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Pathological disgust: In the thoughts, not the eye, of the beholder

Abstract There is now mounting evidence that disgust is critically involved in anxiety disorders. Despite the emphasis on irrational fear in understanding these disorders, there has been little investigation into the cognitive component of disgust. In this theoretical paper, a process to distinguish normal versus pathological disgust responding is proposed and its clinical implications considered. Similar to intrusive thoughts in obsessive-compulsive disorder (OCD), it is the interpretation of a disgust reaction as personally meaningful or threatening that will lead to pathological disgust. Building upon the belief domains thought to contribute to OCD (Obsessive Compulsive Cognition Working Group [OCCWG], 1997) and the laws of sympathetic magic in normal disgust (Rozin & Nemeroff, 1990), it is suggested that beliefs about one's ability to cope with being contaminated, dirty, or disgusted may help predict avoidance and pathological disgust.