A network analysis of disgust proneness in a clinical, adolescent sample: Implications for the treatment of OCD.

Although disgust proneness has been implicated in the development of obsessive-compulsive disorder (OCD), studies to date have failed to identify the core symptom of disgust proneness that may be most strongly associated with OCD and its treatment. Accordingly, we used network analysis to examine which symptoms are most central to disgust proneness and the extent to which such symptoms predicted OCD symptoms before and after treatment. Adolescent participants (N = 434) in a residential treatment program for severe OCD, anxiety, and mood disorders completed pre- and post-treatment measures of OCD, disgust proneness, and general mood symptoms. Network analysis was used to identify the most central symptoms (nodes) and associations between symptoms (edges) of disgust proneness. The results revealed that the most central indicator in the pre- and post-treatment network were symptoms of 'animal-reminder disgust' (i.e., seeing blood in meat at the grocery store) that remind humans of their own mortality and bodily vulnerability. However, the pre- and post-treatment networks did not significantly differ (i.e., no network invariance). Accounting for OCD diagnostic status, animal-reminder disgust symptoms that were central in the network accounted for significant variance in OCD and general mood symptoms at pre- and post-treatment. These findings suggest that aversion towards animal-reminder cues are central symptoms of disgust proneness that may have predictive validity. The implications of these findings for conceptualizing theoretical and treatment models of disgust proneness in OCD are discussed.