Abstract
Abstract An elevated disgust sensitivity (DS) is considered to be a vulnerability factor for the development of a blood-injection-injury (BII) phobia. Within the present functional Magnetic Resonance Imaging (fMRI) study, 12 female BII phobics were scanned while viewing alternating blocks of 40 disgust-inducing, 40 fear-inducing, and 40 affectively neutral pictures. Each block lasted 60s and was repeated six times during the experiment. All scenes were phobia-irrelevant. Afterwards, the subjects gave affective ratings for the pictures and described their DS on a self-report measure for different areas (e.g., poor hygiene, unusual food, death/deformation). The responses were compared with those of 12 nonphobic females. The BII phobics showed a stronger occipital activation within the right cuneus and lingual gyrus during the first viewing of the disgusting pictures. Aside from this finding, which could be interpreted as reflecting increased attention, there was little evidence for a generally elevated DS in BII phobia. On the DS questionnaire, the patients had indicated a greater reactivity only for disorder-relevant contents (death/deformation). Further, both groups gave similar disgust ratings for the pictures and showed comparable brain-dynamic responses over all blocks of the disgust condition, which included the activation of both amygdalae and the left inferior frontal gyrus.
References
(1994). Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).. Washington: American Psychiatric Association. .
Bradley, M.M. , Lang, P.J. (1994). Measuring emotion: The Self-Assessment Manikin and the semantic differential.. Journal of Behaviour Therapy and Experimental Psychiatry, 25, 49– 59 .Breiter, H.C. , Etcoff, N.L. , Whalen, P.J. , Kennedy, W.A. , Rauch, S.L. , Buckner, R.L. , Strauss, M.M. , Hymann, S.E. , Rosen, B.R. (1996). Response and habituation of the human amygdala during visual processing of facial expressions.. Neuron, 17, 875– 887 .Calder, A.J. , Lawrence, A.D. , Young, A.W. (2001). Neuropsychology of fear and loathing.. Nature Reviews Neuroscience, 2, 352– 363 .De Jong, P.J. , Merckelbach, H. (1998). Blood-injection-injury phobia and fear of spiders: Domain specific individual differences in disgust sensitivity.. Personality and Individual Differences, 24, 153– 158 .Fredrikson, M. , Gustav, W. , Greitz, T. , Eriksson, L. , Stone-Elander, S. , Ericson, K. , Sedvall, G. (1993). Regional cerebral blood flow during experimental phobic fear.. Psychophysiology, 30, 126– 130 .Friedman, B.H. , Thayer, J.F. (1998). Anxiety and autonomic flexibility: A cardiovascular approach.. Biological Psychology, 48, 303– 323 .Klorman, R. , Weerts, T. , Hastings, J. , Melamed, B. , Lang, P. (1974). Psychometric description of some fear-specific questionnaires.. Behavior Research, 5, 401– 409 .Lane, R.D. , Reiman, E.M. , Bradley, M.M. , Lang, P.J. , Ahern, G.L. , Davidson, R.J. , Schwartz, G.E. (1997). Neuroanatomical correlates of pleasant and unpleasant emotion.. Neuropsychologia, 35, 1437– 1444 .Lang, P.J. , Bradly, M. , Cuthbert, B. (1995). International affective picture system. . Gainesville, Florida, Center for Research in Psychophysiology, University of Florida. .Lang, P.J. , Bradley, M.M. , Fitzsimmons, J.R. (1998). Emotional arousal and activation of the visual cortex: An fMRI analysis.. Psychophysiology, 35, 199– 210 .Laux, L. , Glanzmann, P. , Schaffner, P. , Spielberger, L. (1981). Das State-Trait-Angstinventar. . Weinheim: Beltz Testgesellschaft. .Margraf, J. (1994). Diagnostisches Kurz-Interview bei psychischen Störungen (Mini DIPS). . Berlin: Springer-Verlag. .Muris, P. , Merckelbach, H. , Schmidt, H. , Tierney, S. (1999). Disgust sensitivity, trait anxiety, and anxiety disorder symptoms in normal children.. Behavior Research and Therapy, 37, 953– 961 .Öst, L.G. (1992). Blood and injection phobia: Background and cognitive, physiological, and behavioral variables.. Journal of Abnormal Psychology, 101, 68– 74 .Page, A.C. (1994). Blood-injury phobia.. Clinical Psychology Review, 14, 443– 461 .Phillips, M.L. , Young, A.W. , Scott, A.W. , Calder, A.J. , Andrew, C. , Giampietro, V. , Williams, S.C.R. , Bullmore, E.T. , Brammer, M. , Gray, J.A. (1998). Neural responses to facial and vocal expressions of fear and disgust.. Proceedings of the Royal Society of London, 265, 1809– 1817 .Phillips, M.L. , Marks, I.M. , Senior, C. , Lythgoe, D. , O'Dwyer, A.M. , Meehan, O. , Williams, S.C.R. , Brammer, M.J. , Bullmore, E.T. , McGuire, P.K. (2000). A differential response in obsessive-compulsive disorder patients with washing compared with checking symptoms to disgust.. Psychological Medicine, 30, 1037– 1050 .Rolls, E.T. (1999). The brain and emotion. . New York: Oxford University Press. .Sawchuck, C.N. , Lohr, J.M. , Tolin, D.F. , Lee, T.C. , Kleinknecht, R.A. (2000). Disgust sensitivity and contamination fears in spider and blood-injection-injury phobia.. Behavior Research and Therapy, 38, 753– 762 .Schienle, A. , Stark, R. , Vaitl, D. (2001). Evaluative conditioning: A possible explanation for the acquisition of disgust responses?. Motivation and Learning, 32, 65– 83 .Schienle, A. , Stark, R. , Walter, B. , Blecker, C. , Ott, U. , Kirsch, P. , Sammer, G. , Vaitl, D. (2002a). The insula is not specifically involved in disgust processing: An fMRI study.. NeuroReport, 13, 2023– 2026 .Schienle, A. , Walter, B. , Stark, R. , Vaitl, D. (2002b). Ein Fragebogen zur Erfassung der Ekelempfindlichkeit. ‘A questionnaire for the assessment of disgust sensitivity (QADS)’.. Zeitschrift für Klinische Psychologie und Psychotherapie, 31, 110– 120 .Sprengelmeyer, R. , Rausch, M. , Eysel, U.T. , Przuntek, H. (1998). Neural structures associated with recognition of facial expressions of basic emotions.. Proceedings of the Royal Society of London, 265, 1927– 1931 .Tolin, D.F. , Lohr, J.M. , Sawchuck, C.N. , Lee, T.C. (1997). Disgust and disgust sensitivity in blood-injection-injury and spider phobia.. Behavior Research and Therapy, 35, 949– 953 .Tzourio-Mazoyer, N. , Landeau, B. , Papathanassiou, D. , Crivello, F. , Etard, O. , Delcroix, N. , Mazoyer, B. , Joliot, M. (2002). Automated anatomical labeling of activation in SPM using a macroscopic anatomical parcellation on the MNI MRI single-subject brain.. NeuroImage, 15, 273– 289 .Zald, D.H. (2003). The human amygdala and the emotional evaluation of sensory stimuli.. Brain Research Review, 41, 88– 123 .
