Disgust and imaginal exposure to memories of sexual trauma: Implications for the treatment of posttraumatic stress

Emerging evidence identifies disgust as a common and persistent reaction following sexual victimization that is linked to posttraumatic stress disorder (PTSD). Importantly, evidence suggests that compared with fear, disgust may be less responsive to repeated exposure, which may have implications for the treatment of PTSD. The current study sought to fill a gap in the existing literature by examining reductions in sexual trauma cue-elicited disgust and anxiety upon repeated imaginal exposure. Method: Seventy-two women with a history of sexual victimization completed a single laboratory-based session that involved repeated imaginal exposure to idiographic disgust-and fear-focused sexual trauma scripts. Results: Results demonstrated that although anxiety and disgust declined at similar rates across exposure trials (t =-.24, p = .81), ratings of disgust (B₀ = 61.93) were elevated compared with ratings of anxiety at initiation (B₀ = 51.03; t = 4.49, p = .001) of exposure even when accounting for severity of PTSD symptoms. Moreover, change in disgust significantly predicted improvement in script-elicited PTSD symptoms across the course of exposure for individuals exhibiting significant decline in anxiety (B = .006, t = 2.00, p = .048). Change in script-elicited PTSD symptoms was minimal (and was not predicted by the decline in disgust) for individuals exhibiting less change in anxiety (B =-.002, t =-0.46, p = .65). Conclusion: These results add to an increasing literature documenting the importance of disgust in the development, maintenance, and treatment of sexual-trauma-related PTSD.