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Karl-Jürgen Bär and Gerd Wagner
J Psychiatry Neurosci September 01, 2015 40 (5) E33; DOI: https://doi.org/10.1503/jpn.150242
Karl-Jürgen Bär
Psychiatric Brain and Body Research Group Jena, Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
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Gerd Wagner
Psychiatric Brain and Body Research Group Jena, Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
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We appreciate the point that elevated feelings of disgust have not been assessed in our study. However, we are at variance to his conclusion. In Vicario’s former letter to the editor of the American Journal of Psychiatry,1 he has strengthened the point of altered insula activation being associated with feelings of disgust. However, we have not observed altered insula activation during pain perception in our patients. In addition, Vicario cites the work by Oaten and colleagues,2 which demonstrates that the experience of disgust is generating an increase in pain sensitivity. However, the opposite is true in patients with anorexia. They are less sensitive to pain, as shown in our study. In addition, it is generally assumed that disgust is accompanied by increased activation of the parasympathetic nervous system (PNS). However, empirical support for the role of PNS in disgust is scarce. Probably, the story is far more complicated. He and colleagues3 reported an increase of heart rate associated with unpleasant odors and facial expressions of disgust, while de Jong and colleagues4 suggested some PNS involvement. However, physiologic reactions were independent from disgust sensitivity. To our knowledge, the specific relation between disgust and PNS activity has not been studied in patients with anorexia nervosa. Thus, we would like to express our sincere doubts on the relation between disgust and our findings as raised by Vicario.

References

  1. ↵
    1. Vicario CM
    .Altered insula response to sweet taste processing in recovered anorexia and bulimia nervosa: A matter of disgust sensitivity?.Am J Psychiatry 2013;170:1497
    OpenUrlCrossRef
  2. ↵
    1. Oaten MJ,
    2. Stevenson RJ,
    3. Case TI
    .The effect of disgust on pain sensitivity.Physiol Behav 2015;138:107–12.
    OpenUrl
  3. ↵
    1. He W,
    2. Boesveldt S,
    3. de Graaf C,
    4. et al
    .Dynamics of autonomic nervous system responses and facial expressions to odors.Front Psychol 2014;13:110
    OpenUrl
  4. ↵
    1. de Jong PJ,
    2. van Overveld M,
    3. Peters ML
    .Sympathetic and parasympathetic responses to a core disgust video clip as a function of disgust propensity and disgust sensitivity.Biol Psychol 2011;88:174–9.
    OpenUrlCrossRefPubMed
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Journal of Psychiatry and Neuroscience: 40 (5)
J Psychiatry Neurosci
Vol. 40, Issue 5
1 Sep 2015
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Karl-Jürgen Bär, Gerd Wagner
J Psychiatry Neurosci Sep 2015, 40 (5) E33; DOI: 10.1503/jpn.150242

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Author response
Karl-Jürgen Bär, Gerd Wagner
J Psychiatry Neurosci Sep 2015, 40 (5) E33; DOI: 10.1503/jpn.150242
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