The Body Odor Disgust Scale (BODS): Development and Validation of a Novel Olfactory Disgust Assessment

Italian validation of the body odor disgust scale

Introduction

Disgust sensitivity to body odors plays a role in a set of psychological mechanisms supposedly evolved to avoid pathogens. To assess individual differences in body odor disgust, we previously developed the body odor disgust scale (BODS) and validated it in English. The BODS presents six scenarios where disgust could be evoked by smells coming from an internal source and an external source. The present study aimed to validate the BODS in the Italian population and to find further evidence for its structural, construct, and criterion validity.

Methods

We used two large samples (N = 1,050, F = 527; and N = 402, F = 203, respectively) that were representative of the Italian population for sex and age.

Results

Across these two studies, we confirmed the hypothesized bifactor structure, with all the items loading onto a general body odor disgust sensitivity factor, and on two specific factors related to the internal structure. In terms of construct validity, we found that the BODS converged with pathogen disgust sensitivity of the three-domain disgust scale (TDDS) but was distinct from a general propensity to experience negative emotions. The BODS showed criterion validity in predicting the behavioral intentions toward COVID-19 avoidance behavior, although it did not seem to be incrementally valid when compared to the TDDS pathogen subscale. We also established scalar measurement invariance of the BODS regarding gender and found that women display higher levels of BODS.

Discussion

Results from the Italian version of the BODS indicate its structural, construct, nomological and criterion validity. Furthermore, our result on sex differences in disgust sensitivity are consistent with previous literature, and we discuss them in the broader context of cross-cultural and primate findings that points toward a possible evolutionary explanation of this difference.

Epidemiological analysis of axillary apocrine bromhidrosis in China: a survey from Chinese higher education students

Background

There are few epidemiological data on axillary apocrine bromhidrosis (AAB) in the Chinese population, making it impossible to accurately estimate its prevalence or impact on individuals.

Objective

To estimate the prevalence of AAB in China, and to survey and compare the psychological status of individuals with and without AAB.

Methods

Students in several universities in China were surveyed online for AAB, and the prevalence of AAB was calculated. The Symptom Checklist 90 (SCL-90) was used to evaluate the psychological status.

Results

The prevalence of AAB in the surveyed students was 7.5% (194/2571). The projected number of Chinese higher education students with AAB was about 3 million. The onset age of AAB was mainly between 11 and 20 years old (79.90%, 155/194). 68.04% (132/194) of individuals with AAB had a positive family history, and 60.30% (117/194) had wet earwax. Individuals with AAB often felt depression, anxiety, loneliness and social alienation, and scored significantly higher on the nine primary psychological symptom dimensions than individuals without AAB.

Conclusion

AAB affects a small proportion but large numbers of Chinese population. China and the West or East-Asia and the West have different perception, recognition and treatment preferences for AAB.

Relationship between disgust and orthorexia nervosa and psychometric properties of the Italian Dusseldorf orthorexia scale in a general population sample

BACKGROUND

It remains unclear among clinicians and researchers whether orthorexia nervosa (ON) is a part of the obsessive-compulsive disorder spectrum or eating disorders. Disgust seems to be a shared psychopathological factor in these clinical presentations, indicating a potentially crucial role in ON. On the other hand, numerous psychometric tools have been developed to evaluate ON. The Dusseldorf Orthorexia Scale (DOS) was recently validated in an Italian sample. However, the study's primary limitation was that the scale was only administered to undergraduate university students. This study aimed to investigate the psychometric properties (including factorial structure, reliability, and measurement invariance conditional on sex) of the Italian version of the DOS (I-DOS) on a sample from the general population. Additionally, the study sought to determine the nomological validity of the I-DOS by examining its relationship with disgust sensitivity.

METHODS

A sample of 521 participants took part in this study and completed a battery that assessed ON and disgust sensitivity. To assess the I-DOS structure, reliability, and measurement invariance we respectively conducted confirmatory factor analysis (CFA), computed McDonalds's omega, and performed hierarchical series of multigroup CFAs. Then, we tested the relationship between ON and disgust sensitivity.

RESULTS

CFA confirmed the unifactorial model of I-DOS and it respected the configural, metric, and strict invariance while a partial scalar invariance was achieved. It also showed good reliability with an omega of 0.87. In addition, we found a positive relationship between ON and disgust sensitivity, thus confirming the nomological validity of I-DOS.

CONCLUSIONS

Our findings suggest that the Italian version of the Dusseldorf orthorexia scale (I-DOS) exhibits strong psychometric properties and can be an effective instrument for assessing ON in a general population sample. Notably, the most significant and innovative outcome was the positive correlation between ON and disgust sensitivity. As disgust has been linked to other clinical presentations, this preliminary result could serve as a foundation for future research exploring this phenomenon in greater detail.

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

Background and objectives

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

Methodology

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

Results

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

Conclusion

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

Odor Hedonic Profile (OHP): a self-rating tool of everyday odors

Odor hedonic estimation (pleasant/unpleasant) is considered the first and one of the most important dimensions in odor perception. Although there are several published scales that rate odor hedonicity, most of them use odorants that induce biases related to stimulus properties or test conditions and make difficult clinical or industrial applications. Thus, this study aimed to propose a model of odor hedonic profile (OHP) based on 14 items related to everyday odors without stimulus. The OHP is a self-rating tool based on the hedonic estimate representation and allows the determination of specific profiles, i.e., "conservative," "neutral," "liberal," "negative olfactory alliesthesia," and "positive olfactory alliesthesia." It can be useful in different contexts (e.g., food studies) and general pathologies (e.g., eating disorders) or pathologies with mood/emotional disturbances (e.g., depression).

Body odour disgust sensitivity is associated with xenophobia: evidence from nine countries across five continents

Body odour disgust sensitivity (BODS) reflects a behavioural disposition to avoid pathogens, and it may also involve social attitudes. Among participants in the USA, high levels of BODS were associated with stronger xenophobia towards a fictitious refugee group. To test the generalizability of this finding, we analysed data from nine countries across five continents (N = 6836). Using structural equation modelling, we found support for our pre-registered hypotheses: higher BODS levels were associated with more xenophobic attitudes; this relationship was partially explained by perceived dissimilarities of the refugees' norms regarding hygiene and food preparation, and general attitudes toward immigration. Our results support a theoretical notion of how pathogen avoidance is associated with social attitudes: 'traditional norms' often involve behaviours that limit inter-group contact, social mobility and situations that might lead to pathogen exposure. Our results also indicate that the positive relationship between BODS and xenophobia is robust across cultures.

Longitudinal changes in disgust sensitivity during pregnancy and the early postpartum period, and the role of recent health problems

Disgust is an essential part of the behavioral immune system, protecting the individual from infection. According to the Compensatory Prophylaxis Hypothesis (CPH), disgust sensitivity increases in times of immunosuppression, potentially including pregnancy. We aimed to replicate a previous study observing longitudinal changes in disgust sensitivity in pregnant women. Additionally, for the first time, we explored how recent health problems influence these changes. To do this, we obtained disgust sensitivity measures from 94 women in each trimester and in early postpartum. In contrast to the original study, where disgust sensitivity was highest in the first trimester, we found that overall and animal reminder disgust increased across pregnancy and after birth. In line with the CPH, women who were recently sick in the first trimester had elevated disgust sensitivity at that time. Although disgust sensitivity was significantly higher in the second trimester and postpartum period compared to the first trimester in mothers pregnant with a male fetus, the overall results regarding the effect of fetus sex on disgust sensitivity were mixed. It seems that changing levels of disgust sensitivity during pregnancy and postpartum result from a suite of physiological and psychological changes that occur during this sensitive period of a woman's life.

Disgust sensitivity in early pregnancy as a response to high pathogen risk

Introduction

Considered a part of the behavioral immune system (BIS), disgust sensitivity is expected to be adjusting as a response to the actual level of the environmental health risks.

Methods

In this preregistered study, we tested the hypothesis that disgust sensitivity would be higher during the COVID-19 pandemic compared to the pre-pandemic period in pregnant women. In this between-subject study with a longitudinal trend design, we administered the Disgust Scale-Revised to 200 pregnant women before the pandemic and to 350 pregnant women during the pandemic.

Results

We found a small but significant effect of the pandemic on disgust sensitivity, such that higher disgust sensitivity was found in women pregnant during the pandemic. This effect was stronger in primiparae, however, the interaction between parity and the pandemic period was not significant. Disgust sensitivity decreased with age. No differences in terms of nausea and vomiting were found between the women pregnant before and during the pandemic.

Discussion

Our findings indicate that although BIS is presumed to function as a complex mechanism to prevent health-threatening behaviors, its activation in pregnant women during the COVID-19 pandemic is rather weak.

Development and Psychometric Validation of the Taste And Smell Tool for Evaluation (TASTE) Questionnaire

Importance

The human senses of taste and smell are essential in everyday life. However, as clinical testing of the senses and patient-reported sensory problems are often diverging, additional validated questionnaires are essential for the evaluation of chemosensory impairments.

Objective

To develop an instrument with all relevant domains concerning chemosensory dysfunction and quality of life using modern psychometrics.

Design, Setting, and Participants

The study was designed as a questionnaire study for developing a new instrument. The study started in 2019 and was completed in 2022. Patients with chemosensory dysfunction were recruited from a specialized smell and taste clinic at an ear, nose, and throat department in Denmark. Healthy participants with no history of chemosensory dysfunction were recruited through social media.

Main Outcomes and Measures

Eight domains were included (distorted chemosensation, emotional, food and meals, social, hygiene, danger, work, and relationship), and 35 items were generated based on review of the existing literature and interviews with patients and experts. Participants were tested with the Major Depression Inventory, 36-Item Short Form Health Survey, Taste Sprays, and Sniffin' Sticks for chemosensory function. Descriptive statistics were calculated for all items. Reliability, internal consistency, and validity were investigated, and a Rasch model was fitted. Healthy controls (n = 39) filled out the questionnaire for comparison of known-groups validity. Confirmatory factor analysis was performed. Finally, item reduction was performed, resulting in a final version with 21 items in 8 domains.

Results

The study included responses from 316 patients, 183 women (58%) and 133 men (42%), with a mean (SD) age of 57 (15.1) years. Rasch model fit was acceptable with P > .05 for all items. An 8-dimensional confirmatory factor analysis model showed a better fit than a bifactor confirmatory factor analysis model. Cronbach α ranged from 0.65 to 0.86. Criterion validity with the Sniffin' Sticks, Taste Sprays, Major Depression Inventory, and the 36-Item Short Form Health Survey was satisfactory. The test-retest reliability was good in all domains, ranging from 0.55 to 0.86. All domains were discriminative, except the social and work domains.

Conclusions and Relevance

In this survey study, the instrument was validated with 8 domains related to chemosensory dysfunction and quality of life. All items had good internal consistency, test-retest reliability, interitem correlations, item-total correlations, and Rasch model fit. The questionnaire appears suitable for use in clinical and research settings.

The Scent of Monogamy: Self-Reported Olfactory Function Predicts Sexual Well-Being and Infidelity in an Italian Population

Previous studies have shown that olfactory function plays an essential role in the bonding of a romantic relationship. Body odors, in particular, seem involved in both mate choices and other intimate behaviors. Our sense of smell is also crucial to detect possible pathogen threats, by activating a suitable disgust reaction. Previous studies have shown that disgust sensitivity is negatively related to sociosexuality, and disgust generally inhibits our sexual drive. In the present study, we explored the possible relation between olfactory function, pathogen disgust sensitivity, sociosexuality, sexual well-being, and infidelity through a web survey. Our exploratory analyses found that, in a large Italian sample (N = 1107), among those in a stable relationship, self-reported olfactory function predicted sexual well-being (p < .05) and negatively predicted infidelity (p < .05) when controlling for other relevant sociodemographics variables. Moreover, the relation between self-reported olfactory function and sexual well-being was mediated by pathogen disgust sensitivity. Although significant, these results must be interpreted with caution, because the effect sizes were small.

The social odor scale: Development and initial validation of a new scale for the assessment of social odor awareness

The degree of attention individuals pay to olfactory cues (called odor awareness) influences the role of odors in everyday life. Particularly, odors produced by the human body (i.e., social odors) are able to carry a wide variety of information and to elicit a broad spectrum of emotional reactions, making them essential in interpersonal relationships. Hence, despite the assessment of awareness toward social odors is crucial, a proper tool is still lacking. Here, we designed and initially validated the Social Odor Scale (SOS), a 12-item scale designed to measure the individual differences in awareness towards different social odors. In Study 1, an exploratory factor analysis (EFA; KMO test: MSA = 0.78; Bartlett's test: χ2(78) = 631.34, p < 0.001; Chi-squared test: χ2(42) = 71.84, p = 0.003) suggests that the three factors structure was the model that best fit with the Italian version of the scale. The confirmatory factor analysis (CFA) supports a second-order model with one higher-order factor representing social odor awareness in general and three lower-order factors representing familiar, romantic partner, and stranger social odors. The final version of the scale presented a good fit (RMSEA = 0.012, SRMR = 0.069, CFI = 0.998, TLI = 0.997). In Study 2, CFA was performed in the German version of the scale confirming the validity of scale structure. Study 3 and 4 revealed that SOS total score and its subscales were positively correlated with other validated olfactory scales, but not with olfactory abilities. Moreover, SOS was found to be related to the gender of the participants: women reported to be more aware to social odors and, specifically, to familiar social odors than men. Overall, the results indicated that SOS is a valid and reliable instrument to assess awareness toward social odors in everyday life.

Sex Differences in Odor Hedonic Perception: An Overview

Odor hedonic evaluation (pleasant/unpleasant) is considered as the first and one of the most prominent dimension in odor perception. While sex differences in human olfaction have been extensively explored, gender effect in hedonic perception appears to be less considered. However, a number of studies have included comparisons between men and women, using different types of measurements (psychophysical, psychophysiological,…). This overview presents experimental works with non-specific and body odors separately presented as well as experimental studies comparing healthy participants vs patients with psychiatric disorders. Contrary to sensitivity, identification or discrimination, the overall literature tends to prove that no so clear differences occur in odor hedonic judgment between men and women. On the whole, gender effect appears more marked for body than non-specific odors and is almost never reported in psychiatric diseases. These findings are discussed in relation to the processes classically implied in pleasantness rating and emotional processes.

A Review of the Effects of Valenced Odors on Face Perception and Evaluation

How do valenced odors affect the perception and evaluation of facial expressions? We reviewed 25 studies published from 1989 to 2020 on cross-modal behavioral effects of odors on the perception of faces. The results indicate that odors may influence facial evaluations and classifications in several ways. Faces are rated as more arousing during simultaneous odor exposure, and the rated valence of faces is affected in the direction of the odor valence. For facial classification tasks, in general, valenced odors, whether pleasant or unpleasant, decrease facial emotion classification speed. The evidence for valence congruency effects was inconsistent. Some studies found that exposure to a valenced odor facilitates the processing of a similarly valenced facial expression. The results for facial evaluation were mirrored in classical conditioning studies, as faces conditioned with valenced odors were rated in the direction of the odor valence. However, the evidence of odor effects was inconsistent when the task was to classify faces. Furthermore, using a z-curve analysis, we found clear evidence for publication bias. Our recommendations for future research include greater consideration of individual differences in sensation and cognition, individual differences (e.g., differences in odor sensitivity related to age, gender, or culture), establishing standardized experimental assessments and stimuli, larger study samples, and embracing open research practices.

It's not you, it's me - disgust sensitivity towards body odor in deaf and blind individuals

Disgust might be elicited by various sensory channels, including the sense of smell. It has been previously demonstrated that unpleasant odors emitted by an external source are more disgusting than those emitted by oneself (the source effect). As disgust's main purpose is to help organisms avoid potentially dangerous, contaminating objects, individuals with visual or hearing sensory impairment (thus, with an impeded ability to detect cues indicating pathogen threat) might have developed an increased levels of olfactory disgust sensitivity (modality compensation in disgust sensitivity). We set out to investigate disgust sensitivity in olfaction using the Body Odor Disgust Scale (BODS) on a large sample of 74 deaf and 98 blind participants, with comparison to control groups without sensory impairment (N = 199 in total). The results did not support the hypothesis of modality compensation in disgust sensitivity. Contrary to previous research, neither sex nor age influenced the outcomes. Evidence for the source effect was found. Acquired data are interpreted in the light of social desirability. The emphasis put on the olfaction by blind and deaf individuals is discussed.

An Overprotective Nose? Implicit Bias Is Positively Related to Individual Differences in Body Odor Disgust Sensitivity

Body odors are universal elicitors of disgust, a core emotion that plays a key role in the behavioral immune system (BIS) - a set of psychological functions working to avoid disease. Recent studies showed that body odor disgust sensitivity (BODS) is associated with explicit xenophobia and authoritarianism. In the current experimental pre-registered study (https://osf.io/6jkp2/), we investigated the association between olfactory pathogen cues, BODS and implicit bias toward an outgroup (tested by an implicit association test). Results show that BODS is positively related to implicit bias toward an outgroup, suggesting that social attitudes may be linked to basic chemosensory processes. These attitudes were not influenced by background odors. Additionally, BODS was related to social, but not economic conservatism. This study extends the BIS framework to an experimental context by focusing on the role of disgust and body odors in shaping implicit bias.

Disease Threat and the Functional Flexibility of Ingroup Derogation

While the findings from previous studies directly relate the ingroup derogation phenomenon to the evolved response of the behavioral immune system, there are three major limitations in the previous studies on the functional flexibility of ingroup derogation. The present study further investigated the functional flexibility of ingroup derogation by conducting three behavioral experiments on Chinese participants. In Experiment 1, we tested whether exposing to situational disease primes leads to an exaggerated ingroup derogation attitude by adopting a more rigorous control. In Experiment 2, we manipulated the source of disease threats to test whether the ingroup derogation mechanism adjusts its response according to the specific perceived vulnerabilities to the disease threats posed by ingroup and outgroup members. In Experiment 3, we tested whether recent illness promotes the expression of ingroup derogation attitudes. Results of the three experiments consistently showed that, the Chinese participants adjusted their ingroup derogation attitudes according to the external environmental disease cues (Experiments 1 and 2) and the internal physiological disease cues (Experiment 3). The results also showed that the ingroup derogation mechanism was sensitive to the specific perceived vulnerabilities to the ingroup disease threat and the outgroup disease threat (Experiment 2). Taken together, these results support the evolutionary hypothesis of ingroup derogation and suggest that the ingroup derogation found in East Asian cultures could be accounted by a functionally flexible disease-avoidance mechanism.

Body Odor Disgust Sensitivity Predicts Moral Harshness Toward Moral Violations of Purity

Detecting pathogen threats and avoiding disease is fundamental to human survival. The behavioral immune system (BIS) framework outlines a set of psychological functions that may have evolved for this purpose. Disgust is a core emotion that plays a pivotal role in the BIS, as it activates the behavioral avoidance motives that prevent people from being in contact with pathogens. To date, there has been little agreement on how disgust sensitivity might underlie moral judgments. Here, we investigated moral violations of "purity" (assumed to elicit disgust) and violations of "harm" (assumed to elicit anger). We hypothesized that individual differences in BIS-related traits would be associated with greater disgust (vs. anger) reactivity to, and greater condemnation of Purity (vs. Harm) violations. The study was pre-registered (https://osf.io/57nm8/). Participants (N = 632) rated scenarios concerning moral wrongness or inappropriateness and regarding disgust and anger. To measure individual differences in the activation of the BIS, we used our recently developed Body Odor Disgust Scale (BODS), a BIS-related trait measure that assesses individual differences in feeling disgusted by body odors. In line with our predictions, we found that scores on the BODS relate more strongly to affective reactions to Purity, as compared to Harm, violations. In addition, BODS relates more strongly to Moral condemnation than to perceived Inappropriateness of an action, and to the condemnation of Purity violations as compared to Harm violations. These results suggest that the BIS is involved in moral judgment, although to some extent this role seems to be specific for violations of "moral purity," a response that might be rooted in disease avoidance. Data and scripts to analyze the data are available on the Open Science Framework (OSF) repository: https://osf.io/tk4x5/. Planned analyses are available at https://osf.io/x6g3u/.

Body odour disgust sensitivity predicts authoritarian attitudes

Authoritarianism has resurfaced as a research topic in political psychology, as it appears relevant to explain current political trends. Authoritarian attitudes have been consistently linked to feelings of disgust, an emotion that is thought to have evolved to protect the organism from contamination. We hypothesized that body odour disgust sensitivity (BODS) might be associated with authoritarianism, as chemo-signalling is a primitive system for regulating interpersonal contact and disease avoidance, which are key features also in authoritarianism. We used well-validated scales for measuring BODS, authoritarianism and related constructs. Across two studies, we found that BODS is positively related to authoritarianism. In a third study, we showed a positive association between BODS scores and support for Donald Trump, who, at the time of data collection, was a presidential candidate with an agenda described as resonating with authoritarian attitudes. Authoritarianism fully explained the positive association between BODS and support for Donald Trump. Our findings highlight body odour disgust as a new and promising domain in political psychology research. Authoritarianism and BODS might be part of the same disease avoidance framework, and our results contribute to the growing evidence that contemporary social attitudes might be rooted in basic sensory functions.