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Disgust and Obsessive Compulsive Disorder

Here you will find an overview of the topics disgust and obsessive-compulsive disorder. For an overview on the topic of disgust-associated disorders and their treatment, we would like to refer to the following book:

Change in pathological experiences of disgust

Disgust is an emotion that maintains various mental disorders. The experience of disgust and the associated feeling of contamination is characterised by rigidity in response to change. Disgust is often overlooked in the diagnostic process and is not always recognised as a diffuse experience in the self-experience. For these reasons, it is important to develop concrete strategies that can directly alter these experiences. Previous studies have shown that adapted cognitive strategies and imagery rescripting (Fink, Pflugradt et al., 2018; Fink & Exner, 2019), as well as self-compassion-based strategies (Fink-Lamotte, Platter, Stierle et al., 2022)  and strategies that combine cognitive and imaginative strategies, such as CRIM (Fink-Lamotte, Kursim & Exner, 2023) help to directly change experiences of disgust and contamination.

 

In further studies we investigated the extent to which technical aids, such as transcranial direct current stimulation (tDCS), improve the effectiveness of strategies (Fink & Exner, 2019; Fink & Exner, 2019a, Parastoo et al., under review).

Further open questions that are being addressed in the research group include:

  • Which strategies are most effective in changing which mechanisms of disgust?
  • What effects do the strategies demonstrate in single-session clinical-naturalistic and clinical-randomised studies?
  • What are the long-term effects of the strategies?

 

Cooperations with:

Interventions used (freely available)

On the diagnosis of rigid contamination/disgust experience (Fink-Lamotte, Bieber, Jordan & Exner, submitted):

For treatment of contamination/disgust experience:

Proposed indication matrix for the treatment of disgust

Object disgustContact contaminationExposure procedureSpecific phobias (spiders, snakes, vomiting, blood-injection-injury type phobia), obsessive-compulsive disorder, eating disorders
Cognitive procedure

Mental contamination

Imagery procedurePost-traumatic stress disorder, obsessive-compulsive disorder, eating disorders
Self disgust Compassion-based proceduresSkin disorders, Eating disorders, Borderline personality disorder, Depression, Sexual dysfunction disorders

 

Investigating disgust-specific mechanisms in the maintenance of psychopathology


Several mechanisms are discussed that directly or indirectly influence and maintain psychological disorders through disgust. These include

  1. Stimulus-related processes, whereby experiencing disgust directly triggers strong avoidance behavior, which contributes to the development and maintenance of psychopathology through feedback processes.
  2. Self-disgust, in which devaluation by oneself or others leads to experiencing disgust directed towards one’s own personality or self. Such processes, as enduring schematic attributions, may contribute to the development of psychopathology.
  3. Moral disgust, in which violations of norms and rules elicit feelings of repulsion and disgust, leading to rejection, avoidance, and social withdrawal.
  4. Cognitive biases (e.g., sympathetic magical laws) distort perception and information processing, thereby shaping and amplifying emotional experience.

In our research, we have so far focused in particular on stimulus-related aspects (Fink-Lamotte, Lüders & Exner, 2020) and cognitive biases. Specifically, we investigate the role of disgust-specific magical beliefs (Fink-Lamotte, Bieber et al., 2024), attentional and memory biases (Fink, Buchta & Exner, 2018; Fink-Lamotte, Widmann et al., 2021; Fink-Lamotte, Svensson et al., 2021), and interpretation biases (Fink-Lamotte, Widmann et al., 2020) in maintaining psychopathology. In the studies, we use eye trackers and eye tracking glasses and psychophysiological measures (ECG and EMG). 


In a large scoping review we examined how cultural norms and historical contexts influence the content and moral meaning of obsessive thoughts (Gitter, Allermann, Fink-Lamotte et al., 2024).

 

Cooperations with:

Maintaining Processes in Obsessive-Compulsive Disorder: Accommodation, Metacognitions, and Coping

Accommodation refers to supportive behaviors by relatives or friends of individuals with mental disorders that may provide short-term relief but contribute to the long-term maintenance of symptoms. In OCD, for example, it is often perceived as helpful when family members repeatedly check whether appliances have been unplugged, help with disinfecting the apartment, or take detours to avoid passing by a kindergarten. As a first step, we translated the Family Accommodation Scale (FAS) into German for both patient and relative versions (Fischer, Kathmann, Rohr, & Fink-Lamotte, in prep.) and developed a German version of the FAS for depressive disorders (Fink-Lamotte, Huhn et al., in prep.). In our first large dyadic study, we examined accommodation experiences and their association with relationship parameters: the results showed that higher levels of accommodation were linked to lower relationship quality (Fink-Lamotte, Nolte et al., 2025). A follow-up project (Rohr et al., in preparation) is examining how empathy and emotion regulation capacities in relatives influence their accommodating behavior.
Metacognitions are thoughts about thoughts. Cognitive fusion processes, such as thought–action fusion, appear to be important maintaining mechanisms in OCD. We investigate how these processes alter memory functioning (Fink-Lamotte et al., 2017) and how they are influenced by shame (Hansmeier et al., 2023).
In addition, we have examined how OCD affects individuals’ coping strategies (Moritz et al., 2018).

Cooperations with:

Static and Dynamic Features of Contamination Concerns

Humans are particularly sensitive to threats that approach or accelerate (Löw et al., 2015). The so-called Looming Vulnerability Model assumes that such motion-related features of a threat (e.g., speed, proximity) can trigger a form of anticipatory anxiety, referred to in research as looming vulnerability (Riskind, 1997). We experimentally investigated how these dynamic threat features are related to the experience of disgust in contamination concerns.

In our study (Pelzer et al., 2026), participants were asked to imagine disgusting bathroom scenarios that varied in the proximity, speed, and acceleration of the threat. The result: dynamic scenarios were perceived as more threatening than static ones. In particular, individuals with stronger contamination fears reported more intense disgust in the dynamic scenarios.

These findings suggest that looming vulnerability is a central cognitive mechanism that amplifies disgust and plays a role in maintaining the symptoms. This hilights the need to address such cognitive processes more directly in therapeutic approaches.

Maintaining Processes in Obsessive-Compulsive Disorder: Combined Cognitive Bias Hypothesis

In a current project, we examine whether the Combined Cognitive Bias Hypothesis (originally developed for anxiety and depression) can also be applied to contamination-related obsessive-compulsive disorder (C-OCD), in which disgust is a central emotion.

In a first study, we employed a newly developed disgust-related version of the Scrambled Sentences Task in combination with eye-tracking and memory tests. Preliminary results indicate that cognitive biases (attention, interpretation, memory) are associated with disgust sensitivity and C-OCD symptoms. However, the hypothesized interaction model (attention → interpretation → memory) did not outperform the simpler model.

A second study is validating several measures of disgust-related interpretation biases to determine the most reliable instrument for research and clinical practice.

Building on these findings, a third study is planned to develop cognitive bias modification interventions specifically targeting disgust-specific beliefs.

 

Cooperation with:

Imagery Rescipting as a transdiagnostic intervention

We conducted a systematic review and meta-analysis (Pelzer, Rothkegel et al., 2025) to explore the broader potential of Imagery Rescripting (ImR) for emotions beyond anxiety. The results indicate that ImR can effectively reduce distressing emotions such as disgust, shame, guilt, sadness, and anger. Effects were strongest in clinical populations and when ImR was applied in a structured, manualized format. ImR proved particularly effective in addressing difficulties linked to autobiographical memories, intrusive imagery, and maladaptive affective schemas.