What therapists need to know about the treatment of OCD when disgust is part of the clinical presentation

Abstract

Background: Research has increasingly identified disgust as a construct that has the ability to significantly impact clinical presentation and treatment of disorders such as Obsessive-Compulsive Disorder (OCD). The primary objective of this paper is to provide a concise summary of key disgust constructs and help clinicians understand how to assess and effectively target these constructs in evidence-based treatments. Methods: A systematic literature review was conducted on disgust-related variables and their impact on psychiatric disorders, namely OCD. Results: We begin by defining key disgust constructs (proneness, propensity, sensitivity) and their respective roles. We then identify clinical presentations typically impacted by disgust (contamination, core, morality). We then discuss the current instruments available for identifying and assessing disgust (DPSS-R, DS-R, OCI-R). We discuss the importance of identifying and addressing disgust-related variables in evidence-based treatment (exposure, CBT). We emphasize how an effective treatment approach can positively impact patient outcomes and course of illness. Limitations: The directionality of this relationship between disgust sensitivity/propensity and OCD remains unclear. Further, only two main treatment modalities are discussed. Conclusions: Disgust is increasingly recognized as an influential variable with clinical implications for disorders such as OCD. This paper comprehensively summarizes recent research findings and how to apply them effectively in evidence-based treatments.

Keywords

• Disgust
• Disgust sensitivity
• Disgust propensity
• Obsessive-compulsive disorder
• Cognitive appraisals
• Avoidance