Non-fear emotions in changes in posttraumatic stress disorder symptoms during treatment.

BACKGROUND AND OBJECTIVES: Posttraumatic stress disorder (PTSD) is not only associated with fear but also with other emotions. The present study aimed to examine if changes in shame, guilt, anger, and disgust predicted changes in PTSD symptoms during treatment, while also testing if PTSD symptoms, in turn, predicted changes in these emotions. METHODS: Participants (N = 155) with childhood-related PTSD received a maximum of 12 sessions of eye movement desensitization and reprocessing or imagery rescripting. The data was analyzed using Granger causality models across 12 treatment sessions and 6 assessment sessions (up until one year after the start of treatment). Differences between the two treatments were explored. RESULTS: Across treatment sessions, shame, and disgust showed a reciprocal relationship with PTSD symptoms, while changes in guilt preceded PTSD symptoms. Across assessments, anger was reciprocally related to PTSD, suggesting that anger might play a more important role in the longer term. LIMITATIONS: The individual emotion items were not yet validated, and the CAPS was not administered at all assessments. CONCLUSIONS: These findings partly differ from earlier studies that suggested a unidirectional relationship in which changes in emotions preceded changes in PTSD symptoms during treatment. This is in line with the idea that non-fear emotions do play an important role in the treatment of PTSD and constitute an important focus of treatment and further research.

Trypophobia, skin disease, and the visual discomfort of natural textures.

In the last decade, the behavioral sciences have described the phenomenon of trypophobia, which is the discomfort felt by some individuals when viewing images containing clusters of bumps or holes. One evolutionary hypothesis for this phenomenon is that this visual discomfort represents an adaptation which helps organisms avoid skin disease and/or ectoparasites. Even though trypophobic imagery and disease imagery are both examples of visual textures, to date there has been no comparison of the visual discomfort elicited by these two specific kinds of textures within the larger context of the visual comfort elicited by natural texture imagery more generally. In the present study, we administered the Trypophobia Questionnaire (TQ) and recorded the visual comfort ratings elicited by a large set of standard natural texture images, including several trypophobic and skin disease images. In two independent samples, we found that while all observers find skin diseases uncomfortable to view, only those scoring high on the TQ rated trypophobic imagery equally uncomfortable. Comparable effects were observed using both standard ANOVA procedures as well as linear mixed effects modeling. Comparing the ratings of both high-TQ and low-TQ participants to the standard textures, we find remarkably consistent rank-order preferences, with the most unpleasant textures (as rated by both groups) exhibiting qualitative similarities to trypophobic imagery. However, we also find that low-level image statistics which have been previously shown to affect visual comfort are poor predictors of the visual comfort elicited by natural textures, including trypophobic and disease imagery. Our results suggest that a full understanding of the visual comfort elicited by natural textures, including those arising from skin disease, will ultimately depend upon a better understanding of cortical areas specialized for the perception of surface and material properties, and how these visual regions interact with emotional brain areas to evoke appropriate behavioral responses, like disgust.

Neurocognitive mechanisms of mental imagery-based disgust learning.

Disgust imagery represents a potential pathological mechanism for disgust-related disorders. However, it remains controversial as to whether disgust can be conditioned with disgust-evoking mental imagery serving as the unconditioned stimulus (US). Therefore, we examined this using a conditioned learning paradigm in combination with event-related potential (ERP) analysis in 35 healthy college students. The results indicated that the initial neutral face (conditioned stimulus, CS+) became more disgust-evoking, unpleasant, and arousing after pairing with disgust-evoking imagery (disgust CS+), compared to pairing with neutral (neutral CS+) and no (CS-) imagery. Moreover, we observed that mental imagery-based disgust conditioning was resistant to extinction. While the disgust CS + evoked larger P3 and late positive potential amplitudes than CS- during acquisition, no significant differences were found between disgust CS+ and neutral CS+, indicating a dissociation between self-reported and neurophysiological responses. Future studies may additionally acquire facial EMG as an implicit index of conditioned disgust. This study provides the first neurobiological evidence that associative disgust learning can occur without aversive physical stimuli, with implications for understanding how disgust-related disorders may manifest or deteriorate without external perceptual aversive experiences, such as in obsessive-compulsive disorder (OCD).

Treatment of disgust in specific emotional disorders.

Although conditioning approaches have highlighted potential characteristics of disgust in anxiety disorders, obsessive-compulsive disorder (OCD), and posttraumatic stress disorder (PTSD), these findings have yet to be translated into evidence-based treatments. Examination of the literature suggests various indicators of disgust that predict treatment outcome in these disorders. However, mechanisms remain unclear because studies examining disgust during the course of treatment are limited. Increasingly, the field has moved toward experimental investigation of strategies that reduce disgust. While cognitive reappraisal and imagery techniques appear promising, such techniques have yet to be examined as anxiety disorder treatments in large-scale randomized clinical trials. The literature also points to novel approaches to treating disgust, ranging from an inhibitory-informed approach to exposure therapy to transcranial direct current stimulation. However, the development of novel treatment approaches will require more rigorous experimental psychopathology approaches that can further elucidate processes that contribute to the etiology and/or maintenance of disorders of disgust.

Orientação a pais por chamadas de áudio durante a pandemia de covid-19 / Support for parents via audio calls during the covid-19 pandemic / Orientación de los padres mediante llamadas de audio durante la pandemia de covid-19

O distanciamento social ocasionado pela pandemia de Covid-19 levou a profundas mudanças na rotina das famílias com crianças pequenas, aumentando o estresse no ambiente doméstico. Este estudo analisou a experiência de planejamento e implementação de um projeto de extensão universitária que ofereceu orientação a pais com filhos de 0 a 11 anos por meio de chamadas de áudio durante a pandemia. O protocolo de atendimento foi desenvolvido para atender às necessidades de famílias de baixa renda e listava problemas específicos relacionados ao confinamento em casa e ao fechamento das escolas seguidos por uma variedade de estratégias de enfrentamento. A análise de 223 queixas relatadas pelos usuários em 130 ligações revelou que 94% dos problemas referidos pelos pais foram contemplados pelo protocolo de atendimento e estavam relacionados aos problemas externalizantes (39%) ou internalizantes (26%) das crianças ou ao declínio do bem-estar subjetivo dos pais (29%). Serviços de apoio devem orientar os pais quanto ao uso de práticas responsivas e assertivas que promovam o bem-estar emocional da criança e estabeleçam expectativas comportamentais em contextos estressantes. A diminuição dos conflitos entre pais e filhos resultante do uso dessas estratégias tende a reduzir o sofrimento dos pais, aumentando sua sensação de bem-estar subjetivo. Recomenda-se ampla divulgação dessas iniciativas e seguimento dos casos.(AU)

The social distancing the COVID-19 pandemic entailed has led to profound changes in the routine of families with young children, increasing stress in the home environment. This study analyzed the experience of planning and implementing a university extension program that offered support to parents with children from 0 to 11 years old via audio calls during the COVID-19 pandemic. The service protocol was developed to meet the needs of low-income families and listed specific problems related to home confinement and school closure followed by a variety of coping strategies. The analysis of 223 complaints reported by users in 130 calls revealed that 94% of the problems reported by parents were addressed by the protocol and were related to children's externalizing (39%) or internalizing (26%) problems or to the decline in parents' subjective well-being (29%). Support services should guide parents on the use of responsive and assertive practices that promote the child's emotional well-being and set behavioral expectations in stressful contexts. The reduction in conflicts between parents and children resulting from the use of these strategies tends to reduce parents' suffering, increasing their sense of subjective well-being. Wide dissemination of these initiatives and case follow-up are recommended.(AU)

La distancia social causada por la pandemia de COVID-19 condujo a cambios profundos en la rutina de las familias con niños pequeños, aumentando el estrés en el entorno del hogar. Este estudio analizó la experiencia de planificar e implementar un proyecto de extensión universitaria que ofreció orientación a los padres con niños de cero a 11 años a través de llamadas de audio durante la pandemia COVID-19. El protocolo de atención se desarrolló para satisfacer las necesidades de las familias de bajos ingresos y enumeró problemas específicos relacionados con el confinamiento en el hogar y el cierre de la escuela, seguido de una variedad de estrategias de afrontamiento. El análisis de 223 quejas informadas por los usuarios en 130 llamadas reveló que el 94% de los problemas informados por los padres fueron abordados por el protocolo de atención y estaban relacionados con los problemas de externalización (39%) o internalización (26%) de los niños o la disminución del bienestar subjetivo de los padres (29%). Los servicios de apoyo deberían aconsejar a los padres sobre el uso de prácticas receptivas y asertivas que promuevan el bienestar emocional del niño y establezcan expectativas de comportamiento en contextos estresantes. La reducción de los conflictos entre padres e hijos como resultado del uso de estas estrategias tiende a reducir el sufrimiento de los padres, aumentando su sensación de bienestar subjetivo. Se recomienda una amplia difusión de estas iniciativas y seguimiento de casos.(AU)

The experience of disgust by nursing and midwifery students: An interpretative phenomenological approach study.

Although disgust is recognized as a common and prominent emotion in healthcare, little is known about how healthcare professionals understand, experience and conceptualize disgust. The aim of the study was to gain an in-depth understanding of how nursing and midwifery students experience, understand and cope with disgust in their clinical work. Interviews were transcribed verbatim and analysed using interpretative phenomenological analysis (IPA). Six participants (all women: two nursing students, four midwifery students) from a university in the South of England were interviewed. Four superordinate themes with eight subthemes were identified. Overall, findings suggest that participants experience both moral and physical disgust; however, they find it difficult to talk about and use other terms to describe their experience. Findings are discussed through the lens of social identity theory, to understand the relevance of professional identity and how this might further maintain the disgust taboo. The strategies participants have developed in order to cope with disgust are explored and understood within the current healthcare climate. Future research should focus on ways of addressing the experience of disgust by healthcare professionals in order to improve the quality of care provided, especially in the climate of the COVID-19 crisis.

Improving interoception and self-disgust in the treatment of patients with anorexia nervosa.

Anorexia nervosa (AN) is a mental disorder in which sufficient evidence points towards the presence of a high level of disturbed interoception and self-disgust. High arousal mood induction is a therapeutic technique that helps improve a patient's interoceptive capacities. With some adjustments to this technique such as adding a challenging behavior that induces a "flow" state or a mindfulness component such as in mindful awareness in body-oriented therapy (MABT), it is expected that patients with AN may benefit from an integrative treatment strategy that helps them improve their symptoms of high self-disgust and low interoception.

Contagious itch and disgust during a lecture on ectoparasitic infestations: Two co-activated complementary parasite defense systems?

(Audio-)visual itch transmission is referred to as "contagious itch" (CI) and has been linked to an evolutionarily ingrained ectoparasite defense system. Disgust is considered to be part of the behavioral immune system aimed to prevent the spreading of pathogens. Although they probably serve a similar purpose, the relationship between CI and disgust is unknown. We investigated their co-prevalence, correlation, and differences between the sexes and between skin-diseased and skin-healthy individuals. Medical students attending a lecture on ectoparasitic infestation indicated their change in itch and disgust compared to baseline on a 0 to 10 numerical rating scale (NRS) and specified which ectoparasitic infestation induced CI and disgust the most. Out of 132 participants, 87.9% reported CI, 84.1% disgust. The maximum intensity of CI was 3.68 ± 2.08 NRS (P < .0001), of disgust 3.80 ± 2.68 NRS (P < .0001), respectively. The CI and disgust correlated positively (rho 0.272; P = .002), but we also found that specific ectoparasitic infestations triggered rather itch than disgust and vice versa. Our results indicate that CI and disgust are coincident phenomena of distinct defense systems: CI is aimed to scrape off ectoparasites, disgust to prevent ingestion of pathogens. Furthermore, our data point to differences in CI and disgust between the sexes and skin-healthy vs skin-diseased participants.

Behavioral inhibition system sensitivity moderates audio-visual neutral information processing.

BACKGROUND AND OBJECTIVES: Misperception of other people's intention and emotions could cause and worsen interpersonal problems, thereby increasing the likelihood of developing depression and anxiety disorders among individuals who are already at risk for those conditions. Although multisensory emotional information is ubiquitous in the real world, most previous research focused exclusively on processing facial expressions. Addressing this gap, the current study examined the association between behavioral inhibition system (BIS) sensitivity and audio-visual emotional information processing. Sensitive BIS suggests heightened sensitivity to anxiety provoking stimuli and is a known risk factor for developing emotional disorders. We hypothesized that higher BIS levels would be associated with inefficient multisensory emotional processing, which might be pronounced for neutral stimuli. METHODS: Seventy-six undergraduates (40 women) completed a task while target faces (disgusted, happy, and neutral) were rendered invisible, and a voice (disgusted, happy, and neutral) or no voice was presented simultaneously. Participants' reaction times to indicate the location of the interocularly suppressed faces were measured. RESULTS: Individuals with lower BIS levels detected neutral faces faster when accompanied by neutral voices than by no voice; individuals with higher BIS levels, however, did not benefit from congruent auditory information when processing neutral faces. LIMITATIONS: The current study cannot address whether the finding is due to attentional biases, interpretation biases, or both in individuals who are prone to become anxious. CONCLUSION: Multisensory processing of neutral information is modulated by individuals' propensity to become anxious.

Placebos can change affective contexts: An event-related potential study.

An unpleasant context (bitter aftertaste) is able to reduce the late positive potential (LPP) elicited by affective pictures. This study attempted to influence this context with a placebo. Sixty-eight women were randomly assigned to three groups: Water, Bitter/No-Placebo, Bitter/Placebo. Participants in the 'bitter groups' first rinsed their mouth with wormwood tea that caused a bitter aftertaste. Subsequently, the placebo group received sham light therapy on the tongue to 'reduce the sensitivity of the taste buds'. All groups viewed disgusting and non-disgusting pictures while their electroencephalogram was recorded. The Bitter/Placebo group reported reduced bitterness and disgust for the aftertaste after the sham treatment. The LPP reduction (300-600 ms after picture onset) associated with the bitter aftertaste (as shown by the Bitter/No-Placebo group) was attenuated due to the placebo treatment. This is the first EEG study to demonstrate that a context-targeting placebo is able to change automatic attention allocation.

Folk beliefs about the relationships anger and disgust have with moral disapproval.

Theories that view emotions as being related in some way to moral judgments suggest that condemning moral emotions should, at a minimum, be understood by laypeople to coincide with judgments of moral disapproval. Seven studies (total N = 826) tested the extent to which anger and disgust align with this criterion. We observed that while anger is understood to be strongly related to moral disapproval of people's actions and character, disgust is not (Studies 1a, 1b, 2a, 2b, and 3), and that, in contexts where disgust expressions are thought to coincide somewhat with moral disapproval, part of the reason is that the expression is perceived as anger (Study 4). Expressions of sadness are also construed as communicating anger in such contexts (Study 5). We discuss our findings in terms of rethinking how we should consider disgust as a moral emotion.

Adolescent Attention to Disgust Visuals in Cigarette Graphic Warning Labels.

PURPOSE: Adolescents are often a target audience for disgust-eliciting antismoking messages, including graphic warning labels (GWLs) on cigarette packages. Yet, few studies have examined how adolescents attend and respond to disgust imagery frequently depicted in these messages. METHODS: A within-subjects eye-tracking experiment with middle school youth (N = 436) examined attention for GWLs that feature disgust versus nondisgust images. Hypotheses were based on emotion theory and previous findings with adult participants. This study also tested whether living with a smoker moderated effects of attention on negative emotions and risk beliefs. RESULTS: Participants paid similar levels of attention to warnings with disgust visuals as they did warnings with nondisgust visuals, accounting for other differences in the warnings. The presence of a disgust visual drew greater attention to the warning image and reduced attention for the warning text. These viewing patterns were similar for youth who live with a smoker and those who do not. Attention to disgust imagery was the only attentional factor to predict negative emotional reactions, and this relationship was driven by results observed among youth who live with a smoker. Attention to neither image nor text predicted risk beliefs. CONCLUSIONS: GWLs with disgust imagery do not trigger more or less attention to the overall warnings but do influence allocation of attention to images over text. Future work should confirm whether attention to disgust imagery itself is important for triggering negative emotional responses, particularly with youth for whom the message is more personally relevant.

Stress and Illness: A Role for Specific Emotions.

Research on stress and disease has often afforded an important role to emotion, typically conceptualized in broad categories (e.g., negative emotions), viewed as playing a causal role (e.g., anger contributing to pathophysiology of cardiovascular disease), and measured using self-report inventories. In this article, I argue for the value of evaluating specific emotions, considering bidirectional causal influences, and assessing actual emotional responding when considering the role that emotions play in the stress-disease relationship. In terms of specificity, specific emotions (e.g., anger, sadness, and embarrassment) can be linked with particular health outcomes (e.g., cardiovascular disease and musculoskeletal disease). In terms of bidirectionality, the influences of emotions on disease as well as the influences of disease on emotional functioning can be considered. In terms of assessing actual emotional responding, emotions can be studied in vivo under controlled conditions that allow behavioral, physiological, and subjective responses to be measured during different kinds of emotional functioning (e.g., responding to emotional stimuli, interacting with relationship partners, and downregulating emotional responses). With these considerations in mind, I review early theories and empirical studies in psychosomatic medicine that considered the role of specific emotions and emotion-related behaviors. Studies from our laboratory are presented that illustrate a) differences in patterns of autonomic nervous system responding associated with specific emotions, b) relationships between specific emotions and particular health outcomes in the context of social relationships, c) age as a moderator of the relationship between specific emotions and well-being, d) bidirectional influences (emotions influencing disease and disease influencing emotional functioning), and e) impact of changes in emotional functioning in individuals with neurodegenerative diseases on the health of familial caregivers.

Electro-cortical correlates of multisensory integration using ecologically valid emotional stimuli: Differential effects for fear and disgust.

Multisensory integration (MSI) is crucial for human communication and social interaction and has been investigated in healthy populations and neurodevelopmental disorders. However, the use of stimuli with high ecological validity is sparse, especially in event-related potential (ERP) studies. The present study examined the ERP correlates of MSI in healthy adults using short (500 ms) ecologically valid professional actor-produced emotions of fear or disgust as vocal exclamation or facial expression (unimodal conditions) or both (bimodal condition). Behaviourally, our results show a general visual dominance effect (similarly fast responses following bimodal and visual stimuli) and an MSI-related speedup of responses only for fear. Electrophysiologically, both P100 and N170 showed MSI-related amplitude increases only following fear, but not disgust stimuli. Our results show for the first time that the known differential neural processing of fear and disgust also holds for the integration of dynamic auditory and visual information.

Changing disgust through imagery rescripting and cognitive reappraisal in contamination-based obsessive-compulsive disorder.

Contamination-related obsessive-compulsive disorder (C-OCD) is characterized by strongly experienced disgust and fear, in response to potentially contaminating stimuli. Both emotions differ in their susceptibility for change by habituation and extinction, which are important processes for the success of exposure therapy. Even though the response rates for exposure therapy for C-OCD are very good, it seems promising to test additional therapeutic techniques which target disgust more directly. Therefore, imagery rescripting and cognitive reappraisal were evaluated for their potential to change levels of disgust (within-subject), in the two-session laboratory study with 30 participants, with diagnosed C-OCD, and 30 matched, healthy controls (between-subject), presented. The results show that both emotion-regulation strategies reduced disgust better than a non-intervention control task (counting fishes), across all the participants. Therefore, both strategies seem to be applicable and effective for reducing disgust, in the short term, in participants with diagnosed C-OCD. The implications of these findings for the experimental approach and for the clinical treatment of C-OCD, are discussed.

Disgust but not Health Anxiety Graphic Warning Labels Reduce Motivated Attention in Smokers: A Study of P300 and Late Positive Potential Responses.

Background: Graphic health warning labels (GHWLs) on tobacco products attempt to leverage avoidance-promoting emotions, such as anxiety and disgust, to encourage cessation. Prior studies have relied on self-report or attentional metrics that may not accurately illuminate GHWLs' ability to motivate change. This report evaluates the impact of disgust- and anxiety-based GHWLs on electroencephalograph (EEG) measures of motivated attention among two groups of smokers-those that report higher versus lower cigarette dependence. We hypothesized that both anxiety and disgust GHWLs would reduce appetitive attention, as indexed by lowered P300 (P3) and late positive potential (LPP) activations. Methods: Sixty-one smokers provided demographic and smoking history before completing an oddball paradigm consisting of three counterbalanced stimuli blocks. Each block (100 trials) contained a neutral, GHWL-anxiety, or GHWL-disgust frequent image and a smoking cue as the oddball image (20%). Oddball trials for each block were averaged, P3 and LPP were identified at midline electrode positions (Fz, Cz, and Pz), and mean amplitude was analyzed. Results: Separate mixed-model ANOVAs of P3 and LPP reactivity revealed disgust-focused GHWLs reduced motivated attentional processing. Conversely, the anxiety-focused GHWL appeared to increase the salience of the smoking cue (Fz only). Less-dependent smokers showed lower P3 reactivity than those with higher dependence at Fz, but greater P3 reactivity at Cz and Pz. Conclusion: These results extend prior work in demonstrating that disgust, but not anxiety-based GHWLs, may reduce EEG-assessed motivated attention to smoking cues. Disgust may thus represent a more fruitful target for public health cessation efforts. Implications: Most GHWL evaluations have focused on fear (or anxiety) elicitation rather than disgust, an emotion that may have a unique link to smoking, having evolved specifically to facilitate the avoidance of contaminants via oral incorporation. Analyses of P300 and LPP responses to GHWLs suggest that disgust-focused images interfere with the EEG-indexed attentional processing of smoking cues and do so better than health anxiety-focused messages. However, interaction effects at different electrode sites indicated that GHWLs have complex effects in more versus less-dependent smokers and that an understanding of how smoking cues and anti-smoking imagery become associated over time is needed to identify relevant targets for public health efforts.

Warmth, competence, and closeness may provide more empirically grounded starts for a theory of sentiments.

Gervais & Fessler dissect the folk concept of "contempt" to argue for a functionally integrated model of attitudes and emotions in the context of social relationships. Existing studies of how evaluations of warmth, competence, and closeness shape people's reactions and behaviors towards others may help in operationalizing and testing the proposed model.

On the substantial contribution of "contempt" as a folk affect concept to the history of the European popular institution of charivari.

The integration of the folk affect concept of "contempt" into the analysis of the complex institution known generally as charivari is mutually beneficial for both ethno-anthropology (which may thus access inner causes for disputed social and collective behaviors) and evolutionary psychology (which may thus study the length of tradition together with the width of the institution spread, serving the same social functions).

On the deep structure of social affect: Attitudes, emotions, sentiments, and the case of "contempt".

Contempt is typically studied as a uniquely human moral emotion. However, this approach has yielded inconclusive results. We argue this is because the folk affect concept "contempt" has been inaccurately mapped onto basic affect systems. "Contempt" has features that are inconsistent with a basic emotion, especially its protracted duration and frequently cold phenomenology. Yet other features are inconsistent with a basic attitude. Nonetheless, the features of "contempt" functionally cohere. To account for this, we revive and reconfigure the sentiment construct using the notion of evolved functional specialization. We develop the Attitude-Scenario-Emotion (ASE) model of sentiments, in which enduring attitudes represent others' social-relational value and moderate discrete emotions across scenarios. Sentiments are functional networks of attitudes and emotions. Distinct sentiments, including love, respect, like, hate, and fear, track distinct relational affordances, and each is emotionally pluripotent, thereby serving both bookkeeping and commitment functions within relationships. The sentiment contempt is an absence of respect; from cues to others' low efficacy, it represents them as worthless and small, muting compassion, guilt, and shame and potentiating anger, disgust, and mirth. This sentiment is ancient yet implicated in the ratcheting evolution of human ultrasocialty. The manifolds of the contempt network, differentially engaged across individuals and populations, explain the features of "contempt," its translatability, and its variable experience as "hot" or "cold," occurrent or enduring, and anger-like or disgust-like. This rapprochement between psychological anthropology and evolutionary psychology contributes both methodological and empirical insights, with broad implications for understanding the functional and cultural organization of social affect.