Elsevier

Journal of Psychiatric Research

Volume 45, Issue 9, September 2011, Pages 1236-1242
Journal of Psychiatric Research

Specificity of disgust vulnerability in the distinction and treatment of OCD

https://doi.org/10.1016/j.jpsychires.2011.01.018Get rights and content

Abstract

A growing body of research has implicated disgust as a potential risk factor for the development and maintenance of obsessive-compulsive disorder (OCD). The first aim of the present study was to determine whether related, yet distinct, disgust vulnerabilities are endorsed more strongly by individuals with OCD than by those with another anxiety disorder. The second aim was to examine the unique contributions of changes in disgust to symptom improvement observed with exposure-based treatment for OCD. In study 1, individuals with OCD, generalized anxiety disorder (GAD), and nonclinical controls (NCCs) completed a measure of disgust propensity and disgust sensitivity. Compared to NCCs and individuals with GAD, those with OCD more strongly endorsed disgust propensity. However, individuals with OCD did not significantly differ from individuals with GAD in disgust sensitivity, although both groups reported significantly higher disgust sensitivity levels compared to NCCs. Study 2 comprised mediation analyses of symptom improvement among individuals with OCD and revealed that decreases in disgust propensity over time mediated improvement in OCD symptoms, even after controlling for improvements in negative affect. The implications of these findings for conceptualizing the role of disgust in the nature and treatment of OCD are discussed.

Section snippets

Sample characteristics

Participants consisted of 30 adults with a diagnosis of GAD, 30 with OCD, and 30 NCCs with no history of an Axis 1 disorder. OCD participants, who mostly (37%) expressed contamination obsessions and washing compulsions, were recruited mainly from the Obsessive-Compulsive Disorder/Tourette Syndrome Program at Vanderbilt University. GAD and NCC participants were recruited from community advertisements or referrals from the Vanderbilt Adult Psychiatry Outpatient Clinic. The Structured Clinical

Sample characteristics

An independent sample of 40 (21 males) participants with a diagnosis of OCD in an intensive outpatient anxiety disorder treatment program participated in the present study. Diagnoses were based upon the Mini International Neuropsychiatric Interview (MINI; Sheehan et al., 1998). The MINI is a structured clinical interview used to assess 17 Axis I disorders. The MINI was administered by trained and certified master- and doctoral-level clinicians. IRB approval was obtained for procedures and all

General discussion

Several lines of evidence suggest that the tendency to experience disgust may play a role in the development and maintenance of OCD (Cisler et al., 2009, Olatunji et al., 2010a, Olatunji et al., 2010b). However, it is unclear if the disgust vulnerability that may give rise to OCD is best characterized by disgust propensity or disgust sensitivity. Furthermore, before causality can be inferred between disgust and OCD, it is necessary (but certainly not sufficient) to show that OCD patients

Contributors

B. Olatunji designed the study, analyzed data, and wrote first draft of the manuscript. C. Tart assisted with the design of the study, data analysis, and preparation of the manuscript. B. Ciesielski assisted with data collect, data analysis, and preparation of the manuscript. P. McGrath assisted with data management and processing. J. Smits assisted with the design of the study, data analysis, and preparation of the manuscript.

Role of funding source

Funding for this study was supported in part by NIMH Grant RO3MH082210-01A1; the NIMH had no further role in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication.

Conflict of interest

All authors declare that they have no conflicts of interest.

Acknowledgment

None.

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