The fear of contamination
Contact contamination and mental contamination
Obsessive-compulsive (DOC) disorder is a psychopathological framework characterized by the presence of thoughts, images, recurring impulses. These are perceived by the subject as unwanted and/or involuntary (obsessions) generating a marked individual discomfort. The subject therefore feels pushed to implement externally visible or internal/mental behaviors (compulsions) aimed at preventing or reducing anxiety, disgust or discomfort generated by obsessions.
There are various manifestations of the disorder, so much so that today in the clinical field we often speak of Obsessive-compulsive “disorders”. The subtype characterized by fear of contamination It is the most frequent and widespread in the clinical population.
It is characterized by excessive fears related to dirt and the possibility of contaminating with it. They accompany compensatory behavior, such as, for example, body washing, cleaning of objects or clothing, controls and avoidance, aimed at canceling or reducing contact with contaminating agents.
Classically for fear of contamination We mean the fear of coming into direct or indirect contact with people or things considered dirty or potentially harmful (Rachman, 2004). However, in parallel with this type of contamination (called “contact contamination”) another form of contamination has been recognized and investigated (called “mental contamination”).
It is also present in the absence of contact with a tangible source of dirt, because it is generated by mental images, memories or thoughts associated with sensations of “dirty internal” (Rachman, 2004, 2006). In the case of mental contaminationthe discomfort typically tried by the person is more pervasive and often not eliminated through washing or other compulsions.
Disgust in fear of contamination
The most frequently found emotional manifestations in patients with obsessive fear of contamination include experiences of anxiety, fear and often disgust. The latter is one of the basic emotions evolutionary associated with the purpose of generating rejection towards pathogenic agents to facilitate expulsive behaviors by the individual (Olatunji & Sawchuck, 2005).
The research on the role of the emotion of disgust in the doc has often resorted to the construct of Disgust Propensitythat is, the propensity of a sudden to frequently experience the emotion of disgust (David et al., 2009). A large amount of data supports the association between fear of contamination in the doc and propensity to disgust (eg, David et al., 2009; Olatunji et al., 2005; back them et al., 2003).
The association between the propensity to disgust and the DOC symptoms from contamination proved to be highly significant (among other studies, Olatunji et al., 2010; back them et al., 2003). In fact, the propensity to disgust seems to be a significant predictor both of the obsessive washing symptoms and, to a lesser extent, of those of control and order and symmetry (Mancini et al., 2001; Olatunji et al., 2004; Melli et al., 2015).
The propensity to disgust and its size
In the last 20 years, the theoretical reference model for the study of disgust in psychopathology (Haidt et al., 1994) has recognized several underground undergrounds of the disgust. There are nuclear disgust, animal disgust, interpersonal and moral disgust. More recently, Tybur and colleagues (2009) then proposed a model in which the disgust would include 3 dimensions:
- pathogen (aversion to potentially harmful or contaminating agents for man)
- sexual (aversion to partners or potentially unsuccessful sexual behaviors for the success of the species)
- Moral (aversion to individuals who transgress moral rules or implement non -socially acceptable behaviors)
Associations between disgust and contact and mental contamination
In line with this model with three factors, Tybur and colleagues have also proposed a measurement tool (TDDS, Three Domains of Disgust Scale) aimed at investigating the individual propensity to experience emotions of disgust. It has three seabed: pathogen, sexual and moral disgust.
La Scala, only recently has been translated and validated in Italian (Poli, Melli & Radomsky, 2019). It was then used in order to investigate the hypothesis that sub-domini of the propensity to disgust differently associated with the Contact contamination fears and to the mental contamination.
The study (Poli et al., 2019) was conducted on a large Italian champion of clinical subjects (103 patients) with obscent-compliant symptoms.
The results showed that patients with greater propensity to experiment pathogenic disgust they were more likely to demonstrate Obsessive symptoms of contact contamination. The subjects with the highest propensity to sexual disgust they tended to present above all symptoms of mental contamination.
In addition, the propensity to pathogenic disgust was the only significant predictor of the obsessive symptoms related to contact contamination. The propensity for sexual disgust has instead only predicted the symptoms of mental contamination.
Conclusions about the fear of contamination and disgust
In conclusion, the study confirms the different role of the different subtypes of disgust in the development and maintenance of the fear of contamination. The result is the importance, at the time of taking charge of patients with a contamination DOC, to evaluate the type of disgust well involved well. This is in such a way that we can drop the intervention in a more targeted way on the emotional-emotional components involved in the phenomenology of the disorder.
Essential bibliography:
- Rachman, SJ (2004). Fear of Contamination. Behaviour Research and Therapy, 42 (11), 1227-1255.
- Rachman, SJ (2006). The Fear of Contamination: Assessment and Treatment, NY: Oxford University Press.
- Olatunji, Bo & Sawchuck, CN (2005). Disgust: Characteristic features, Social Manifestations and Clinical Implications. Journal of Social and Clinical Psychology, 24 (7), 932-962.
- Poli, a.; Melli, G. & Radomsky, AS (2019). Different Disgust Domains Specifically Relate to Mental and Contact Contamination Fear in OCD: Evidence from A Path Analytic Model in An Italian Clinical Sample. Behavior Therapy, 50, 380-394.
- Tybur, JM; Lieberman, D. & Griskevicius, V. (2009). Microbes, Matting and Morality: Individual Differences in Three Functional Domainins of Disgust. Journal of Personality and Social Psychology, 97 (1), 103-122.
