Enhanced disgust generalization in obsessive-compulsive disorder is related to insula and putamen hyperactivity

Compulsive cleaning is a characteristic symptom of a particular subtype of obsessive-compulsive disorder (OCD) and is often accompanied by intense disgust. While overgeneralization of threat is a key factor in the development of obsessive-compulsive symptoms, previous studies have primarily focused on fear generalization and have rarely examined disgust generalization. A systematic determination of the behavioral and neural mechanisms underlying disgust generalization in individuals with contamination concern is crucial for enhancing our understanding of OCD.

In this study, we recruited 27 individuals with high contamination concerns and 30 individuals with low contamination concerns. Both groups performed a disgust generalization task while undergoing functional magnetic resonance imaging (fMRI).

The results revealed that individuals with high contamination concern had higher disgust expectancy scores for the generalization stimulus GS4 (the stimulus most similar to CS+) and exhibited higher levels of activation in the left insula and left putamen. Moreover, the activation of the left insula and putamen were positively correlated with a questionnaire core of the ratings of disgust and also positively correlated with the expectancy rating of CS+ during the generalization stage.

Hyperactivation of the insula and putamen during disgust generalization neutrally mediates the higher degree of disgust generalization in subclinical OCD individuals. This study indicates that altered disgust generalization plays an important role in individuals with high contamination concerns and provides evidence of the neural mechanisms involved. These insights may serve as a basis for further exploration of the pathogenesis of OCD in the future.