Introduction:
Contamination-based Obsessive-Compulsive Disorder (OCD) is a severe and disabling subtype, primarily driven by the emotion of disgust rather than anxiety. It manifests through compulsive washing, avoidance, and excessive concerns about cleanliness. This study aimed to explore the cognitive, emotional, and sociocultural mechanisms of disgust in individuals with this OCD subtype to inform more effective treatment strategies.

 Materials and Methods:

A mixed-methods design was employed with 30 clinically diagnosed participants aged 22–42. Data collection included semi-structured interviews, standardized questionnaires, behavioral observations, and clinical assessments. Grounded Theory, Structural Equation Modeling (SEM), network analysis, and fuzzy-set Qualitative Comparative Analysis (fsQCA) were used for data analysis and model construction.

 Results and Discussion:

Disgust emerged as the core affective mechanism reinforcing compulsive washing (73.3%) and contamination avoidance (36.7%). SEM and network analysis confirmed significant links between disgust sensitivity and compulsive behaviors, while fsQCA identified demographic and sociocultural configurations—such as female gender, single status, and religious upbringing—that amplify these behaviors. Disgust showed notable resistance to traditional ERP treatments, suggesting the need for disgust-specific interventions. The study emphasizes that disgust, shaped by biological, cognitive, and environmental factors, operates as a self-reinforcing emotional driver of obsessive-compulsive patterns.

Conclusion:

This study proposes a multidimensional model positioning disgust at the center of contamination-based OCD. Addressing this emotion directly through innovative therapeutic strategies is essential for improving outcomes in this resistant OCD subtype.