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.     

Health anxiety, hypochondriasis, and the anxiety disorders

Although clinical observations suggest that health-related anxiety is present, to some extent, in a number of anxiety disorders, this relationship has not been examined empirically. The present study therefore utilized the Short Health Anxiety Inventory (SHAI) to elucidate the structure of such symptoms among patients with anxiety disorders and to empirically investigate the presence of health anxiety in various anxiety disorders. Confirmatory factor analysis yielded equivalent support for either a 2-factor or 3-factor model of the SHAI's latent structure. The measure demonstrated good reliability, convergent validity, and discriminant validity. Comparison of SHAI scores across groups of patients with various anxiety disorders revealed elevated levels of health anxiety among patients with hypochondriasis and panic disorder relative to those with other anxiety disorders. Receiver operating characteristic analyses supported the utility of the SHAI as a diagnostic tool for screening patients with hypochondriasis utilizing empirically derived cut scores. Findings are discussed in terms of cognitive-behavioral models of anxiety disorders.     

Orienting and maintenance of gaze in contamination fear: Biases for disgust and fear cues

The present study examines the extent to which attentional biases in contamination fear commonly observed in obsessive-compulsive disorder (OCD) are specific to disgust or fear cues, as well as the components of attention involved. Eye tracking was used to provide greater sensitivity and specificity than afforded by traditional reaction time measures of attention. Participants high (HCF; n = 23) and low (LCF; n = 25) in contamination fear were presented with disgusted, fearful, or happy faces paired with neutral faces for 3 s trials. Evidence of both vigilance and maintenance-based biases for threat was found. The high group oriented attention to fearful faces but not disgusted faces compared to the low group. However, the high group maintained attention on both disgusted and fearful expressions compared to the low group, a pattern consistent across the 3 s trials. The implications of these findings for conceptualizing emotional factors that moderate attentional biases in contamination-based OCD are discussed.     

A Taxometric Investigation of the Latent Structure of Worry: Dimensionality and Associations With Depression, Anxiety, and Stress

Worry has been described as a core feature of several disorders, particularly generalized anxiety disorder (GAD). The present study examined the latent structure of worry by applying 3 taxometric procedures (MAXEIG, MAMBAC, and L-Mode) to data collected from 2 large samples. Worry in the first sample (Study 1) of community participants (n = 1,355) was operationalized by worry engagement, absence of worry, and the worry feature of trait anxiety. Worry in the second sample (Study 2) of undergraduate participants (n = 1,171) was operationalized by the tendency to experience worry, intolerance of uncertainty, beliefs about worry, and symptoms of GAD. Results across both samples provided converging evidence that worry is best conceptualized as a dimensional construct, present to a greater or lesser extent in all individuals. Findings from Study 2 also indicated that the latent dimension of worry generally has an equal association with symptoms of depression, anxiety, and stress across the entire continuum. These findings are discussed in relation to the conceptualization and assessment of worry in GAD and related disorders.     

The effects of safety behaviors on health anxiety: an experimental investigation

The present study examined the extent to which safety behaviors exacerbate symptoms of hypochondriasis (severe health anxiety). Participants were randomized into a safety behavior (n = 30) or control condition (n = 30). After a baseline period, participants in the safety behavior condition spent one week actively engaging in a clinically representative array of health-related safety behaviors on a daily basis, followed by a second week-long baseline period. Participants in the control condition monitored their normal use of safety behaviors. Compared to control participants, those in the safety behavior condition reported significantly greater increases in health anxiety, hypochondriacal beliefs, contamination fear, and avoidant responses to health-related behavioral tasks after the safety behavior manipulation. In contrast, general anxiety symptoms did not significantly differ between the two groups as a function of the manipulation. Mediational analyses were consistent with the hypothesis that changes in the frequency of health-related thoughts mediated the effects of the experimental manipulation on health anxiety. These findings suggest that safety behaviors are associated with increases in health anxiety, perhaps by fostering catastrophic thoughts about health. The implications of these findings for the conceptualization of hypochondriasis as an anxiety disorder are discussed.     

Crying for a Vision: The Native American Sweat Lodge Ceremony as Therapeutic Intervention

The Native American sweat lodge ceremony or sweat therapy is being used increasingly in various medical, mental health, correctional, and substance abuse treatment centers serving both Native and non‐Native clients. This article explores the sweat lodge ceremony's background, elements of Native American spirituality, origin story, cultural symbolism, prayer, and contemporary use. Current evidence of effectiveness and therapeutic benefits is presented, then implications for integrating the sweat lodge ceremony as a complementary counseling approach are discussed.     

Attentional bias toward threat in contamination fear: overt components and behavioral correlates

Recent research suggests that an attentional bias toward threat may play a causal role in obsessive-compulsive disorder (OCD) with contamination concerns. However, the attentional components involved in this bias, as well as its behavioral correlates, remain unclear. In the present study, eye movements were recorded in individuals high and low in contamination fear (HCF, LCF, respectively) during 30-s exposures to stimulus arrays containing contamination threat, general threat, pleasant, and neutral images. HCF individuals oriented gaze toward contamination threat more often than LCF individuals in initial fixations, and this bias mediated group differences in responding to a behavioral challenge in a public restroom. No group differences were found in the maintenance of gaze on contamination threat, both in terms of initial gaze encounters, as well as gaze duration over time. However, the HCF group made shorter fixations on contamination threat relative to other image types. The implications of these findings for further delineating the nature and function of attentional biases in contamination-based OCD are discussed.     

Individual differences in disgust sensitivity and health-related avoidance: Examination of specific associations

This present study examined the specificity of disgust sensitivity in predicting health-related anxiety and behavioral avoidance. Participants (n = 60) completed self-report measures of disgust sensitivity, health anxiety, anxiety, and depression. They then completed three randomly presented health-related behavioral avoidance tasks (BATs) that consisted of potential exposure to the common cold, the flu, and mononucleosis. Results indicated that disgust sensitivity was significantly associated with anxious and avoidant responding to the health-related BATs. This association also remained largely intact after controlling for gender, anxiety, depression, and health anxiety. These findings indicate that disgust sensitivity has a specific and robust association with health-related anxiety and avoidance commonly observed among those with excessive health anxiety and obsessive compulsive disorder. The unique role of disgust sensitivity in relation to health anxiety is discussed in the context of a disease-avoidance model.     

The moderating effects of contamination sensitivity on state affect and information processing: Examination of disgust specificity

Although contamination sensitivity has been implicated in several disorders, there is a paucity of research examining the influence of this trait on various outcomes. Accordingly, the present study examined the extent to which individual differences in contamination sensitivity moderated state affect in response to a mood induction and subsequent information processing biases, as assessed by a lexical decision task (LDT). It was hypothesised that the moderating effects of contamination sensitivity would be specific to disgust responding to a negative but not positive mood induction, and to reaction times to disgust and fear compared to happy words on the LDT. The findings were largely consistent with this hypothesis, as contamination sensitivity predicted increased disgust and arousal to the negative mood induction. Contamination sensitivity was also a better predictor of reaction times to disgust and fear words than happy words. However, the moderating effect of contamination sensitivity on reaction times on the LDT was not mediated by its effects on response to the negative mood induction. Implications of these findings for conceptualising the role of contamination sensitivity and its association with disgust in specific disorders are discussed.