Disgust sensitivity and contamination fears in spider and blood-injection-injury phobias

Disgust has been implicated in the onset and maintenance of blood-injection-injury (BII) and animal phobias. Research suggests that people with these phobias are characterized by an elevated sensitivity to disgust-evoking stimuli separate from their phobic concerns. The disgust response has been described as the rejection of potential contaminants. Disgust-motivated avoidance of phobic stimuli may therefore be related to fears of contamination or infection. The present study compared BII phobics, spider phobics and nonphobics on two measures of disgust sensitivity and two measures of contamination fears. Positive correlations were found between disgust sensitivity and contamination fear. Specific phobics scored higher than nonphobics on all scales and BII phobics scored higher than spider phobics on contamination fear measures. Furthermore, the contamination fear scales were correlated with the blood phobia measure, but not correlated with the spider phobia measure. The results suggest that while both phobias are characterized by elevated disgust sensitivity, contamination fear is more prominent in BII than spider phobia.     

Fear and Disgust Responding to Heterogeneous Blood-Injection-Injury Stimuli: Distinctions from Anxiety Symptoms

Discrepancies exist in the literature regarding the unique role of disgust in Blood-Injection-Injury (BII) phobia. The present study attempts to clarify the discrepancy using a sample of analogue BII phobics (n = 40) and nonphobics (n = 40) who completed a series of questionnaires and were exposed to blood, mutilation, and injection pictures. The findings revealed that BII phobics reported greater disgust and contamination fears than nonphobics after controlling for anxious symptoms. When rating phobia-relevant pictures, BII phobics responded with greater fear and disgust than nonphobics after controlling for baseline anxiety scores. Furthermore, disgust was the dominant emotional response for BII phobics for the blood and mutilation stimuli. However, no differences were found between fear and disgust within the BII group when rating injection stimuli. The implications of these findings for better understanding the potential unique role of disgust in the etiology, maintenance, and treatment of BII phobia are discussed.

Some animal specific fears are more specific than others: Evidence from attention and emotion measures

Using a visual search methodology we investigated the effect of feared animal stimuli on attention. Our results confirmed the important role of emotion on attention. All participants detected fear-relevant stimuli (snakes and spiders) faster than neutral (mushrooms) ones against a background of fruits. In addition, spider fearful participants were sensitized specifically to detect their feared stimulus (spiders), compared to their fear-relevant but non-feared (snakes) and neutral stimuli. However, for participants fearful of snakes there was no significant difference in detection latencies between the feared (snakes) and the fear-relevant but non-feared animal stimuli (spiders). The results from the attention task were mirrored in the emotional ratings, which showed that spider fear was highly specific, whereas snake fear was associated with a more generalized enhanced evaluation of all negative stimuli.     

I am going to gag: Disgust cognitions in spider and blood-injury-injection fears

There is mounting evidence that disgust plays an important role in certain anxiety disorders, yet little is known about disgust's cognitive component. The current study introduces a measure of cognitions associated with disgust and contamination to assess the role of disgust-specific primary and secondary appraisals in phobic responding. A multi-modal assessment of blood-injury-injection (BII) and spider phobia was conducted using BII (N=29) and spider (N=30) fearful groups, and a non-fearful control group (N=30). The Disgust Cognitions scale showed good reliability and validity, and distinguished among the groups. For example, relative to the other groups, the spider fear group reported higher disgust cognitions following presentation of a live spider, whereas the BII Fear group reported higher disgust cognitions following a surgery video. Moreover, the scale was associated with multiple phobic indicators (behavioral avoidance, subjective distress, symptom endorsement), suggesting cognitions may be critical to understanding how disgust contributes to anxiety disorders.     

I am going to gag: Disgust cognitions in spider and blood–injury–injection fears

There is mounting evidence that disgust plays an important role in certain anxiety disorders, yet little is known about disgust's cognitive component. The current study introduces a measure of cognitions associated with disgust and contamination to assess the role of disgust-specific primary and secondary appraisals in phobic responding. A multi-modal assessment of blood–injury–injection (BII) and spider phobia was conducted using BII (N=29) and spider (N=30) fearful groups, and a non-fearful control group (N=30). The Disgust Cognitions scale showed good reliability and validity, and distinguished among the groups. For example, relative to the other groups, the spider fear group reported higher disgust cognitions following presentation of a live spider, whereas the BII Fear group reported higher disgust cognitions following a surgery video. Moreover, the scale was associated with multiple phobic indicators (behavioural avoidance, subjective distress, symptom endorsement), suggesting cognitions may be critical to understanding how disgust contributes to anxiety disorders.     

Reliability and validity of some specific fear questionnaires

Normative psychometric data on a Swedish translation of fear questionnaires concerning snakes, spiders, public speaking, and mutilation given to 223 college students are presented. High internal consistencies were found for all four questionnaires, and low intercorrelations among the four inventories emerged. In a separate study the inventories were administered to a clinical sample of spider and snake phobics. Phobics scored higher on their respective phobic scale than the college group but did not differ from controls on mutilation or public speaking scales. A significant negative correlation emerged between snake and spider scores among the phobics. One year test-retest reliabilities in the phobic sample were high. Finally, snake and spider phobics viewed and rated phobic and nonphobic slides. Snake phobics rated snake slides as more aversive than spider slides, whereas the reverse was true for spider phobics. The correlation between fear ratings and questionnaire scores was significant. Use of these scales in evaluating therapeutic changes is encouraged.     

Attentional bias and evoked heart-rate response in specific phobia

The relationship between the evoked heart-rate (HR) reaction to phobic pictures and the attentional bias was investigated in specific phobics. Forty-five specific phobic and 39 control participants were shown phobia-related pictures while HR was being recorded; they were administered the modified dot-probe task, the modified Stroop task, and gave subjective ratings of pictures. Unlike control participants, specific phobics showed HR acceleration to phobia-related pictures, which was significantly correlated with their fear ratings, and a significant Stroop interference effect. There were no group differences with regard to an attentional bias in the dot-probe task but early deceleration of the HR reaction to phobic pictures was related to more pronounced selective attention toward these stimuli in phobics. The results provide partial support for Cook and Turpin's (1997) conjecture of a relationship between the early decelerative orienting component of the HR reaction and the selective attentional bias in phobia.     

Covariation bias,classical conditioning,and phobic fear

The present study investigated whether phobics show an illusory correlation (IC) between phobia-relevant stimuli and aversive events. Nineteen treated and 19 untreated spider phobics were exposed to a series of 72 slides. Three different categories were used: Phobia-relevant slides (spiders), alternative fear-relevant slides (weapons), and neutral slides (flowers). Slides were randomly paired with either a shock, a siren, or nothing at all. All slide/outcome combinations occurred equally frequently. A posteriori recorded contingency estimates indicated that untreated phobics dramatically overestimate the covariation of spiders and shock. On-line recorded outcome expectancies revealed that the bias to overestimate the spider-shock contingency is highly resistant to extinction. The covariation bias was accompanied by differentially heightened electrodermal first interval responses (FIR) and unconditioned electrodermal responses (third interval responses: TIR) on phobia-relevant trials. Treated phobics did not show a covariation bias, indicating that such bias can be modulated by behavioral treatment. The present findings sustain the hypothesis that phobic subjects process information in a fear-confirming way.     

Emotional responses in spider fear are closely related to picture awareness

Theories of emotion propose that responses to emotional pictures can occur independently of whether or not people are aware of the picture content. Because evidence from dissociation paradigms is inconclusive, we manipulated picture awareness gradually and studied whether emotional responses varied with degree of awareness. Spider fearful and non-fearful participants viewed pictures of spiders and flowers at four levels of backward masking while electrodermal activity and heart rate were measured continuously. Recognition ratings confirmed that participants’ picture awareness decreased with masking. Critically, effects of spider fear on emotion ratings and heart rate also decreased with masking. These findings suggest that effects of spider fear on emotion ratings and heart rate are closely related to picture awareness.     

Emotional responses in spider fear are closely related to picture awareness

Theories of emotion propose that responses to emotional pictures can occur independently of whether or not people are aware of the picture content. Because evidence from dissociation paradigms is inconclusive, we manipulated picture awareness gradually and studied whether emotional responses varied with degree of awareness. Spider fearful and non-fearful participants viewed pictures of spiders and flowers at four levels of backward masking while electrodermal activity and heart rate were measured continuously. Recognition ratings confirmed that participants' picture awareness decreased with masking. Critically, effects of spider fear on emotion ratings and heart rate also decreased with masking. These findings suggest that effects of spider fear on emotion ratings and heart rate are closely related to picture awareness.     

Sensitivity and response bias in fear of spiders

According to cognitive theories of anxiety, phobic patients are searching the environment for threatening stimuli, and detecting them rapidly. However, previous studies failed to find a lowered perceptual threshold for threatening stimuli in specific phobias. Therefore, two experiments applying a signal detection paradigm were conducted. Highly spider fearful and nonfearful participants were asked to decide whether a picture of a spider, beetle, or butterfly was presented. In both experiments, spider fearfuls were not better at detecting spiders, or any other animal, than healthy controls. Instead, spider fearfuls were more liberal in assuming that they had seen a spider or a beetle. In accord with earlier studies, these results suggest that spider phobics may exhibit an interpretation bias rather than improved detection of threat.     

Exposure to disgust-evoking imagery and information processing biases in blood-injection-injury phobia

Biased processing of threat-relevant information is a central construct among contemporary theories of anxiety. However, biases in attentional and memory processes have not been systematically investigated in blood-injection-injury (BII) phobia. Theory has suggested that disgust rather than fear characterizes BII phobia and may mediate processing biases differently. We investigated the effects of a disgust mood induction on attention and memory in BII phobic and nonphobic participants. The Stroop task failed to demonstrate an attentional bias toward medical and disgust words, even under conditions of disgust provocation. However, an implicit memory task showed that BII phobics completed more medical and disgust word stems than nonphobics. These results suggest that BII phobia may be characterized by a similar implicit memory, but not an attentional, bias found in other anxiety disorders. As such, information processing in BII phobia may be qualitatively different from other anxiety disorders. Implications for further research regarding information processing biases in BII phobia are discussed.     

恐惧与厌恶情绪图片系统的编制：基于两种情绪的区分

基于恐惧与厌恶情绪刺激材料界定模糊的问题,实验一在总结前人研究中实验材料方面混淆恐惧和厌恶的基础上,通过问卷法完成了对恐惧与厌恶图片系统初步的搜集、整理工作;实验二通过进一步测评得到了具有良好信度的恐惧与厌恶情绪图片系统,图片系统中的恐惧与厌恶情绪很好的分离,且图片系统中动物、场景、物体三类图片的恐惧、厌恶程度均存在显著差异,可适用于需要不同种类情绪刺激的具体应用性研究。     

恐惧与厌恶情绪图片系统的编制：基于两种情绪的区分

基于恐惧与厌恶情绪刺激材料界定模糊的问题,实验一在总结前人研究中实验材料方面混淆恐惧和厌恶的基础上,通过问卷法完成了对恐惧与厌恶图片系统初步的搜集、整理工作;实验二通过进一步测评得到了具有良好信度的恐惧与厌恶情绪图片系统,图片系统中的恐惧与厌恶情绪很好的分离,且图片系统中动物、场景、物体三类图片的恐惧、厌恶程度均存在显著差异,可适用于需要不同种类情绪刺激的具体应用性研究。     

The Effect of d-Cycloserine on Subliminal Cue Exposure in Spider Fearful Individuals

Research on d-cycloserine (DCS) has demonstrated a significant effect on symptom reduction in human studies that utilized conventional exposure-based approaches. Recent studies have offered promising results for targeting fears through subliminal paradigms. In this double-blind, randomized placebo-controlled study, 45 spider fearful individuals received DCS or placebo pills prior to completing a subliminal cue exposure task to images of spiders. Participants completed self-report questionnaires and a behavioral approach task to a live caged tarantula. After repeated exposure to subliminal spider cues, participants in the DCS group reported a greater reduction in disgust than individuals in the placebo group. No difference was observed in fear ratings. These findings suggest that DCS augments the reduction in disgust in spider fearful subjects after subliminal exposure to spider cues.     

The influence of animal fear on attentional capture by fear-relevant animal stimuli in children

The present study demonstrated that pictures of fear-relevant animals, snakes and spiders, presented among backgrounds of other animal stimuli captured attention and interfered in the detection of a neutral target to the same extent in a large sample of unselected children (N=81). Moreover, detection of a neutral target animal was slowed more in the presence of a feared fear-relevant distracter, e.g., a snake for snake fearful children, than in the presence of a not feared fear-relevant distracter, e.g., a spider for snake fearful children. These results indicate attentional capture by phylogenetically fear-relevant animal stimuli in children and the selective enhancement of this effect by fear of these animals. These findings are consistent with current models of preferential processing of phylogenetically prepared threat stimuli and with cognitive models of anxiety that propose an enhancing effect of fear in the processing of fear-related stimuli.     

Scary and nasty beasts: Self-reported fear and disgust of common phobic animals

Animal phobias are one of the most prevalent mental disorders. We analysed how fear and disgust, two emotions involved in their onset and maintenance, are elicited by common phobic animals. In an online survey, the subjects rated 25 animal images according to elicited fear and disgust. Additionally, they completed four psychometrics, the Fear Survey Schedule II (FSS), Disgust Scale – Revised (DS-R), Snake Questionnaire (SNAQ), and Spider Questionnaire (SPQ). Based on a redundancy analysis, fear and disgust image ratings could be described by two axes, one reflecting a general negative perception of animals associated with higher FSS and DS-R scores and the second one describing a specific aversion to snakes and spiders associated with higher SNAQ and SPQ scores. The animals can be separated into five distinct clusters: (1) non-slimy invertebrates; (2) snakes; (3) mice, rats, and bats; (4) human endo- and exoparasites (intestinal helminths and louse); and (5) farm/pet animals. However, only snakes, spiders, and parasites evoke intense fear and disgust in the non-clinical population. In conclusion, rating animal images according to fear and disgust can be an alternative and reliable method to standard scales. Moreover, tendencies to overgeneralize irrational fears onto other harmless species from the same category can be used for quick animal phobia detection.     

Case Study: A Quantitative Report of Early Attention,Fear, Disgust,and Avoidance in Specific Phobia for Buttons

Specific phobia is characterized by elevated early attention to the phobic object, negative emotion, and avoidance. Typically, phobic objects are biologically relevant, such as potentially threatening snakes or spiders, or potentially contaminating needles or rodents. It is unclear whether the same early attention, emotion, and avoidance responses can be observed in phobia for uncommon, nonbiologically relevant objects, such as buttons (koumpounophobia). In an experimental case study, we measured early attention (detection rates to briefly presented images before a backward mask), emotion, and avoidance to clothing buttons in a button-phobic participant. We compared these responses to nonphobic objects (zippers), and to well-matched control participants. We observed elevated early attention, fear, and disgust to buttons, which did not generalize to nonphobic emotional stimuli. In addition, we observed elevated avoidance of buttons, which did generalize to normatively fearful and disgusting pictures. If replicated, our results indicate that nonbiologically prepared phobic objects elicit similar elevated early attention, emotion, and avoidance as biologically prepared phobic objects. The finding that avoidance was the only response that generalized to nonphobic objects may have treatment implications—namely, that therapeutic attempts to reduce avoidance might consider including a variety of objects, not just the phobic object.     

Self-reported automaticity and irrationality in spider phobia

Spider phobic women (n = 39) and nonfearful controls (n = 41) completed a 20-item questionnaire measuring the extent to which they experience their fear reactions to spiders as automatic and irrational. For the phobic sample, therapy outcome data were also collected. Results suggest that spider phobics tend to view their attitude to spiders as irrational and in this respect, they do not differ from control subjects. Furthermore, compared to control subjects, phobics more often perceive their responses to spiders as automatic, i.e., not under intentional control. Contrary to expectation, no robust correlation was found between automaticity and irrationality. Interestingly, automaticity was not related to treatment outcome, while irrationality to some extent predicted therapy outcome (i.e., the more phobics experienced their fear as irrational, the more they profited from exposure treatment).     

The role of fear and expectancies in capture of covert attention by spiders

Fear-related stimuli are often prioritized during visual selection but it remains unclear whether capture by salient objects is more likely to occur when individuals fear those objects. In this study, participants with high and low fear of spiders searched for a circle while on some trials a completely irrelevant fear-related (spider) or neutral distractor (butterfly/leaf) was presented simultaneously in the display. Our results show that when you fear spiders and you are not sure whether a spider is going to be present, then any salient distractor (i.e., a butterfly) grabs your attention, suggesting that mere expectation of a spider triggered compulsory monitoring of all irrelevant stimuli. However, neutral stimuli did not grab attention when high spider fearful people knew that a spider could not be present during a block of trials, treating the neutral stimuli just as the low spider fearful people do. Our results show that people that fear spiders inspect potential spider-containing locations in a compulsory fashion even though directing attention to this location is completely irrelevant for the task. Reduction of capture can only be accomplished when people that fear spiders do not expect a spider to be present.