Differential habituation of fear and disgust during repeated exposure to threat-relevant stimuli in contamination-based OCD: an analogue study.

In the present study, participants (N=20) displaying marked contamination concerns were provided 30 min of repeated in vivo exposure to threat-relevant stimuli (cleaning a 'dirty' bed pan), during which time their fear and disgust levels were repeatedly assessed. Results indicated that repeated exposure led to a significant decline in fear but not disgust. The observed decline in fear remained significant after accounting for changes in disgust and vice versa. Although initial disgust was higher than initial fear ratings, differences between the two slopes were not statistically significant. Baseline trait anxiety and global disgust sensitivity levels prior to exposure did not moderate the level of fear or disgust activation during exposure. However, sensitivity specifically related to core and contamination disgust was marginally associated with fear and disgust parameters during outcome. There was also evidence that less fear decline during repeated exposure was associated with higher disgust ratings after the exposure was completed. Theoretical and clinical implications of the present findings for the treatment of contamination concerns in obsessive-compulsive disorder are discussed.

Information processing in contamination fear: a covariation bias examination of fear and disgust.

The current study represents the first examination of covariation biases in contamination fear. Using an undergraduate sample we examined covariation bias for specific emotion outcomes (fear specific and disgust specific) associated with contamination stimuli in high contamination fear (HCF; n=32) and low contamination fear (LCF; n=30) individuals. Following random stimulus-outcome presentation participants provided estimations on the proportion of each presented stimulus-expression pairing. Analyses revealed a specific bias for the over-estimation of fear and disgust contingencies among the HCF group, but not the LCF group. The current study also revealed a specific covariation bias among HCF, not LCF, participants to over-estimate the contingency between contamination stimuli and fear outcomes, not disgust outcomes. Further, results indicate that HCF individuals significantly under-estimate the covariation among contamination stimuli and safety outcomes compared to LCF participants. These findings are discussed in terms of theoretical implications for information processing biases in anxiety disorders.

Attentional Bias Differences between Fear and Disgust: Implications for the Role of Disgust in Disgust-Related Anxiety Disorders.

Research demonstrates a relation between disgust and anxiety-related pathology; however, research has yet to reveal mechanisms by which disgust may contribute to anxiety. The current experiment examined attentional bias characteristics as one route by which disgust influences anxiety. Eighty undergraduate participants completed a rapid serial visual presentation attention task using fear, disgust, or neutral target stimuli. Task-relevance of the target's presentation was also manipulated. Results revealed that task-relevant disgust targets impaired attention among all participants, but task-irrelevant disgust targets impaired attention only in high disgust prone individuals. Difficulty in disengagement characterized both disgust and fear attentional biases, but the difficulty in disengagement was greater for disgust compared to fear attentional biases. High disgust prone individuals displayed exaggerated difficulty in disengaging attention from disgust targets compared to low disgust prone individuals. The results suggest that disgust attentional biases differ from fear attentional biases. The characteristics of disgust attentional biases are discussed as possible mechanisms by which disgust functions in certain anxiety disorders.

Specificity of emotional maintenance processes among contamination fears and blood-injection-injury fears.

Research evidence consistently demonstrates a relation between disgust and anxiety-related pathology. Despite ample evidence implicating a functional role of disgust in anxiety, limited research has focused on the process by which disgust influences anxiety. Recent evidence indicates that fear of responding with disgust predicts contamination fears, thus elucidating a process by which disgust contributes to contamination fears. In the current study, we tested whether fear of responding with disgust is specific to contamination fears or generalizes to blood-injection-injury (BII) fears. Undergraduate psychology students (N=259) completed measures of anxiety sensitivity (AS), trait anxiety, disgust, contamination fears, and BII fears. Data analysis revealed main effects of both AS and disgust in predicting both contamination and BII fears. The interaction between AS and disgust (i.e., being fearful of responding with disgust), however, predicted only contamination fears and not BII fears. The results suggest that fear of responding with disgust is a unique maintenance process specific to contamination fears. Theoretical and clinical implications for both contamination and BII fears are discussed.

Information processing biases in spider phobia: application of the Stroop and "White Noise" Paradigm.

The present study examines attentional and implicit memory biases in spider phobic and nonphobic participants. The results showed that spider phobics demonstrated increased interference for neutral, negative, and spider-relevant words on a computerized Stroop task. However, no group differences emerged when adjusting for differences in color-naming speed. Prior exposure to a dead spider did result in higher overall Stroop interference in spider phobics and this appeared to be mostly pronounced for spider-relevant words. Implicit memory bias for threat was examined with a noise judgment task. Participants first heard neutral and spider-relevant sentences and implicit memory for these sentences was evaluated by having participants rate the volume of noise accompanying the presentation of old sentences intermixed with new sentences. An implicit memory bias is indicated if participants rate noise accompanying old sentences as less loud than noise accompanying new sentences. No evidence was found for an implicit memory bias in spider phobics. These findings are discussed in relation to the role of information processing biases in spider phobia.

Disgust sensitivity mediates the effects of race on contamination aversion.

African Americans report greater contamination aversion than European Americans. Few studies have attempted to identify potential causes for this elevated contamination aversion, though existing research and theory suggests this may be partly due to concomitant heightened disgust sensitivity. The present study examined the relations between race, disgust sensitivity, and contamination aversion among African and European Americans. A convenience sample of fourhundred and twenty-nine participants completed the Disgust Scale - Revised (DS-R) and the Padua Inventory - Revised (PI-R). African Americans endorsed greater disgust sensitivity (DS-R total) - particularly on the core and contamination subscales of the DS-R - and scored higher on the contamination subscale of the PI-R (but not on other subscales) than European Americans. Mediational analyses revealed a significant total effect of race on contamination aversion and a significant indirect effect of race on contamination aversion through disgust sensitivity; the direct effect of race on contamination aversion remained significant even after controlling for race. These findings suggest that elevated contamination aversions among African Americans may be partly due to elevated disgust sensitivity. If confirmed with larger and clinical samples, and more robust experimental methods, this relationship may prove to have implications for the treatment of contamination-based obsessive-compulsive disorder (OCD) among African Americans.

A functional analysis of danger and safety signals in anxiety disorders.

Research in experimental psychopathology indicates that predictability and controllability of threatening events mediate the development, maintenance, and modification of anxiety disorders. We propose that a more thorough analysis of predictability and controllability requires the explication of danger and safety, and those events that provide such signal functions. Although most research is concerned with the identification of signals that predict danger, relatively little attention has been given to the identification of signals that predict safety. The current manuscript outlines the functional analysis of both danger and safety signals as they relate to the various disorders of anxiety. Consideration of pharmacological treatments suggests that the modification of danger and safety signals may function only as incidental features of the intervention. The potential advantages of cognitive-behavioral interventions that maximize treatment-specific self-control of signal functions are discussed.

Multimodal assessment of disgust in contamination-related obsessive-compulsive disorder.

The present study utilizes multiple methods to examine the relationship between disgust and contamination-related obsessive-compulsive disorder (OCD) symptoms in an analogue sample. Questionnaire findings revealed that participants with high OCD contamination concerns showed stronger disgust sensitivity than did participants with low OCD contamination symptoms after controlling for negative affect. High OCD participants (N=30) also reported significantly more disgust than did low OCD participants (N=30) when exposed to a disgust-inducing video, whereas no significant between-group differences were detected on other negative emotional dimensions. Results from a series of disgust-specific behavioral avoidance tasks (BATs) revealed that high OCD participants demonstrated both less compliance and less approach behavior. Subsequent analysis also revealed that disgust sensitivity generally mediated avoidance on the BATs among high OCD subjects. High OCD participants also rated the BATs as more fearful and disgusting than did low OCD participants, with disgust generally emerging as the dominant emotional response. The results are consistent with a disgust-based, disease-avoidance approach in understanding contamination-related OCD themes.

Structural differentiation of disgust from trait anxiety in the prediction of specific anxiety disorder symptoms.

Research has begun to implicate the role of disgust in the etiology of specific phobias and obsessive-compulsive disorder (OCD). However, it remains unclear if the association between disgust and specific anxiety disorder symptoms is an artifact of trait anxiety or a potential mechanism through which trait anxiety effects specific anxiety disorder symptoms. The present study employed structural equation modeling to differentiate disgust from trait anxiety in the prediction of four types of specific anxiety disorder symptoms in a non-clinical sample (N=352). Results indicate that disgust and trait anxiety latent factors were independently related to spider fears, blood-injection-injury (BII) fears, general OCD symptoms, and OCD washing concerns. However, when both variables were simultaneously modeled as predictors, latent disgust remained significantly associated with the anxiety disorder symptoms, whereas the association between latent trait anxiety and the anxiety disorder symptoms became non-significant or was substantially reduced. Statistical tests of intervening variable effects converged in support of disgust as a significant intervening variable between trait anxiety and spider fears, BII fears, and OCD symptoms (particularly washing concerns). The relevance of these findings for future research investigating the role of disgust in specific anxiety disorders is discussed.

Interpretation biases in victims and non-victims of interpersonal trauma and their relation to symptom development.

Previous studies examining information processing in posttraumatic stress disorder (PTSD) have focused on attention and memory biases, with few studies examining interpretive biases. The majority of these studies have employed lexically based methodologies, rather than examining the processing of visual information. In the present study, victims (N=40) and non-victims (N=41) of interpersonal trauma viewed a series of short positive, neutral, and threatening filmstrips of social situations with ambiguous endings. Participants were then asked about their perceptions and interpretations of the situations. Victims perceived threatening situations as more predictable and more quickly increasing in risk than non-victims. Trauma status interacted with the perceived predictability of positive situations and the perceived speed with which neutral situations reached their conclusion to predict anxious symptoms. In addition, trauma status interacted with the perceived increase in risk of positive situations to predict PTSD symptoms. The implications of these findings for theories of PTSD are discussed.

The Disgust Propensity and Sensitivity Scale-Revised: psychometric properties and specificity in relation to anxiety disorder symptoms.

The present study examined the factor structure and psychometric properties of the Disgust Propensity and Sensitivity Scale-Revised (DPSS-R) in a nonclinical sample (N=340). Principal components analysis of the DPSS-R revealed a two-factor structure consisting of Disgust Propensity and Disgust Sensitivity. Although the two-factor structure converged well with prior research, four of the 16 DPSS-R items did not load onto the predicted factor. The DPSS-R demonstrated good reliability and validity. The DPSS-R and its two factors were moderately correlated with spider fear and contamination fear and mildly correlated with injection fear. The relation between the DPSS-R and these anxiety disorder symptoms remained largely intact after controlling for negative affect. Regression analyses also revealed that the two DPSS-R factors demonstrate specificity in the prediction of anxiety disorder symptoms. These findings are discussed in terms of promoting a more valid and reliable assessment of disgust in anxiety disorders.

Scrupulosity and obsessive-compulsive symptoms: confirmatory factor analysis and validity of the Penn Inventory of Scrupulosity.

The current study examined scrupulosity in 352 unselected college students as measured by the 19-item Penn Inventory of Scrupulosity (PIOS). Confirmatory factor analysis yielded support for a two-factor model of the 19-item PIOS. However, item-level analyses provided preliminary support for the validity of a 15-item PIOS (PIOS-R) secondary to the removal of items 2, 6, 15, and 10. The two domains of scrupulosity identified on the PIOS-R consisted of the Fear of Sin and the Fear of God. Both domains and total scrupulosity scores were strongly related to obsessive-compulsive symptoms. Scrupulosity also showed significant, but more modest correlations with a broad range of other measures of psychopathology symptoms (i.e., state anxiety, trait anxiety, negative affect, disgust sensitivity, specific fears). However, only obsessive-compulsive symptoms and trait anxiety contributed unique variance to the prediction of scrupulosity. Examination of specific obsessive-compulsive symptom dimensions revealed that only obsessions contributed unique positive variance to the prediction of Fear of God. However, OCD obsessions, washing, and hoarding symptoms contributed unique positive variance to the prediction of Fear of Sin. These findings are interpreted in the context of future research elucidating the relationship between scrupulosity and obsessive-compulsive symptom dimensions.

Examination of the decline in fear and disgust during exposure to threat-relevant stimuli in blood-injection-injury phobia.

In the present study, participants (N=22) displaying marked fear of blood-injection-injury (BII) stimuli were provided 30 min of in vivo exposure to threat-relevant stimuli, during which time their fear and disgust levels were repeatedly assessed. Growth curve analyses were then conducted to examine the decay slopes in both fear and disgust and their relationship. Results indicated that exposure led to significant declines in fear and disgust across trials. However, the decay slope observed for fear was significantly greater than that for disgust. Further analyses revealed that the decline in fear across trials remained significant after accounting for the changes in disgust. However, the effect of trial on disgust was no longer significant after controlling for the reduction in fear. Global disgust sensitivity levels prior to exposure did not moderate the level of fear activation or fear reduction during exposure. BII-specific digust sensitivity was also not associated with initial levels of fear. However, levels of BII-specific disgust sensitivity were independently negatively associated with fear decline. Theoretical and clinical implications of the findings are discussed.

The Disgust Scale: item analysis, factor structure, and suggestions for refinement.

In the 4 studies presented (N = 1,939), a converging set of analyses was conducted to evaluate the item adequacy, factor structure, reliability, and validity of the Disgust Scale (DS; J. Haidt, C. McCauley, & P. Rozin, 1994). The results suggest that 7 items (i.e., Items 2, 7, 8, 21, 23, 24, and 25) should be considered for removal from the DS. Secondary to removing the items, exploratory and confirmatory factor analyses revealed that the DS taps 3 dimensions of disgust: Core Disgust, Animal Reminder Disgust, and Contamination-Based Disgust. Women scored higher than men on the 3 disgust dimensions. Structural modeling provided support for the specificity of the 3-factor model, as Core Disgust and Contamination-Based Disgust were significantly predictive of obsessive- compulsive disorder (OCD) concerns, whereas Animal Reminder Disgust was not. Results from a clinical sample indicated that patients with OCD washing concerns scored significantly higher than patients with OCD without washing concerns on both Core Disgust and Contamination-Based Disgust, but not on Animal Reminder Disgust. These findings are discussed in the context of the refinement of the DS to promote a more psychometrically sound assessment of disgust sensitivity.

Disgust, anxiety and fainting symptoms associated with blood-injection-injury fears: a structural model.

The present study examines the structural relations between disgust sensitivity, anxiety symptoms, blood-injection-injury (BII) fears, and fainting symptoms associated with BII fears in 259 nonclinical participants. Results revealed that both disgust and BII fear were independent predictors of fainting symptoms. However, structural equation modeling revealed that the relation between disgust sensitivity and fainting was reduced to negative and non-significance when the path from BII fear to fainting was also introduced. Subsequent analysis indicated that the relation between disgust sensitivity and fainting symptoms was fully mediated by BII fear. It was also found that animal reminder disgust was related to fainting symptoms whereas core disgust was not. However, the relation between animal reminder disgust and fainting was also fully mediated by BII fear. Furthermore, anxiety symptoms did not add directly to the structural model predicting fainting associated with BII fears. Implications of these findings for better understanding the interaction of the emotional mechanisms that mediate fainting responses in BII phobia are discussed.

The structural relation between disgust sensitivity and blood-injection-injury fears: a cross-cultural comparison of US and Dutch data.

A growing body of literature has implicated the role of disgust sensitivity in blood-injection-injury (BII) phobia. The present study sought to extend this line of research by investigating the structural relation between Rozin et al.'s [(2000). Disgust. In M. Lewis, J.M. Haviland (Eds.), Handbook of emotions. New York: Guilford Publications.] theoretical model of core and animal reminder disgust as they relate to BII fears in US (N = 162) and Dutch (N = 260) samples. Using confirmatory factor analysis (CFA), the hypothesized relation between the theoretical model of disgust and BII fears demonstrated good model fit in both samples. Consistent with previous findings on the differential relation between core and animal reminder disgust and BII fears [de Jong, P. J., & Merckelbach H. (1998). Blood-injection-injury phobia and fear of spiders: Domain specific individual differences in disgust sensitivity. Personality and Individual Differences, 24, 153-158], structural equation modeling (SEM) provided support for a domain specific relationship in both samples: animal reminder disgust was specifically related to the BII latent factor, whereas core disgust was not. The clinical and research implications regarding the relationships between disgust and BII fears across cultures are discussed.

The structure of disgust: domain specificity in relation to contamination ideation and excessive washing.

The primary goal of the present study was to employ confirmatory factor analysis to compare two theoretical models regarding the factor structure of disgust (N=307). The two-factor model of Animal Reminder and Core disgust proposed by Rozin et al. (2000) demonstrated superior model fit over a one-factor model that has been implicated in prior research. However, contrary to theoretical predictions, categorizing Hygiene disgust as Core disgust rather than Animal Reminder disgust provided an overall better fit for the two-factor model. The second aim of the study was to investigate the relationship between the empirically derived two-factor model and contamination ideation and excessive washing using structural equation modeling. Findings indicated that the Contamination Ideation and Excessive Washing latent factor was specifically related to Core disgust (domain specific) and negatively related to Animal Reminder disgust. The relevance of these findings in the context of future research investigating the role of disgust in specific anxiety disorders is discussed.

Using facial expressions as CSs and fearsome and disgusting pictures as UCSs: affective responding and evaluative learning of fear and disgust in blood-injection-injury phobia.

Two experiments examine use of an evaluative conditioning (EC) paradigm in the acquisition of fear and disgust responding to neutral facial expressions. In Experiment 1, 60 participants were randomly assigned to one of three evaluative learning conditions in which neutral facial expressions were paired with fearsome, disgusting, or neutral pictures. No statistically significant differences were detected between the three conditions. However, significant differences emerged within subjects as post-exposure of fear and disgust ratings were higher among expressions that were paired with pictorial stimuli. Experiment 2 sought to examine if an analogue sample of BII phobics would be more susceptible than nonphobic controls to fear and disgust EC utilizing a similar experimental design, given the co-occurrence of fear and disgust in BII-phobic responding. Results failed to demonstrate an EC effect specific to the analogue phobic group, although both groups showed an evaluative shift toward disgust for those facial expressions paired with BII-relevant pictures. Consistent with previous findings, examination of picture rating data suggested that analogue BII phobics rated the BII pictures as significantly more disgusting than fearful. The role of EC processes and a priori expectancy biases in the associative learning of disgust in BII phobia is discussed.

The Anxiety Sensitivity Profile revisited: factor structure and psychometric properties in two nonclinical samples.

Anxiety sensitivity (AS) refers to the fear of anxiety-related symptoms based upon the belief that the sensations have harmful consequences. Although the most popular existing measure is the Anxiety Sensitivity Index (ASI), the Anxiety Sensitivity Profile (ASP) was developed as an alternative and theoretically improved assessment of the multifaceted nature of the AS construct. Nevertheless, there has been a paucity of research on this measure. We evaluated the psychometric properties and factor structure of the ASP in two large, geographically diverse undergraduate samples who completed the ASP and measures of anxiety and depression. Exploratory factor analysis revealed four lower order ASP factors in both samples: (1) fear of arousal-related symptoms, (2) fear of cognitive dyscontrol and dissociation, (3) fear of gastrointestinal symptoms, and (4) fear of cardiac symptoms. The fear of cardiac symptoms factor was relatively unstable in both studies. Correlations between the ASP factors and related variables were consistent with AS theory. The strengths and limitations of the ASP are offered as well as the implications of our findings for the nature and assessment of AS.

Disgust domains in the prediction of contamination fear.

Previous research has shown a relationship between the emotion of disgust and the fear of contamination. Heightened sensitivity to disgust and increased concerns over contamination has been observed in various disorders, such as obsessive-compulsive disorder (OCD) and specific phobias. However, there is a paucity of research identifying the specific domains of disgust that contribute to contamination fear. The present study soughts to determine which domains of disgust elicitors reliably predict scores on a measure of OCD contamination obsessions and washing compulsions. We further conducted exploratory analyses that examined differences in disgust sensitivity among individuals classified as high and low in contamination fear. Three hundred and twenty-three undergraduate participants completed two measures of disgust sensitivity (Disgust Scale; Disgust Emotion Scale) and a measure of contamination fear (Padua inventory, contamination obsessions and washing compulsions subscale). Stepwise multiple regression analyses indicated that contamination fear was best predicted by seven different disgust domains, thereby suggesting that contamination fear is accounted for by generalized, rather than domain-specific, disgust elicitors. The categories of disgust that predicted contamination fear appeared to have an underlying commonality of threat of contagion. The relationship between fear of contamination and disgust sensitivity was more pronounced for animal reminder disgust elicitors as opposed to core disgust elicitors. Results also showed that individuals classified as high in contamination fear scored significantly higher than the low contamination fear group on all disgust domains. Clinical and research implications regarding the interrelationships between fear, disgust, and the fear of contamination are discussed.