A systematic review of the clinical utility of the concept of self‐disgust

Abstract

This systematic literature review examined the clinical utility of the construct of self‐disgust in understanding mental distress. Specifically, the review assessed whether there is a shared conceptual definition of self‐disgust, the face and construct validity of the quantitative assessment measures of self‐disgust, and the predictive validity of self‐disgust in formulating the development of a range of psychological difficulties. A systematic database search supplemented by manual searches of references and citations identified 31 relevant papers (27 quantitative, 3 qualitative, and 1 mixed). Analysis of qualitative papers indicated a number of shared features in the definition of self‐disgust, including a visceral sense of self‐elicited nausea accompanied by social withdrawal and attempts at cleansing or suppressing aspects of the self. Quantitative assessment measures appeared to capture these dimensions and evidenced good psychometric properties, although some measures may have only partially captured the full self‐disgust construct. Strong relationships were observed between self‐disgust and a range of mental health presentations, in particular, depression, body‐image difficulties, and trauma‐related difficulties. However, these relationships are smaller when the effects of other negative self‐referential emotions were controlled, and stronger conclusions about the predictive validity of self‐disgust are limited by the cross‐sectional nature of many of the studies.

Self-disgust, loneliness and mental health outcomes in older adults: An eye-tracking study

“…In Study 1 we demonstrated that self-disgust was positively associated with loneliness, anxiety and depression symptoms in older adults. These findings further extend previous research that showed a positive association between self-disgust and loneliness in older adults (Laffan et al, 2017;Ypsilanti, 2019), and a positive association between selfdisgust and anxiety symptoms in the general population (for a review see Clarke et al, 2019).…”

Self‐disgust mediates the relationship between childhood adversities and psychosis

“…In relation to psychosis, self‐disgust can be understood as a maladaptive cognitive structure (Powell et al , ), one of the three categories of potential mediators between childhood trauma and psychosis recently outlined (Williams et al , ). Given the potential of self‐disgust to complicate and intensify other psychological difficulties (see Clarke et al , ), it is important for clinicians to explore experiences indicative of self‐disgust with clients with psychosis presenting with an abusive/traumatic history. Understanding and responding to such experiences is an important component of an effective formulation and therapy plan.…”

“…One variable which has not yet been researched in relation to psychosis but which is gaining significant interest as a transdiagnostic construct relevant to a number of mental health difficulties is self‐disgust (see Clarke et al , , for a review). Disgust, categorized as a primary emotion since the emergence of Darwinian concepts regarding the evolutionary function of human emotions (Rozin & Fallon, ), is commonly understood as an affective rejection response, with the overall purpose being the prevention of contamination.…”

Questionnaire for the Assessment of Self‐Disgust: The psychometric testing among mental disorders in China

“…Because the QASD has been shown to be a reliable tool for measuring the self‐disgust in mental disorders (Clarke, Simpson, & Varese, 2019; Ille et al, 2014; A. Schienle et al, 2014; A. Schienle, Leutgeb, & Wabnegger, 2015; A. Schienle, 2018), we believe that the QASD must be adapted for application to Chinese patients in future research. Thus, in order to advance the clinical research of self‐disgust in China, especially the relationship between self‐disgust and other psychopathology, we performed this study to translate the questionnaire for the assessment of self‐disgust (QASD) into Chinese and evaluate its validity and reliability among Chinese mental disorders.…”