This thesis sought to investigate the role of disgust and other negative emotions in disorders of body image, specifically eating disorders and muscle dysmorphia. Eating disorders are known to negatively impact on the physical and mental wellbeing of a significant portion of the population, disproportionally affecting more females than males. Muscle dysmorphia, whilst classed under body dysmorphic disorders, has been theorized to be a predominantly male equivalent to eating disorders.
For eating disorders there are multiple conceptual theories on the maintenance of the disorders, largely focusing on the cognitive aspects of the disorders. There is a maintenance model as to the emotional processes, Schematic Propositional Analogical Associative Representation System for Eating Disorders (SPAARS-ED), which proposes that disgust is used to mediate unacceptable feelings of anger by converting the anger to disgust at the self. The role of disgust has been a subject of interest within eating disorders for a while, but there is not a recent systematic review of this. The literature review presented here, included twenty-seven studies, which covered the role of disgust in perception of emotions in others, in how disgust is experienced, its links to other emotions and to other pathologies. Large effect sizes were found within each area of study, which allowed the review to conclude that, despite the limitations of a single reviewer and an over-reliance on case control studies within the literature, disgust plays an important role in the maintenance of eating disorders and self-disgust may be of particular importance as to how the disorders cause distress.
The research around muscle dysmorphia has also included maintenance models that focus largely on cognitions. The experimental condition of this thesis interviewed five participants screened for a high probability of muscle dysmorphia as to the role of their emotions in their muscle gaining behaviours. The interviews demonstrated sadness, fear and anger to be prominent emotions related to muscle gaining behaviours, with self-directed components of each emotion being present. The self-directed elements of disgust, shame and guilt, were also discussed, though disgust itself was not commonly mentioned. The participants all indicated a pattern whereby muscle gaining behaviours were initially used to healthily suppress sadness, but then the progress towards matching an ideal body image, regulated by self-conscious emotions, becomes rigid and inflexible which led to further fear, anger, sadness and self-directed derivatives of disgust. It was concluded that, even though the sample size for the study was small due to COVID-19 restrictions impacting on recruitment, the study showed sufficient promise for the use of current eating disorder treatments with this population, as well as recommending treatments that focus on alleviating sadness and soothing shame and guilt.
