Emotion regulation changes the duration of the BOLD response to emotional stimuli.

Emotion regulation theories posit that strategies like reappraisal should impact both the intensity and duration of emotional responses. However, research on reappraisal to date has examined almost exclusively its effect on the intensity of responses while failing to examine its effect on the duration of responses. To address this, we used inverse logit functions to estimate the height and duration of hemodynamic responses to negative pictures when individuals with recent life stress were instructed to use reappraisal either to decrease their negative emotion or to increase their positive emotion (relative to unregulated viewing of negative pictures). Several emotion-generative regions such as the amygdala, thalamus and midbrain exhibited decreases in duration of activation, even when controlling for differences in height of activation. In addition, whereas the amygdala exhibited both decreased activation height and duration when participants reappraised to decrease their negative emotion, it only exhibited decreased duration when participants reappraised to increase their positive emotion. These results indicate that emotion regulation alters the temporal dynamics of emotional responding and that models of reappraisal should accommodate whether reappraisal influences the height of activation, duration of activation or both, which may change based on the goal of the reappraisal strategy being used.

A taxometric investigation of the latent structure of eating disorders.

The present study examined the latent structure of eating disorder symptoms in a large sample of patients with a diagnosis of anorexia nervosa restricting type, anorexia nervosa binge eating/purging type, and bulimia nervosa (n=3747). Three taxometric procedures (MAXimum EIGenvalue (MAXEIG), Mean Above Minus Below A (MAMBAC), and Latent-Mode Factor Analysis (L-Mode)) were applied to self-reported symptoms of bulimia, drive for thinness, body dissatisfaction, as well as body mass index. Taxometric analysis among patients with the restricting and binge eating/purging subtype of anorexia and those with bulimia nervosa supported a dimensional latent structure of eating disorder symptoms. Taxometric analysis also revealed a dimensional latent structure of eating disorder symptoms among patients with the restricting and binge eating/purging subtype of anorexia suggesting that the two anorexia subtypes may not represent discrete categories. These findings suggest that the diagnosis and assessment of eating disorder symptoms should be conceptualized from a dimensional framework.

Effects of experienced disgust on habituation during repeated exposure to threat-relevant stimuli in blood-injection-injury phobia.

Despite growing evidence implicating disgust in the etiology of blood-injection-injury (BII) phobia, the relevance of disgust for exposure-based treatment of BII phobia remains largely unknown. Individuals with BII phobia were randomly assigned to a disgust (view vomit videos) or neutral activation (view waterfall videos) condition. They were then exposed to 14 videotaped blood draws, during which fear and disgust levels were repeatedly assessed. Participants then engaged in a behavioral avoidance test (BAT) consisting of exposure to threat-relevant stimuli. Examination of outcome comparing the identical first and last blood-draw clips revealed that fear and disgust toward blood draws was significantly reduced in both groups. Disgust levels were also found to be more intense for the video stimuli relative to fear levels whereas the opposite was true for BAT stimuli. Contrary to predictions, the disgust induction did not enhance reductions in negative responses to the target video or reduce behavioral avoidance. Growth curve analyses did show that individuals with BII phobia exposed to the disgust induction showed greater initial fear levels during repeated exposure than those in the neutral condition. However, this effect was not consistently observed across different analytic approaches. Changes in fear during exposure were also found to be independent of changes in disgust but not vice versa, and greater initial fear levels during repeated exposure to threat was associated with fear and disgust levels during the BAT. The implications of these findings for conceptualizing the role of disgust in etiology and treatment of BII phobia are discussed.

Who am I to judge? Self-disgust predicts less punishment of severe transgressions.

Although recent research has shown that experimentally induced disgust and the personality trait of disgust sensitivity is associated with more severe moral decisions, no study to date has examined how disgust, experienced specifically toward the self, influences morally relevant decisions. Participants (n = 109) in the present study completed a measure of self-disgust, disgust sensitivity, and depressive symptoms and then evaluated nonoffenses, moderate offenses, and severe offenses with regard to level of disgust and punishment deserved. The results showed that self-disgust significantly predicted more disgust and punishment ratings of nonoffenses when controlling for individual differences in both depressive symptoms and disgust sensitivity. In contrast, self-disgust significantly predicted less disgust and punishment ratings of severe offenses when controlling for individual differences in depressive symptoms and disgust sensitivity. The implications of these findings for further conceptualizing how the heterogeneous construct of disgust operates in the moral domain are discussed.

A selective impairment in attentional disengagement from erotica in obsessive-compulsive disorder.

Although an attentional bias for threat has been implicated in obsessive-compulsive disorder (OCD), evidence supporting such a bias has been inconsistent. Furthermore, few studies have made distinctions between attentional capture vs. attentional disengagement and the extent to which different emotional content modulates attention in OCD also remains unclear. To address these issues, we examined patients with OCD (n=30) and controls (n=30) during an emotional attentional blink paradigm in which participants searched for a target embedded within a series of rapidly presented images. Critically, an erotic, fear, disgust, or neutral distracter image appeared 200 ms or 800 ms before the target. Impaired target detection was observed among OCD patients relative to controls following erotic distracters, but only when presented 800 ms, and not 200 ms, prior to the target, indicating difficulty with attentional disengagement. Difficulty disengaging from erotic images was significantly correlated with OCD symptoms in the full sample but not with symptoms of trait anxiety. These data delineate a specific information processing abnormality in OCD.

The effects of safety behaviors on health anxiety: an experimental investigation.

The present study examined the extent to which safety behaviors exacerbate symptoms of hypochondriasis (severe health anxiety). Participants were randomized into a safety behavior (n=30) or control condition (n=30). After a baseline period, participants in the safety behavior condition spent one week actively engaging in a clinically representative array of health-related safety behaviors on a daily basis, followed by a second week-long baseline period. Participants in the control condition monitored their normal use of safety behaviors. Compared to control participants, those in the safety behavior condition reported significantly greater increases in health anxiety, hypochondriacal beliefs, contamination fear, and avoidant responses to health-related behavioral tasks after the safety behavior manipulation. In contrast, general anxiety symptoms did not significantly differ between the two groups as a function of the manipulation. Mediational analyses were consistent with the hypothesis that changes in the frequency of health-related thoughts mediated the effects of the experimental manipulation on health anxiety. These findings suggest that safety behaviors are associated with increases in health anxiety, perhaps by fostering catastrophic thoughts about health. The implications of these findings for the conceptualization of hypochondriasis as an anxiety disorder are discussed.

Emotional expressions and visual search efficiency: specificity and effects of anxiety symptoms.

Although facial expressions are thought to vary in their functional impact on perceivers, experimental demonstration of the differential effects of facial expressions on behavior are lacking. In the present study, we examined the effects of exposure to facial expressions on visual search efficiency. Participants (n = 31) searched for a target in a 12 location circle array after exposure to an angry, disgusted, fearful, happy, or neutral facial expression for 100 ms or 500 ms. Consistent with predictions, exposure to a fearful expression prior to visual search resulted in faster target identification compared to exposure to other facial expressions. The effects of other facial expressions on visual search did not differ from each other. The fear facilitating effect on visual search efficiency was observed at 500-ms but not at 100-ms presentations, suggesting a specific temporal course of the facilitation. Subsequent analysis also revealed that individual differences in fear of negative evaluation, trait anxiety, and obsessive-compulsive symptoms possess a differential pattern of association with visual search efficiency. The experimental and clinical implications of these findings are discussed.

Specificity of disgust vulnerability in the distinction and treatment of OCD.

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.

Making something out of nothing: neutral content modulates attention in generalized anxiety disorder.

BACKGROUND: Although an attentional bias for threat has been implicated in generalized anxiety disorder (GAD), evidence supporting such a bias has been inconsistent. This study examines whether exposure to different emotional content modulates attention disengagement and impairs the perception of subsequently presented nonemotional targets in GAD. METHODS: Patients with GAD (n = 30) and controls (n = 30) searched for a target embedded within a series of rapidly presented images. Critically, an erotic, fear, disgust, or neutral distracter image appeared 200 msec or 800 msec before the target. RESULTS: Impaired target detection was observed among GAD patients relative to controls following only fear and neutral distractors. However, this effect did not significantly vary as a function of distractor stimulus duration before the target. Furthermore, group differences in target detection after fear distractors were no longer significant when controlling target detection after neutral distractors. Subsequent analysis also revealed that the impaired target detection among those with GAD relative to controls following neutral (but not fear) distractors was mediated by deficits in attentional control. CONCLUSIONS: The implications of these findings for further delineating the function of attentional biases in GAD are discussed.

Emotion modulation of visual attention: categorical and temporal characteristics.

BACKGROUND: Experimental research has shown that emotional stimuli can either enhance or impair attentional performance. However, the relative effects of specific emotional stimuli and the specific time course of these differential effects are unclear. METHODOLOGY/PRINCIPAL FINDINGS: In the present study, participants (n = 50) searched for a single target within a rapid serial visual presentation of images. Irrelevant fear, disgust, erotic or neutral images preceded the target by two, four, six, or eight items. At lag 2, erotic images induced the greatest deficits in subsequent target processing compared to other images, consistent with a large emotional attentional blink. Fear and disgust images also produced a larger attentional blinks at lag 2 than neutral images. Erotic, fear, and disgust images continued to induce greater deficits than neutral images at lag 4 and 6. However, target processing deficits induced by erotic, fear, and disgust images at intermediate lags (lag 4 and 6) did not consistently differ from each other. In contrast to performance at lag 2, 4, and 6, enhancement in target processing for emotional stimuli was observed in comparison to neutral stimuli at lag 8. CONCLUSIONS/SIGNIFICANCE: These findings suggest that task-irrelevant emotion information, particularly erotica, impairs intentional allocation of attention at early temporal stages, but at later temporal stages, emotional stimuli can have an enhancing effect on directed attention. These data suggest that the effects of emotional stimuli on attention can be both positive and negative depending upon temporal factors.

Disgust vulnerability and symptoms of contamination-based OCD: descriptive tests of incremental specificity.

The present investigation examines the incremental association between disgust propensity and sensitivity and contamination-based obsessive-compulsive disorder (OCD) symptoms. Structural equation modeling in Study 1 indicated that general disgust was related to contamination fear even when controlling for negative affect in a nonclinical sample. Evidence was also found for a model in which the effect of negative affect on contamination fear is mediated by general disgust. Study 1 also showed that both disgust sensitivity and disgust propensity uniquely predicted contamination fear when controlling for negative affect. Growth curve analyses in Study 2 indicated that higher baseline contamination fear is associated with less reduction in contamination fear over a 6-week period as disgust sensitivity increases even when controlling for negative affect. Lastly, disgust propensity was associated with concurrent levels of excessive washing symptoms among patients with OCD in Study 3 when controlling for depression. Implications of these findings from nonclinical, analogue, and clinical samples for future research on the specificity of disgust-related vulnerabilities in the etiology of contamination concerns in OCD are discussed.

Disgust, anxiety, and vasovagal syncope sensations: a comparison of injection-fearful and nonfearful blood donors.

Although research has implicated disgust in the fainting response observed in blood-injection-injury (BII) phobia, this finding has not been consistently observed in the literature. The present study further examines the relationship between disgust and fainting symptoms among injection-fearful (n=108) and nonfearful (n=338) blood donors. Volunteers from community blood drives provided pre-donation levels of anxiety and disgust towards giving blood and completed a standardized measure of vasovagal reactions (fainting) to blood donation after giving blood. As predicted, injection-fearful participants reported significantly more pre-donation anxiety and disgust compared to nonfearful participants. Injection-fearful donors also reported experiencing more fainting symptoms during blood donation and found the donation experience more unpleasant than did nonfearful participants. Although pre-donation disgust and anxiety levels each uniquely predicted fainting symptoms among nonfearful donors, only pre-donation anxiety uniquely predicted fainting symptoms among injection-fearful donors. Implications of these findings for conceptualizing the disgust-faint relationship in BII phobia are discussed.

Factor structure and psychometric properties of the Injection Phobia Scale-Anxiety.

The present investigation examined the factor structure and psychometric properties of the Injection Phobia Scale-Anxiety (IPS-Anx). Principal components analysis of IPS-Anx items in Study 1 (n = 498) revealed a 2-factor structure consisting of Distal Fear and Contact Fear. However, CFA results in Study 2 (n = 567) suggest that a 1-factor structure may be more parsimonious. IPS-Anx scores demonstrated excellent reliability including test-retest over a 12-week period in Study 3 (n = 195). Supportive evidence for convergent and divergent validity of IPS-Anx scores was also found in Study 4 (n = 319), with strong associations with disgust propensity and sensitivity and weak associations with positive affect. Further evidence of validity was found in Study 5 (n = 1,674) because IPS-Anx scores discriminated those who have experienced fainting symptoms or avoided medical procedures from those without a history of such symptoms. In Study 6, data from Studies 2 through 5 were pooled, and the findings of Study 2 were replicated. The 1-factor model also fit the data well for men and women in Study 6. Lastly, IPS-Anx scores differentiated those with blood-injection-injury phobia (n = 39) from those without this phobia (n = 43) in Study 7. These findings suggest that the IPS-Anx has excellent psychometric properties, making it suitable for use in programmatic research on injection phobia. However, future research examining the validity of a short form of the scale with only the Contact Fear items may further improve the efficiency and utility of the IPS-Anx.

Vasovagal syncope and blood donor return: examination of the role of experience and affective expectancies.

Vasovagal sensations (e.g., dizziness, nausea, and fainting) are one of the main reasons people find blood donation unpleasant. A better understanding of predictors of vasovagal sensations during blood donation could inform interventions designed to increase donor return rates. The present investigation examined the extent to which experience with blood donation and vasovagal sensations during blood donation uniquely predict the likelihood of donor return, even when controlling for affective expectancies. Participants presenting at community blood drives indicated how many times they have given blood and provided ratings of expected anxiety, pain, disgust, as well as fear of fainting before giving blood. After donating, participants completed a measure of vasovagal sensations experienced during blood donation. They also rated the pleasantness of the experience and willingness to donate blood in the future. The findings showed that experience with blood donation and vasovagal sensations during blood donation uniquely predicted willingness to donate blood in the future even when controlling for age and negative affective expectancies about giving blood. This finding suggests that vasovagal sensations and experience with blood donation have unique (and perhaps additive) effects on willingness to donate blood in the future, suggesting that behavior modification interventions that directly target these variables could potentially increase donor retention.

Fear and loathing: a meta-analytic review of the specificity of anger in PTSD.

The available empirical literature suggests that anger may be characteristic of posttraumatic stress disorder (PTSD). Meta-analytic strategies were used to evaluate the extent to which the experience of anger is specific to PTSD rather than anxiety disorders in general. Thirty-four anxiety disorder patient samples (n=2,169) from 28 separate studies were included in the analysis. Results yielded a large effect size indicating greater anger difficulties among anxiety disorder patients versus controls. Compared to control samples, a diagnosis of PTSD was associated with significantly greater difficulties with anger than was any other anxiety disorder diagnosis. Other anxiety disorder diagnoses did not differ significantly from each other. However, the specific association between PTSD and anger did vary depending on the anger domain assessed. Difficulties with anger control, anger in, and anger out significantly differentiated PTSD from non-PTSD anxiety disorder samples, whereas difficulties with anger expression, state anger, and trait anger did not. These findings are discussed in the context of future research on the role of anger in PTSD.

Incremental specificity of disgust sensitivity in the prediction of obsessive-compulsive disorder symptoms: Cross-sectional and prospective approaches.

The present study examines the association between disgust sensitivity (DS) and obsessive-compulsive disorder (OCD) symptoms in two non-clinical samples. Findings from Study 1 (n=270) revealed a significant association between DS and OCD symptoms even after controlling for negative affect and anxiety sensitivity. Subsequent analysis also revealed a specific association between DS and the washing subtype of OCD symptoms when controlling for other OCD symptom dimensions. DS did not significantly predict residual change in total symptoms of OCD over a 12-week period (n=300) when controlling for risk factors for anxiety disorder symptoms in general (e.g., negative affect, anxiety sensitivity) and OCD specifically (e.g., obsessive beliefs) in Study 2. However, exploratory analyses suggest that DS may be predictive of residual change in some OCD symptom subtypes but not others. Implications of these findings for future research on the role of disgust in OCD are discussed.

Fear and disgust processing during repeated exposure to threat-relevant stimuli in spider phobia.

Although disgust plays a significant role in the etiology of spider phobia, there remains a paucity of research examining the role of disgust in the treatment of spider phobia. Spider fearful participants (N = 46) were randomly assigned to a disgust (view vomit images) or neutral activation (view inanimate objects) condition. They were then repeatedly exposed to a videotaped tarantula, during which time their fear, disgust, and physiological levels were assessed repeatedly. Growth curve analyses indicated that repeated exposure led to significant declines in fear and disgust with no statistically significant differences between the two conditions. However, there was marginal evidence for decreased physiological arousal during repeated exposure among spider fearful participants in the disgust activation condition compared to those in the neutral condition. Reduction in disgust during exposure in the disgust activation condition remained significant after controlling for change in fear, whereas change in fear was no longer significant after controlling for change in disgust. However, the opposite pattern of relations between change in fear and disgust was observed in the neutral activation condition. Higher fear and disgust activation during exposure was also associated with higher fear and disgust responding on a subsequent behavioral task and higher spider fear and disgust at 3-month follow-up. Baseline trait disgust propensity also predicted fear and disgust parameters during repeated exposure. The implications of these findings for the role of disgust in the treatment of spider phobia are discussed.