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

  • Anxiety Disorders (A Pelissolo, Section Editor)
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Abstract

Purpose of Review

In the past 20 years, the role of disgust in anxiety disorders and obsessive-compulsive disorder (OCD) has been investigated with increasing precision. In this review, we examine recent evidence implicating disgust in anxiety and OCD, highlighting recent measurement and methodological improvements. Specific emphasis is placed on understanding the mechanisms that may account for the role of disgust in OCD and related disorders.

Recent Findings

Recent developments include clarification of the role of distinct disgust-relevant vulnerabilities in the etiology of anxiety and OCD, an improved understanding of the neurobiology of disgust processing in OCD, and an increased focus on disgust-related mechanisms that contribute to psychopathology, such as disgust-based learning and emotion regulation.

Summary

Disgust proneness is increasingly linked with symptoms of anxiety and OCD. However, further examination of the mechanisms that account for the roles of distinct disgust-relevant vulnerabilities is needed, and studies that directly examine disgust during the course of treatment are limited. Increasingly, the field has moved toward experimental investigation of specific disgust-relevant mechanisms that influence the etiology and treatment of OCD and related anxiety disorders.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Phillips ML, Senior C, Fahy T, David AS. Disgust—the forgotten emotion of psychiatry. Br J Psychiatry. 1998;172:373–5.

    Article  PubMed  CAS  Google Scholar 

  2. McNally RJ. Disgust has arrived. J Anxiety Disord. 2002;16:561–6.

    Article  PubMed  Google Scholar 

  3. Matchett G, Davey GCL. A test of a disease-avoidance model of animal phobias. Behav Res Ther. 1991;29:91–4. https://doi.org/10.1016/S0005-7967(09)80011-9.

    Article  PubMed  CAS  Google Scholar 

  4. •• Olatunji BO, Armstrong T, Elwood L. Is disgust proneness associated with anxiety and related disorders? A qualitative review and meta-analysis of group comparison and correlational studies. Perspect Psychol Sci. 2017;12:613–48. This comprehensive meta-analysis examined 96 studies and found a moderate association between disgust proneness and anxiety-related disorder symptoms even after controlling for negative affect.

    Article  PubMed  Google Scholar 

  5. Kim EH, Ebesutani C, Young J, Olatunji BO. Factor structure of the disgust scale-revised in an adolescent sample. Assessment. 2013;20:620–31.

    Article  PubMed  Google Scholar 

  6. Rozin P, Haidt J, McCauley CR. Disgust. In: Lewis M, Haviland-Jones JM, Barrett LF, editors. Handb Emot. 3rd ed. New York: The Guilford Press; 2008. p. 757–76.

    Google Scholar 

  7. Askew C, Çakir K, Põldsam L, Reynolds G. The effect of disgust and fear modeling on children’s disgust and fear for animals. J Abnorm Psychol. 2014;123:566–77.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Curtis V, de Barra M, Aunger R. Disgust as an adaptive system for disease avoidance behaviour. Philos Trans R Soc B Biol Sci. 2011;366:389–401.

    Article  Google Scholar 

  9. • Sherlock JM, Zietsch BP, Tybur JM, Jern P. The quantitative genetics of disgust sensitivity. Emotion. 2016;16:43–51. This large twin study found that approximately half of the variation in self-reported pathogen, sexual, and moral disgust is due to genetic effects.

    Article  PubMed  Google Scholar 

  10. van Overveld WJM, de Jong PJ, Peters ML, Cavanagh K, Davey GCL. Disgust propensity and disgust sensitivity: separate constructs that are differentially related to specific fears. Personal Individ Differ. 2006;41:1241–52.

    Article  Google Scholar 

  11. Olatunji BO, Sawchuk CN. Disgust: characteristic features, social manifestations, and clinical implications. J Soc Clin Psychol. 2005;24:932–62.

    Article  Google Scholar 

  12. Goetz AR, Lee HJ, Cougle JR, Turkel JE. Disgust propensity and sensitivity: differential relationships with obsessive-compulsive symptoms and behavioral approach task performance. J Obsessive Compuls Relat Disord. 2013;2:412–9. https://doi.org/10.1016/j.jocrd.2013.07.006.

    Article  Google Scholar 

  13. Travis R, Fergus TA. The potentiating effect of disgust sensitivity on the relationship between disgust propensity and mental contamination. J Obsessive Compuls Relat Disord. 2015;6:114–9. https://doi.org/10.1016/j.jocrd.2015.06.007.

    Article  Google Scholar 

  14. Fan Q, Olatunji BO. Individual differences in disgust sensitivity and health-related avoidance: examination of specific associations. Personal Individ Differ. 2013;55:454–8. https://doi.org/10.1016/j.paid.2013.04.007.

    Article  Google Scholar 

  15. Rozin P, Haidt J, McCauley CR, Dunlop L, Ashmore M. Individual differences in disgust sensitivity: comparisons and evaluations of paper-and-pencil versus behavioral measures. J Res Pers. 1999;33:330–51.

    Article  Google Scholar 

  16. Deacon BJ, Olatunji BO. Specificity of disgust sensitivity in the prediction of behavioral avoidance in contamination fear. Behav Res Ther. 2007;45:2110–20.

    Article  PubMed  Google Scholar 

  17. Vrana SR. The psychophysiology of disgust: differentiating negative emotional contexts with facial EMG. Psychophysiology. 1993;30:279–86. https://doi.org/10.1111/j.1469-8986.1993.tb03354.x.

    Article  PubMed  CAS  Google Scholar 

  18. de Jong PJ, Peters M, Vanderhallen I. Disgust and disgust sensitivity in spider phobia: facial EMG in response to spider and oral disgust imagery. J Anxiety Disord. 2002;16:477–93.

    Article  PubMed  Google Scholar 

  19. de Jong PJ, van Overveld M, Peters ML. Sympathetic and parasympathetic responses to a core disgust video clip as a function of disgust propensity and disgust sensitivity. Biol Psychol. 2011;88:174–9. https://doi.org/10.1016/j.biopsycho.2011.07.009.

    Article  PubMed  Google Scholar 

  20. Aldao A, Dixon-Gordon KL, De Los Reyes A. Individual differences in physiological flexibility predict spontaneous avoidance. Cognit Emot. 2016;30:985–98. https://doi.org/10.1080/02699931.2015.1042837.

    Article  Google Scholar 

  21. Armstrong T, McClenahan L, Kittle J, Olatunji BO. Don’t look now! Oculomotor avoidance as a conditioned disgust response. Emotion. 2014;14:95–104.

    Article  PubMed  Google Scholar 

  22. van Hooff JC, Devue C, Vieweg PE, Theeuwes J. Disgust- and not fear-evoking images hold our attention. Acta Psychol. 2013;143:1–6. https://doi.org/10.1016/j.actpsy.2013.02.001.

    Article  Google Scholar 

  23. Liu Y, Zhang D, Luo Y. How disgust facilitates avoidance: an ERP study on attention modulation by threats. Soc Cogn Affect Neurosci. 2015;10:598–604.

    Article  PubMed  Google Scholar 

  24. Chapman HA, Johannes K, Poppenk JL, Moscovitch M, Anderson AK. Evidence for the differential salience of disgust and fear in episodic memory. J Exp Psychol Gen. 2013;142:1100–12.

    Article  PubMed  Google Scholar 

  25. Ferré P, Haro J, Hinojosa JA. Be aware of the rifle but do not forget the stench: differential effects of fear and disgust on lexical processing and memory. Cognit Emot. 2017;1–16.

  26. Whitton AE, Grisham JR, Henry JD, Palada HD. Interpretive bias modification for disgust. J Exp Psychopathol. 2013;4:341–59.

    Article  Google Scholar 

  27. Knowles KA, Cox RC, Armstrong T, Olatunji BO. Cognitive mechanisms of disgust in the development and maintenance of psychopathology: a qualitative review and synthesis. Clin Psychol Rev. 2018; https://doi.org/10.1016/j.cpr.2018.06.002.

  28. Rachman S. Fear of contamination. Behav Res Ther. 2004;42:1227–55.

    Article  PubMed  CAS  Google Scholar 

  29. Stein DJ, Liu Y, Shapira NA, Goodman WK. The psychobiology of obsessive-compulsive disorder: how important is the role of disgust? Curr Psychiatry Rep. 2001;3:281–7.

    Article  PubMed  CAS  Google Scholar 

  30. Husted DS, Shapira NA, Goodman WK. The neurocircuitry of obsessive-compulsive disorder and disgust. Prog Neuro-Psychopharmacol Biol Psychiatry. 2006;30:389–99.

    Article  Google Scholar 

  31. Tolin DF, Woods CM, Abramowitz JS. Disgust sensitivity and obsessive-compulsive symptoms in a non-clinical sample. J Behav Ther Exp Psychiatry. 2006;37:30–40.

    Article  PubMed  Google Scholar 

  32. Mancini F, Gragnani A, D’Olimpio F. The connection between disgust and obsessions and compulsions in a non-clinical sample. Personal Individ Differ. 2001;31:1173–80.

    Article  Google Scholar 

  33. Olatunji BO, Ebesutani C, David B, Fan Q, McGrath PB. Disgust proneness and obsessive-compulsive symptoms in a clinical sample: structural differentiation from negative affect. J Anxiety Disord. 2011;25:932–8. https://doi.org/10.1016/j.janxdis.2011.05.006.

    Article  PubMed  Google Scholar 

  34. Olatunji BO, Ebesutani C, Kim J, Riemann BC, Jacobi DM. Disgust proneness predicts obsessive-compulsive disorder symptom severity in a clinical sample of youth: distinctions from negative affect. J Affect Disord. 2017;213:118–25. https://doi.org/10.1016/j.jad.2017.02.017.

    Article  PubMed  Google Scholar 

  35. Olatunji BO, Lohr JM, Sawchuk CN, Tolin DF. Multimodal assessment of disgust in contamination-related obsessive-compulsive disorder. Behav Res Ther. 2007;45:263–76.

    Article  PubMed  Google Scholar 

  36. Whitton AE, Henry JD, Grisham JR. Cognitive and psychophysiological correlates of disgust in obsessive-compulsive disorder. Br J Clin Psychol. 2015;54:16–33.

    Article  PubMed  Google Scholar 

  37. Duncko R, Veale D. Changes in disgust and heart rate during exposure for obsessive compulsive disorder: a case series. J Behav Ther Exp Psychiatry. 2016;51:92–9. https://doi.org/10.1016/j.jbtep.2016.01.001.

    Article  PubMed  Google Scholar 

  38. Critchley HD, Wiens S, Rotshtein P, Öhman A, Dolan RJ. Neural systems supporting interoceptive awareness. Nat Neurosci. 2004;7(2):189.

    Article  PubMed  CAS  Google Scholar 

  39. Phan KL, Wager T, Taylor SF, Liberzon I. Functional neuroanatomy of emotion: a meta-analysis of emotion activation studies in PET and fMRI. Neuroimage. 2002;16:331–48.

    Article  PubMed  Google Scholar 

  40. Wicker B, Keysers C, Plailly J, Royet JP, Gallese V, Rizzolatti G. Both of us disgusted in my insula. The common neural basis of seeing and feeling disgust. Neuron. 2003;40:655–64.

    Article  PubMed  CAS  Google Scholar 

  41. Shapira NA, Liu Y, He AG, Bradley MM, Lessig MC, James GA, et al. Brain activation by disgust-inducing pictures in obsessive-compulsive disorder. Biol Psychiatry. 2003;54:751–6.

    Article  PubMed  Google Scholar 

  42. Wright P, He G, Shapira NA, Goodman WK. Disgust and the insula: fMRI responses to pictures of mutilation and contamination. Neuroreport. 2004;15:2347–51.

    Article  PubMed  CAS  Google Scholar 

  43. Phillips ML, Marks IM, Senior C, Lythgoe DJ, O’Dwyer AM, Meehan O, et al. A differential neural response in obsessive-compulsive disorder patients with washing compared with checking symptoms to disgust. Psychol Med. 2000;30:1037–50.

    Article  PubMed  CAS  Google Scholar 

  44. Berlin HA, Stern ER, Ng J, Zhang S, Rosenthal D, Turetzky R, et al. Altered olfactory processing and increased insula activity in patients with obsessive-compulsive disorder: an fMRI study. Psychiatry Res Neuroimaging. 2017;262:15–24. https://doi.org/10.1016/j.pscychresns.2017.01.012.

    Article  PubMed  Google Scholar 

  45. Jhung K, Ku J, Kim SJ, Lee H, Kim KR, An SK, et al. Distinct functional connectivity of limbic network in the washing type obsessive-compulsive disorder. Prog Neuro-Psychopharmacol Biol Psychiatry. 2014;53:149–55. https://doi.org/10.1016/j.pnpbp.2014.04.007.

    Article  Google Scholar 

  46. Berlin HA, Schulz KP, Zhang S, Turetzky R, Rosenthal D, Goodman W. Neural correlates of emotional response inhibition in obsessive-compulsive disorder: a preliminary study. Psychiatry Res Neuroimaging. 2015;234:259–64. https://doi.org/10.1016/j.pscychresns.2015.09.019.

    Article  Google Scholar 

  47. Basile B, Mancini F. Neurobiological mechanisms underlying abnormal processing of guilt, disgust, and intentionality in obsessive-compulsive disorder: a critical review. Clin Neuropsychiatry. 2014;11:187–93.

    Google Scholar 

  48. Thiel A, Thiel J, Oddo S, Langnickel R, Brand M, Markowitsch HJ, et al. Obsessive-compulsive disorder patients with washing symptoms show a specific brain network when confronted with aggressive, sexual, and disgusting stimuli. Neuropsychoanalysis. 2014;16:83–96. https://doi.org/10.1080/15294145.2014.976649.

    Article  Google Scholar 

  49. Rachman S. Pollution of the mind. Behav Res Ther. 1994;32:311–4.

    Article  PubMed  CAS  Google Scholar 

  50. Melli G, Bulli F, Carraresi C, Stopani E. Disgust propensity and contamination-related OCD symptoms: the mediating role of mental contamination. J Obsessive Compuls Relat Disord. 2014;3:77–82. https://doi.org/10.1016/j.jocrd.2014.01.002.

    Article  Google Scholar 

  51. Melli G, Bulli F, Carraresi C, Tarantino F, Gelli S, Poli A. The differential relationship between mental contamination and the core dimensions of contact contamination fear. J Anxiety Disord. 2017;45:9–16. https://doi.org/10.1016/j.janxdis.2016.11.005.

    Article  PubMed  Google Scholar 

  52. Jalal B, Ramachandran VS. “I feel your disgust and relief”: can the action understanding system (mirror neuron system) be recruited to induce disgust and relief from contamination vicariously, in individuals with obsessive–compulsive disorder symptoms? Neurocase. 2017;23:31–5. https://doi.org/10.1080/13554794.2017.1279638.

    Article  PubMed  Google Scholar 

  53. Obsessive Compulsive Cognitions Working Group. Development and initial validation of the obsessive beliefs questionnaire and interpretations of intrusions inventory. Behav Res Ther. 2001;39:987–1006.

    Article  Google Scholar 

  54. Obsessive Compulsive Cognitions Working Group. Psychometric validation of the obsessive belief questionnaire and interpretation of intrusions inventory—part 2: factor analyses and testing of a brief version. Behav Res Ther. 2005;43:1527–42.

    Article  Google Scholar 

  55. Ching THW, Williams MT, Siev J, Olatunji BO. Responsibility/threat overestimation moderates the relationship between contamination-based disgust and obsessive–compulsive concerns about sexual orientation. Arch Sex Behav. 2018;47:1109–17. https://doi.org/10.1007/s10508-018-1165-z.

    Article  PubMed  Google Scholar 

  56. Inozu M, Ulukut FO, Ergun G, Alcolado GM. The mediating role of disgust sensitivity and thought-action fusion between religiosity and obsessive compulsive symptoms. Int J Psychol. 2014;49:334–41. https://doi.org/10.1002/ijop.12041.

    Article  PubMed  Google Scholar 

  57. Inozu M, Eremsoy E, Cicek NM, Ozcanli F. The association of scrupulosity with disgust propensity and contamination based obsessive compulsive symptoms: an experimental investigation using highly scrupulous Muslims. J Obsessive Compuls Relat Disord. 2017;15:43–51. https://doi.org/10.1016/j.jocrd.2017.08.004.

    Article  Google Scholar 

  58. Melli G, Moulding R, Poli A. Is it more disgusting if I think about it? Examining the interaction of obsessive beliefs and disgust propensity in clinical obsessive-compulsive disorder. J Obsessive Compuls Relat Disord. 2016;11:74–81. https://doi.org/10.1016/j.jocrd.2016.09.001.

    Article  Google Scholar 

  59. Oaten MJ, Stevenson RJ, Case TI. Disgust as a disease-avoidance mechanism. Psychol Bull. 2009;135:303–21. https://doi.org/10.1037/a0014823.

    Article  PubMed  Google Scholar 

  60. van Overveld M, de Jong PJ, Peters ML, van Hout WJPJ, Bouman TK. An internet-based study on the relation between disgust sensitivity and emetophobia. J Anxiety Disord. 2008;22:524–31.

    Article  PubMed  Google Scholar 

  61. Verwoerd J, Van Hout WJPJ, de Jong PJ. Disgust- and anxiety-based emotional reasoning in non-clinical fear of vomiting. J Behav Ther Exp Psychiatry. 2016;50:83–9. https://doi.org/10.1016/j.jbtep.2015.05.009.

    Article  PubMed  Google Scholar 

  62. Olatunji BO, Williams NL, Lohr JM, Connolly KM, Cisler JM, Meunier SA. Structural differentiation of disgust from trait anxiety in the prediction of specific anxiety disorder symptoms. Behav Res Ther. 2007;45:3002–17.

    Article  PubMed  Google Scholar 

  63. Muris P, van der Heiden S, Rassin E. Disgust sensitivity and psychopathological symptoms in non-clinical children. J Behav Ther Exp Psychiatry. 2008;39:133–46.

    Article  PubMed  Google Scholar 

  64. Olatunji BO, Williams NL, Sawchuk CN, Lohr JM. Disgust, anxiety and fainting symptoms associated with blood-injection-injury fears: a structural model. J Anxiety Disord. 2006;20:23–41.

    Article  PubMed  Google Scholar 

  65. Slovic P, Finucane M, Peters E, MacGregor DG. The affect heuristic. In: Gilovich T, Griffin D, Kahneman D, editors. Heuristics and Biases: The Psychology of Intuitive Judgment; 2002.

  66. Page AC. Blood-injury phobia. Clin Psychol Rev. 1994;14:443–61.

    Article  Google Scholar 

  67. Vossbeck-Elsebusch AN, Gerlach AL. The relation between disgust-sensitivity, blood-injection-injury fears and vasovagal symptoms in blood donors: disgust sensitivity cannot explain fainting or blood donation-related symptoms. J Behav Ther Exp Psychiatry. 2012;43:607–13. https://doi.org/10.1016/j.jbtep.2011.08.005.

    Article  PubMed  Google Scholar 

  68. Vossbeck-Elsebusch AN, Steinigeweg K, Vögele C, Gerlach AL. Does disgust increase parasympathetic activation in individuals with a history of fainting? A psychophysiological analysis of disgust stimuli with and without blood-injection-injury association. J Anxiety Disord. 2012;26:849–58. https://doi.org/10.1016/j.janxdis.2012.07.003.

    Article  PubMed  Google Scholar 

  69. Simon E, Meuret AE, Ritz T. Sympathetic and parasympathetic cardiac responses to phobia-relevant and disgust-specific emotion provocation in blood-injection-injury phobia with and without fainting history. Psychophysiology. 2017;54:1512–27.

    Article  PubMed  Google Scholar 

  70. Caseras X, Giampietro V, Lamas A, Brammer MJ, Vilarroya O, Carmona S, et al. The functional neuroanatomy of blood-injection-injury phobia: a comparison with spider phobics and healthy controls. Psychol Med. 2010;40:125–34.

    Article  PubMed  CAS  Google Scholar 

  71. Wheaton MG, Berman NC, Franklin JC, Abramowitz JS. Health anxiety: latent structure and associations with anxiety-related psychological processes in a student sample. J Psychopathol Behav Assess. 2010;32:565–74.

    Article  Google Scholar 

  72. Hedman E, Lekander M, Karshikoff B, Ljótsson B, Axelsson E, Axelsson J. Health anxiety in a disease-avoidance framework: investigation of anxiety, disgust and disease perception in response to sickness cues. J Abnorm Psychol. 2016;125:868–78.

    Article  PubMed  Google Scholar 

  73. Brady RE, Lohr JM. A behavioral test of contamination fear in excessive health anxiety. J Behav Ther Exp Psychiatry. 2014;45:122–7. https://doi.org/10.1016/j.jbtep.2013.09.011.

    Article  PubMed  Google Scholar 

  74. Bienvenu OJ, Samuels JF, Riddle MA, Hoehn-Saric R, Liang KY, Cullen BA, et al. The relationship of obsessive–compulsive disorder to possible spectrum disorders: results from a family study. Biol Psychiatry. 2000 Aug 15;48(4):287–93.

    Article  PubMed  CAS  Google Scholar 

  75. Reuman L, Jacoby RJ, Blakey SM, Riemann BC, Leonard RC, Abramowitz JS. Predictors of illness anxiety symptoms in patients with obsessive compulsive disorder. Psychiatry Res. 2017 Oct 1;256:417–22.

    Article  PubMed  Google Scholar 

  76. • Brady RE, Cisler JM, Lohr JM. Specific and differential prediction of health anxiety by disgust sensitivity and propensity. Anxiety Stress Coping. 2014;27:90–9. This study directly compared the effects of disgust sensitivity and propensity on health anxiety symptoms and found that disgust sensitivity, but not disgust propensity, strongly contributed to health anxiety.

    Article  PubMed  Google Scholar 

  77. Weck F, Esch S, Rohrmann S. The role of disgust in patients with hypochondriasis. Anxiety Stress Coping. 2014;27:576–86.

    Article  PubMed  Google Scholar 

  78. Brand J, McKay D, Wheaton MG, Abramowitz JS. The relationship between obsessive compulsive beliefs and symptoms, anxiety and disgust sensitivity, and swine flu fears. J Obsessive Compuls Relat Disord. 2013;2:200–6. https://doi.org/10.1016/j.jocrd.2013.01.007.

    Article  Google Scholar 

  79. Wheaton MG, Abramowitz JS, Berman NC, Fabricant LE, Olatunji BO. Psychological predictors of anxiety in response to the H1N1 (swine flu) pandemic. Cogn Ther Res. 2012;36:210–8.

    Article  Google Scholar 

  80. Blakey SM, Reuman L, Jacoby RJ, Abramowitz JS. Tracing “Fearbola”: psychological predictors of anxious responding to the threat of Ebola. Cogn Ther Res. 2015;39:816–25.

    Article  Google Scholar 

  81. • Olatunji BO. Selective effects of excessive engagement in health-related behaviours on disgust propensity. Cognit Emot. 2015;29:37–41. This experimental study examined the role of health behaviors on disgust propensity and found that healthy individuals who performed excessive health behaviors over a one-week period reported increased disgust propensity after one week.

    Article  Google Scholar 

  82. Feldner MT, Frala J, Badour CL, Leen-Feldner EW, Olatunji BO. An empirical test of the association between disgust and sexual assault. Int J Cogn Ther. 2010;3:11–22.

    Article  Google Scholar 

  83. Shin LM, McNally RJ, Kosslyn SM, Thompson WL, Rauch SL, Alpert NM, et al. Regional cerebral blood flow measurement during script-driven imagery in childhood sexual abuse-related PTSD: a PET investigation. Am J Psychiatry. 1999;156:575–84.

    PubMed  CAS  Google Scholar 

  84. Foy DW, Rueger DB, Sipprelle RC, Carroll EM. Etiology of posttraumatic stress disorder in Vietnam veterans: analysis of premilitary, military, and combat exposure influences. J Consult Clin Psychol. 1984;52:79–87.

    Article  PubMed  CAS  Google Scholar 

  85. Engelhard IM, Olatunji BO, de Jong PJ. Disgust and the development of posttraumatic stress among soldiers deployed to Afghanistan. J Anxiety Disord. 2011;25:58–63. https://doi.org/10.1016/j.janxdis.2010.08.003.

    Article  PubMed  Google Scholar 

  86. Fairbrother N, Rachman S. Feelings of mental pollution subsequent to sexual assault. Behav Res Ther. 2004;42:173–89.

    Article  PubMed  Google Scholar 

  87. Fairbrother N, Newth SJ, Rachman S. Mental pollution: feelings of dirtiness without physical contact. Behav Res Ther. 2005;43:121–30.

    Article  PubMed  Google Scholar 

  88. Badour CL, Feldner MT, Babson KA, Smith RC, Blumenthal H, Trainor CD, et al. Differential emotional responding to ideographic cues of traumatic interpersonal violence compared to non-interpersonal traumatic experiences. J Exp Psychopathol. 2011;2:400–17.

    Article  Google Scholar 

  89. Olatunji BO, Babson KA, Smith RC, Feldner MT, Connolly KM. Gender as a moderator of the relation between PTSD and disgust: a laboratory test employing individualized script-driven imagery. J Anxiety Disord. 2009;23:1091–7.

    Article  PubMed  Google Scholar 

  90. Badour CL, Ojserkis R, McKay D, Feldner MT. Disgust as a unique affective predictor of mental contamination following sexual trauma. J Anxiety Disord. 2014;28:704–11. https://doi.org/10.1016/j.janxdis.2014.07.007.

    Article  PubMed  PubMed Central  Google Scholar 

  91. Bomyea J, Allard CB. Trauma-related disgust in veterans with interpersonal trauma. J Trauma Stress. 2017;30:149–56.

    Article  PubMed  Google Scholar 

  92. Bomyea J, Amir N. Disgust propensity as a predictor of intrusive cognitions following a distressing film. Cogn Ther Res. 2012;36:190–8.

    Article  Google Scholar 

  93. Olatunji BO, Armstrong T, Fan Q, Zhao M. Risk and resiliency in posttraumatic stress disorder: distinct roles of anxiety and disgust sensitivity. Psychol Trauma. 2014;6:50–5.

    Article  Google Scholar 

  94. Knowles KA, Viar-Paxton MA, Riemann BC, Jacobi DM, Olatunji BO. Is disgust proneness sensitive to treatment for OCD among youth? Examination of diagnostic specificity and symptom correlates. J Anxiety Disord. 2016;44:47–54.

    Article  PubMed  Google Scholar 

  95. Athey AJ, Elias JA, Crosby JM, Jenike MA, Pope HG, Hudson JI, et al. Reduced disgust propensity is associated with improvement in contamination/washing symptoms in obsessive-compulsive disorder. J Obsessive Compuls Relat Disord. 2015;4:20–4. https://doi.org/10.1016/j.jocrd.2014.11.001.

    Article  PubMed  PubMed Central  Google Scholar 

  96. Olatunji BO, Tart CD, Ciesielski BG, McGrath PB, Smits JAJ. Specificity of disgust vulnerability in the distinction and treatment of OCD. J Psychiatr Res. 2011;45:1236–42.

    Article  PubMed  PubMed Central  Google Scholar 

  97. Taboas W, Ojserkis R, McKay D. Change in disgust reactions following cognitive-behavioral therapy for childhood anxiety disorders. Int J Clin Health Psychol. 2014;15:1–7. https://doi.org/10.1016/j.ijchp.2014.06.002.

    Article  Google Scholar 

  98. • Armstrong T, Olatunji BO. Pavlovian disgust conditioning as a model for contamination-based OCD: evidence from an analogue study. Behav Res Ther. 2017;93:78–87. https://doi.org/10.1016/j.brat.2017.03.009. This test of a basic associative disgust learning mechanism in individuals with contamination concerns revealed that contamination fear may be related to difficulty in inhibiting acquired disgust reactions. Disgust sensitivity may also explain changes in disgust reponding before and after extinction.

    Article  PubMed  PubMed Central  Google Scholar 

  99. Andersson E, Ljótsson B, Hedman E, Enander J, Kaldo V, Andersson G, et al. Predictors and moderators of internet-based cognitive behavior therapy for obsessive-compulsive disorder: results from a randomized trial. J Obsessive Compuls Relat Disord. 2015;4:1–7. https://doi.org/10.1016/j.jocrd.2014.10.003.

    Article  Google Scholar 

  100. McKay D. Treating disgust reactions in contamination-based obsessive-compulsive disorder. J Behav Ther Exp Psychiatry. 2006;37:53–9.

    Article  PubMed  Google Scholar 

  101. Melli G, Chiorri C, Carraresi C, Stopani E, Bulli F. The role of disgust propensity and trait guilt in OCD symptoms: a multiple regression model in a clinical sample. J Obsessive Compuls Relat Disord. 2015;5:43–8. https://doi.org/10.1016/j.jocrd.2015.01.007.

    Article  Google Scholar 

  102. D’Olimpio F, Cosentino T, Basile B, Tenore K, Gragnani A, Mancini F. Obsessive-compulsive disorder and propensity to guilt feelings and to disgust. Clin Neuropsychiatry. 2013;10:20–9.

    Google Scholar 

  103. Melli G, Gremigni P, Elwood LS, Stopani E, Bulli F, Carraresi C. The relationship between trait guilt, disgust propensity, and contamination fear. Int J Cogn Ther. 2015;8:1–13.

    Article  Google Scholar 

  104. Olatunji BO, Berg HE, Zhao Z. Emotion regulation of fear and disgust: differential effects of reappraisal and suppression. Cognit Emot. 2015;9931:1–8.

    Google Scholar 

  105. Olatunji BO, Berg H, Cox RC, Billingsley A. The effects of cognitive reappraisal on conditioned disgust in contamination based OCD: an analogue study. J Anxiety Disord. 2017;51:86–93.

    Article  PubMed  Google Scholar 

  106. • Fink J, Pflugradt E, Stierle C, Exner C. Changing disgust through imagery rescripting and cognitive reappraisal in contamination-based obsessive-compulsive disorder. J Anxiety Disord. 2018;54:36–48. This study tested therapeutic techniques that could be used to reduce disgust in individuals with contamination-based OCD. Both imagery rescripting and cognitive reappraisal were effective and may be useful in addition to exposure when treating OCD.

    Article  PubMed  Google Scholar 

  107. Olatunji BO, Huijding J, de Jong PJ, Smits JAJ. The relative contributions of fear and disgust reductions to improvements in spider phobia following exposure-based treatment. J Behav Ther Exp Psychiatry. 2011;42:117–21. https://doi.org/10.1016/j.jbtep.2010.07.007.

    Article  PubMed  Google Scholar 

  108. Cougle JR, Summers BJ, Harvey AM, Dillon KH, Allan NP. Contamination-focused exposure as a treatment for disgust-based fears: a preliminary test in spider-fearful women. Behav Cogn Psychother. 2016;44:640–51.

    Article  PubMed  Google Scholar 

  109. Oar EL, Farrell LJ, Conlon EG, Waters AM, Ollendick TH. Patterns of response and remission following a one-session treatment for blood-injection-injury phobia in youth. Child Family Behav Ther. 2017;39:43–63. https://doi.org/10.1080/07317107.2016.1268007.

    Article  Google Scholar 

  110. • Badour CL, Feldner MT. Disgust and imaginal exposure to memories of sexual trauma: implications for the treatment of posttraumatic stress. Psychol Trauma. 2016;8(3):267. This study of women who had experienced sexual victimization found higher reported levels of disgust compared to anxiety in a single session of script-based exposure. Changes in disgust reactions significantly predicted improvement in PTSD symptoms for women whose anxiety also decreased.

    Article  PubMed  Google Scholar 

  111. • Berle D, Starcevic V, Brakoulias V, Sammut P, Milicevic D, Hannan A, et al. Disgust propensity in obsessive-compulsive disorder: cross-sectional and prospective relationships. J Behav Ther Exp Psychiatry. 2012;43:656–63. https://doi.org/10.1016/j.jbtep.2011.09.002. This is the first study to examine prospective relationships between disgust propensity and OCD over an extended interval (six months).

    Article  PubMed  Google Scholar 

  112. Çek D, Sánchez A, Timpano KR. Social anxiety-linked attention bias to threat is indirectly related to post-event processing via subjective emotional reactivity to social stress. Behav Ther. 2016;47(3):377–87. https://doi.org/10.1016/j.beth.2016.02.007.

    Article  PubMed  Google Scholar 

  113. Judah MR, Grant DM, Carlisle NB. The effects of self-focus on attentional biases in social anxiety: an ERP study. Cogn Affect Behav Neurosci. 2016;16:393–405. https://doi.org/10.3758/s13415-015-0398-8.

    Article  PubMed  Google Scholar 

  114. Grisham JR, King BJ, Makkar SR, Felmingham KL. The contributions of arousal and self-focused attention to avoidance in social anxiety. Anxiety Stress Coping. 2015;28(3):303–20. https://doi.org/10.1080/10615806.2014.968144.

    Article  PubMed  Google Scholar 

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Correspondence to Bunmi O. Olatunji.

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Kelly A. Knowles, Sarah C. Jessup, and Bunmi O. Olatunji declare no conflict of interest.

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All reported studies/experiments with human or animal subjects performed by the authors have been previously published and complied with all applicable ethical standards (including the Helsinki declaration and its amendments, institutional/national research committee standards, and international/national/institutional guidelines).

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This article is part of the Topical Collection on Anxiety Disorders

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Knowles, K.A., Jessup, S.C. & Olatunji, B.O. Disgust in Anxiety and Obsessive-Compulsive Disorders: Recent Findings and Future Directions. Curr Psychiatry Rep 20, 68 (2018). https://doi.org/10.1007/s11920-018-0936-5

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