Background Strong feelings of disgust and anxiety are maintaining factors in contamination-related obsessive–compulsive disorder (C-OCD). To this day there are not many studies that investigated strategies for changing pathological disgust. In a previous study, it was shown that imagery rescripting could successfully change disgust. However, whether imagery rescripting or more general imagery processing, helps to reduce pathological disgust, remains unclear. Therefore, the aim of the present study was to investigate how successful imagery rescripting is in comparison to imagery self-compassion and a passive positive imagery condition in reducing disgust. Methods For this, the three strategies were compared to each other on 2 days (within-subject) in a laboratory experiment. The study included 24 subjects with diagnosed C-OCD, and 24 matched, healthy controls (between-subject). Results The results show that all three strategies changed disgust, they do not differ from each other and that different traits appear to influence the strategies’ success or failure. The theoretically derived underlying mechanisms of the strategies were found in an elaborate content analysis. Conclusions The present study provides first indications that imagery in general can help to change pathological disgust experience.

<b><i>Hintergrund:</i></b> PatientInnen mit Zwangsstörungen werden in klinischer Forschung und Praxis häufig nicht erkannt oder fehldiagnostiziert, wodurch es zu verzögerten und unzureichenden Behandlungen kommt. Ein Aspekt, der maßgeblich dazu beiträgt, sind unter anderem unzureichende Screening- und Diagnostikinstrumente, da bestehende Fragebögen zur Erfassung von Zwangsstörungen zu einem großen Teil Limitationen hinsichtlich ihrer psychometrischen Qualitäten und ihrer Aktualität unterliegen. Mit der Dimensional Obsessive-Compulsive Scale (DOCS) steht im englischsprachigen Raum seit mehreren Jahren bereits ein vielversprechendes Instrument zur Erfassung von Zwangsstörungen zur Verfügung. <b><i>Patienten und Methoden:</i></b> Ziel der vorliegenden Arbeit war es, erstmalig die Faktorstruktur sowie die psychometrischen Eigenschaften der deutschsprachigen DOCS-Version zu überprüfen. Hierzu wurden 177 PatientInnen (107 mit Zwangsstörung, 30 mit Angststörungen und 40 mit Depression) sowie eine nicht-klinische Kontrollgruppe mit 223 Probanden untersucht. <b><i>Ergebnisse:</i></b> Die vierfaktorielle Originalstruktur der DOCS konnte in explorativen und konfirmatorischen Faktoranalysen repliziert werden. Interne Konsistenzen und die zeitliche Stabilität der DOCS fielen akzeptabel bis sehr gut aus. Die Konstruktvalidität der DOCS-Gesamtskala fiel zufriedenstellend bis gut aus. Die Kriteriumsvaliditäten fielen bedingt zufriedenstellend aus. Die diagnostische Genauigkeit der DOCS fiel befriedigend aus. <b><i>Schlussfolgerung:</i></b> Die deutsche Version der DOCS ist ein robustes, reliables und erstmals validiertes Instrument zur dimensionalen Beschreibung des Schweregrads von Zwangsstörungen.

The present eye-tracking study investigates whether individuals with different levels of contamination fear are more likely to focus their attention on disgusting stimuli to explore them or to pull their attention away to avoid them. Ninety-two nonclinical participants with varying degrees of contamination fear performed a dot probe task. Eye-tracking methodology was employed to record gaze patterns during the task. In each trial participants looked at two pictures (disgust-neutral, fear-neutral, or neutral-neutral). Participants were further asked about the contents of the picture and the confidence of their answer. The results show that reaction times were slower and fixations were longer and more frequent for disgust targets compared with fear and neutral targets, which was further amplified in individuals with high contamination fear. However, image details of disgusting pictures were remembered less correctly than details of fearful pictures. These findings confirm the idea that attention on disgusting stimuli is maintained. Further, the findings indicate that disgust is processed more superficially and might also be related to disgust-associated uncertainty and ambiguity. The results may help to understand the difficult-to-change nature of disgust, which could be relevant to habituation and extinction processes in exposure therapy.

Biased processing of disgust-related stimuli is increasingly discussed in addition to fearrelated processing as a maintenance factor for contamination-based obsessive-compulsive disorder (C-OCD). However, the differential impact of fear and disgust on biased processing in C-OCD is not yet completely understood. Because it is difficult to distinguish the two emotions in self-report assessment by directly addressing the specific emotions, a text paragraphbased interpretation bias paradigm was applied to more implicitly assess emotions. For the text-based interpretation bias paradigm, disgust-related, fear-related, disgust-fear-ambiguous and neutral text paragraphs describing everyday life situations were developed and validated in a pre-study (N = 205). Fifty-nine healthy participants watched either disgust-or fear-inducing movies and afterwards rated their experienced emotional response to the text paragraphs. The results show that fear and disgust components of an emotional response to mixed-emotional situations are strongly influenced by the situational context, and across the levels of trait contamination fear people did not differ in their fear experiences to everyday situations (which was overall strong), but in their disgust experiences. These findings highlight the strength of situational context on interpretation bias for mixed-emotional disorders and the important role of disgust for C-OCD.

Disgust has recently been characterized as a low-urgency emotion, particularly compared to fear. The aim of the present study is to clarify whether behavioral inhibition during disgust engagement is characteristic of a low-urgency emotion and thus indicates self-imposed attentional avoidance in comparison to fear. Therefore, 54 healthy participants performed an emotional go/no-go task with disgust- and fear-relevant as well as neutral pictures. Furthermore, heart rate activity and facial muscle activity on the fear-specific m. corrugator supercilli and the disgust-specific m. levator labii were assessed. The results partially support the temporal urgency hypothesis of disgust. The emotion conditions significantly differed in emotional engagement and in the facial muscle activity of the m. levator labii as expected. However, contrary to our expectations, no differences between the emotion conditions regarding behavioral inhibition as well as heart rate change could be found. Furthermore, individuals with a higher-trait disgust proneness showed faster reactions and higher activity of the m. levator labii in response to disgust stimuli. The results show that different trait levels influence attentional engagement and physiological parameters but have only a small effect on behavioral inhibition.