Peter J. de Jong

Disgust domains in the prediction of contamination fear.

Previous research has shown a relationship between the emotion of disgust and the fear of contamination. Heightened sensitivity to disgust and increased concerns over contamination has been observed in various disorders, such as obsessive-compulsive disorder (OCD) and specific phobias. However, there is a paucity of research identifying the specific domains of disgust that contribute to contamination fear. The present study soughts to determine which domains of disgust elicitors reliably predict scores on a measure of OCD contamination obsessions and washing compulsions. We further conducted exploratory analyses that examined differences in disgust sensitivity among individuals classified as high and low in contamination fear. Three hundred and twenty-three undergraduate participants completed two measures of disgust sensitivity (Disgust Scale; Disgust Emotion Scale) and a measure of contamination fear (Padua inventory, contamination obsessions and washing compulsions subscale). Stepwise multiple regression analyses indicated that contamination fear was best predicted by seven different disgust domains, thereby suggesting that contamination fear is accounted for by generalized, rather than domain-specific, disgust elicitors. The categories of disgust that predicted contamination fear appeared to have an underlying commonality of threat of contagion. The relationship between fear of contamination and disgust sensitivity was more pronounced for animal reminder disgust elicitors as opposed to core disgust elicitors. Results also showed that individuals classified as high in contamination fear scored significantly higher than the low contamination fear group on all disgust domains. Clinical and research implications regarding the interrelationships between fear, disgust, and the fear of contamination are discussed.

Fear of movement/(re)injury and muscular reactivity in chronic low back pain patients : an experimental investigation

This experiment was set up to test the hypothesis that confrontation with feared movements would lead to symptom-specific muscular reactivity in chronic low back pain patients who report high fear of movement/(re)injury. Thirty-one chronic low back pain patients were asked to watch a neutral nature documentary, followed by a fear-eliciting video-presentation, while surface electromyography (EMG) recordings were made from the lower paraspinal and the tibialis anterior muscles. It was further hypothesized that negative affectivity (NA) would moderate the effects of fear on symptom-specific muscular reactivity, as well as the effects of muscular reactivity on pain report. The results were partly as predicted. Unexpectedly, paraspinal EMG-readings decreased during video-exposure but this decrement tended to be less in fearful patients than in the non-fearful patients. Negative affectivity did not moderate this effect, but moderated the effect of pain-related fear on muscular reactivity of lower leg muscles. In addition, NA directly predicted muscular reactivity in the right tibialis anterior muscle. As predicted, there was a significant covariation between left paralumbar muscular activity and pain report. This association was moderated by NA, but in the opposite direction. The findings extend the symptom-specificity model of psychophysiological reactivity, and support the idea that pain-related fear perpetuates pain and pain disability through muscular reactivity.

THE INFLUENCE OF ANXIETY ON PAIN - ATTENTIONAL AND ATTRIBUTIONAL MEDIATORS

&NA; Two psychological processes mediating the influence of anxiety on pain have been proposed: an attributional process in which the pain‐relevance of anxiety is the essential factor, and an attentional process in which the focus of attention is the essential factor. The present study investigated the influences of attentional focus, pain‐irrelevant anxiety and pain‐relevant anxiety in a within‐subject design (n = 40). Subjects received painful electrical stimulation in each of 5 experimental conditions. The results indicate that pain ratings were only influenced by attentional focus and not by anxiety, regardless of whether it was pain‐relevant or pain‐irrelevant. Autonomic responses (skin conductance responses) were, however, only influenced by pain‐relevant anxiety. Thus, it seems that with respect to subjective pain responses the attentional theory on the influence of anxiety on pain can explain the results. The attributional theory seems to hold for autonomic pain responses. However, these responses might as well be considered as fear responses. Whereas there is clear evidence for a role of attentional focus in the influence of anxiety on pain, the role of attributional processes remains to be demonstrated.

Blood-injection-injury phobia and fear of spiders : Domain specific individual differences in disgust sensitivity

We investigated whether disgust sensitivity is associated with blood-injection-injury (BII) and spider fear. We also explored whether the relationship between disgust sensitivity and phobic fears is domain specific. Ninety-six undergraduates (all women) completed the Disgust Questionnaire (DQ) (Rozin et al., 1984), The Disgust Scale (DS) (Haidt et al., 1994), the Spider Phobia Questionnaire (SPQ) (Klorman et al., 1974), and the Blood-Injury Phobia Questionnaire (BIQ) (Merckelbach et al., submitted). No relationship was evident between DQ scores and BII fear. Yet, BII fear was found to be related to the Body Envelope Violations subscale of the DS. Spider fear was found to be associated with DQ scores and the Animal sub-scale of the DS. Thus, the relationship between phobic fears and high disgust sensitivity was found to be domain specific with BII fear being related to animal-reminder disgust and spider fear to oralcentred disgust.

The etiology of specific phobias: A review

Abstract The present article summarizes theory and data about symptomatology, epidemiology, and etiology of specific phobias. Additionally, the cognitive mechanisms involved in specific phobias are briefly discussed. By and large, the general pattern behind the development of specific phobias can be summarized as follows. Specific fears are highly prevalent among young children. In most children, these fears represent transitory phenomena. However, in a small sub-group of children, specific fears become chronic due to classical conditioning, modelling, and/or negative information transmission. Once a specific phobia has developed, it may be maintained by cognitive biases (i.e., attentional bias, covariation bias, and reasoning bias). Though specific phobias form a heterogeneous class of disorders, this pattern appears to be a good approximation. Nevertheless, several questions remain. For example, there is no ready explanation for the fact that specific phobias are more often diagnosed in women than in men. Similarly, it is not clear to what extent the nonrandom distribution of phobias can be interpreted in terms of cultural factors. Resolving these issues is not only important in its own right, but may have considerable heuristic value for our understanding of other anxiety disorders.

A cross-cultural study of animal fears.

The present study represents a cross-cultural study of animal fears in which subjects from seven Western and Asian countries were asked to rate their fear of a range of familiar animals. Factor analyses of these ratings in all samples revealed a coherent three factor solution in which animals fell into a fear-irrelevant, fear-relevant (fierce) or disgust-relevant category. The core group of animals making up the disgust-relevant category were similar across cultures. Some views on how a universal disgust-relevant category of feared animals may have developed are discussed.

The role of evaluative learning and disgust sensitivity in the etiology and treatment of spider phobia

Abstract The role of disgust and contamination sensitivity in the development and treatment of spider phobia was examined. It was predicted that spider phobia high in disgust and contamination sensitivity have been more susceptible to evaluative conditioning processes and, as a result, less often report traumatic conditioning events and benefit less from exposure treatment than phobics low in disgust sensitivity ( Baeyens, Eelen, Crombez, & van den Bergh, 1992 ). As a group, spider phobics ( N = 46) were characterized by higher disgust sensitivity than nonphobic control subjects ( N = 28). However, phobics high in disgust sensitivity reported, if anything, more conditioning events than low digust sensitivity phobics. Treatment effects of exposure were evident in both self-report measures and the behavioral modality. These effects were comparable for high and low disgust sensitivity phobics. Remarkably, high and low disgust sensitivity phobics did not differ with regard to the perceived dirtiness of spiders. Even when the perceived dirtiness of spiders was used as a classifying variable, no differences in acquisition history or treatment outcome emerged between high and low groups. Thus, the findings lend no support to the views that traumatic conditioning events are rare and that exposure treatment is less successful in phobics who presumably have an evaluative learning background. The methodological limitations of the present study are discussed.

Child abuse and negative explicit and automatic self-associations: the cognitive scars of emotional maltreatment

Individuals reporting Childhood Abuse (CA) (i.e., emotional neglect, emotional-, physical- and sexual-abuse) are marked by increased explicit (i.e. self-reported) negative self-associations, and an increased risk to develop depression or anxiety disorders. Automatic self-associations might play an important role in the development and maintenance of affective disorders after exposure to CA, since automatic associations are assumed to be involved in uncontrolled (spontaneous) affective behavior. This study examined whether individuals reporting a history of CA show stronger automatic (and explicit) self-depression and/or self-anxiety associations than individuals who report no CA in a large cohort study (Netherlands Study of Depression and Anxiety (NESDA), n = 2981). The Implicit Association Test (IAT) was utilized to assess automatic self-depression and self-anxiety associations. We found that CA was associated with enhanced automatic (and explicit) self-depression and self-anxiety associations. Additionally, when compared to physical- and sexual-abuse, Childhood Emotional Maltreatment (CEM; emotional abuse and emotional neglect) had the strongest link with enhanced automatic (and explicit) self-depression and self-anxiety associations. In addition, automatic and explicit negative self-associations partially mediated the association between CEM and depressive or anxious symptomatology. Implications regarding the importance of CA, and CEM in particular will be discussed.

Fear of blushing: effects of task concentration training versus exposure in vivo on fear and physiology.

Patients with fear of blushing as the predominant complaint (N = 31) were randomly assigned to (1) exposure in vivo (EXP), or (2) task concentration training (TCT), in order to test the effect of redirecting attention above exposure only. In addition, it was investigated whether treatment reduced actual blush behavior; therefore, physiological parameters of blushing were measured during two behavioral tests. Half of the patients served as waiting-list controls first. Assessments were held before and after treatment, at 6-weeks, and at 1-year follow-up. Both treatments appeared to be effective in reducing fear of blushing and realizing cognitive change. Yet, at posttest, TCT tended to produce better results with respect to fear of blushing. At 6-weeks follow-up, TCT produced significantly more cognitive change. At 1-year follow-up, patients further improved, while differential effects had disappeared. The reduction in fear of blushing was not paralleled by a reduction in actual blush behavior during the behavioral assessments. Thus, it seems that fear of blushing reflects a fearful preoccupation, irrespective of actual facial coloration.

SELF-REPORTED COGNITIVE FAILURES AND NEUROTIC SYMPTOMATOLOGY

Abstract Three studies examined the Cognitive Failures Questionnaire (CFQ) and its psychopathological correlates. In Study 1, the psychometric qualities of the Dutch translation of the CFQ were evaluated in a student sample. Internal consistency and test-retest stability were found to be satisfactory. Furthermore, CFQ was positively correlated with anxiety symptoms, even when the influence of traditional trait variables (i.e., neuroticism and trait anxiety) was partialled out. Study 2 examined the CFQ as a predictor of treatment outcome in spider phobia. No evidence was found to suggest that high CFQ scores are associated with a less favourable treatment outcome. Also, spider phobics had CFQ scores in the normal range. Study 3 evaluated the CFQ in a mixed sample of anxiety disordered and depressive outpatients. Depressive patients, but not anxiety disordered patients, were found to have heightened CFQ scores. Overall, CFQ scores were positively associated with symptom severity. Yet, there were no indications that patients with high CFQ scores profit less from treatment than those with low CFQ scores. Taken together, the results provide support for the view that the CFQ taps daily cognitive routines that are undermined by anxiety and depression. However, the findings do not point to the CFQ being a cognitive vulnerability measure that is related to treatment success.