Disgust and disgust sensitivity in blood-injection-injury and spider phobia

doi:10.1016/S0005-7967(97)00048-X

Behaviour Research and Therapy

Volume 35, Issue 10, October 1997, Pages 949-953

https://doi.org/10.1016/S0005-7967(97)00048-X Get rights and content

Abstract

Blood-injection-injury (BII) phobics and spider phobics show markedly different cognitive, psychophysiological, and motoric reactions to activating stimuli. These observations have led theorists to question whether the emotion of fear mediates both phobias. The present study examined the role of disgust and disgust sensitivity in these subtypes of specific phobia. BII phobics, spider phobics, and nonphobics completed questionnaires and rated pictures of specific objects on fear and disgust scales. Questionnaire data indicated that phobic participants were higher than nonphobics on fear, and also on disgust sensitivity. The reaction of BII phobics to pictures of medical stimuli was one of disgust, rather than fear. The reaction of spider phobics to pictures of spiders was a combination of fear and disgust, though fear appeared to predominate. Results are discussed in view of current theories of emotional factors in specific phobia.

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Cited by (182)

The role of fear, disgust, and relevant experience in the assessment of stimuli associated with blood-injury-injection phobia
2022, Heliyon
Individuals with high levels of blood-injection-injury (BII) fears are more likely to avoid health screenings, vaccination, and even minor medical interventions. This could result in more serious health issues, lower quality of life, and even shorter life expectancy. However, still little is known about how various emotions (i.e., fear and disgust) affect subjective evaluation on phobia-related stimuli, and what are the potential risk and protective factors that may change the perception of such stimuli throughout these emotions. We investigated the role of fear of medical interventions and the degree of disgust sensitivity in the evaluation of BII phobia-related content and whether previous relevant experience and age may provide protection against the development of a phobia. We collected online survey data from multiple university sources. Participants (N = 228) completed measures of medical fear, disgust sensitivity, prior relevant experience and medical knowledge. Participants were also asked to rate images related to medical settings on dimensions of valence, arousal, disgust, and threat. Our results suggest that high disgust sensitivity and fear of medical interventions may be a risk factor for avoiding medical settings. However, previous relevant medical experience may function as protective factor. The pandemic of recent years underscored the importance of medical intervention and screening tests. These results have implications for professionals helping (e.g., as counselors) people with BII phobia, and physicians and nurses in informing and treating patients.
More than just fear: Development and psychometric evaluation of the Spider Distress Scale to assess spider fear and spider-related disgust
2022, Journal of Anxiety Disorders
Spider fear is an excellent model to experimentally study processes in the maintenance and treatment of long-lasting fears. A valid, reliable, and practical tool to assess spider-related distress dimensionally, and to differentiate between spider-related fear and disgust in a time-sensitive manner, may help to better understand individual differences in these two emotions and to tailor treatments accordingly. We developed a concise self-report questionnaire, the Spider Distress Scale (SDS), that combines the strengths of established spider fear questionnaires and addresses their shortcomings. We explored (study 1 and 2) and confirmed (study 3) a two-factor structure of the SDS in samples from the general population (n = 370; n = 360; n = 423), recruited online via Prolific Academic from the United Kingdom, the Netherlands, and the United States. The fear and disgust factors of the SDS are highly internally consistent and the SDS has excellent test-retest reliability. We found good convergent and discriminant validity, based on self-report measures and spider behavioural approach tasks, and the SDS successfully differentiated between individuals with and without spider fear (study 4, n = 75). Our series of studies suggests that fear and disgust are functionally related, but that disgust towards spiders can be differentially assessed when focussing on unique elements of disgust-related information.
The roles of disgust sensitivity and anxiety sensitivity in attentional bias in dental anxiety
2021, Journal of Anxiety Disorders
Individuals with dental anxiety show biased attentional processing of threat- and dental-related information. Disgust sensitivity and anxiety sensitivity are both associated with dental fears and attentional biases. Whereas disgust sensitivity is generally associated with attentional avoidance (Armstrong et al., 2014), anxiety sensitivity may be associated with attentional engagement (Keogh et al., 2001a). Elucidating the role of these constructs in dental anxiety-relevant attentional biases could inform theoretical models and/or intervention recommendations. Participants (N = 51) with high dental anxiety completed a Posner paradigm to assess attentional biases to dental versus neutral stimuli. We examined whether disgust sensitivity and anxiety sensitivity moderated degree of attentional bias. Results indicated that both disgust sensitivity (mutilation subscale) and anxiety sensitivity (physical concerns subscale) statistically moderated degree of attentional bias at trend level, and in opposite directions. Simple effects analyses further indicated that disgust sensitivity regarding mutilation was associated with less attentional bias toward dental relative to neutral stimuli, potentially indicating attentional avoidance, and remained so when adjusting for anxiety sensitivity. In contrast, simple effects analysis indicated that anxiety sensitivity regarding physical concerns was not associated with magnitude of attentional bias. If replicated, findings highlight the potential role of disgust in dental anxiety.
Super-natural fears
2021, Neuroscience and Biobehavioral Reviews
Citation Excerpt :
Many such agents have features humans are evolutionarily prepared to fear or avoid, such as cues of contamination and other disgust-evoking qualities; traits that facilitate predation, such as fangs or claws; and a tendency to appear suddenly, often at nighttime, just like real-world ambush predators. Disgust and contamination-related associations as emotional factors seem to play a crucial role in the development and maintenance of specific phobias (Huijding and de Jong, 2007; Polák et al., 2020; Tolin et al., 1997). The disease-avoidance model of animal phobias (Matchett and Davey, 1991) claims that disgust and contamination sensitivity is mostly related to animals that are not perceived to attack and harm people, thus phobic fear for such animals is best explained through disease-avoidance rather than predator-avoidance processes.
Supernatural fears, although common, are not as well-understood as natural fears and phobias (e.g., social, blood, and animal phobias) which are prepared by evolution, such that they are easily acquired through direct experience and relatively immune to cognitive mediation. In contrast, supernatural fears do not involve direct experience but seem to be related to sensory or cognitive biases in the interpretation of stimuli as well as culturally driven cognitions and beliefs. In this multidisciplinary synthesis and collaborative review, we claim that supernatural beliefs are “super natural.” That is, they occur spontaneously and are easy to acquire, possibly because such beliefs rest on intuitive concepts such as mind-body dualism and animism, and may inspire fear in believers as well as non-believers. As suggested by psychological and neuroscientific evidence, they tap into an evolutionarily prepared fear of potential impending dangers or unknown objects and have their roots in “prepared fears” as well as “cognitively prepared beliefs,” making fear of supernatural agents a fruitful research avenue for social, anthropological, and psychological inquires.
Relationship of affect intolerance with anxiety, depressive, and obsessive-compulsive symptoms in youth
2021, Journal of Affective Disorders
Citation Excerpt :
Intolerance of uncertainty reflects one's capacity to withstand situations involving ambiguity (Buhr and Dugas, 2002), whereas disgust sensitivity captures the tendency to perceive the emotion of disgust as aversive (Van Overveld et al., 2006). Given that both intolerance of uncertainty and disgust sensitivity are transdiagnostic factors relevant to a range of internalizing symptoms (e.g., Carleton et al., 2012; Tolin et al., 1997), future research should examine these as additional indicators of affect intolerance in youth. Relatedly, our findings were limited by including only two indicators, as it was not feasible to confirm that affect intolerance is truly a unidimensional construct.
Structural research on the construct of affect intolerance (an overarching latent construct indicated by distress tolerance and anxiety sensitivity) has only been conducted in adults. Given that a self-report measure of distress tolerance was recently validated for youth and affect intolerance may be a core mechanism of transdiagnostic interventions for internalizing disorders, we examined how affect intolerance relates to internalizing symptoms in youth. We predicted that a latent affect intolerance factor (indicated by distress tolerance and anxiety sensitivity) would be associated with self and parent-reports of youth anxiety, depressive, and obsessive-compulsive symptoms, controlling for age and gender.
At a pre-treatment evaluation, youth with a primary depressive, anxiety, or obsessive-compulsive spectrum disorder (N=277) aged 8-17, and their parent, completed questionnaires.
Greater levels of the affect intolerance factor predicted greater youth- and parent-reported youth anxiety, depression, and obsessive-compulsive symptoms, controlling for age.
Future research should replicate findings in a sample with a greater proportion of depressed youth and utilize experimental or longitudinal methods.
Importantly, distress tolerance and anxiety sensitivity are core transdiagnostic processes that can be targeted in cognitive-behavioral interventions. Future research should examine how transdiagnostic interventions for youth with internalizing disorders can target these cross-cutting emotional vulnerabilities.
Effects of repeated exposure to fearful and disgusting stimuli on fear renewal in blood-injection-injury phobia
2020, Journal of Anxiety Disorders
Although exposure is effective for blood-injection-injury (BII) phobia, fear often returns after treatment. While disgust has been implicated in BII phobia, its effects on fear renewal are unclear. To address this knowledge gap, the present study examined the effect of repeated video exposure to fearful and disgusting stimuli in multiple contexts on fear renewal in BII phobia. Individuals with BII phobia (N = 57) were randomized to Disgust-Specific Exposure (DSE) which included exposure to disgusting but threat-irrelevant stimuli (i.e., vomit), Fear-Specific Exposure (FSE) which included exposure to threat-relevant stimuli (i.e., injections), or General Negative Exposure (GNE) which included exposure designed to elicit negative affect (i.e., tornado) without being disgusting or threat-relevant. During session one, participants watched a pre- and post-exposure assessment injection video (“pre/post assessment”), and a novel injection video after exposure to assess renewal effects (“novel 1”). Participants came in one week later to rate the same videos, and a new injection video (“novel 2”). For week one outcomes, comparisons of covariate adjusted means indicated the fear-specific group reported significantly lower levels of anxiety than the general-negative group to the post-exposure and novel 1 stimulus. When presented with the post-exposure stimuli during week two, the disgust-specific and fear-specific groups reported significantly lower levels of anxiety than the general negative group. The fear-specific group also reported significantly lower levels of anxiety than the disgust-specific and general-negative groups when presented with novel 1 and novel 2 stimuli at week two. These findings suggest that repeated exposure to threat-relevant cues in multiple contexts does reduce the return of anxiety. However, repeated exposure to disgusting but threat irrelevant stimuli may also produce some therapeutic effects. The implications of the integration of disgust-relevant processes into exposure-based treatment of BII phobia are discussed.

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^☆: This manuscript was written as part of a doctoral dissertation by the first author under the supervision of the second author.

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Behaviour Research and Therapy

Abstract

References (19)

Selective association of fainting with blood-injury-illness fear

Behavior Therapy

Individual differences in sensitivity to disgust: Scale sampling seven domains of disgust elicitors

Personality and Individual Differences

Psychometric description of some specific fear questionnaires

Behavior Therapy

A test of a disease-avoidance model of animal phobias

Behaviour Research and Therapy

The role of evaluative learning and disgust sensitivity in the etiology and treatment of spider phobia

Advances in Behaviour Research and Therapy

One versus five sessions of exposure in the treatment of injection phobia

Behavior Therapy

Exposure in vivo vs. applied relaxation in treatment of blood phobia

Behaviour Research and Therapy

Physiological responses in blood phobics

Behaviour Research and Therapy

Blood-injury phobia

Clinical Psychology Review

Cited by (182)

The role of fear, disgust, and relevant experience in the assessment of stimuli associated with blood-injury-injection phobia

More than just fear: Development and psychometric evaluation of the Spider Distress Scale to assess spider fear and spider-related disgust

The roles of disgust sensitivity and anxiety sensitivity in attentional bias in dental anxiety

Super-natural fears

Relationship of affect intolerance with anxiety, depressive, and obsessive-compulsive symptoms in youth

Effects of repeated exposure to fearful and disgusting stimuli on fear renewal in blood-injection-injury phobia

Shorter communicationDisgust and disgust sensitivity in blood-injection-injury and spider phobia☆

Abstract

Behavior Therapy

Personality and Individual Differences

Behavior Therapy

Behaviour Research and Therapy

Advances in Behaviour Research and Therapy

Behavior Therapy

Behaviour Research and Therapy

Behaviour Research and Therapy

Clinical Psychology Review

Shorter communication
Disgust and disgust sensitivity in blood-injection-injury and spider phobia☆