Anti-Disgust Cognitive Behavioral Therapy for Contamination-Based Obsessive Compulsive Disorder: A Randomized Controlled Clinical Trial

Abstract

Background: Disgust is a strong and persistent emotion that frequently occurs during exposure-based treatments for contamination-based obsessive compulsive disorder (C-OCD). This study aimed to examine the efficacy of augmenting cognitive behavioral therapy (CBT) with a novel type of anti-disgust cognitive intervention in reducing the severity of OCD, disgust propensity/sensitivity, and refusal rate of exposure and response prevention, while simultaneously increasing acceptance of disgust. Materials and Methods: Fifty-five individuals with C-OCD (mean age 28.1 years, SD = 3.52; 77% female) were randomly assigned to 15 weekly sessions of anti-disgust plus CBT (AD-CBT) or CBT alone. They were evaluated for outcomes four times (pretreatment, prior to exposure and response prevention (ERP) sessions, posttreatment, and three-month follow-up), and mixed-design ANOVAs were used to analyze the data. Results: The findings indicated that when compared to CBT alone, AD-CBT significantly reduced OCD severity, disgust propensity/sensitivity, and concurrently increased disgust acceptance (p < 0.001). Additionally, engaging in an anti-disgust cognitive intervention was associated with lower ERP refusal rate (4% vs. 16%). The superiority of AD-CBT over CBT persisted through the three-month follow-up period. Conclusions: The current study suggests that supplementing CBT for C-OCD with an anti-disgust cognitive intervention significantly increased acceptance of disgust and decreased the refusal rate of ERP, OCD severity, and disgust-related factors.

Two Years After the Beginning of COVID-19: Comparing Families Who Had or Did not Have Patients with COVID-19 on Health Beliefs and Obsessive-Compulsive Symptoms

“…( 61 ), the present study showed that self-efficacy scores in FIM+ at T1 were meaningfully associated with reducing OCS at T2. It is unclear to what extent these results could generalize to patients with OCD, and we suggest future studies examine the role of health beliefs on response to treatment in this sample (e.g., 62 ).…”

Relationship between disgust and Orthorexia Nervosa and psychometrics properties of the Italian Dusseldorf Orthorexia Scale in a general population sample

“…On the other hand, there are many studies in the literature that support the hypothesis that one of the main psychopathological factors in OCD is precisely disgust [12,37]. Further, a recent meta-analysis showed that ON symptoms are more related to EDs compared to OCD suggesting that ON might belong to the rst spectrum.…”

Relationship between Disgust and Orthorexia Nervosa and psychometric properties of the Italian Dusseldorf Orthorexia Scale in a general population sample

“…On the other hand, there are many studies in the literature that support the hypothesis that one of the main psychopathological factors in OCD is precisely disgust [7,55]. Further, a recent meta-analysis showed that ON symptoms are more related to EDs compared to OCD suggesting that ON might belong to the rst spectrum.…”

“…Nonetheless, clinicians and researchers have not clari ed whether ON pertains to eating disorders (EDs) [3,4] or the obsessive-compulsive disorder (OCD) spectrum [5,6]. OCD, especially contamination-related OCD, is characterized by a heightened experience of disgust [7,8].…”