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Freier Beitrag

Die Bedeutung von Ekel- und Angstsensitivität bei Personen mit der Verdachtsdiagnose einer Hypochondrie

Published Online:February 28, 2015https://doi.org/10.1024/1661-4747.a000030

Abstract

Zentrales Merkmal bei der hypochondrischen Störung ist die Befürchtung, an einer schweren Erkrankung zu leiden. Dies führt zur Fehlinterpretation normaler Körperfunktionen. Neben dysfunktionalen Angstzuständen ist auch stark ausgeprägte Angstsensitivität störungsrelevant. Das aktuelle Hypochondriekonzept ist vorwiegend angstfokussiert, während die Bedeutung anderer Emotionen wie zum Beispiel von Ekel bisher kaum untersucht wurde. Ziel dieser Untersuchung war es herauszufinden, ob die habituelle Ekelneigung einen zusätzlichen Prädiktor für die Vorhersage von Hypochondrie darstellt. Nach einem Screening mit einem standardisierten klinischen Interview wurden 27 Personen mit und 27 Personen ohne Verdachtsdiagnose Hypochondrie in die Studie eingeschlossen und getestet. Mittels Diskriminanzanalyse wurde überprüft, ob Ekelempfindlichkeit (Neigung einer Person, mit Ekel zu reagieren) und Ekelsensitivität (Neigung, Ekelempfindungen als bedrohlich zu bewerten) für die Gruppentrennung in Personen mit und ohne Verdachtsdiagnose Hypochondrie (Kriterium: Whitely Index) relevant sind. Es zeigte sich, dass habituelle Angst, Ekelsensitivität und spezifische Bereiche der Ekelempfindlichkeit (z. B. Abneigung vor mangelhafter Hygiene) zwischen den beiden Gruppen differenzierten. Domänenspezifische Beziehungen zwischen Ekelempfindlichkeit und Hypochondrie werden diskutiert.


The Role of Disgust and Anxiety Sensitivity in Individuals with the Suspected Diagnosis of Hypochondriasis

The essential feature of hypochondriasis is a preoccupation with fears of having a serious disease, which leads to misinterpretation of normal somatic functions. In addition to these dysfunctional states of fear, elevated anxiety sensitivity is disorder-relevant. The current hypochondriasis concept is mainly anxiety-focused, whereas the role of other emotions like disgust has hardly been investigated. This study examined whether habitual disgust responses constitute an additional criterion for predicting hypochondriasis. After performing a screening with a standardized clinical interview we included and tested 27 individuals with and 27 persons without a tentative diagnosis of hypochondriasis. A discriminant analysis was calculated to find out, if individuals with and without hypochondriacal tendencies (criterion: Whitely Index) can be classified by means of disgust propensity (tendency to experience disgust) and disgust sensitivity (tendency to perceive disgust experiences as aversive). Habitual anxiety, disgust sensitivity and specific domains of disgust propensity (e.g., aversion of poor hygiene) differentiated between the two groups. Domain-specific relations between disgust propensity and hypochondriasis are discussed.

References

  • Abramowitz, J. S. , Deacon, B. J. , Valentiner, D. P. (2007). The short health anxiety inventory in an undergraduate sample: Implications for a cognitive-behavioral model of hypochondriasis. Cognitive Therapy and Research, 31, 871–883. First citation in articleCrossref, Google Scholar

  • Abramowitz, J. S. , Schwartz, S. A. , Whiteside, S. P. (2002). A contemporary conceptual model of hypochondriasis. Mayo Clinic Proceedings, 77, 1323–1330. First citation in articleCrossref, Google Scholar

  • Bleichhardt, G. , Weck, F. (2007). Kognitive Verhaltenstherapie bei Hypochondrie und Krankheitsangst. Heidelberg: Springer. First citation in articleGoogle Scholar

  • Bravo, I. M. , Silverman, W. K. (2001). Anxiety sensitivity and depression on older patients and their relation to hypochondriacal concerns and medical illness. Aging and Mental Health, 5, 349–357. First citation in articleCrossref, Google Scholar

  • Cisler, J. M. , Olatunji, B. O. , Lohr, J. M. (2009). Disgust sensitivity and emotion regulation potentiate the effect of disgust propensity on spider fear, blood-injection-injury fear, and contamination fear. Journal of Behavior Therapy and Experimental Psychiatry, 40, 219–229. First citation in articleCrossref, Google Scholar

  • Cox, B. J. , Fuentes, K. , Borger, S. C. , Taylor, S. (2001). Psychopathological correlates of anxiety sensitivity: Evidence from clinical interviews and self-report measures. Journal of Anxiety Disorders, 15, 317–332. First citation in articleCrossref, Google Scholar

  • Creed, F. , Barsky, A. (2004). A systematic review of the epidemiology of somatisation disorder and hypochondriasis. Journal of Psychosomatic Research, 56, 391–408. First citation in articleCrossref, Google Scholar

  • Curtis, V. , Aunger, R. , Rable, T. (2003). Evidence that disgust evolved to protect from risk of disease. Proceedings of the Royal Society Biological Sciences Series B, 271(Suppl. 4), 131–133. First citation in articleCrossref, Google Scholar

  • Davey, G. C. L. , Bond, N. (2006). Using controlled comparisons in disgust psychopathology research: The case of disgust, hypochondriasis and health anxiety. Journal of Behavior Therapy and Experimental Psychiatry, 37, 4–15. First citation in articleCrossref, Google Scholar

  • Davey, G. C. L. , Buckland, G. , Tantow, B. , Dallos, R. (1998). Disgust and eating disorders. European Eating Disorders Review, 6, 201–211. First citation in articleCrossref, Google Scholar

  • Druschel, B. A. , Sherman, M. F. (1999). Disgust sensitivity as a function of the big five and gender. Personality and Individual Differences, 26, 739–748. First citation in articleCrossref, Google Scholar

  • Fessler, D. M. T. , Eng, S. J. , Navarrete, C. D. (2005). Elevated disgust sensitivity in the first trimester of pregnancy. Evidence supporting the compensatory prophylaxis hypothesis. Evolution and Human Behavior, 26, 344–351. First citation in articleGoogle Scholar

  • Fink, P. , Hansen, M. S. , Oxhoj, M. L. (2004). The prevalence of somatoform disorders among internal medical inpatients. Journal of Psychosomatic Research, 56, 413–418. First citation in articleCrossref, Google Scholar

  • Haidt, J. , McCauley, C. R. , Rozin, P. (1994). Individual differences in sensitivity to disgust: A scale sampling seven domains of disgust elicitors. Personality and Individual Differences, 16, 701–713. First citation in articleCrossref, Google Scholar

  • Hautzinger, M. , Bailer, M. , Worall, H. , Keller, F. (1994). Beck-Depressions-Inventar (BDI). Bern: Huber. First citation in articleGoogle Scholar

  • Jang, K. L. , Stein, M. B. , Taylor, S. , Livesley, W. J. (1999). Gender differences in the etiology of anxiety sensitivity: A twin study. Journal of Gender-Specific Medicine, 2, 39–44. First citation in articleGoogle Scholar

  • Laux, L. , Glanzmann, P. , Schaffner, P. , Spielberger, C. D. (1981). State-Trait-Angstinventar (STAI). Weinheim: Beltz. First citation in articleGoogle Scholar

  • Margraf, J. (1994). Mini-DIP. Diagnostisches Kurz-Interview bei psychischen Störungen. Heidelberg: Springer. First citation in articleCrossref, Google Scholar

  • Martin, A. , Jacobi, F. (2006). Features of hypochondriasis and illness worry in the general population in Germany. Psychosomatic Medicine, 68, 770–777. First citation in articleCrossref, Google Scholar

  • Marzillier, S. L. , Davey, G. C. L. (2004). The emotional profiling of disgust-eliciting stimuli: Evidence for primary and complex disgusts. Cognition and Emotion, 18, 313–336. First citation in articleCrossref, Google Scholar

  • Matchett, G. , Davey, G. C. L. (1991). A test of a disease-avoidance model of animal phobias. Behaviour Research and Therapy, 29, 91–94. First citation in articleCrossref, Google Scholar

  • McElroy, S. L. , Phillips, K. A. , Keck, P. E. (1994). Obsessive-compulsive spectrum disorders. Journal of Clinical Psychiatry, 55(Suppl. 10), 33–51. First citation in articleGoogle Scholar

  • Morschitzky, H. (2000). Somatoforme Störungen. Diagnostik, Konzepte und Therapie bei Körpersymptomen ohne Organbefund. Wien: Springer. First citation in articleGoogle Scholar

  • Mulkens, A. N. , DeJong, P. J. , Merckelbach, H. (1996). Disgust and spider phobia. Journal of Abnormal Psychology, 105, 464–468. First citation in articleCrossref, Google Scholar

  • Muris, P. , Merckelbach, H. , Nederkoorn, S. , Rassin, E. , Candel, I. , Horserlenberg, R. (2000). Disgust and psychopathological symptoms in a nonclinical sample. Personality and Individual Differences, 29, 1163–1167. First citation in articleCrossref, Google Scholar

  • Norton, P. J. , Sexton, K. A. , Walker, J. R. , Norton, G. R. (2005). Hierarchical model of vulnerabilities for anxiety: Replication and extension with a clinical sample. Cognitive Behaviour Therapy, 34, 50–63. First citation in articleCrossref, Google Scholar

  • Noyes, R. , Stuart, S. , Longley, S. , Langbehn, D. R. , Hapel, R. L. (2002). Hypochondriasis and fear of death. The Journal of Nervous and Mental Disease, 190, 503–509. First citation in articleCrossref, Google Scholar

  • Olatunji, B. O. (2009). Incremental specificity of disgust propensity and sensitivity in the prediction of health anxiety dimensions. Journal of Behavior Therapy and Experimental Psychiatry, 40, 230–239. First citation in articleCrossref, Google Scholar

  • Olatunji, B. O. , Cisler, J. M. (2008). Disgust sensitivity: Psychometric overview and operational definition. In B.O. Olatunji, D. McKay (Eds.), Disgust and its disorders: Theory, assessment, and treatment implications (pp. 31–56). Washington, DC: APA. First citation in articleGoogle Scholar

  • Olatunji, B. , Cisler, J. , Deacon, B. , Connolly, K. , Lohr, J. (2007). The Disgust Propensity and Sensitivity Scale-Revised: Psychometric properties and specificity in relation to anxiety disorder symptoms. Journal of Anxiety Disorders, 21, 918–930. First citation in articleCrossref, Google Scholar

  • Olatunji, B. O. , McKay, D. (2007). Disgust in psychiatric illness: Have we remembered? British Journal of Psychiatry, 190, 457–459. First citation in articleCrossref, Google Scholar

  • Olatunji, B. O. , McKay, D. (2008). Disgust and its disorders: Theory, assessment, and treatment implications. Washington, DC: APA. First citation in articleGoogle Scholar

  • Olatunji, B. O. , Sawchuk, C. N. (2005). Disgust: Characteristic features, social implications, and clinical manifestations. Journal of Social and Clinical Psychology, 24, 932–962. First citation in articleCrossref, Google Scholar

  • Olatunji, B. O. , Unoka, Z. S. , Beran, E. , David, B. , Armstrong, T. (2009). Disgust sensitivity and psychopathological symptoms: Distinctions from harm avoidance. Journal of Psychopathology and Behavioral Assessment, 31, 137–142. First citation in articleCrossref, Google Scholar

  • Otto, M. W. , Demopulos, C. M. , McLean, N. E. , Pollack, M. H. , Fava, M. (1998). Additional findings on the association between anxiety sensitivity and hypochondriacal concerns: Examination of patients with major depression. Journal of Anxiety Disorders, 12, 225–232. First citation in articleCrossref, Google Scholar

  • Otto, M. W. , Pollack, M. H. , Sachs, G. S. , Rosenbaum, J. F. (1992). Hypochondriacal concerns, anxiety sensitivity, and panic disorder. Journal of Anxiety Disorders, 6, 93–104. First citation in articleCrossref, Google Scholar

  • Pilowsky, I. (1967). Dimensions of hypochondriasis. British Journal of Psychiatry, 113, 89–93. First citation in articleCrossref, Google Scholar

  • Rachman, S. (2004). Fear of contamination. Behaviour Research and Therapy, 42, 1227–1255. First citation in articleCrossref, Google Scholar

  • Ravindran, A. V. , da Silva, T. L. , Ravindran, L. N. , Richter, M. A. , Rector, N. A. (2009). Obsessive-compulsive spectrum disorders: A review of the evidence-based treatments. Canadian Journal of Psychiatry, 54, 331–343. First citation in articleCrossref, Google Scholar

  • Reiss, S. , Peterson, R. A. , Gursky, D. M. , McNally, R. J. (1986). Anxiety sensitivity, anxiety frequency and the prediction of fearfulness. Behaviour Research and Therapy, 24, 1–8. First citation in articleCrossref, Google Scholar

  • Rief, W. , Hiller, W. , Goebel, G. , Fichter, M. M. (1995). Zur zeitlichen Stabilität der Angaben hypochondrischer und somatoformer Symptome. Diagnostica, 41, 172–180. First citation in articleGoogle Scholar

  • Rozin, P. , Fallon, A. (1987). A perspective on disgust. Psychological Review, 94, 23–41. First citation in articleCrossref, Google Scholar

  • Rozin, P. , Haidt, J. , McCauley, C. R. (2000). Disgust. In M. Lewis, J. M. Haviland-Jones (Eds.), Handbook of Emotions (pp. 637–653). New York: Guilford. First citation in articleGoogle Scholar

  • Rozin, P. , Markwith, M. , Nemeroff, C. (1992). Magical contagion beliefs and fear of AIDS. Journal of Applied Social Psychology, 22, 1081–1092. First citation in articleCrossref, Google Scholar

  • Sawchuck, C. N. , Lohr, J. M. , Westendorf, D. H. , Meunier, S. A. , Tolin, D. F. (2002). Emotional responding to fearful and disgusting stimuli in specific phobics. Behaviour Research and Therapy, 40, 1031–1046. First citation in articleCrossref, Google Scholar

  • Schienle, A. , Dietmaier, G. , Ille, R. , Leutgeb, V. (im Druck). Eine Skala zur Erfassung der Ekelsensitivität. Zeitschrift für Klinische Psychologie und Psychotherapie. First citation in articleGoogle Scholar

  • Schienle, A. , Walter, B. , Schäfer, A. , Stark, R. , Vaitl, D. (2003). Disgust sensitivity in psychiatric disorders: A questionnaire study. Journal of Nervous and Mental Disease, 191, 831–834. First citation in articleCrossref, Google Scholar

  • Schienle, A. , Walter, B. , Stark, R. , Vaitl, D. (2002). A questionnaire for the assessment of disgust sensitivity. Zeitschrift für Klinische Psychologie und Psychotherapie, 31, 110–120. First citation in articleLink, Google Scholar

  • Schwarz, D. , Witthöft, M. , Bailer, J. (2007). Kritische Überprüfung der Faktorenstruktur und Konstruktvalidität des Whiteley-Index – einem etablierten Screening-Instrument zur Erfassung von Hypochondrie. Zeitschrift für Klinische Psychologie und Psychotherapie, 26, 128–136. First citation in articleLink, Google Scholar

  • Sexton, K. A. , Norton, P. J. , Walker, J. R. , Norton, G. R. (2003). Hierarchical model of generalized and specific vulnerabilities in anxiety. Cognitive Behaviour Therapy, 32, 82–94. First citation in articleCrossref, Google Scholar

  • Speckens, A. E. M. , Spinhoven, P. , Sloekers, P. P. A. , Bolk, J. H. , van Hemert, A. M. (1996). A validation study of the Whitely Index, the Illness Attitude Scales, and the Somatosensory Amplification Scale in general medical practice patients. Journal of Psychosomatic Research, 40, 95–104. First citation in articleCrossref, Google Scholar

  • Starcevic, V. , Berle, D. (2006). Cognitive specificity of anxiety disorders: A review of selected key constructs. Depression and Anxiety, 23, 51–61. First citation in articleCrossref, Google Scholar

  • Thorpe, S. J. , Patel, S. P. , Simonds, L. M. (2003). The relationship between disgust sensitivity, anxiety and obsessions. Behavior Research and Therapy, 41, 1397–1409. First citation in articleCrossref, Google Scholar

  • Van Overveld, W. J. M. , DeJong, P. J. , Peters, M. L. , Cavanagh, K. , Davey, G. C. L. (2006). Disgust propensity and disgust sensitivity: Separate constructs that are differentially related to specific fears. Personality and Individual Differences, 41, 1241–1252. First citation in articleCrossref, Google Scholar

  • Warwick, H. M. C. (1998). Cognitive therapy in the treatment of hypochondriasis. Advances in Psychiatric Treatment, 4, 285–295. First citation in articleCrossref, Google Scholar

  • Warwick, H. M. , Salkovskis, P. M. (1990). Hypochondriasis. Behaviour Research and Therapy, 28, 105–117. First citation in articleCrossref, Google Scholar

  • Watt, M. C. , Stewart, S. H. (2000). Anxiety sensitivity mediates the relationships between childhood learning experiences and elevated hypochondriacal concerns in young adulthood. Journal of Psychosomatic Research, 49, 107–118. First citation in articleCrossref, Google Scholar