the mediating role of anxiety sensitivity and distress tolerance in the relationship between disgust and severity of washing/contamination obsessive-compulsive symptoms among adolescents with obsessive-compulsive disorder

Background :disgust is among the most prevalent emotions experienced in obsessive-compulsive disorder (ocd). individual differences in emotional processing and response patterns significantly influence coping strategies employed when confronting aversive emotional experiences. objectives :the ocd represents a chronic psychiatric condition, with adolescent symptom onset potentially indicating a more adverse long-term prognosis. the present study examined how two modifiable psychological constructs — anxiety sensitivity (as) and distress tolerance (dt) — mediate the relationship between disgust propensity and sensitivity and washing/contamination ocd symptom severity. methods :this cross-sectional investigation employed structural equation modeling to examine data from 189 adolescents (ages 11 - 18 years) diagnosed with ocd, recruited through convenience sampling from kargarnejad hospital and affiliated psychotherapy centers in 2024. assessment instruments included the disgust propensity and sensitivity scale-revised (dpss-r), padua inventory-washington state university revision (pi-wsur), anxiety sensitivity index (asi), and distress tolerance scale (dts). statistical analyses were conducted using spss version 26 and smartpls version 3. results :correlation analyses revealed significant associations between disgust propensity and washing/contamination ocd symptoms (r = 0.79, p < 0.01), as (r = 0.67, p < 0.01), and dt (r = 0.39, p < 0.01). structural equation modeling demonstrated significant partial mediation effects for both dt (indirect path coefficient = -0.123, vaf = 0.194) and as (indirect path coefficient = 0.228, vaf = 0.241) in the disgust-ocd symptom relationship (p < 0.001). model fit indices indicated adequate model fit (nfi = 0.915, srmr = 0.09, χ2 = 48.296). conclusions :elevated as and diminished dt were associated with greater severity of disgust-related ocd symptoms in adolescents. these findings suggest that therapeutic interventions specifically targeting as reduction and dt enhancement may optimize treatment outcomes for washing/contamination ocd presentations, particularly when integrated with exposure-based therapeutic approaches addressing disgust-related triggers.