Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-16T09:25:14.388Z Has data issue: false hasContentIssue false

Contamination-Focused Exposure as a Treatment for Disgust-Based Fears: A Preliminary Test in Spider-Fearful Women

Published online by Cambridge University Press:  28 July 2016

Jesse R. Cougle*
Affiliation:
Florida State University, Tallahassee, USA
Berta J. Summers
Affiliation:
Florida State University, Tallahassee, USA
Ashleigh M. Harvey
Affiliation:
Florida State University, Tallahassee, USA
Kirsten H. Dillon
Affiliation:
Florida State University, Tallahassee, USA
Nicholas P. Allan
Affiliation:
Florida State University, Tallahassee, USA
*
Correspondence to Jesse R. Cougle, Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL, 32306, USA. E-mail: [email protected]

Abstract

Background: Disgust is thought to play a prominent role in multiple anxiety disorders and fears, including spider phobia, though little attention has been given to specific treatment strategies that may be effective for multiple disgust-based fears. Aims: In the present study, we evaluated contamination-focused exposure as a potential transdiagnostic treatment strategy for disgust-based fears in a spider fearful sample. Method: Women with significant spider fear were randomized to three 30-minute sessions of exposure therapy involving repeated contact with a dirt mixture (n=17) or a waitlist control condition (n=17). Assessments of spider fear and disgust were administered at baseline and at one-week posttreatment. Results: At high (but not low) levels of pretreatment disgust propensity, exposure led to lower in vivo spider fear and perceived danger than waitlist, though exposure had no effects on spider-related disgust. Similar effects of exposure on spider fear were found at high levels of pretreatment spider-related disgust. Exposure also reduced fear and danger perceptions, but not disgust, related to a separate contamination assessment (touching a toilet). No effects of treatment were found on self-report measures of spider fear or disgust propensity. Conclusions: These findings suggest contamination-focused exposure therapy may be an effective transdiagnostic treatment strategy for individuals with elevated disgust propensity. Limitations and directions for future research are discussed.

Type
Research Article
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aiken, L. S. and West, S. G. (1991). Multiple Regression: testing and interpreting interactions. Newbury Park: Sage.Google Scholar
Brady, R. E., Adams, T. G., and Lohr, J. M. (2010). Disgust in contamination-based obsessive-compulsive disorder: a review and model. Expert Review of Neurotherapeutics. 10, 12951305. doi:10.1586/ern.10.46 Google Scholar
Brady, R. E., Cisler, J. M. and Lohr, J. M. (2014). Specific and differential prediction of health anxiety by disgust sensitivity and propensity. Anxiety, Stress and Coping. 27, 9099. doi: 10.1080/10615806.2013.772588 Google Scholar
Brady, R. E. and Lohr, J. M. (2014). A behavioral test of contamination fear in excessive health anxiety. Journal of Behavior Therapy and Experimental Psychiatry. 45, 122127. doi: 10.1016/j.jbtep.2013.09.011 CrossRefGoogle ScholarPubMed
Cisler, J. M., Olatunji, B. O. and Lohr, J. M. (2009). Disgust, fear, and the anxiety disorders: a critical review. Clinical Psychology Review. 29, 3446. doi:10.1016/j.cpr.2008.09.007 Google Scholar
Cougle, J. R. and Hawkins, K. A. (2013). Priming of courageous behavior: contrast effects in spider fearful women. Journal of Clinical Psychology, 69, 896902. doi:10.1002/jclp.21961 Google Scholar
Davey, G. C., Bickerstaffe, S. and MacDonald, B. A. (2006). Experienced disgust causes a negative interpretation bias: a causal role for disgust in anxious psychopathology. Behaviour Research and Therapy. 44, 13751384. doi:10.1016/j.brat.2005.10.006 Google Scholar
de Jong, P. J., Vorage, I., and van den Hout, M. A. (2000). Counterconditioning in the treatment of spider phobia: effects on disgust, fear and valence. Behaviour Research and Therapy. 38, 10551069. doi:10.1016/S0005-7967(99)00135-7 Google Scholar
Edwards, S. and Salkovskis, P. M. (2006). An experimental demonstration that fear, but not disgust, is associated with return of fear in phobias. Journal of Anxiety Disorders. 20, 5871. doi:10.1016/j.janxdis.2004.11.007 Google Scholar
Engelhard, I. M., Olatunji, B. O. and de Jong, P. J. (2011). Disgust and the development of posttraumatic stress among soldiers deployed to Afghanistan. Journal of Anxiety Disorders. 25, 5863. doi:10.1016/j.janxdis.2010.08.003 Google Scholar
Fergus, T. A. and Valentiner, D. P. (2009). The Disgust Propensity and Sensitivity Scale–Revised: an examination of a reduced-item version. Journal of Anxiety Disorders. 23, 703710. doi:10.1016/j.janxdis.2009.02.009 Google Scholar
Fredrikson, M., Annas, P., Fischer, H. and Wik, G. (1996). Gender and age differences in the prevalence of specific fears and phobias. Behaviour Research and Therapy, 34, 3339. doi:10.1016/0005-7967(95)00048-3 Google Scholar
Goetz, A. R., Cougle, J. R. and Lee, H. J. (2013). Revisiting the factor structure of the 12-item Disgust Propensity and Sensitivity Scale–Revised: evidence for a third component. Personality and Individual Differences. 55, 579584. doi: 10.1016/j.paid.2013.04.029 Google Scholar
Hayes, A. F. (2013). Introduction to Mediation, Moderation, and Conditional Process Analysis: a regression-based approach. New York: Guilford Press.Google Scholar
Mason, E. C. and Richardson, R. (2012). Treating disgust in anxiety disorders. Clinical Psychology: Science and Practice. 19, 180194. doi: 10.1111/j.1468-2850.2012.01282.x Google Scholar
Meunier, S. A. and Tolin, D. F. (2009). The treatment of disgust. In Olatunji, B. O. and McKay, D. (Eds.), Disgust and its Disorders: theory, assessment, and treatment implications (pp. 271283). Washington, DC: American Psychological Association.Google Scholar
Muris, P. and Merckelbach, H. (1996). A comparison of two spider fear questionnaires. Journal of Behavior Therapy and Experimental Psychiatry, 27, 241244. doi:10.1016/S0005-7916(96)00022-5 Google Scholar
Muris, P., Mayer, B. and Merckelbach, H. (1998). Trait anxiety as a predictor of behaviour therapy outcome in spider phobia. Behavioural and Cognitive Psychotherapy, 26, 8791. doi:10.1017/S1352465898000095 Google Scholar
Olatunji, B. O. (2009). Incremental specificity of disgust propensity and sensitivity in the prediction of health anxiety dimensions. Journal of Behavior Therapy and Experimental Psychiatry. 40, 230239. doi:10.1016/j.jbtep.2008.10.003 Google Scholar
Olatunji, B. O., Cisler, J. M., Deacon, B. J., Connolly, K. and Lohr, J. M. (2007). The Disgust Propensity and Sensitivity Scale-Revised: psychometric properties and specificity in relation to anxiety disorder symptoms. Journal of Anxiety Disorders. 21, 918930. doi:10.1016/j.janxdis.2006.12.005 Google Scholar
Olatunji, B. O., Cisler, J., McKay, D. and Phillips, M. L. (2010). Is disgust associated with psychopathology? Emerging research in the anxiety disorders. Psychiatry Research. 175, 110. doi:10.1016/j.psychres.2009.04.007 Google Scholar
Olatunji, B. O., Huijding, J., de Jong, P. J. and Smits, J. A. (2011). The relative contributions of fear and disgust reductions to improvements in spider phobia following exposure-based treatment. Journal of Behavior Therapy and Experimental Psychiatry. 42, 117121. doi:10.1016/j.jbtep.2010.07.007 CrossRefGoogle ScholarPubMed
Olatunji, B. O., Tart, C. D., Ciesielski, B. G., McGrath, P. B., and Smits, J. A. (2011). Specificity of disgust vulnerability in the distinction and treatment of OCD. Journal of Psychiatric Research. 45, 12361242. doi:10.1016/j.jpsychires.2011.01.018 CrossRefGoogle ScholarPubMed
Olatunji, B. O., Wolitzky-Taylor, K. B., Ciesielski, B. G., Armstrong, T., Etzel, E. N. and David, B. (2009). Fear and disgust processing during repeated exposure to threat-relevant stimuli in spider phobia. Behaviour Research and Therapy. 47, 671679. doi:10.1016/j.brat.2009.04.012 Google Scholar
Schmidt, N. B., Richey, J. A., Funk, A. P. and Mitchell, M. A. (2010). Cold pressor “augmentation” does not differentially improve treatment response for spider phobia. Cognitive Therapy and Research, 34, 413420. doi:10.1007/s10608-010-9310-6 Google Scholar
Smits, J. A. J., Telch, M. J. and Randall, P. K. (2002). An examination of the decline in fear and disgust during exposure-based treatment. Behaviour Research and Therapy. 40, 12431253. doi:10.1016/S0005-7967(01)00094-8 Google Scholar
Szymanski, J. and O'Donohue, W. (1995). Fear of spiders questionnaire. Journal of Behavior Therapy and Experimental Psychiatry, 26, 3134. doi:10.1016/0005-7916(94)00072-T Google Scholar
van Overveld, M., de Jong, P. J. and Peters, M. L. (2010). The disgust propensity and sensitivity scale–revised: its predictive value for avoidance behavior. Personality and Individual Differences. 49, 706711. doi:10.1016/j.paid.2010.06.008 Google Scholar
van Overveld, M., de Jong, P. J., Peters, M. L., van Hout, W. J. and Bouman, T. K. (2008). An internet-based study on the relation between disgust sensitivity and emetophobia. Journal of Anxiety Disorders. 22, 524531. doi:10.1016/j.janxdis.2007.04.001 Google Scholar
Submit a response

Comments

No Comments have been published for this article.