Department of Psychiatry, University of California San Diego, San Diego, California, USA.
Int J Eat Disord. 2019 Apr;52(4):462-465. doi: 10.1002/eat.23006. Epub 2019 Jan 9.
Selective eating is a common presenting problem in Avoidant/Restrictive Food Intake Disorder (ARFID). Understanding the etiology of selective eating will lead to the creation of more effective treatments for this problem. Recent reports have linked disgust sensitivity to picky eating, and the field has yet to conceptualize the role that disgust might play in ARFID. Disgust has long been tied to formation of taste aversions and is considered at its core to be a food-related emotion. A brief review of the literature on disgust reveals that disgust has a unique psychophysiological profile compared to other emotions, like anxiety, and that disgust is resistant to extinction procedures. If disgust is implicated in the etiology of selective eating, its presence would have a significant impact on treatment approaches. This article provides an overview of the research on disgust and eating, a clinical example of the treatment challenges that disgust may pose, and an overview of the unique clinical features of disgust as they apply to psychopathology. We pose several research questions related to disgust and selective eating and discuss initial hypotheses for pursing this line of inquiry. Finally, we discuss the possible implications of this line of research for treatment.
选择性进食是回避/限制型食物摄入障碍（ARFID）中常见的表现问题。了解选择性进食的病因将有助于为这一问题创造更有效的治疗方法。最近的报告将厌恶敏感性与挑食联系起来，但该领域尚未将厌恶感在 ARFID 中可能发挥的作用概念化。厌恶感长期以来一直与味觉厌恶的形成有关，并且被认为是一种与食物有关的核心情绪。简要回顾一下关于厌恶感的文献，揭示了与其他情绪（如焦虑）相比，厌恶感具有独特的心理生理学特征，并且厌恶感对灭绝程序具有抵抗力。如果厌恶感与选择性进食的病因有关，那么它的存在将对治疗方法产生重大影响。本文概述了关于厌恶感和进食的研究、厌恶感可能带来的治疗挑战的临床实例，以及厌恶感在精神病理学中的独特临床特征概述。我们提出了几个与厌恶感和选择性进食相关的研究问题，并讨论了探讨这一研究方向的初步假设。最后，我们讨论了这一研究方向对治疗的可能影响。
