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Disgust and implicit self-concept in women with borderline personality disorder and posttraumatic stress disorder

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Abstract

Disgust may be a key emotion and target for psychotherapeutic interventions in borderline personality disorder (BPD) and posttraumatic stress disorder (PTSD) at explicit and implicit-automatic levels. However, automatically activated disgust reactions in individuals with these disorders have not been studied. Disgust and its correlation with childhood abuse were assessed in women with BPD, but without PTSD; women with PTSD, but without BPD; women with BPD and PTSD; and healthy women. Disgust sensitivity, anxiety and depression were measured by self-report. Implicit disgust-prone (relative to anxiety-prone) self-concept was assessed using the Implicit Association Test. Women with BPD and/or PTSD reported more disgust sensitivity than controls. The implicit self-concept among patients was more disgust-prone (relative to anxiety-prone) than in controls. Women with BPD, with PTSD, or BPD and PTSD did not differ significantly in self-reported disgust levels or implicit disgust-related self-concept. Among women with BPD and/or PTSD, current psychiatric comorbidity (major depression, anxiety disorder, eating disorder, or substance-related disorder) did not affect disgust-related variables. More severe physical abuse in childhood was associated with a more anxiety-prone (less disgust-prone) implicit self-concept. Independent of psychiatric comorbidity, disgust appears to be elevated at implicit and explicit levels in trauma-related disorders. Psychotherapeutic approaches to address disgust should take implicit processes into account.

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Acknowledgments

We are grateful to all participants. Nicolas Rüsch was supported by a Marie Curie Outgoing International Fellowship of the European Union. Preliminary data from a subgroup of participants were presented at the 23rd Annual Meeting of the International Society for Traumatic Stress Studies, 16 November 2007, Baltimore.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Social and General Psychiatry, Psychiatric University Hospital Zürich, Militärstr. 8/Postfach 1930, 8021, Zürich, Switzerland

    Nicolas Rüsch

  2. Department of Psychiatry and Psychotherapy, University of Freiburg, Freiburg, Germany

    Nicolas Rüsch

  3. Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany

    Daniela Schulz, Gabi Valerius, Regina Steil, Martin Bohus & Christian Schmahl

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  1. Nicolas Rüsch
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  2. Daniela Schulz
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  3. Gabi Valerius
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  4. Regina Steil
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  5. Martin Bohus
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  6. Christian Schmahl
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Correspondence to Nicolas Rüsch.

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Rüsch, N., Schulz, D., Valerius, G. et al. Disgust and implicit self-concept in women with borderline personality disorder and posttraumatic stress disorder. Eur Arch Psychiatry Clin Neurosci 261, 369–376 (2011). https://doi.org/10.1007/s00406-010-0174-2

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  • DOI: https://doi.org/10.1007/s00406-010-0174-2

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