Disgust and psychopathological symptoms in a nonclinical sample

Contamination-Focussed Vignettes as an Analogue of Infectious Pandemics: An Experimental Validation using the State Disgust and Anxiety Responses in OCD

Despite infectious pandemics proving particularly detrimental to those with Obsessive-Compulsive Disorder (OCD), the investigation of analogous experimental paradigms is lacking. To address this gap, we conducted two studies employing vignettes that depicted contamination-related situations commonly experienced during a pandemic (e.g., Coughing into hands and failing to use hand sanitizer). We manipulated the salience of these vignettes across three levels: high contamination, low contamination, and a neutral control condition. Our examination of state anxiety and disgust responses in all participants revealed the successful manipulation of the vignettes' impact. Specifically, individuals with more severe OCD symptoms reported significantly higher levels of state disgust and anxiety for both high and low contamination vignettes, in contrast to the group with lower symptom severity. No significant differences were observed in the neutral vignette condition between the high- and low-scoring groups. Interestingly, for those with higher OCD symptoms, high salience contamination-focused vignettes resulted in similarly elevated state disgust and anxiety, regardless of whether the vignettes were situated in public (Study 1) or domestic (Study 2) settings. This suggests that the heightened sensitivity to contamination-related scenarios observed in individuals with OCD symptoms in the present study is not confined to a specific context. These findings support the use of contamination-focused vignettes as analogues for studying infectious pandemics and provide valuable insights into OCD models, interventions, and future research.

Linking Pavlovian Disgust Conditioning and Eating Disorder Symptoms: An Analogue Study

Although the experience of disgust is commonly endorsed among women with eating disorders, it remains unclear how to best model this emotion in relation to disordered eating. The present study sought to identify potential disgust conditioning abnormalities that may underlie the development of eating disorder symptoms. Individuals high and low in eating disorder symptoms (HED, n = 19; LED, n = 18) completed a Pavlovian conditioning procedure in which one neutral food item (conditioned stimulus; CS+) was followed by disgusting videos of individuals vomiting (unconditioned stimulus; US) and another neutral food item (CS-) was not reinforced with the disgusting video. Following this acquisition procedure, there was an extinction procedure in which both CSs were presented unreinforced. The results showed that ratings of disgust, fear, and willingness to eat the CS+ and CS- did not significantly vary as a function of the conditioning phase for the LED group. However, the HED group rated the CS+ as significantly more disgusting and fear inducing than the CS- after the acquisition phase and this pattern persisted after extinction. These conditioning effects were also observed to be significantly larger for disgust compared to fear. The HED group also reported being significantly less willing to eat the CS+ compared to the CS- after the acquisition phase and this pattern also persisted after extinction. In the full sample, only discriminant disgust responding after acquisition was associated with the amount of calorie consumption over the 24-hour period after conditioning. These findings suggest that eating disorder symptoms may result from a heightened proneness to associate disgusting outcomes with otherwise neutral food items. This pattern of disgust learning may reinforce food avoidance in eating disorders and appears to be difficult to fully unlearn.

"The Fathers have eaten Sour Grapes, and the Children's Teeth are set on Edge": Differentiating the Emotional Experiences of Grima and Disgust

The Spanish term grima refers to the aversive emotional experience typically evoked when one hears, for example, a scratch upon a chalkboard. Whereas Spanish speakers can distinguish between the concepts of grima and disgust, English and German speakers lack a specific word for this experience and typically label grima as disgust. In the present research, we tested the degree of differentiation between the two aversive experiences in Spanish speakers. Study 1 addressed whether Spanish speakers apply spontaneously the term grima rather than disgust to grima-eliciting experiences. Study 2 systematically addressed the constitutive features of both grima and disgust by mapping their internal structures. Results showed that the noise of a chulk on a blackboard and scraping fingernails on a blackboard, along with the physical manifestation of goose bumps, were the most typical features of the category. Whereas both grima and disgust were characterized as unpleasant sensations, t(193) = 1.21, ns, they differed with respect to their physiological signatures (e.g., producing shivers was characteristic of grima, as compared to disgust, t(194) = 12.02, p = .001, d = 1.72) and elicitors (e.g., a fractured bone was a characteristic elicitor of grima; t(193) = 5.78, p = .001, d = .83, whereas pederasts and pedophiles were the most characteristic elicitor of disgust, t(193) = 8.46, p = .001, d = 1.21). Thus, both grima and disgust are conceptually different experiences, whose shared features hold different degrees of typicality. The present research suggests that grima and disgust are two distinct emotion concepts.

Disgust sensitivity mediates the effects of race on contamination aversion

African Americans report greater contamination aversion than European Americans. Few studies have attempted to identify potential causes for this elevated contamination aversion, though existing research and theory suggests this may be partly due to concomitant heightened disgust sensitivity. The present study examined the relations between race, disgust sensitivity, and contamination aversion among African and European Americans. A convenience sample of fourhundred and twenty-nine participants completed the Disgust Scale - Revised (DS-R) and the Padua Inventory - Revised (PI-R). African Americans endorsed greater disgust sensitivity (DS-R total) - particularly on the core and contamination subscales of the DS-R - and scored higher on the contamination subscale of the PI-R (but not on other subscales) than European Americans. Mediational analyses revealed a significant total effect of race on contamination aversion and a significant indirect effect of race on contamination aversion through disgust sensitivity; the direct effect of race on contamination aversion remained significant even after controlling for race. These findings suggest that elevated contamination aversions among African Americans may be partly due to elevated disgust sensitivity. If confirmed with larger and clinical samples, and more robust experimental methods, this relationship may prove to have implications for the treatment of contamination-based obsessive-compulsive disorder (OCD) among African Americans.

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.

Self-Disgust within Eating Disordered Groups: Associations with Anxiety, Disgust Sensitivity and Sensory Processing

This study aimed to assess the relationship between self-disgust and sensory processing within eating psychopathology. Five hundred and ninety-one women with a self-reported diagnosis of anorexia nervosa, bulimia nervosa or who had no previous history of an eating disorder completed a battery of online questionnaires measuring disgust, emotion and sensory variables. Those with an eating disorder reported significantly higher rates of self-disgust than those with no history of disordered eating. In groups of women with self-reported bulimia, self-disgust was associated with sensation avoidance and sensation seeking. Within the group with anorexia nervosa, self-disgust was associated with low registration and sensation seeking. This report is the first to examine the expression of the emotion self-disgust within eating psychopathology and examine associations of this factor with sensory processing. The emotion self-disgust needs to be further examined to understand its possible role in the onset and maintenance of disordered eating. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

Zusammenhänge zwischen Ekelempfindlichkeit, Ekelsensitivität und hypochondrischen Merkmalen

Theoretischer Hintergrund: Es gibt Hinweise, dass Ekelempfindlichkeit (Neigung, mit Ekel zu reagieren) und Ekelsensitivität (Neigung, Ekelempfindungen negativ zu bewerten) eine Rolle bei der Entstehung und Aufrechterhaltung der Hypochondrie spielen. Fragestellung: Besteht ein Zusammenhang zwischen Ekelempfindlichkeit bzw. Ekelsensitivität und hypochondrischen Merkmalen? Bleiben diese Zusammenhänge bei statistischer Kontrolle anderer Persönlichkeitseigenschaften bestehen? Methodik: Sechsundvierzig Probandinnen bearbeiteten folgende Fragebögen: Whiteley-Index (hypochondrische Merkmale), Fragebogen zur Erfassung der Ekelempfindlichkeit, Skala zur Erfassung der Ekelsensitivität, Angst-Sensitivitäts-Index, State-Trait-Angst-Depressions-Inventar (Ängstlichkeit). Ergebnisse: Es zeigten sich jeweils positive Zusammenhänge zwischen Ekelempfindlichkeit bzw. Ekelsensitivität und Krankheitsängsten. Auch nach Kontrolle des Lebensalters, Angstsensitivität und Ängstlichkeit konnten beide Ekeldomänen zusätzlich 12 % der Varianz von Krankheitsängsten aufklären. Schlussfolgerung: Die Bedeutung von Ekel für hypochondrische Merkmale erscheint größer als bisher angenommen.

Disgust: the disease-avoidance emotion and its dysfunctions

This review analyses the accumulating evidence from psychological, psychophysiological, neurobiological and cognitive studies suggesting that the disease-avoidance emotion of disgust is a predominant emotion experienced in a number of psychopathologies. Current evidence suggests that disgust is significantly related to small animal phobias (particularly spider phobia), blood-injection-injury phobia and obsessive-compulsive disorder contamination fears, and these are all disorders that have primary disgust elicitors as a significant component of their psychopathology. Disgust propensity and sensitivity are also significantly associated with measures of a number of other psychopathologies, including eating disorders, sexual dysfunctions, hypochondriasis, height phobia, claustrophobia, separation anxiety, agoraphobia and symptoms of schizophrenia--even though many of these psychopathologies do not share the disease-avoidance functionality that characterizes disgust. There is accumulating evidence that disgust does represent an important vulnerability factor for many of these psychopathologies, but when disgust-relevant psychopathologies do meet the criteria required for clinical diagnosis, they are characterized by significant levels of both disgust and fear/anxiety. Finally, it has been argued that disgust may also facilitate anxiety and distress across a broad range of psychopathologies through its involvement in more complex human emotions such as shame and guilt, and through its effect as a negative affect emotion generating threat-interpretation biases.

The association between health anxiety and disgust reactions in a contamination-based behavioral approach task

Existing evidence suggests that disgust is an important affective process related to health anxiety. The present study sought to determine the contribution of health anxiety symptoms in the prediction of disgust and behavioral avoidance in a large, nonclinical sample (N=156). Regression analyses showed that overall health anxiety symptoms predicted disgust on a behavioral approach task independent of gender, negative affect, and fear of contamination. Particularly, health anxiety-related reassurance seeking was found to be uniquely associated with disgust and behavioral avoidance after controlling for the aforementioned covariates. In addition, the interaction between health anxiety and contamination fear was tested, and remained significant when controlling for gender and negative affect. These results suggest that heightened contamination fear is associated with elevated disgust reactions such that high levels of health anxiety leads even those low in contamination fear to be disgusted during a behavioral task. These results are in line with previous research on the role of disgust in health anxiety.

Disgust propensity in obsessive-compulsive disorder: cross-sectional and prospective relationships

BACKGROUND AND OBJECTIVES

Findings from non-clinical samples suggest that disgust propensity is associated with contamination concerns in obsessive-compulsive disorder (OCD). However, studies of clinical samples have yielded conflicting results. We investigated the relationship between disgust propensity and OCD symptoms in a clinical sample and examined whether changes in disgust propensity are associated with changes in OCD symptoms.

METHODS

One hundred and nine OCD participants completed measures of disgust propensity and OCD symptoms. Sixty of these underwent a six-month follow-up assessment.

RESULTS

At the baseline assessment, disgust propensity was associated with all OCD symptom dimensions except hoarding. Changes in overall disgust propensity between baseline and the six-month follow-up assessment were associated with changes in overall self-reported OCD symptoms but not with changes in contamination-based OCD symptoms or changes in interviewer-assessed OCD symptoms.

LIMITATIONS

There was substantial participant attrition between the baseline and follow-up assessments.

CONCLUSIONS

Our study is the first to investigate prospective relationships between disgust propensity and OCD across a six-month interval. Our findings suggest that if there is an association between changes in disgust propensity and changes in contamination-based OCD symptoms its magnitude is likely to be small.

A delicious fly in the soup. The relationship between disgust, obesity, and restraint

Disgust is a core emotion that serves to protect one from engaging in activities that promote contamination and contracting disease. Since disgust is intimately connected to ingesting food, disgust sensitivity is probably also associated with dietary habits. The aim of the present study was to examine the relationship between obesity and disgust and between restraint and disgust. Participants (n=135, all female) were recruited and tested via the Internet. They indicated their desire to eat high-calorie foods and filled out several questionnaires assessing restrained eating and disgust sensitivity. We hypothesized that more restrained eaters would show increased disgust and that women with a higher BMI would show decreased disgust, which is what we found; that is, more restrained eaters showed increased core disgust and contamination disgust, whereas women with a higher BMI showed decreased core disgust and contamination disgust. Hence, feeling disgusted by food may be a strategy to uphold restraint, whereas relatively decreased disgust could encourage overeating.

Why disgust matters

The new synthesis about disgust is that it is a system that evolved to motivate infectious disease avoidance. There are vital practical and intellectual reasons why we need to understand disgust better. Practically, disgust can be harnessed to combat the behavioural causes of infectious and chronic disease such as diarrhoeal disease, pandemic flu and smoking. Disgust is also a source of much human suffering; it plays an underappreciated role in anxieties and phobias such as obsessive compulsive disorder, social phobia and post-traumatic stress syndromes; it is a hidden cost of many occupations such as caring for the sick and dealing with wastes, and self-directed disgust afflicts the lives of many, such as the obese and fistula patients. Disgust is used and abused in society, being both a force for social cohesion and a cause of prejudice and stigmatization of out-groups. This paper argues that a better understanding of disgust, using the new synthesis, offers practical lessons that can enhance human flourishing. Disgust also provides a model system for the study of emotion, one of the most important issues facing the brain and behavioural sciences today.

Fear- and disgust-related covariation bias and eating disorders symptoms in healthy young women

Covariation bias refers to the phenomenon of overestimating the contingency between certain stimuli and negative outcomes, which is considered as a heuristic playing a role in the maintenance of certain types of psychopathology. In the present study, an attempt was made to investigate covariation bias within the context of eating pathology. In a sample of 61 female undergraduates, a priori and a posteriori contingencies were measured between pictures of obese and slim bodies, on the one hand, and fear- or disgust-relevant outcomes, on the other hand. Results indicated that participants in general displayed an a priori and an a posteriori covariation bias reflecting an overestimation of the link between obese bodies and disgust-relevant outcomes. However, this bias was not related to eating disorder symptomatology. Meanwhile, eating pathology was positively associated with a priori covariation biases referring to the associations between obese bodies and fear-relevant outcomes, and between slim bodies and disgust-relevant outcomes. All in all, these findings suggest that covariation bias plays a role in eating pathology.

The Mediating Roles of Disgust Sensitivity and Danger Expectancy in Relation to Hand Washing Behaviour

Background: Recent interest in the role of vulnerability factors in obsessional washing has suggested that disgust sensitivity, danger expectancy and health anxiety may be of interest. Aims: This study explores the differential impact of these factors on both behavioural and cognitive measures of washing behaviour and is based on a replication of the Jones and Menzies (1997) experiment, during which participants immersed their hands in a noxious compound while rating themselves on a range of measures: the time they subsequently took to wash their hands was measured and danger expectancies were found to be the best predictor of this. Method: The present study added measures of disgust sensitivity and health anxiety to this experimental methodology while removing factors they found to be of little import to compulsive washing. Thirty non-clinical participants took part. Results: Results confirmed that disgust sensitivity was related to the behavioural measure of washing time, but that this relationship was almost entirely mediated by the danger expectancy concerning judgements of severity of consequent disease. However, a different pattern emerged when the outcome measure was questionnaire based: danger expectancy was not at all related to this. Disgust sensitivity mediated the relationship between health anxiety and scores on a questionnaire measure of washing compulsions. Interestingly, these scores were not related to the behavioural measure of washing time. Conclusions: The implications of these relationships to the further development of subtypes of Obsessive Compulsive Disorder (OCD) are discussed.

Is disgust associated with psychopathology? Emerging research in the anxiety disorders

Recent evidence indicates that the propensity towards experiencing disgust may contribute to the development and maintenance of some anxiety disorders. This article summarizes the empirical evidence with emphasis on illuminating potential mediators, moderators, and mechanisms of the disgust-anxiety disorder association that may inform the development of an integrative conceptual model. Early research using neuroimaging methods suggest that disgust processing is associated with activation of the insula. This research has the potential to facilitate progress in developing an empirically informed psychobiological theory on the causal role of disgust in the anxiety disorders.

Orienting and maintenance of gaze in contamination fear: Biases for disgust and fear cues

The present study examines the extent to which attentional biases in contamination fear commonly observed in obsessive-compulsive disorder (OCD) are specific to disgust or fear cues, as well as the components of attention involved. Eye tracking was used to provide greater sensitivity and specificity than afforded by traditional reaction time measures of attention. Participants high (HCF; n = 23) and low (LCF; n = 25) in contamination fear were presented with disgusted, fearful, or happy faces paired with neutral faces for 3 s trials. Evidence of both vigilance and maintenance-based biases for threat was found. The high group oriented attention to fearful faces but not disgusted faces compared to the low group. However, the high group maintained attention on both disgusted and fearful expressions compared to the low group, a pattern consistent across the 3 s trials. The implications of these findings for conceptualizing emotional factors that moderate attentional biases in contamination-based OCD are discussed.

Die Bedeutung von Ekel- und Angstsensitivität bei Personen mit der Verdachtsdiagnose einer Hypochondrie

Zentrales Merkmal bei der hypochondrischen Störung ist die Befürchtung, an einer schweren Erkrankung zu leiden. Dies führt zur Fehlinterpretation normaler Körperfunktionen. Neben dysfunktionalen Angstzuständen ist auch stark ausgeprägte Angstsensitivität störungsrelevant. Das aktuelle Hypochondriekonzept ist vorwiegend angstfokussiert, während die Bedeutung anderer Emotionen wie zum Beispiel von Ekel bisher kaum untersucht wurde. Ziel dieser Untersuchung war es herauszufinden, ob die habituelle Ekelneigung einen zusätzlichen Prädiktor für die Vorhersage von Hypochondrie darstellt. Nach einem Screening mit einem standardisierten klinischen Interview wurden 27 Personen mit und 27 Personen ohne Verdachtsdiagnose Hypochondrie in die Studie eingeschlossen und getestet. Mittels Diskriminanzanalyse wurde überprüft, ob Ekelempfindlichkeit (Neigung einer Person, mit Ekel zu reagieren) und Ekelsensitivität (Neigung, Ekelempfindungen als bedrohlich zu bewerten) für die Gruppentrennung in Personen mit und ohne Verdachtsdiagnose Hypochondrie (Kriterium: Whitely Index) relevant sind. Es zeigte sich, dass habituelle Angst, Ekelsensitivität und spezifische Bereiche der Ekelempfindlichkeit (z. B. Abneigung vor mangelhafter Hygiene) zwischen den beiden Gruppen differenzierten. Domänenspezifische Beziehungen zwischen Ekelempfindlichkeit und Hypochondrie werden diskutiert.

Disgust and eating disorder symptomatology in a non-clinical population: the role of trait anxiety and anxiety sensitivity

The present paper reports the results of a study investigating the relationship between a domains-independent measure of disgust (the Disgust Propensity and Sensitivity Scale-Revised) and measures of eating disorder symptomatology in a non-clinical population. Significant correlations between disgust sensitivity and disgust propensity and selected eating disorder symptomatology measures suggested that disgust is significantly correlated with measures of eating disorder symptomatology and is appraised more negatively. However, both measures of disgust propensity and sensitivity failed to predict any significant residual variance in scores on eating symptomatology measures when either trait anxiety or anxiety sensitivity was controlled for. This suggests that while the experience of disgust may be heightened in individuals with eating disorders, it may be linked to other relevant emotions such as anxiety and anxiety sensitivity rather than being an independent risk factor for symptoms.

Do obsessive compulsive symptoms mediate the relationship between maternal eating psychopathology and restrictive feeding practices?

OBJECTIVE

Symptoms of maternal eating disorders have been linked with the use of maladaptive restrictive child feeding practices. However, how these symptoms impact upon restriction in child feeding is poorly understood. The aims of this research were to assess whether symptoms of obsessive compulsiveness, which are often comorbid with eating disorder symptoms, mediate the relationships between maternal eating disorder symptoms and the use of restrictive feeding practices.

METHOD

A total of 128 mothers of children aged 2-6 years completed measures of their restrictive feeding practices, symptoms of eating disorders, and obsessive compulsiveness.

RESULTS

Maternal restriction was positively correlated with symptoms of drive for thinness, bulimia, and checking and cleaning obsessions and compulsions. Cleaning obsessions and compulsions mediated the relationships between maternal drive for thinness and feeding restriction.

CONCLUSION

Cleaning obsessions and compulsions may help to explain the relationships between some symptoms of maternal eating disorders and the use of restrictive feeding practices.

Disgust sensitivity and eating disorder symptoms in a non-clinical population

In order to further explore the relationship between disgust sensitivity and eating disorder symptoms, 2 studies were carried out. In the first study, 352 higher education students (166 women, 186 men) completed a set of questionnaires measuring various aspects of disgust sensitivity and eating disorder symptoms. A correlational analysis revealed that there were few significant correlations between disgust scales and eating pathology scores. One exception was the relation between disgust sensitivity and external eating behavior, although this link only emerged in women. To investigate this relationship in more detail, Study 2 confronted women high (n=29) and low (n=30) on external eating behavior with a series of disgusting and neutral pictures. It was hypothesized that women who scored high on external eating would display shorter viewing times of disgusting pictures (i.e., show more avoidance behavior) than women scoring low on external eating. However, this hypothesis was not confirmed by the data. Altogether, the results of these studies suggest that there seems to be no convincing relationship between disgust sensitivity and eating disorder symptomatology, thereby casting doubts on the role of this individual difference factor in the development of eating pathology.

The effect of disgust on anxiety ratings to fear-relevant, disgust-relevant and fear-irrelevant stimuli

This study investigated the effect of an experimental disgust induction and experience of a homophone spelling task on subsequent anxiety to fear-relevant, disgust-relevant and fear-irrelevant stimuli in a non-clinical population. The design of the study allowed an assessment of (1) whether disgust facilitates anxiety only if the stimulus being evaluated is disgust-relevant and (2) whether experiencing the threat-interpretation bias induced by disgust facilitates anxiety generally. The results indicated that a disgust induction facilitated levels of self-reported anxiety to a range of scenarios regardless of whether they were disgust-relevant, fear-relevant or fear-irrelevant, and regardless of whether participants had experienced the disgust-induced threat-interpretation bias. This study provides evidence for a general effect of disgust on self-reported anxiety to stimuli regardless of the disgust-relevance or fear-relevance of those stimuli. The results lend support to the view that disgust has a causal effect on anxiety, and implicates disgust as a risk factor for anxious psychopathology.

Trait anxiety, disgust sensitivity, and the hierarchic structure of fears

This paper describes an evaluation of Taylor's (1998) hierarchic model of fears and its relationship to trait anxiety and disgust sensitivity (DS). In Study 1 (N=420), a confirmatory factor analysis supported a hierarchic structure of fears. Next, an analysis using structural equation modeling indicated that trait anxiety is associated with claustrophobic and social fears, whereas DS is associated with all four fear subtypes examined (claustrophobic, social, blood-injection-injury and animal). However, trait anxiety and DS did not account for all variance shared by fear subtypes. The addition of a generalized "fear factor" accounted for significant residual shared variance between the four fear subtypes, beyond that accounted for by trait anxiety and DS. Study 2 (N=213) generally replicated these results. Findings suggest that the hierarchic structural model of fears would benefit from inclusion of trait anxiety and DS as higher-order contributors to fearfulness.

Disgust sensitivity and psychopathological symptoms in non-clinical children

There is clear evidence in the adult literature that disgust sensitivity is implicated in various psychopathological syndromes. The current study examined the link between disgust sensitivity and psychopathological symptoms in youths. In a sample of non-clinical children aged 9-13 years, disgust sensitivity was assessed by two self-report questionnaires (i.e., the Disgust Scale and the Disgust Sensitivity Questionnaire) and a behavioural test. Furthermore, children completed scales for measuring the personality trait of neuroticism and various types of psychopathological symptoms. Results showed that disgust measures had sufficient to good convergent validity. Further, significant positive correlations were found between disgust sensitivity and symptoms of specific phobias (i.e., spider phobia, blood-injection phobia, small-animal phobia), social phobia, agoraphobia, obsessive-compulsive disorder (OCD), and eating problems, and these links were not attenuated when controlling for neuroticism. The possible role of disgust sensitivity in the aetiology of child psychopathology is discussed.

Disgust sensitivity as a predictor of obsessive-compulsive contamination symptoms and associated cognitions

Disgust sensitivity has been hypothesized to play a key role in the etiology and maintenance of several anxiety disorders. The association between disgust sensitivity, trait anxiety, and washing and contamination-related concerns was tested using two different measures of obsessive-compulsive contamination fears using linear structural modeling. Two different models were tested, one where trait anxiety mediated the relationship between disgust sensitivity and contamination fear, and a second model unmediated by trait anxiety. A total of 740 undergraduates completed self-report measures of disgust sensitivity, trait anxiety, and obsessive-compulsive symptoms for course credit. The results indicated that there was insufficient evidence for the mediating role of trait anxiety, and the more parsimonious structural models specifying direct effects between disgust sensitivity and both washing and contamination concerns fit the data well. The results of this research support the central role of disgust in contamination fear.

Does disgust enhance eating disorder symptoms?

In the present study, the hypothesized causal relationship between disgust and eating pathology was investigated. Female undergraduates were either assigned to an experimental condition in which feelings of disgust were induced by means of a bad smelling odorant, or to a control condition in which no such disgust manipulation was carried out. Both groups completed questionnaires for measuring various eating disorder-related concepts (i.e., body esteem, restraint eating, and body change strategies). In addition, explicit and implicit preferences for high-caloric food were measured. Results demonstrated that women in the experimental condition did not report lower levels of body esteem, and neither showed higher levels of restraint eating or other body change strategies. Furthermore, they did not display a decreased explicit or implicit preference for high-caloric food. Thus, in the present study no indication for a causal relation between disgust and eating disorder symptoms in young females was found.

Mechanisms of change in ERP treatment of compulsive hand washing: does primary threat make a difference?

The present study sought to examine patterns of habituation in exposure and response prevention (ERP) treatment of compulsive hand washing. Sub-clinical compulsive washers (n=27) with illness or non-illness primary threats were compared in order to detect potential differences in response to a single session of ERP. Changes in anxiety, disgust, and urge to wash were analyzed, and significant reductions in both anxiety and disgust were noted. Urge to wash significantly declined among washers primarily concerned with illness; among those concerned with non-illness threats, urge to wash did not significantly decline. Moreover, anxiety was found to decline when controlling for disgust and vice versa. Lastly, when both anxiety and disgust were entered into a model predicting changes in urge to wash, anxiety but not disgust predicted urge to wash for those with illness-related threats; for washers with non-illness threats, the findings were the reverse. Several clinical and theoretical implications are discussed.

Experienced disgust causes a negative interpretation bias: A causal role for disgust in anxious psychopathology

This paper reports the results of an experiment investigating the effect of induced disgust on interpretational bias using the homophone spelling task. Four groups of participants experienced a disgust, anxiety, happy or neutral mood induction and then completed the homophone spelling task which requires the participant to interpret ambiguous words presented through headphones. Both the disgust and anxiety groups interpreted significantly more threat/neutral homophones as threat than both the happy and neutral groups; the disgust group also interpreted significantly fewer positive/neutral homophones as positive than the happy group. These findings are consistent with the view that induced disgust causes a negative interpretational bias which is similar to that reported for anxiety. The results could not be interpreted in terms of the disgust induction concurrently raising levels of self-reported anxiety, but could be interpreted in terms of disgust maintaining existing levels of anxiety. The effect of disgust was to facilitate negative interpretations rather than emotional interpretations regardless of valence. These findings provide the basis for a causal role for disgust in anxious psychopathology. Because the effect is a non-specific emotion-congruent one, elevated disgust levels will result in a predisposition to interpret information in a threatening way across a broad range of anxious- and threat-relevant domains.

The neurocircuitry of obsessive-compulsive disorder and disgust

Recent evidence from human research has indicated that discrete regions of the brain control different basic emotions. Whether the recognition and formulation of emotions truly stem from compartmentalized systems or arise from a multidimensional framework has yet to be elucidated, however. Disgust is a basic emotion that has been hypothesized to constitute an evolutionary function of contamination and disease avoidance. Disgust involves the appraisal of objects and events for their potential role in contamination, and OCD conceivably involves a dysfunction of this appraisal process. Disgust sensitivity has been shown to be positively correlated with OCD and to significantly predict contamination fear. Likewise, functional imaging studies of OCD patients with contamination concerns demonstrate activation of the same neural regions with disgust-inducing pictures as symptom relevant stimuli. Therefore, the neurocircuits involved in disgust processing may be relevant to OCD and, in particular, the contamination subtype. This review focuses on describing what is known to date concerning the neurocircuitry of disgust, and its relevance to the apparent neurocircuitry of OCD.

Using controlled comparisons in disgust psychopathology research: the case of disgust, hypochondriasis and health anxiety

The present paper describes the results of a study investigating the relationship between measures of disgust and measures of hypochondriasis and health anxiety. The results indicated that (1) there were highly significant correlations between measures of trait disgust and disgust sensitivity and measures of hypochondriasis and health anxiety, (2) the relationship between disgust sensitivity measures and hypochondriasis and health anxiety were still significant even when levels of trait anxiety were controlled for, but (3) controlled comparisons revealed that the measures of disgust also predicted scores on measures of disgust-irrelevant control psychopathologies (claustrophobia and height phobia)--even after trait anxiety had been partialled out. In addition, the series of multiple regressions carried out clearly indicated that trait anxiety and disgust sensitivity appear to be independent constructs each of which have relationships with anxious psychopathologies over and above the effect of the other. The discussion explores the nature of the possible relationships between disgust, hypochondriasis and health anxiety, and also looks at the implications for disgust psychopathology research of using controlled comparisons which indicate the existence of significant relationships between measures of disgust and anxious psychopathologies that, a priori, would be considered to be disgust irrelevant.

The role of cognitions, trait anxiety and disgust sensitivity in generating faintness around blood-injury phobic stimuli

The effects on blood-injury fear and fainting of scripts concerning pain, nausea, and anger and individual differences in trait anxiety and disgust sensitivity were investigated. Eighteen participants were high in disgust sensitivity and trait anxiety, 11 were low in disgust sensitivity but high in trait anxiety, 10 were high in disgust sensitivity but low in trait anxiety, and 16 were low in disgust sensitivity and trait anxiety. Participants were exposed to pain, nausea, and anger scripts during presentation of blood-injury slides. The ability of the scripts to increase symptoms of fear and faintness, on a state version of the Blood-Injection Symptom Scale (BISS; Page, A. C., Bennett, K. S., Carter, O., Smith, J., & Woodmore, K. (1997). Blood-Injection Symptom Scale (BISS): Assessing the structure of phobic symptomatology elicited by blood and injections. Behaviour Research and Therapy, 35, 457-464) were examined. Analyses indicated that individual differences in trait anxiety and disgust sensitivity interact to generate symptoms of faintness when the pain script was read. That is, disgust sensitive and trait anxious participants reported greater faintness relative to other conditions. The implications for theory and treatment of blood-injury-injection phobia are discussed.

A Treatment Most Foul: Handling Disgust in Cognitive-Behavior Therapy

The nature of disgust as it relates to psychopathology is described. Evaluative conditioning, an important theory for understanding the acquisition and maintenance of disgust reactions, is discussed, and linked with the general theory of disgust by Rozin and Fallon (1987). The empirical literature on the role of disgust in psychopathology, primarily phobias and general problems of fearful avoidance, is covered, as well as cognitive biases and distortions. Finally, a hierarchy of psychopathology influenced by disgust is presented.

Behavioral avoidance tests and disgust in contamination fears: distinctions from trait anxiety

Much of the existing literature examining the role of disgust is limited to specific phobia. Recent research has begun to examine the role of disgust in contamination fear, a subtype of obsessive-compulsive symptoms. Through the use of behavioral avoidance tasks (BATs), the current study was designed to examine the role of disgust in people with contamination fears, with attention to distinguishing high and low trait anxiety. From a large screening of undergraduate students, three groups were formed based on their level of contamination fear and level of trait anxiety: contamination fearful ( n = 12 ), high-trait anxiety ( n = 11 ), and low trait anxiety ( n = 15 ). Subjects were asked to engage in six different BATs corresponding to six domains of disgust (food, animals, body products, body envelope violations, death, and sympathetic magic). One-way analysis of variance (ANOVA) showed significant differences between the contamination fearful group and the high trait anxiety group on the animal and sympathetic magic BATs. Significant differences on the food, animal, body envelope violations, and death BATs were also found between the contamination fearful group and the low-trait anxious group. The findings modestly support the importance of disgust in contamination fears. Implications for the study of disgust in contamination fear are provided.

Disgust domains in the prediction of contamination fear

Previous research has shown a relationship between the emotion of disgust and the fear of contamination. Heightened sensitivity to disgust and increased concerns over contamination has been observed in various disorders, such as obsessive-compulsive disorder (OCD) and specific phobias. However, there is a paucity of research identifying the specific domains of disgust that contribute to contamination fear. The present study soughts to determine which domains of disgust elicitors reliably predict scores on a measure of OCD contamination obsessions and washing compulsions. We further conducted exploratory analyses that examined differences in disgust sensitivity among individuals classified as high and low in contamination fear. Three hundred and twenty-three undergraduate participants completed two measures of disgust sensitivity (Disgust Scale; Disgust Emotion Scale) and a measure of contamination fear (Padua inventory, contamination obsessions and washing compulsions subscale). Stepwise multiple regression analyses indicated that contamination fear was best predicted by seven different disgust domains, thereby suggesting that contamination fear is accounted for by generalized, rather than domain-specific, disgust elicitors. The categories of disgust that predicted contamination fear appeared to have an underlying commonality of threat of contagion. The relationship between fear of contamination and disgust sensitivity was more pronounced for animal reminder disgust elicitors as opposed to core disgust elicitors. Results also showed that individuals classified as high in contamination fear scored significantly higher than the low contamination fear group on all disgust domains. Clinical and research implications regarding the interrelationships between fear, disgust, and the fear of contamination are discussed.