The effects of safety behaviors on the fear of contamination: an experimental investigation

The strategies used by anxious individuals to prevent feared outcomes, known as safety behaviors, are thought to maintain pathological anxiety by preventing the disconfirmation of inaccurate threat beliefs. However, it is possible that safety behaviors might also contribute to the development and exacerbation of anxiety symptoms. The present study tested this notion in a sample of undergraduate participants with either low (n=30) or high (n=26) levels of contamination fear. After a week-long baseline period, participants spent 1 week engaging in a clinically representative array of contamination-related safety behaviors on a daily basis, followed by a second baseline period. Subsequent to the safety behavior manipulation, participants evidenced statistically significant increases in threat overestimation, contamination fear symptoms, and emotional and avoidant responses to three contamination-related behavioral avoidance tasks (BATs). In contrast, anxiety and depressive symptoms remained stable. The magnitude of change in contamination concerns was equivalent among participants in both contamination fear groups. Our findings suggest that contamination-related safety behaviors elicit a modest and specific increase in the fear of contamination. Possible mechanisms for this effect, as well as implications for the role of safety behaviors in the psychopathology of anxiety disorders, 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.     

Specificity of disgust sensitivity in the prediction of behavioral avoidance in contamination fear

This study examined the specificity of disgust sensitivity in predicting contamination-related anxiety and behavioral avoidance. Participants high (n=26) and low (n=30) in contamination fear completed self-report measures of disgust sensitivity, contamination cognitions (overestimation of the likelihood and severity of contamination from everyday objects), anxiety, and depression. They then completed three randomly presented contamination-based behavioral avoidance tasks (BATs) that consisted of exposure to a used comb, a cookie on the floor, and a bedpan filled with toilet water. Results indicated that disgust sensitivity was significantly associated with anxious and avoidant responding to the contamination-related BATs. This association remained largely intact after controlling for gender, contamination fear group membership, anxiety, and depression. Contamination cognitions were also significantly related to BAT responses. However, this relationship was fully mediated by disgust sensitivity. These findings indicate that disgust sensitivity has a specific and robust association with contamination concerns commonly observed in obsessive compulsive disorder. The findings are discussed in the context of a disease-avoidance model.     

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.

Automatic avoidance tendencies in individuals with contamination-related obsessive-compulsive symptoms

We used an approach-avoidance task (AAT) to examine response to threatening stimuli in 20 individuals high in contamination-related obsessive-compulsive symptoms (HCs) and 21 individuals low in contamination-related obsessive-compulsive symptoms (LCs). Participants were instructed to respond to contamination-related and neutral pictures by pulling a joystick towards themselves or by pushing it away from themselves. Moving the joystick changed the size of the image to simulate approaching or distancing oneself from the object. Consistent with our hypothesis, the HC group was significantly slower in pulling contamination-related pictures than in pulling neutral pictures, whereas in the LC group there was no difference between speed of pulling contamination-related pictures and neutral pictures. Contrary to our hypothesis, we did not find support for faster pushing away of contamination-related pictures than neutral pictures by the HC group. Moreover, the degree of avoidance of contamination-related stimuli when pulling - but not when pushing - was significantly correlated with self-reported contamination-related obsessive-compulsive symptoms. These results suggest a biased behavioral response for threatening objects in individuals high in contamination fears only when inhibiting the prepotent response to avoid threatening stimuli and not when performing a practiced avoidance response. Thus, our results validate the use of the AAT as a measure of inhibited and uninhibited automatic avoidance reactions to emotional information in individuals with contamination-related obsessive-compulsive symptoms.     

Children,Object Value,and Persuasion

We argue that, contrary to standard views of development, children understand the world in terms of hidden, nonobvious structure. We review research showing that early in childhood, items are not understood strictly in terms of the features that present themselves in the immediate “here‐and‐now,” but rather are thought to have a hidden reality. We illustrate with two related but distinct examples: category essentialism, and attention to object history. We discuss the implications of each of these capacities for how children determine object value. Across a broad range of object types (natural and artifactual, real and virtual, durable and consumable), an item is evaluated very differently, depending on inferred qualities and context. In this way, children's early‐emerging conceptual frameworks influence how objects attain both psychological and monetary value, and may have important implications for which messages children find most persuasive.     

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.     

Components of attentional biases in contamination fear: Evidence for difficulty in disengagement

Attentional bias for threat has been implicated in the contamination fear (CF) subtype of obsessive-compulsive disorder, but the components of the bias (facilitated attention versus difficulty in disengagement) and the stage of processing during which the bias occurs (early versus late stage of processing) remains unclear. Further, it is unclear whether attentional biases in CF are towards fear or disgust-related stimuli. The present study examined attentional biases in a group of individuals selected to have elevated CF (n = 23) and a control group (n = 28) using the spatial cueing task. Stimuli were neutral, disgusting, or frightening pictures presented for either 100 or 500 ms. Results revealed evidence for delayed disengagement from both fear and disgust stimuli in the CF group, but not in the control group. The effect appeared to be greater at 500 ms stimulus presentation, but did not appear to differ between fear and disgust stimuli. The CF group was associated with delayed disengagement from threat even when controlling for generic response slowing. Theoretical and clinical implications are discussed.