Effects of emetophobia symptoms, disgust propensity, and disgust sensitivity on state disgust and behavioral avoidance of a vomit-like stimulus

People with emetophobia (specific fear of vomiting) are prone to experience disgust and tend to interpret feelings of disgust as signs of imminent vomiting. Accordingly, they typically avoid situations they believe might increase the likelihood of vomiting or expose them to others vomiting. Because of this, vomit-related stimuli are often used as part of exposure exercises during treatment. To examine relationships between emetophobia symptoms, disgust, and avoidance behavior in more detail, the current study tested 126 participants (77% female) who completed self-report measures on emetophobia symptoms, disgust propensity, disgust sensitivity, and state disgust, and performed a behavioral approach test (BAT) involving a vomit-like substance in the laboratory. Higher emetophobic symptomatology related to higher disgust sensitivity but did not relate to disgust propensity. Both emetophobic symptomatology and disgust sensitivity—but not disgust propensity—related to higher state disgust before the BAT. In contrast, higher disgust propensity—but not emetophobic symptomatology or disgust sensitivity—related to larger increases in state disgust from before to after the BAT and to higher avoidance of the vomit-like substance. Results suggest that people with emetophobia may not be more easily disgusted by external stimuli than people without emetophobia but their subjective feelings of disgust are driven by their expectations and their tendency to evaluate the experience of disgust more negatively. This implies that the aim of exposure exercises should not be reducing vomit stimuli-induced disgust intensity but modifying patients’ expectations and interpretation of feelings of disgust.