Disgust sensitivity and contamination fears in spider andblood±injection±injury phobiasCraig N. Sawchuka,*, Jerey M. Lohra, David F. Tolinb, Thomas C. Leea,Ronald A. KleinknechtcaUniversity of Arkansas, Fayetteville, AR, 72701, USAbAllegheny University of the Health Sciences, Philadelphia, PA, 19129, USAcWestern Washington University, Bellingham, WA, 98225-9089, USAAbstractDisgust has been implicated in the onset and maintenance of blood±injection±injury (BII) and animalphobias. Research suggests that people with these phobias are characterized by an elevated sensitivity todisgust-evoking stimuli separate from their phobic concerns. The disgust response has been described asthe rejection of potential contaminants. Disgust-motivated avoidance of phobic stimuli may therefore berelated to fears of contamination or infection. The present study compared BII phobics, spider phobicsand nonphobics on two measures of disgust sensitivity and two measures of contamination fears.Positive correlations were found between disgust sensitivity and contamination fear. Speci®c phobicsscored higher than nonphobics on all scales and BII phobics scored higher than spider phobics oncontamination fear measures. Furthermore, the contamination fear scales were correlated with the bloodphobia measure, but not correlated with the spider phobia measure. The results suggest that while bothphobias are characterized by elevated disgust sensitivity, contamination fear is more prominent in BIIthan spider phobia. 7 2000 Elsevier Science Ltd. All rights reserved.1. IntroductionA number of investigators have suggested that emotions other than fear may be implicated inthe etiology and maintenance of speci®c phobias (Davey, 1992; Merckelbach, de Jong, Arntz &Schouten, 1993; Tolin, Lohr, Sawchuk & Lee, 1997). The relative contribution of disgust inBehaviour Research and Therapy 38 (2000) 753±7620005-7967/00/$ - see front matter 7 2000 Elsevier Science Ltd. All rights reserved.PII: S 0005 - 7 9 6 7 ( 9 9) 00 09 3- 5www.elsevier.com/locate/brat* Corresponding author. Department of Psychiatry and Behavioral Sciences, University of Washington School ofMedicine, Box 356560, Seattle, WA 90195-6560, USA. Tel.: 206 543 7576; fax: 206 685 8592.E-mail address: [email protected] (C.N. Sawchuk).animal and blood±injection±injury (BII) phobic behavior has generated considerable theoreticaland experimental interest in the empirical literature. For instance, fear ratings of small animalshave been found to be positively correlated with characteristics associated with disgust (e.g. dirty,slimy; Merckelbach, van den Hout & van der Molen, 1987). Davey (1992) argued that certainanimal fears, especially those animals considered nonpredatory (e.g. spiders, cockroaches,maggots), are mediated by a disease-avoidance process as they are perceived to be associated withdirt and disease-carrying characteristics (Rozin, Haidt & McCauley, 1993). Thus, the disease-avoidance model of animal fears suggests that phobic avoidance is mediated by perceptions ofcontamination and disease acquisition rather than a fear of being attacked and physically harmed(Matchett & Davey, 1991). Disgust-mediated aversion in various animal phobias, therefore, maybe related to the prevention of disease transmission (Rozin & Fallon, 1987; Rozin et al., 1993).Although disgust may be generally involved in spider phobia, it plays a more prominent role inBII phobia (Page, 1994). Clinical and experimental evidence suggests that exposure to blood±injury stimuli evokes reactions of aversion and nausea (Gross & Levenson, 1993; Rachman, 1990),especially among BII phobics who are prone to fainting (Kleinknecht, Thorndike & Walls, 1996).Psychophysiological data indicate that exposure to BII phobic stimuli often results incardiovascular deceleration (Thyer & Curtis, 1985), implying activation of the parasympatheticnervous system (Levenson, 1992). Physiological correlates of the disgust response also re¯ectparasympathetic activity (Ekman, Levenson & Friesen, 1983). The physiological mechanism ofdisgust contrasts with the acute sympathetic nervous system reaction (e.g. cardiovascularacceleration) associated with the fear response to phobic stimuli (Gelder & Mathews, 1968).A number of studies have demonstrated that self-report measures of disgust and disgustsensitivity (e.g. Disgust Scale; Haidt, McCauley & Rozin, 1994) are positively correlated withboth animal phobias (Matchett & Davey, 1991; Mulkens, de Jong & Merckelbach, 1996) andBII phobia (de Jong & Merckelbach, 1998; Sawchuk, Lee, Tolin & Lohr, 1997). Heighteneddisgust sensitivity may therefore serve as a diathesis in facilitating the acquisition of spider andBII phobias (de Jong & Merckelbach, 1998). Furthermore, disgust-evoking properties ofphobic stimuli may initiate and exacerbate phobic action tendencies, such as avoidance(Merckelbach et al., 1993).Disgust has been identi®ed as a basic emotion (Ekman, 1992), characterized by well-de®nedand reliable physiological (e.g. nausea), expressive (e.g. facial), behavioral (e.g. rejection) andinterpretive (e.g. contaminant) response components (Rozin et al., 1993). An array of stimulimay evoke reactions of aversion and repulsion. Two general categories of disgust elicitors havebeen dierentiated by Rozin et al. (1993): core and animal-reminder. Core disgust ischaracterized by a sense of oensiveness and a perceived threat of contamination. Core-disgustelicitors encompass a variety of stimuli such as rotting foods, animal waste products (Angyal,1941) and fear-relevant, nonpredatory animals associated with dirt and disease (Davey, 1992;Matchett & Davey, 1991). Animal-reminder disgust refers to the emotional aversion/revulsionof stimuli that prove to be salient reminders of the `animalness' of humans. Blood, veins,connective tissue and muscle tissue serve as potent animal-reminder disgust elicitors as theyresemble similar physical properties in humans.Recently, de Jong and Merckelbach (1998) found that disgust elicitors for spider and BIIfears are domain-speci®c. That is, spider fears were associated with core-disgust sensitivitywhereas BII fears were associated with animal-reminder disgust sensitivity. It remains possible,C.N. Sawchuk et al. / Behaviour Research and Therapy 38 (2000) 753±762754however, that in vivo exposure to blood±injury stimuli may potentially evoke core disgustreactions in addition to animal-reminder disgust as such stimuli may carry the
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