Department of Psychology, Vanderbilt University, Nashville, Nashville, TN 37203, USA.
J Psychiatr Res. 2011 Sep;45(9):1236-42. doi: 10.1016/j.jpsychires.2011.01.018. Epub 2011 Feb 24.
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.
越来越多的研究表明，厌恶感可能是强迫症（OCD）发展和维持的潜在风险因素。本研究的首要目的是确定与强迫症相关但不同的厌恶易感性是否在强迫症患者中比在其他焦虑症患者中更为强烈。第二个目的是研究在强迫症的暴露治疗中观察到的症状改善中，厌恶感的变化是否有独特的贡献。在研究 1 中，强迫症患者、广泛性焦虑症（GAD）患者和非临床对照者（NCC）完成了一项厌恶倾向和厌恶敏感性的测量。与 NCC 和 GAD 患者相比，强迫症患者更强烈地认同厌恶倾向。然而，强迫症患者在厌恶敏感性方面与 GAD 患者没有显著差异，尽管与 NCC 相比，两组都报告了明显更高的厌恶敏感性水平。研究 2 包括对强迫症患者症状改善的中介分析，结果表明，随着时间的推移，厌恶倾向的降低中介了 OCD 症状的改善，即使在控制了负性情绪的改善之后也是如此。这些发现对概念化厌恶在 OCD 的性质和治疗中的作用具有启示意义。
