Disgust and Fear Responding in Contamination-Based Obsessive-Compulsive Disorder During Pictorial Exposure

The emotion of disgust has been implicated in the development and maintenance of contamination-based obsessive-compulsive disorder (OCD). In the present study nonclinical participants with high (n = 26) and low (n = 28) levels of OCD contamination symptoms were exposed to 2 categories of disgust stimuli (blood injury and body waste) across 4 blocks using standardized disgust images. Self-report disgust and fear were recorded, as well as cardiovascular heart rate. In both groups, an initial primary disgust reaction was observed. Self-report disgust and fear, but not heart rate deceleration, was greater in the high symptom group. The high symptom group showed reductions in heart rate deceleration, whereas the low symptom group did not. Significant differences in self-report changes across time were observed between the groups, with fear increasing to a greater extent for high contamination fearful individuals when viewing body waste images. The implications of these findings for theoretical models and clinical treatment of OCD with prominent contamination symptoms are discussed.

► High- and low-contamination-fearful individuals were exposed to images of 2 disgust categories across a 4-block session.
► High symptom participants reported greater self-report disgust and fear than low symptom participants.
► Both groups showed an initial deceleration of heart rate responding.
► Body waste stimuli may be more suitable than blood injury for teasing apart disgust and fear reactions in C-OCD.