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Disgust and fear: common emotions between eating and phobic disorders

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Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity Aims and scope Submit manuscript

Abstract

Eating disorders (ED) are prevalent mental illnesses composed mainly of anorexia nervosa, bulimia nervosa and binge eating disorders. Anxiety disorders are another set of mental illnesses, with phobic disorder (PD) being the most prevalent disorder. ED and PD are highly comorbid. The aim of this study is to assess, in 131 individuals attending an outpatient clinic for different health issues, the level of fear related to situations generating avoidance such as in social anxiety and specific phobias according to the fear questionnaire (FQ), the level of disgust according to the disgust scale (DS-R) and the vulnerability towards ED according to the SCOFF scale to demonstrate that high levels of both fear and disgust increase the vulnerability towards ED. The study demonstrated that the level of disgust increased when fear increases (r = 0.377, p < 0.001 for the first part of the FQ; r = 0.225, p = 0.01 for the second part of the FQ). Moreover, individuals with vulnerability towards having an ED presented a higher level of disgust than individuals without this vulnerability (p = 0.009). Furthermore, individuals with vulnerability towards ED have a higher level of anxiety related to PD subtypes (p = 0.008 for agoraphobia; p = 0.001 for injection/blood phobia) as well as to social anxiety (p = 0.01), independently from having a depressive or another anxiety disorder. In the multivariate analysis, a history of psychiatric consultation has been the only significantly different parameter between individuals with or without vulnerability towards ED (p = 0.0439). Accordingly, fear and disgust are negative emotions that seem to be clinically associated which better explains the comorbidity of ED with PD.

Level of evidence

Level III. Evidence obtained from well-designed cohort or case–control analytic studies, preferably from more than one center or research group.

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References

  1. Aharoni R, Hertz MM (2012) Disgust sensitivity and anorexia nervosa. Eur Eat Disord 20(2):106–110. https://doi.org/10.1002/erv.1124

    Article  Google Scholar 

  2. Anderson AK, Christoff K, Panitz D, De Rosa E, Gabrieli JDE (2003) Neural correlates of the automatic processing of threat facial signals. J Neurosci 23(13):5627–5633

    Article  CAS  Google Scholar 

  3. American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, fifth edition: DSM-5. American Psychiatric Publishing, Arlington, USA

  4. Bandelow B, Michaelis S (2015) Epidemiology of anxiety disorders in the 21st century. Dialogues Clin Neurosci 17(3):327–335

    PubMed  PubMed Central  Google Scholar 

  5. Becker AE, Thomas JJ, Pike KM (2009) Should non-fat-phobic anorexia nervosa be included in DSM-V? Int J Eat Disord 42(7):620–635. https://doi.org/10.1002/eat.20727

    Article  PubMed  Google Scholar 

  6. Bell K, Coulthard H, Wildbur D (2017) Self-disgust within eating disordered groups: associations with anxiety, disgust sensitivity and sensory processing. Eur Eat Disord Rev 25(5):373–380. https://doi.org/10.1002/erv.2529

    Article  PubMed  Google Scholar 

  7. Berle D, Phillips ES (2006) Disgust and obsessive-compulsive disorder: an update. Psychiatry 69(3):228–238. https://doi.org/10.1521/psyc.2006.69.3.228

    Article  PubMed  Google Scholar 

  8. Bou Khalil R, Souaiby L, Farès N (2017) The importance of the hypothalamo-pituitary-adrenal axis as a therapeutic target in anorexia nervosa. Physiol Behav 171:13–20. https://doi.org/10.1016/j.physbeh.2016.12.035

    Article  CAS  PubMed  Google Scholar 

  9. Carter JC, Bewell-Weiss CV (2011) Nonfat phobic anorexia nervosa: clinical characteristics and response to inpatient treatment. Int J Eat Disord 44(3):220–224. https://doi.org/10.1002/eat.20820

    Article  PubMed  Google Scholar 

  10. Çavuşoğlu M, Dirik G (2011) Fear or disgust? The role of emotions in spider phobia and blood-injection-injury phobia. Turk J Psychiatry 22(2):115–122

    Google Scholar 

  11. Cisler JM, Olatunji BO, Lohr JM (2009) Disgust, fear, and the anxiety disorders: a critical review. Clin Psychol Rev 29(1):34–46. https://doi.org/10.1016/j.cpr.2008.09.007

    Article  PubMed  Google Scholar 

  12. Davey GCL, Chapman L (2009) Disgust and eating disorder symptomatology in a non-clinical population: the role of trait anxiety and anxiety sensitivity. Clin Psychol Psychother 16(4):268–275. https://doi.org/10.1002/cpp.623

    Article  PubMed  Google Scholar 

  13. De Jong PJ, Peters ML (2007) Contamination vs. harm-relevant outcome expectancies and covariation bias in spider phobia. Behav Res Ther 45:1271e1284

    Google Scholar 

  14. Diehl NS, Johnson CE, Rogers RL, Petrie TA (1998) Social physique anxiety and disordered eating: what’s the connection? Addict Behav 23(1):1–6

    Article  CAS  Google Scholar 

  15. Etkin A, Wager TD (2007) Functional neuroimaging of anxiety: a meta-analysis of emotional processing in PTSD, social anxiety disorder, and specific phobia. Am J Psychiatry 164(10):1476–1488. https://doi.org/10.1176/appi.ajp.2007.07030504

    Article  PubMed  PubMed Central  Google Scholar 

  16. Fox JRE, Harrison A (2008) The relation of anger to disgust: the potential role of coupled emotions within eating pathology. Clin Psychol Psychother 15(2):86–95. https://doi.org/10.1002/cpp.565

    Article  PubMed  Google Scholar 

  17. Fusar-Poli P, Placentino A, Carletti F, Landi P, Allen P, Surguladze S, Politi P et al (2009) Functional atlas of emotional faces processing: a voxel-based meta-analysis of 105 functional magnetic resonance imaging studies. J Psychiatry Neurosci JPN 34(6):418–432

    PubMed  Google Scholar 

  18. Haidt J, McCauley C, Rozin P (1994) Individual differences in sensitivity to disgust: A scale sampling seven domains of disgust elicitors. Personal Individ Differ 16(5):701–713. https://doi.org/10.1016/0191-8869(94)90212-7

    Article  Google Scholar 

  19. Hart EA, Leary MR, Rejeski WJ (1989) The measurement of social physique anxiety. J Sport Exerc Psychol 11:94–104

    Article  Google Scholar 

  20. Harvey T, Troop NA, Treasure JL, Murphy T (2002) Fear, disgust, and abnormal eating attitudes: a preliminary study. Int J Eat Disord 32(2):213–218. https://doi.org/10.1002/eat.10069

    Article  PubMed  Google Scholar 

  21. Hinrichsen H, Sheffield A, Waller G (2007) The role of parenting experiences in the development of social anxiety and agoraphobia in the eating disorders. Eat Behav 8(3):285–290

    Article  Google Scholar 

  22. Hoek HW (2016) Review of the worldwide epidemiology of eating disorders. Curr Opin Psychiatry 29(6):336–339. https://doi.org/10.1097/YCO.0000000000000282

    Article  PubMed  Google Scholar 

  23. Kaye WH, Wierenga CE, Bailer UF, Simmons AN, Wagner A, Bischoff-Grethe A (2013) Does a shared neurobiology for foods and drugs of abuse contribute to extremes of food ingestion in anorexia and bulimia nervosa? Biol Psychiat 73(9):836–842. https://doi.org/10.1016/j.biopsych.2013.01.002

    Article  PubMed  Google Scholar 

  24. Marks IM, Mathews AM (1979) Brief standard self-rating for phobic patients. Behav Res Ther 17(3):263–267

    Article  CAS  Google Scholar 

  25. Mayer B, Muris P, Wilschut M (2011) Fear- and disgust-related covariation bias and eating disorders symptoms in healthy young women. J Behav Ther Exp Psychiatry 42(1):19–25

    Article  Google Scholar 

  26. Morgan JF, Reid F, Lacey JH (1999) The SCOFF questionnaire: assessment of a new screening tool for eating disorders. BMJ 319(7223):1467–1468

    Article  CAS  Google Scholar 

  27. Olatunji BO (2009) Incremental specificity of disgust propensity and sensitivity in the prediction of health anxiety dimensions. J Behav Ther Exp Psychiatry 40(2):230–239

    Article  Google Scholar 

  28. Olatunji BO, Cisler J, McKay D, Phillips ML (2010) Is disgust associated with psychopathology? Emerging research in the anxiety disorders. Psychiatry Res 175(1–2):1–10. https://doi.org/10.1016/j.psychres.2009.04.007

    Article  PubMed  Google Scholar 

  29. Royet J-P, Plailly J, Delon-Martin C, Kareken DA, Segebarth C (2003) fMRI of emotional responses to odors: influence of hedonic valence and judgment, handedness, and gender. NeuroImage 20(2):713–728. https://doi.org/10.1016/S1053-8119(03)00388-4

    Article  PubMed  Google Scholar 

  30. Sassaroli S, Bertelli S, Decoppi M, Crosina M, Milos G, Ruggiero GM (2005) Worry and eating disorders: a psychopathological association. Eat Behav 6(4):301–307

    Article  CAS  Google Scholar 

  31. Stip E, Lungu OV (2015) Salience network and olanzapine in schizophrenia: implications for treatment in anorexia nervosa. Can J Psychiatry 60(3 Suppl 2):S35–S39

    PubMed  PubMed Central  Google Scholar 

  32. Swinbourne J, Hunt C, Abbott M, Russell J, St. Clare T, Touyz S (2012) The comorbidity between eating disorders and anxiety disorders: prevalence in an eating disorder sample and anxiety disorder sample. Austr N Z J Psychiatry 46(2):118–131. https://doi.org/10.1177/0004867411432071

    Article  Google Scholar 

  33. Tomarken AJ, Sutton SK, Mineka S (1995) Fear-relevant illusory correlations: what types of associations promote judgmental bias? J Abnorm Psychol 104:312–e326

    Article  CAS  Google Scholar 

  34. Torralbas-Ortega J, Puntí-Vidal J, Valls-Ibáñez MV, Arias-Núñez E, Naranjo-Díaz MC (2012) Choking phobia: care plan in children and adolescents. Enferm Clin 22(4):224–230. https://doi.org/10.1016/j.enfcli.2012.02.003

    Article  PubMed  Google Scholar 

  35. Troisi A, Di Lorenzo G, Alcini S, Nanni RC, Di Pasquale C, Siracusano A (2006) Body dissatisfaction in women with eating disorders: relationship to early separation anxiety and insecure attachment. Psychosom Med 68(3):449–453

    Article  Google Scholar 

  36. Veale D, Costa A, Murphy P, Ellison N (2012) Abnormal eating behaviour in people with a specific phobia of vomiting (emetophobia). Eur Eat Disord Rev 20(5):414–418. https://doi.org/10.1002/erv.1159

    Article  PubMed  Google Scholar 

  37. Vicario CM, Rafal RD, Martino D, Avenanti A (2017) Core, social and moral disgust are bounded: a review on behavioral and neural bases of repugnance in clinical disorders. Neurosci Biobehav Rev 80:185–200. https://doi.org/10.1016/j.neubiorev.2017.05.008

    Article  PubMed  Google Scholar 

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Funding

This research did not receive any funding.

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Authors and Affiliations

  1. Hotel Dieu de France, A. Naccache boulevard, Achrafieh, P.O. Box 166830, Beirut, Lebanon

    Rami Bou Khalil & Yara Tabet

  2. Saint Joseph University, Beirut, Lebanon

    Rami Bou Khalil, Yara Tabet, Lama Souaiby & Hayat Azouri

  3. Institute for Global Health and Development, Queen Margaret University, Edinburgh, UK

    Ibrahim R. Bou-Orm

Authors
  1. Rami Bou Khalil
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  2. Ibrahim R. Bou-Orm
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  3. Yara Tabet
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  4. Lama Souaiby
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  5. Hayat Azouri
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Correspondence to Rami Bou Khalil.

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The authors declare that they have no conflict of interest.

Ethical approval

This study has received the approval of the ethical committee of Hotel dieu de France hospital (file registered under the Reference Number CEHDF 968).

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Informed consent was obtained from all individual participants included in the study.

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Bou Khalil, R., Bou-Orm, I.R., Tabet, Y. et al. Disgust and fear: common emotions between eating and phobic disorders. Eat Weight Disord 25, 79–86 (2020). https://doi.org/10.1007/s40519-018-0512-3

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  • DOI: https://doi.org/10.1007/s40519-018-0512-3

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