity (6.57 ± 0.19 vs. 6.59 ± 0.21) during the quarantine, compared to pre-quarantine. There was a correlation between improvement and number of days of stay-at-home. When results were stratified for geographic area, we found a tendency toward worsening of headache frequency in northern Italy. Disgust regarding viral infection corresponded to a minor improvement in migraine. Conclusions: Migraine patients showed a mild improvement of migraine features, probably attributable to resilient behavior toward pandemic distress. Disgust regarding the contagion whereas potentially favoring defensive behavior, could potentially worsen migraine. The spontaneous limitation of migraine burden during quarantine could favor patient follow-up via the use of telemedicine visits, reliable diaries, and frequent remote contacts.

CRISPR: a journey of gene-editing based medicine

CRISPR (Clustered Regularly Interspaced Short Palindromic Repeat) is one of the hallmark of biological tools, contemplated as a valid and hopeful alternatives to genome editing. Advancements in CRISPR-based technologies have empowered scientists with an editing kit that allows them to employ their knowledge for deleting, replacing and lately “Gene Surgery”, and provides unique control over genes in broad range of species, and presumably in humans. These fast-growing technologies have high strength and flexibility and are becoming an adaptable tool with implementations that are altering organism’s genome and easily used for chromatin manipulation. In addition to the popularity of CRISPR in genome engineering and modern biology, this major tool authorizes breakthrough discoveries and methodological advancements in science. As scientists are developing new types of experiments, some of the applications are raising questions about what CRISPR can enable. The results of evidence-based research strongly suggest that CRISPR is becoming a practical tool for genome-engineering and to create genetically modified eukaryotes, which is needed to establish guidelines on new regulatory concerns for scientific communities.

Facial emotion recognition in people with schizophrenia and a history of violence: a mediation analysis

Evidence for an association between impaired facial emotion recognition and violence in people with schizophrenia is inconclusive. In particular, the role of misidentification patterns involving specific emotions such as anger and the influence of clinical characteristics on this association remain unclear. In this study, we compared facial emotion recognition performance in age- and gender-matched schizophrenia spectrum disorders subjects with (N = 52) and without (N = 52) a history of violence. Data on current symptom severity, Cluster B personality status, past victimization, and alcohol and substance misuse were also collected. Compared to those without, subjects with a history of violence showed worse facial emotion recognition performances, involving anger, fear, disgust, sadness, and happiness. When formally testing the reporting of angry faces, evidence of enhanced sensitivity to anger was not supported. Finally, when the impact of current symptoms was assessed, higher severity of activation symptoms, including motor hyperactivity, elevated mood, excitement and distractibility, mediated the relationship between history of violence and poor facial emotion recognition performance. As a whole, our findings seem to support the role of perceptual deficits involving different emotions as well as of a mediation played by activation symptoms. Facial emotion recognition deficits associated with the propensity to violence, as well certain symptoms mediating their relationship, should be targeted by specific treatment approaches.

Translating dignity principles into practice for continence care for older people in care homes: A study protocol

AIM

To develop, implement, evaluate, and disseminate an evidence-based, person-centred education program to protect the dignity of care-dependent older people with dementia and continence care needs in care homes.

DESIGN

A mixed method two-phase design underpinned by integrated knowledge translation.

METHODS

An education program that frames dignity as the main goal of continence care will be co-designed with a purposive sample of care home staff who provide or supervise continence care for care-dependent older people with dementia in care homes and resident relatives. The program will then be implemented and evaluated in a representative sample of care home staff to determine its clinical relevance, feasibility, acceptability, and effects on staff ratings of dignity in continence care; self-reported continence care practices and the person centeredness of the environment. Data analysis will include descriptive statistics (survey data) and thematic analysis (focus groups). Funding obtained November 2018. Ethics approval obtained May 2019.

DISCUSSION

This protocol outlines a mixed methods integrated knowledge translation protocol designed to translate principles about dignity into practice to improve the care of older people who are at risk of violations to their dignity in care homes. The outcome will be a contextually appropriate, evidence-based education program that protects the dignity of care-dependent older people who have dementia and continence care needs.

IMPACT

Based on a sound theoretical model, the education program will be contextually appropriate for use in the care homes setting and contribute to improving the overall quality and safety of care in this setting. It could also support and inform continence care for other individuals who are care dependent. Adopting an integrated knowledge translation approach to the design and delivery of the education program and piloting it will ensure the program is contextually relevant and sustainable.

Psychological states of COVID-19 quarantine

The psychological effects of mass quarantine following the COVID-19 lockdown are likely to be significant. Emotional and behavioural responses to quarantine are related to a psychological state of anxiety. These and other emotions are normal and may even be adaptive. The exceptional circumstances of a national lockdown provide an opportunity to develop mental health literacy in the form of psychological first aid, to enable wider awareness of how individuals can contribute to listening and supporting others psychologically. This has potential implications for skilling clinicians and the public about responding to mental distress. As frontline health-care workers, general practitioners may themselves need to be recipients of psychological first aid and support as they deal with adverse consequences of the quarantine period.

Consumer acceptance of novel food technologies

Novel food technologies are important for food security, safety and sustainability. Consumers, however, are often hesitant to accept them. In this narrative Review, we organize the research describing how heuristics and individual differences among consumers influence the acceptance of agri-food technologies. Associations evoked by a food technology, its perceived naturalness and trust in the industry using it influence consumer acceptance. Food neophobia, disgust sensitivity and cultural values are crucial personality factors for explaining individual differences. Using gene technology, nanotechnology, cultured meat and food irradiation as cases, we explore factors that may explain consumers' acceptance or lack of acceptance. Climate change, food supply shocks caused by crises such as pandemics and population growth are imminent threats to the food system. Therefore, disruptive food technologies will be needed to progress towards a more resilient food system. Taking into account the factors influencing consumers' perceptions of novel food technologies during the early stage of development and introduction will hopefully result in a higher acceptance of such technologies.

In sickness and in filth: Developing a disdain for dirty people

Cleanliness is universally valued, and people who are dirty are routinely marginalized. In this research, we measured the roots of negative attitudes toward physically unclean individuals and examined the differences that exist in these attitudes between childhood and adulthood. We presented 5- to 9-year-old children and adults (total N = 260) with paired photographs of a dirty person and a clean person, and we measured biases with a selective trust task and an explicit evaluation task. In Study 1, where images of adults were evaluated, both children and adults demonstrated clear biases, but adults were more likely to selectively trust the clean informant. Study 2 instead used images of children and included several additional tasks measuring implicit attitudes (e.g., an implicit association task) and overt behaviors (a resource distribution task) and also manipulated the cause of dirtiness to include illness, enjoyment of filth, and accidental spillage. Children and adults again revealed strong biases regardless of the cause of dirtiness, but only children exhibited a bias on the explicit evaluation task. Study 3 replicated these findings in India, a country that has historically endorsed strong purity norms. Overall, this research indicates that dirty people are targets of discrimination from early in development, that this is not merely a Western phenomenon, and that this pervasive bias is most strongly directed at individuals of similar ages.

Neuroanatomy of expressive suppression: The role of the insula

Expressive suppression is a response-focused regulatory strategy aimed at concealing the outward expression of emotion that is already underway. Expressive suppression requires the integration of interoception, proprioception, and social awareness to guide behavior in alignment with personal and interpersonal goals-all processes known to involve the insular cortex. Frontotemporal dementia (FTD) provides a useful patient model for studying the insula's role in socioemotional regulation. The insula is a key target of early atrophy in FTD, causing patients to lose the ability to represent the salience of internal and external conditions and to use these representations to guide behavior. We examined a sample of 59 patients with FTD, 52 patients with Alzheimer's disease (AD), and 38 neurologically healthy controls. Subjects viewed 2 disgust-eliciting films in the laboratory. During the first film, subjects were instructed to simply watch (emotional reactivity trial); during the second, they were instructed to hide their emotions (expressive suppression trial). Structural images from a subsample of participants (n = 42; 11 FTD patients, 11 AD patients, and 20 controls) were examined in conjunction with behavior. FreeSurfer was used to quantify regional gray matter volume in 41 empirically derived neural regions in both hemispheres. Of the 3 groups studied, FTD patients showed the least expressive suppression and had the smallest insula volumes, even after controlling for age, gender, and emotional reactivity. Among the brain regions examined, the insula was the only significant predictor of expressive suppression ability, with lower insula gray matter volume in both hemispheres predicting less expressive suppression. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Are unpopular children more likely to get sick? Longitudinal links between popularity and infectious diseases in early childhood

Social stress and inflammatory processes are strong regulators of one another. Considerable evidence shows that social threats trigger inflammatory responses that increase infection susceptibility in both humans and animals, while infectious disease triggers inflammation that in turn regulates social behaviours. However, no previous study has examined whether young children’s popularity and their rate of infectious disease are associated. We investigated the longitudinal bidirectional links between children’s popularity status as perceived by peers, and parent reports of a variety of infectious diseases that are common in early childhood (i.e. common cold as well as eye, ear, throat, lung and gastric infections). We used data from the ‘Matter of the First Friendship Study’ (MOFF), a longitudinal prospective multi-informant study, following 579 Norwegian pre-schoolers (292 girls, median age at baseline = six years) with annual assessments over a period of three years. Social network analysis was used to estimate each child’s level of popularity. Cross-lagged autoregressive analyses revealed negative dose–response relations between children’s popularity scores and subsequent infection (b = –0.18, CI = –0.29, –0.06, and b = –0.13, CI = –0.23, –0.03). In conclusion, the results suggest that children who are unpopular in early childhood are at increased risk of contracting infection the following year.

When Evolution Works Against the Future: Disgust's Contributions to the Acceptance of New Food Technologies

New food technologies have a high potential to transform the current resource-consuming food system to a more efficient and sustainable one, but public acceptance of new food technologies is rather low. Such an avoidance might be maintained by a deeply preserved risk avoidance system called disgust. In an online survey, participants (N = 313) received information about a variety of new food technology applications (i.e., genetically modified meat/fish, edible nanotechnology coating film, nanotechnology food box, artificial meat/milk, and a synthetic food additive). Every new food technology application was rated according to the respondent's willingness to eat (WTE) it (i.e., acceptance), risk, benefit, and disgust perceptions. Furthermore, food disgust sensitivity was measured using the Food Disgust Scale. Overall, the WTE both gene-technology applications and meat coated with an edible nanotechnology film were low and disgust responses toward all three applications were high. In full mediation models, food disgust sensitivity predicted the disgust response toward each new food technology application, which in turn influenced WTE them. Effects of disgust responses on the WTE a synthetic food additive were highest for and lowest for the edible nanotechnology coating film compared to the other technologies. Results indicate that direct disgust responses influence acceptance and risk and benefit perceptions of new food technologies. Beyond the discussion of this study, implications for future research and strategies to increase acceptance of new food technologies are discussed.

Don't be the "Fifth Guy": Risk, Responsibility, and the Rhetoric of Handwashing Campaigns

In recent years, outbreaks such as H1N1 have prompted heightened efforts to manage the risk of infection. These efforts often involve the endorsement of personal responsibility for infection risk, thus reinforcing an individualistic model of public health. Some scholars-for example, Peterson and Lupton (1996)-term this model the "new public health." In this essay, I describe how the focus on personal responsibility for infection risk shapes the promotion of hand hygiene and other forms of illness etiquette. My analysis underscores the use of constitutive and stigmatizing rhetoric to depict individual bodies, rather than environments, as prime sources of infection. Common among workplaces, this rhetoric provides the impetus for encouraging individual behavior change as a hedge against infection risk. I argue, though, that the mandating of personal responsibility for infection risk galvanizes a culture of stigma and blame that may work against the aims of public health.