State of the Science in Practice: Targeting Disgust to Enhance the Treatment of Anxiety and Related Disorders

• Disgust is increasingly recognized as a key emotion involved in anxiety and related disorders. • Research into disgust-based mechanisms suggests a potential challenge for standard cognitive-behavioral treatments. • Understanding the mechanisms could enhance treatment outcomes for various disorders. • Clear need for more rigorous testing of potential treatments targeting disgust to better inform clinical practice. Disgust is increasingly recognized as a key emotion involved in the etiology and maintenance of several anxiety-related disorders, from obsessive-compulsive disorder (OCD) to post-traumatic stress disorder (PTSD). Research into disgust-based mechanisms has shown that disgust is resistant to extinction and habituation, posing a potential challenge for standard cognitive-behavioral treatments, such as exposure therapy. Understanding the mechanisms that facilitate disgust reactions offers valuable insights into adjuvant strategies that could enhance treatment outcomes for disorders characterized by heightened disgust. In this review, we discuss exposure-based strategies and provide a case illustration to demonstrate how these techniques can be integrated into treatment for contamination-based OCD. We also explore cognitive interventions and present a framework emphasizing a shift in therapeutic goals from disgust reduction to disgust tolerance. Although this review highlights evidence-based strategies to address disgust-related symptoms, there is a clear need for more rigorous testing of potential treatments targeting disgust to better inform clinical practice.