The association between health anxiety and disgust reactions in a contamination-based behavioral approach task

Abstract

Existing evidence suggests that disgust is an important affective process related to health anxiety. The present study sought to determine the contribution of health anxiety symptoms in the prediction of disgust and behavioral avoidance in a large, nonclinical sample (N=156). Regression analyses showed that overall health anxiety symptoms predicted disgust on a behavioral approach task independent of gender, negative affect, and fear of contamination. Particularly, health anxiety-related reassurance seeking was found to be uniquely associated with disgust and behavioral avoidance after controlling for the aforementioned covariates. In addition, the interaction between health anxiety and contamination fear was tested, and remained significant when controlling for gender and negative affect. These results suggest that heightened contamination fear is associated with elevated disgust reactions such that high levels of health anxiety leads even those low in contamination fear to be disgusted during a behavioral task. These results are in line with previous research on the role of disgust in health anxiety.

Keywords:

• disgust
• contamination fear
• health anxiety
• hypochondriasis
• behavioral approach task
• reassurance seeking

Notes

1. Fear ratings, in addition to disgust response ratings on the BAT, were also obtained using a 0–10 scale, with 0 being “no fear” and 10 being “extreme fear.” However, we did not include BAT fear ratings in the main analyses because it is beyond the scope of the current study which focused on the impact of health anxiety on disgust reactions. Nevertheless, we repeated the main analyses of the study using mean BAT fear ratings as the primary BAT outcome variable in order to examine whether the effects of health anxiety and its interaction with contamination fear were specific to disgust reactions. Results failed to show a significant main effect of overall health anxiety (R ²=.14, R ²Δ=.01, F(1,150)=1.94, p=.17) or its interaction effect with contamination fear (R ²=.14, R ²Δ=.004, F(1,149)=0.72, p=.17) in predicting mean BAT fear reactions (after controlling for gender, negative affect, and contamination fear). Taken together, these additional analyses indicate that the current findings are specific to disgust reactions, rather than reflecting general aversive emotional reactions to potential contaminants.