Article

Body Position Influences

Cardiovascular Disgust Reactivity
A Tilt Table Experiment
Anne Schienle,1 Sonja Übel,1 Andreas Rössler,2 Andreas Schwerdtfeger,3
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and Helmut Karl Lackner2

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1
Department of Clinical Psychology, University of Graz, Austria, 2Institute of Physiology,
Medical University Graz, Austria, 3Department of Health Psychology, University Graz, Austria

Abstract. It has been suggested that elevated trait disgust constitutes a vulnerability factor for fainting episodes. We tested the hypothesis that
disgust-prone individuals are susceptible to vasovagal syncope by means of a tilt table experiment, during which 30 women were presented with
disgusting pictures in a supine and a 70 upright position. The results showed that relative to disgust elicitation in the supine position, tilting
reduced diastolic blood pressure during disgust elicitation, which could indicate increased risk for presyncope. Moreover, self-reported disgust
proneness was positively correlated with heart rate during disgust induction in the tilted position. This association may point to a compensatory
mechanism that aims at stabilizing mean arterial pressure. Disgust-prone individuals possibly utilized this mechanism more extensively to
prevent fainting. Future investigations with a longer duration should follow up on this finding and compare the onset of presyncope between
high and low disgust-prone individuals.

Keywords: disgust, disgust proneness, tilt table, cardiovascular, pictures

In his initial formulation of the disgust theory of fainting,
Page (1994) proposed that disgust-prone individuals show
pronounced parasympathetic activation when confronted
with repulsive stimuli. He argued that the associated
marked heart rate deceleration and blood pressure reduction
may even lead to fainting. Consequently, the personality
trait disgust proneness (the tendency of a person to experi-
ence disgust across different situations) was conceptualized
as a vulnerability factor for fainting episodes (Page, 2003;
Page & Tan, 2009).
There is however mixed empirical evidence that the
experience of disgust is indeed associated with parasympa-
thetic activation. The most commonly applied experimental
design for studying the psychophysiology of disgust has
been passive picture viewing. The participants are presented
with aversive scenes or video clips while their cardiovascu-
lar responses (e.g., heart rate) are recorded. In line with
Page’s hypothesis many studies observed heart rate reduc-
tion during visual disgust elicitation (e.g., Rohrmann &
Hopp, 2008; Schienle, Stark, & Vaitl, 2001; Stark, Walter,
Schienle, & Vaitl, 2005). However, some authors reported
no heart rate changes (e.g., Sarlo, Buodo, Munafò,
Stegagno, & Palomba, 2008; van Overveld, de Jong, &
Peters, 2009; Vossbeck-Elsebusch, Steinigweg, Vögele, &
Gerlach, 2012) or even heart rate acceleration (e.g., de
Jong, van Overveld, & Peters, 2011).
The discrepant findings may be related to different
methodological factors. First, a sufficient exposure time to
disgust elicitors is necessary in order to be able to observe
a prolonged heart rate deceleration and to be able to com-
pute additional cardiac indices like heart rate variability.
However, in early investigations the chosen indicators were
limited to heart rate (e.g., Levenson, Ekman, & Friesen,
1990). This approach does not provide a detailed picture
of the cardiovascular processes associated with disgust.
More recent studies that included a variety of cardiac
parameters described a more complex picture. de Jong
et al. (2011) observed a disgust-related increase in heart rate
together with an increase in high frequency band power
of heart rate variability during the presentation of repulsive
video clips (de Jong et al., 2011). Thus, there were simulta-
neous sympathetic and parasympathetic influences.
Vossbeck-Elsebusch, Steinigweg, et al. (2012) recorded
several measures of (para)sympathetic activation (e.g., heart
rate, skin conductance, blood pressure, respiratory sinus
arrhythmia [RSA]) while they confronted their participants
with disgusting pictures. The pattern of results did not indi-
cate an increase of parasympathetic activation, but an
increase in sympathetic tone (increase in heart rate and skin
conductance, minor RSA changes relative to the baseline).
Another reason for inconsistent findings refers to the fact
that the disgust sensitivity of individuals as a moderating

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DOI: 10.1027/0269-8803/a000136
 74 A. Schienle et al.: Disgust and Body Position
personality factor of their disgust reactivity has widely been
neglected with only a few exceptions (e.g., de Jong et al.,
2011; Gerlach et al., 2006; Rohrmann & Hopp, 2008).
It can be assumed that only individuals with elevated disgust
proneness show substantial physiological changes during
disgust exposure (Schienle, Walter, & Vaitl, 2002). This
hypothesis is in line with the typical finding for unselected
samples that alterations in (para)sympathetic activation dur-
ing visual disgust induction are rather small. For example,
the disgust-related heart rate reduction was not even two
beats per minute in the study by Stark et al. (2005).
Another moderating factor that is directly related to dis-
gust proneness is female gender. Women consistently report
higher disgust proneness compared to men (e.g., Schienle,
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Walter, et al., 2002). Several psychophysiological disgust
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studies were conducted with gender-mixed groups,
sometimes with unequal proportions of female and male
participants (e.g., de Jong et al., 2011; Rohrmann & Hopp,
2008). This fact may (at least partially) explain why cardio-
vascular studies examining disgust have been inconclusive.
Based on these observations, we only tested women with
an above average disgust proneness in the present investiga-
tion. They were exposed to a set of validated disgust pictures
that are able to specifically elicit this emotion with sufficient
intensity (Schienle, Stark, et al., 2002). By means of a tilt
table the participants were brought from a supine to an
upright position. This leads to a rapid translocation of blood
to the lower body. As a response individuals typically acti-
vate their sympathetic nervous system. Tachycardia
(increase in heart rate of 10–30 beats per minute) and vaso-
constriction occur as part of the compensatory response to
orthostasis (Lackner, Goswami, Papousek, et al., 2010).
Avery different response pattern is displayed by individu-
als who suffer from orthostatic intolerance. Their reaction is
characterized by a decrease in blood pressure and heart rate
during the tilt, which can even result in fainting. It has been
shown that patients suffering from blood phobia have a ten-
dency to not only faint in disorder-relevant situations, but also
during orthostatic stress. Accurso et al. (2001) reported that
during a 70 head-up tilt, 82% of the examined blood-phobic
subjects experienced presyncope or syncope, in contrast to
only 9% of the control subjects. Moreover, this patient group
typically reports elevated disgust proneness, which points to a
possible association between disgust and faint proneness (for a
summary see Schienle & Leutgeb, 2012).
To the best of our knowledge, it has not been studied
whether disgust-prone individuals (not afflicted with blood
phobia) suffer from orthostatic intolerance. Therefore, we
tested the hypothesis that individuals with elevated disgust
proneness are susceptible to vasovagal syncope during head-
up tilt, especially when disgust-relevant pictures are shown.
Methods
Participants
We studied 30 healthy female students with a mean age
of M = 23.0 years (SD = 2.4) and an average BMI of
Journal of Psychophysiology 2015; Vol. 29(2):73–79
22.9 kg/m2 (SD = 4.0; range: 17.9–32). The participants
had been asked for the presence of somatic and/or mental
disorders and the intake of medication. Positive answers
led to exclusion from the study.
We only included participants with at least moderate
disgust proneness in our sample in order to assure sufficient
psychophysiological disgust responses to the pictures.
The selection was based on participants’ scores on the
Questionnaire for the Assessment of Disgust Proneness
(QADP; Schienle, Walter, et al., 2002). In the construction
sample, women had obtained a mean QADP score of
M = 2.28 (SD = 0.52). The participants of the present study
were required to have the same or higher scores. The sam-
ple had been restricted to females because there are consid-
erable gender differences in disgust proneness. Females
describe themselves as more disgust-sensitive than males
(Schienle, Walter, et al., 2002).
Material and Design
The participants viewed 40 disgusting and 20 neutral
pictures. The disgust scenes showed repulsive animals
(e.g., maggots, snails), poor hygiene (e.g., dirty toilet,
garbage), and unusual/spoiled food (e.g., a man eats a
grasshopper). The neutral pictures depicted geometric
figures, nature scenes, and household items. All pictures
were taken from a validated picture set (Schienle, Stark,
et al., 2002). Previous investigations were able to demon-
strate that these images are able to induce the target
emotion disgust to a significantly higher degree than any
other basic emotion, especially fear (e.g., Schienle, Übel,
Schöngassner, Ille, & Scharmüller, in press), and therefore
can be considered specific disgust elicitors.
The design consisted of two disgust-picture blocks and
one neutral-picture block. Each block comprised 20 pic-
tures of the same type, which were shown in random order.
Each image was presented for a period varying between
6 and 12 s (M = 9 s) to prevent effects of paced stimuli
(Lackner, Goswami, Hinghofer-Szalkay, et al., 2010).
The picture-block duration was 3 min.
The participants viewed the disgust picture blocks in
two body positions; in a lying position (Supine_Disgust),
and in a 70 upright position (Tilted_Disgust). They were
randomly assigned to one of two sequence groups (tilting
first or tilting second). Both groups started the experiment
with the neutral condition in a lying position (Supine_
Neutral) followed by the disgust conditions.
Self-Report Measures
(a) The Questionnaire for the Assessment of Disgust
Proneness (QADP; Schienle, Walter, et al., 2002)
describes 37 situations (e.g., ‘‘You touch the toilet seat
with part of your body in a public restroom’’; ‘‘You
smell vomit’’), that have to be rated on 5-point
scales (0 = not disgusting; 4 = very disgusting).
 2015 Hogrefe Publishing
 A. Schienle et al.: Disgust and Body Position
The Cronbach’s a for the total scale is .90.
(b) The German version of the Multidimensional Blood/
Injury Phobia Inventory (MBI; Gebhardt et al.,
2010; short form) consists of 20 items and 4 subscales
(injections, blood, fainting, hospital). The rater indi-
cates whether a statement applies to herself/himself
(0 = not at all; 3 = very often). The Cronbach’s a
for the total scale is .96. This questionnaire was used
to exclude participants with blood-phobic symptoms.
(c) All participants rated how often they had experienced
a (pre)syncope when standing upright for a longer per-
iod of time. This was done on a 5-point Likert scale
(1 = never; 5 = often).
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(d) Picture ratings: Subsequent to the viewing of a picture
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block, the participants verbally indicated to the exper-
imenter to what degree the images elicited disgust,
nausea, dizziness, and sweating. This was done on
9-point scales (1 = low intensity; 9 = high intensity).
Procedure
Both sequence groups started the experiment with a 16-min
resting period (without picture presentation) in supine posi-
tion on the tilt table. Then they were presented with the
neutral pictures (3 min), which were projected to the wall
by means of a beamer. The projected picture size was
1.3 m (width) and 80 cm (height); the distance from the tilt
table (head of the participant) to the wall was 2 m. Subse-
quent to the viewing of the picture block, the participants
rated the pictures (1-min rating period).
Subsequently, the table was brought into a 70 upright
position for one group (n = 15), whereas the other group
(n = 15) remained in the lying position. After 6 min, the
participants were presented with the disgust-picture block
followed by the rating.
Finally, the body position was changed again (the lying
group was tilted, and the tilted group was brought into a
supine position). After 6 min, the women again viewed
20 disgusting pictures followed by the rating. The design
of the study is displayed in Figure 1.
The study had been approved by the ethics committee of
the University of Graz. All participants gave their written
informed consent after the study had been explained to
them in detail.
Physiological Recordings and Analysis
Continuous hemodynamic monitoring of heart rate (HR),
blood pressure (BP), and thoracic impedance was car-
ried out with the Task Force Monitor (TFM; CNSystems,
Graz, Austria). HR was recorded by 3-lead electro-
cardiography (ECG; sampling rate = 1 kHz, fcut-off =
0.08–150 Hz) using CNSystems ECG-electrodes placed
at the thoracic region. Continuous BP (sampling
rate = 100 Hz, BPrange = 50–250 mmHg, ±5 mmHg) was
derived from the finger using a refined version of the
 2015 Hogrefe Publishing
75
Figure 1. Study design.
vascular unloading technique and corrected to absolute val-
ues with oscillometric BP measurement on the contralateral
upper arm. The method is based on concentrically inter-
locking control loops for correct long-term tracing of finger
BP and delivers, in contrast to intermittent set point
re-adjustments of the conventional vascular unloading tech-
nique, BP without interruptions (Fortin, Marte, et al., 2006).
For thoracic impedance measurement, three CNSystems
short band electrodes (two electrode bands set at a
predefined distance onto a common adhesive medium;
sampling rate = 500 Hz, Ieff < 400 lA, f = 45 kHz,
Z0,range = 10–75 X, dZ/dt = ±10 X/s) were placed onto
the participant: One placed at the nape of the neck close
to the glottis, two others placed on the thorax close to the
xiphoid (see Fortin, Habenbacher, et al., 2006). The respira-
tory signal was derived from the raw data of thoracic
impedance (i.e., Ernst, Litvack, Lozano, Cacioppo, &
Berntson, 1999).
For heart rate and blood pressure beat-to-beat values
were used. Artifact handling of beat-to-beat values
was done semi-automatically with a signal analyzer
developed in MATLAB (MATLAB, MathWorks Natick,
MA) which identifies artifacts by the physiological limits
and the maximal percentage of change in relationship to
standard deviation of the signal, using the time series with
equidistant time steps after resampling beat-to-beat values
with 4 Hz. Single artifacts were replaced by linear interpo-
lation and their appearance was recorded.
The time domain variable of heart rate variability was
computed as the standard deviation (SDNN, standard devi-
ation of normal-to-normal beat), the frequency domain vari-
ables as the power in the high/ low frequency band of heart
rate variability. In more detail, the autoregressive Burg
algorithm (model order = 24) after resampling with 4 Hz
using piecewise cubic spline interpolation after above-
mentioned artifact correction and removing the trend
of 2nd order for frequency domain variables of heart
rate variability was used. Low frequency was defined as
Journal of Psychophysiology 2015; Vol. 29(2):73–79
 76 A. Schienle et al.: Disgust and Body Position
0.04–0.15 Hz (LFrr), high frequency was defined as 0.15–
0.40 Hz (HFrr), according to published recommendations
(Task Force, 1996). Because of skewed distributions of
the frequency domain variables, a natural logarithmic trans-
formation (ln) was applied.
All variables were computed across the 3-min epochs of
picture presentation and for 3-min epochs preceding each of
the three picture conditions (baselines), in order to control
for effects of initial transient responses due to the ortho-
static challenge (Goswami et al., 2010; Lackner, Goswami,
Papousek, et al., 2010).
Statistical Analysis
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We conducted analyses of variance for repeated measures
with the within-subjects factor picture-condition
(Supine_Neutral, Supine_Disgust, Tilted_Disgust) for the
subjective ratings as well as for the physiological data.
Moreover, we computed an ANOVA for the physiological
data of the three baseline conditions (without picture pre-
sentation) in order to determine the effects of tilting.
Observed significant main effects were followed up by
paired t-tests with Bonferroni correction for the three con-
ditions (significance cut-off: .05/3 = .016).
The main effects for the between-subject factor
sequence as well as the interactions Sequence · Picture-
condition were always nonsignificant (and are therefore
not reported).
Results
Self-Report Measures
Questionnaires
In the present investigation, the average score on the
Questionnaire for the Assessment of Disgust Proneness
(QADP; Schienle, Walter, et al., 2002) was M = 2.71
(SD = 0.34), which was significantly higher than the score
of the construction sample (p < .001).
The scores (M, SD) on the subscales of the MBPI were
as follows: injections, 5.3 (5.1); blood, 5.5 (4.9); fainting,
1.8 (2.5); hospital, 5.2 (4.3). These values did not differ
from the mean scores of the non-anxious participants
(n = 536) tested for the construction of the questionnaire
(all p’s > .38).
The mean rating for experienced faintness symptoms
during orthostatic load was M = 1.63 (SD = 0.99; range:
1–4). 57% of the participants indicated that they had never
experienced a (pre)syncope after standing upright for a
longer period of time.
Affective Ratings
The main effect for picture-condition was statistically
significant for experienced disgust, F(2, 58) = 177.1,
Journal of Psychophysiology 2015; Vol. 29(2):73–79
p < .001, gp2 = .859), nausea, F(2, 58) = 47.0, p < .001,
gp2 = .619, dizziness, F(2, 58) = 11.7, p < .001, gp2 = .286,
and sweating, F(2, 58) = 15.3, p < .001, gp2 = .345.
The conducted post hoc t-tests indicated that experi-
enced disgust did not differ between the two Disgust condi-
tions, t(29) = 0.67, p = .51, which were both rated as more
repulsive than the Neutral condition (both p’s < .001).
Similarly, experienced nausea, sweating, and dizziness only
differed between the two Disgust and the Neutral conditions
(all p’s < .001), whereas the two Disgust conditions were
comparable (all p’s > .02). The ratings are displayed in
Table 1.
Physiological Responses
We first analyzed the baseline data and observed significant
main effects for all recorded variables: heart rate,
F(2, 58) = 207.4, p < .001, gp2 = .877, heart rate variability,
F(2, 58) = 13.4, p < .001, gp2 = .317, the high frequency
component of heart rate variability, F(2, 58) = 67.5,
p < .001, gp2 = .700, the low frequency component of heart
rate variability, F(2, 58) = 3.5, p = .038, gp2 = .107, systolic
blood pressure, F(2, 58) = 16.7, p < .001, gp2 = .374, and
diastolic blood pressure, F(2, 58) = 50.5, p < .001,
gp2 = .643, as well as breathing frequency, F(2, 58) = 3.9,
p = .02, gp2 = .121.
The conducted post hoc t-tests indicated that the tilting
condition was associated with increased heart rate, systolic/
diastolic blood pressure, and lowered heart rate variability
as well as lowered power in the high frequency band of
heart rate variability compared to both lying conditions
(all p’s < .001). The post hoc t-tests for the low frequency
component and for breathing frequency were nonsignificant
(all p’s > .03).
In order to identify the additional effects of disgust elic-
itation, we conducted analyses of variance for repeated
measures for baseline-corrected values for each of the three
conditions (e.g., Tilted_Disgust minus Tilted_Baseline).
The main effect for condition was statistically significant
for diastolic blood pressure, F(2, 58) = 5.34, p = .008,
gp2 = .160, and for breathing frequency, F(2, 58) = 18.3,
p < .001, gp2 = 387. All other main effects were nonsignif-
icant (all p’s > .08).
The post hoc t-tests indicated that the Tilted_Disgust
condition was associated with a lower diastolic blood pres-
sure compared to Supine_Disgust, t(29) = 3.9, p = .001.
The breathing frequency differed between Neutral and
Supine_Disgust as well as between Neutral and Tilted_
Disgust (both p’s < .001). The difference between the two
disgust conditions was statistically nonsignificant (p = .04).
As an exploratory approach, we correlated self-reported
disgust proneness (QADP scores) with the six baseline-
corrected cardiovascular variables in the three conditions
(Bonferroni cutoff: .05/18 = .0027). We observed a signif-
icant correlation between disgust proneness and heart rate
in the Tilted_Disgust condition (r = .55, p = .002). Further,
QADP scores were positively associated with experienced
disgust in the Supine_Disgust (r = .41, p = .02) and in
the Tilted_Disgust condition (r = .44, p = .01).
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 A. Schienle et al.: Disgust and Body Position 77

Table 1. Self-report and physiological data for the experimental conditions

Supine_Neutral Supine_Disgust Tilted_Disgust
M (SD) M (SD) M (SD)
Self-Report (ratings for picture blocks)
Experienced intensity of
Disgust 1.2 (0.6) 6.7 (2.1) 6.9 (1.9)
Dizziness 1.0 (0.2) 2.0 (1.1) 2.7 (2.4)
Sweating 1.1 (0.3) 2.0 (1.2) 2.8 (2.3)
Nausea 1.0 (0.2) 3.9 (2.2) 4.6 (2.5)
Physiological variables
Baseline (before picture viewing)
Heart rate [bpm] 68.9 (7.7) 66.5 (8.1) 91.1 (11.9)
Heart rate variability [SDNN: ms] 58.7 (29.0) 60.7 (29.7) 38.4 (15.2)
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High frequency power [HFrr: ms2] 6.6 (1.1) 6.8 (1.2) 4.5 (1.2)
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Low frequency power [LFrr: ms2] 6.6 (0.9) 6.6 (1.1) 6.2 (0.9)
Systolic blood pressure [mmHg] 122.4 (10.6) 123.1 (11.6) 127.4 (11.5)
Diastolic blood pressure [mmHg] 79.9 (9.0) 79.0 (9.9) 87.4 (9.6)
Breathing frequency [1/min] 17.5 (3.7) 17.6 (3.3) 16.5 (3.6)
Effects of picture viewing (minus baseline)
Heart rate [bpm] 0.58 (2.9) 1.07 (2.1) 0.35 (3.8)
Heart rate variability [SDNN: ms] 0.95 (8.8) 0.70 (14.4) 1.25 (7.0)
High frequency power [HFrr: ms2] 0.11 (0.4) 0.08 (0.6) 0.07 (0.5)
Low frequency power [LFrr: ms2] 0.12 (0.6) 0.21 (0.6) 0.09 (0.5)
Systolic blood pressure [mmHg] 0.36 (3.5) 0.81 (2.9) 0.16 (3.5)
Diastolic blood pressure [mmHg] 0.01 (3.1) 1.39 (2.0) 1.20 (4.1)
Breathing frequency [1/min] 0.98 (1.6) 0.28 (1.5) 1.02 (1.8)
Notes. SDNN = standard deviation for normal to normal beat; HFrr = power in the high frequency band of heart rate variability
[0.15–0.40 Hz] component; LFrr = power in the low frequency band of heart rate variability component [0.04–0.15 Hz].

Finally, we compared those participants who had
reported no faintness symptoms during long standing
(n = 17) or at least some (n = 13) with regard to their
QADP scores, disgust ratings in the Supine_Disgust and
in the Tilted-Disgust condition. The results of the three con-
ducted t-tests were all nonsignificant (all p’s > .09).
Discussion
The aim of the present study was to investigate whether
body position influences cardiovascular disgust reactivity
and whether disgust-proneness is associated with the sus-
ceptibility for vasovagal syncope during head-up tilt.
The tilting procedure (without picture presentation)
resulted in pronounced cardiovascular effects. The change
from a supine to an upright position led to a mean heart rate
increase of almost 25 beats per minute. Also, blood pres-
sure increased, and heart rate variability as well as its high
frequency power decreased. These changes are indicators of
sympathetic activation and parasympathetic deactivation
(Goswami et al., 2009; Lackner, Goswami, Papousek,
et al., 2010).
The main purpose of the present study was to analyze
the effects of disgust elicitation in combination with tilting.
The disgust induction was successful according to the self-
report of the participants. The women perceived the aver-
sive pictures as very repulsive. However, the disgust ratings
in the Supine_Disgust condition did not differ from the
Tilted_Disgust condition. This also applied to perceived
somatic symptoms such as dizziness, nausea, and sweating.
In contrast, the diastolic blood pressure, an indicator of
peripheral resistance, differed between the two disgust con-
ditions. This parameter was smaller in the tilted position
reflecting reduced sympathetic efferent activity. Obviously,
disgust induction was associated with less effective vaso-
constriction in the upright relative to the supine condition.
From a physiological standpoint, a typical syncope devel-
ops because of vasodilatation and venous blood pooling
in the lower body. This ultimately reduces brain perfusion
below a certain level, which in turn triggers fainting.
The additional reduction of diastolic blood pressure due
to disgust elicitation in the upright position may therefore
constitute a risk factor for presyncope.
Moreover, disgust-proneness was positively correlated
with heart rate, but only during tilting. This association
might point to a compensatory mechanism which aims at
stabilizing mean arterial pressure, the primary regulated
variable during stress induction (Julius, 1988; Lackner,
Goswami, Papousek, et al., 2010). It is a typical observation
that participants of tilt-table experiments display continuous
heart rate increases during the first phase of orthostatic load
(Goswami et al., 2009; Hinghofer-Szalkay et al., 2011;
Lackner, Goswami, Papousek, et al., 2010). This response
can be understood as a compensatory mechanism. Due to
the postural change, the blood tends to pool in the legs,
potentially reducing the amount of blood available to return

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 78 A. Schienle et al.: Disgust and Body Position
to the heart and the brain. Increases in heart rate help to
redistribute blood volume to the upper part of the body.
However, this negative feedback loop only works up to a
certain point. When the individual compensatory threshold
is reached, and the postural orthostatic hypotension
becomes too pronounced, then the syncope occurs. Depend-
ing on the disgust proneness of individuals this mechanism
might be used differentially. It can be assumed that espe-
cially women with very high trait disgust counter-regulated
more extensively to prevent fainting.
Although body position and trait disgust were associated
with cardiovascular disgust reactivity, we were not able to
observe a correlation between faint and disgust proneness
on the self-report level. Participants with and without expe-
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rience of faintness symptoms during long standing in every-
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day life (as rated with the Likert scale) did neither differ in
their questionnaire scores nor affective ratings. The latter
findings are in line with reports by several authors (e.g.,
Olatunji et al., 2006; Vossbeck-Elsebusch & Gerlach,
2012), who were not able to identify a disgust-faint relation-
ship. For example, Olatunji et al. (2006) computed a struc-
tural equation model that revealed that the relation between
disgust proneness and fainting symptoms was fully medi-
ated by blood-related fears. However, the mentioned studies
were only based on self-report and it cannot be excluded
that the participants’ interoceptive capabilities were not suf-
ficient to detect symptoms of presyncope reliably. The asset
of the present investigation is that the susceptibility for
vasovagal syncope during orthostatic load was directly
tested for the first time in disgust-prone individuals.
We have to mention several limitations of our study.
We had selected disgust-prone individuals for our experi-
ment in order to secure a sufficient reactivity to the visual
stimuli. However, it cannot be excluded that these individ-
uals exhibited special physiological patterns. Therefore,
future studies should compare two extreme groups with
high and low disgust proneness in their onset of presyncope
during orthostatic load. For this, the duration of the exper-
iment should be extended. Another option is the investiga-
tion of a group with high trait disgust variance. We have to
admit that the observed correlations between the measured
cardiovascular variables and disgust proneness were only
moderate, which might be due to the range restriction,
because only women with elevated QADP scores were
included.
Further, we did not control respiration, although this
parameter influences measures of cardiac vagal tone (Ritz
& Dahme, 2006). We had refrained from using a respiratory
control method since this might have interfered with
emotion elicitation. By demonstrating that the baseline-
corrected breathing frequency did not differ between the
two disgust conditions, we believe that our approach can
be considered acceptable.
In summary, we were able to demonstrate that body
position influenced cardiovascular disgust reactivity, which
was additionally associated with participants’disgust prone-
ness. Our data point to a possible disgust-faint relationship
that is only present in individuals with a particular predispo-
sition (elevated disgust sensitivity), who experience disgust
during somatic (orthostatic) stress.
Journal of Psychophysiology 2015; Vol. 29(2):73–79
Ethics and Disclosure Statements
All participants of the study provided written informed con-
sent and the study was approved by the Ethics Committee
of the University of Graz. All authors disclose no actual
or potential conflicts of interest including any financial,
personal, or other relationships with other people or organi-
zations that could inappropriately influence (bias) their
work.
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Accepted for publication: July 10, 2014
Published online: March 25, 2015
Anne Schienle
University of Graz
Department of Psychology
Universitätsplatz 2/III
8010 Graz
Austria
Tel. +43 316 380-5086
Fax +43 316 380-9808
E-mail anne.schienle@uni-graz.at
Journal of Psychophysiology 2015; Vol. 29(2):73–79