The spit-face scenario: Inducing Contamination-Based Disgust and Anxiety and Investigating the Effects of Imagery Rescripting in an Online Experiment

Abstract Background In the treatment of obsessive–compulsive disorder (OCD), imagery rescripting (ImRs) is considered promising. However, there is a paucity of randomized-controlled trials (RCTs) with active control groups in this context. Methods We developed an audio imagery, which we refer to as the spit-face scenario , to induce disgust without any sexual content. In an online RCT, we then investigated disgust (SDQ-13, visual analogue scale (VAS)) and anxiety (STAI-SKD, VAS) in participants reporting at least mild OC symptoms after one of three manipulations, ImRs ( n = 34), imagery focus ( n = 25) or distraction ( n = 34). Results The spit-face scenario significantly induced disgust, e.g., comparable with watching a disgusting film, and over 70% of the participants were able to vividly visualize and follow the scenario effectively. Although ImRs and distraction reduced disgust, it did not decline following imagery focus (e.g., SDQ-13, F -HF = 86.600 (1.756), p < .001, f = 0.98). Whereas disgust performed similarly in the SDQ-13 and the VAS, there were slightly different patterns in the anxiety measures. Conclusions Although the results might suggest an effect of a one-session online ImRs audio manipulation, the question remained if ImRs had a differential effect beyond distraction. The results thus underline the need to conduct further research on the active elements of ImRs.