Disgust Sensitivity in Psychiatric Disorders: A Questionnaire Study

Disgust experiences are discrete emotional states that involve parasympathetic activation, withdrawal behavior, and feelings of revulsion. For the majority of researchers, disgust is considered a food-related emotion, which evolved as an accompanying affect of an oral defense reaction (e.g., Rozin and Fallon, 1987). During the cultural development of disgust, further elicitors have become relevant. Among these, aspects involving interpersonal and moral aspects are now commonly mentioned (Rozin and Fallon, 1987). Recently a growing research interest has begun to evolve around the role disgust plays for mental disorders. Within this context specific phobias, obsessive-compulsive disorders (OCD), depression, and eating disorders belong to the most frequently named syndromes, which are thought to be characterized by an altered disgust processing (Phillips et al., 1998). Results from questionnaire studies have been quite consistent in demonstrating that individuals with a proneness to or a clinical diagnosis of small animal phobia (e.g., spider), blood-injection-injury phobia, or OCD report an elevated disgust sensitivity (e.g., de Jong and Merckelbach, 1998; Mancini et al., 2001; Matchett and Davey, 1991; Schienle et al., 2001). Additionally, during the presentation of disorderrelevant stimuli, these patients often experience intense feelings of disgust (e.g., Tolin et al., 1997). Findings associated with the function of disgust in eating disorders such as anorexia or bulimia nervosa and depression are not yet clear. Whereas in some questionnaire studies the patients had indicated a greater disgust reactivity (Davey et al., 1998), in others no elevated disgust proneness could be found (Muris et al., 2000; Troop et al., 2000). Besides the investigation of altered disgust experiences in individuals with mental disorders, some studies have focused on the recognition of disgust elicitors. In the most frequently used experimental approach, psychiatric patients are presented with pictures showing facial disgust expressions together with other affective mimic. In a study by Lembke and Ketter (2002), subjects with a bipolar disorder undergoing a manic episode showed an impaired ability to identify disgust and fear expressions compared with healthy controls. In contrast, Harmer et al. (2002) observed selectively facilitated disgust recognition in euthymic patients with a bipolar disorder. A tendency to miscategorize disgust as either anger or fear was displayed by nonparanoid as compared with paranoid schizophrenics (Phillips et al., 1999). Finally, Sprengelmeyer et al. (1997) found a specific deficit in the recognition of facial disgust expressions by OCD patients compared with patients with a panic disorder, generalized anxiety, or no mental disorder. Altogether the present findings suggest that disgust is involved in the etiology and maintenance of certain mental disorders, especially anxiety disorders; however, many psychiatric groups have not been studied yet. Therefore, in an exploratory investigation we assessed this personality trait in psychiatric inpatients by means of a self-report measure and compared them with healthy controls and mentally disordered outpatients.