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Scrupulosity is treated as a particular presentation of the symptomatology characteristic for obsessive-compulsive disorder (OCD). However, typical treatment of OCD (e.g. cognitive-behavioral therapy) is less effective in the case of religious scruples. Recently, schema therapy has appeared as an alternative effective treatment in obsessive-compulsive symptomatology. The present study investigated the associations between early maladaptive schemas (EMSs) and scrupulosity in a non-clinical sample of 376 poles. The participants assessed their EMSs with the Young Schema Questionnaire 3 – Short Form and their scrupulosity with the Pennsylvania Inventory of Scrupulosity. We used network analysis to control for the EMS interconnectivity. We showed that accounting for the interactions within the EMSs, three schemas, namely, Punitiveness, Subjugation, and Enmeshment/Undeveloped Self, were positively correlated with scrupulosity. Given the central position of the Negativity/Pessimism schema in the examined network, we suggested that activation of this schema could be indirectly correlated to scruples via an escalation of activation to the Punitiveness, Subjugation, and Enmeshment schemas. The findings suggest that dependency and fear of rejection problems (present in Subjugation and Enmeshment EMSs) and over-compensation by perfectionism (present in Punitiveness EMS) could be addressed in the treatment of scruples. [ABSTRACT FROM AUTHOR]

Anxiety disorder in children requires attention due to its comorbidity with depression. Proper management of this condition is essential. This single case study research explored the effectiveness of cognitive-behavioral play therapy in treating a 6-year-old girl attending an Islamic school who exhibited symptoms of religious anxiety. The client attended a total of 8 intervention sessions. The assessment process involved interviews, observations, and psychological tests, including CPM, Bender-Gestalt, and SCARED for Parents. Pre- and post-intervention results, measured using the SCARED for Parents and unstructured interviews, indicated a reduction in anxiety symptoms, improved coping mechanisms, and changes in maladaptive thinking.

"Scrupulosity" is a common but understudied subtype of obsessive-compulsive disorder (OCD) characterized by religious obsessions and compulsions. Although scrupulosity is a common manifestation of OCD, it has not been adequately addressed in treatment studies. The aim of this study was to understand the conceptual nuances of scrupulosity, its diagnosis, the unique differences in conceptualization and interventions during its treatment, the specific tools needed to monitor the prognosis of the pathology, and the limitations of existing studies through a systematic review. Following PRISMA guidelines, a literature search was conducted, and 13 relevant studies were found in Google Scholar, Scopus, PubMed, EbscoHost + Ulakbim, Wiley Online Library, ScienceDirect, Taylor & Francis Online, and Web of Science databases. Two researchers independently rated the included articles using the MMAT and then met to compare the ratings. Disagreements were resolved through discussion and consensus was reached. There was a general lack of clarity in the conceptualization, diagnosis, and measurement of the severity of scrupulosity, and the content of religious or cultural interventions in the studies was not always clear. For future studies, further clarification, and systematization of the phenomenological features of scrupulosity and related epidemiological and empirical/experimental treatment research are needed. [ABSTRACT FROM AUTHOR]

Theology and disability studies regularly engage both physical and cognitive impairments, with Peter Bellini’s recent work broadening the field to include even the psychiatric disability of depression (The Cerulean Soul, 2021). Other psychiatric disabilities also stand to be constructively engaged by theological discourse. This study takes up the subjects of anxiety and obsessive-compulsive disorder, especially variants which feature specifically religious anxiety, moral scrupulosity, and pathological guilt, illustrating how transactional understandings of forgiveness and atonement can covary with the symptomatology of such conditions, possibly even exacerbating them. In response, I conscript Martin Luther’s provocative but oft-neglected description of Christ’s “marvelous combat with the Law” in order to stage a uniquely “therapeutic” outlook on atonement in which Christ’s passion is rendered as a struggle with the uniquely psychological contours of moral performance and the felt experience of guilt under divine judgment, offering embodied hope to the anxious and scrupulous conscience. [ABSTRACT FROM AUTHOR]

Background: Given the continued rise in negative mental health globally, including among university students, research continues to investigate potential correlates that negatively or positively influence mental health. Our study sought to investigate the relationship between religiosity, spirituality, scrupulosity and mental health among university students. Methods: University students (age: 18+) were administered an anonymous survey consisting of questions assessing: 1) demographics, 2) mental health, 3) spirituality and religiosity, and 4) scrupulosity. The final number of participants whose responses met inclusion criteria was 638. Results: Our results indicate a substantial proportion of participants reporting severe or extremely severe depression, anxiety and stress, and potentially clinically relevant scrupulosity. Additionally, various correlations were observed between the measures addressed, as well as differences in religiosity, spirituality and scrupulosity between participants scoring worse relative to better in mental health. Moreover, while both spirituality and negative religious coping mediated the relationship between scrupulosity and mental health (positively and negatively, respectively), positive religious coping was not involved in such mediation. Limitations: A key limitation of this study includes the difficulty/inability in addressing the complexity underlying spirituality/religiosity in any single study. Conclusions: Our findings indicate negative effects of scrupulosity on mental health, and a mediating role of negative religious coping on this relationship. Spirituality, unlike positive religious coping, appeared to assist in minimizing/mitigating the negative impact of scrupulosity on mental health. This suggests the need for the deeper reality and higher cognitive involvement reflected in spirituality and the appropriate application of such behaviors, including at the clinical level.

Medieval theologians considered that it was a mortal sin to act against one's conscience, even though they knew that conscience sometimes erred. This article inquires how they, as pastors, nevertheless engaged with the laity's real-world experiences of conscience and with problems that this involved. In focus of the inquiry are pastoral tracts written by Jean Gerson (d. 1429). In these tracts, Gerson described troubling behaviour that he associated with malfunctions of conscience, and he observed how the precept that conscience obliged was a burden that some individuals could not handle. Gerson offered an analysis of these problems as well as alleviating pastoral advice. He agreed that one should obey one's conscience, but this article argues that his analysis and advice went far towards circumscribing the force of this precept. [ABSTRACT FROM AUTHOR]

Scrupulosity is a phenomenon of the intersection between religiosity and obsessive-compulsive disorder. It could be regarded as an interactive effect of religiosity, religious internal conflicts, cognitive distortions associated with thought processing and self-reference, and obsessiveness. The present study investigated scrupulosity in the network of religious/spiritual struggles, obsessive-compulsive disorder (OCD) symptoms, self-compassion, and religiosity in order to better describe a position of scrupulosity in the dimensions of mental health and illness. Two hundred and ninety-two religious individuals from Poland (two hundred and two women) between the ages of 18 and 83 (M = 39.3; SD = 13.7) participated in the study. We applied the Self-Compassion Scale, Religious and Spiritual Struggle Scale, Obsessive-Compulsive Inventory-Revised, Pennsylvania Inventory of Scrupulosity, and posed questions concerning identification with religious beliefs, the role of religion in one's identity, and religious attendance. Using correlation analysis and a network analysis, we demonstrated that scrupulosity was positively correlated with religious/spiritual struggles (mostly with moral struggles and religious doubts) and with obsessing as an OCD symptom. The bridge strength analysis indicated that scrupulosity may be regarded as a bridge symptom between religious/spiritual struggles and OCD symptoms. Pastoral and psychological counselling could use these results in order to design efficient treatments for people suffering from religious scruples. [ABSTRACT FROM AUTHOR]

Introduction: Cognitive-behavioral therapy (CBT) is one of the most important well-known treatments for obsessive-compulsive disorder (OCD), including the scrupulosity type. Technology-based interventions can increase the effects of CBT by different methods. The aim of this study was to examine the effectiveness of online cognitive therapy in a Muslim patient with scrupulosity employing in-vivo exposure, with the therapist virtually present and using a treatment application. Case Presentation: The patient was a 37-year-old female diagnosed with scrupulosity in OCD by a psychiatrist. The patient's symptoms were measured at baseline for 6 weeks then underwent 12 sessions of CBT with the therapist present via video call. All the exposure sessions were conducted in real situations triggering thoughts and compulsions. The therapy application was also used between sessions as an assistive treatment tool. Conclusions: The results of this treatment model showed a decrease in obsessive symptoms and beliefs and anxiety and depression symptoms at the end of treatment and after a 3-month follow-up. Moreover, the quality of life was improved in the patient. [ABSTRACT FROM AUTHOR]

Background: Scrupulosity or religious obsession is a form of obsessive-compulsive disorder (OCD) and is recognized to be treatment-resistant. One of the most common treatments for treatment-resistant disorders is schema therapy. Objectives: This study aimed to compare the early maladaptive schemas and schema modes of individuals with high and low scores in scrupulosity, as well as religious people with no disorder. Methods: The population of this cross-sectional study consisted of all patients with OCD referred to Iran Psychiatric Hospital and the Clinic of Behavioral Sciences and Mental Health in Tehran, Iran, in 2019. The sample included 75 individuals with high score in scrupulosity, 75 individuals with low score in scrupulosity, and 75 religious people with no disorder. At first, all participants were evaluated with the structured clinical interview for DSM-5 disorders-clinical version (SCID-5-CV). Then, they completed the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Penn Inventory of Scrupulosity (PIOS), Young Schema Questionnaire-Short Form (YSQ-SF), and Schema Mode Inventory (SMI). Data were analyzed using the one-way analysis of variance (ANOVA) and Kruskal-Wallis test. Results: Individuals with high scores in scrupulosity were significantly different from normal religious people in the "disconnection and rejection" and "impaired autonomy and performance" schema domains. However, there was no significant difference between individuals with high scores in scrupulosity and those with a low score in any of the schema domains. Also, individuals with a high score in scrupulosity scored higher in almost all schema modes compared to normal religious people. Finally, the "punitive and demanding parent modes" of individuals with a high score in scrupulosity was significantly different from that of individuals with a low score. Conclusions: According to our results, it is essential to focus on "disconnection and rejection" and "impaired autonomy and performance" schema domains, as well as child and parent modes, especially the dysfunctional parent mode, to treat individuals with a high scrupulosity score. Due to limited literature, further research is needed to confirm our results. [ABSTRACT FROM AUTHOR]

Obsessive–compulsive disorders (OCDs) are one of the top 10 contributors of debilitating medical illnesses and are the fourth most common psychiatric disorder. Blasphemous thoughts, also known as scrupulosity, as an obsessional theme has piqued curiosities long before it was considered a neurosis. Such obsessions may or may not have an accompanying compulsion and comprise 5% of the patients of OCD. The case series is of three patients suffering from repetitive, intrusive, ego-dystonic, and distressing blasphemous thoughts, which are extremely distressing to them, rendering them unable to perform any other activity. The symptoms also indicate the presence of comorbid depressive and anxiety disorders, developing secondary to the blasphemous thoughts. Inadequate knowledge in this subtype of OCD mandates the need for more studying and research, especially with new texts suggesting the implementation of faith-assisted psychotherapy in addition to the conventional psychotherapy and pharmacotherapy.

Ruhsal hastalıkların geçmişi insanlık tarihi kadar eskidir. Tarihsel süreç içinde değişen toplumsal, kültürel pek çok faktörden etkilenen ruhsal bozukluklar, kavramsal olarak sürekli yeniden yapılandırılarak tanımları ve sınıflandırmaları değişikliğe uğramıştır. Kökleri insanlık tarihi kadar eski bir geçmişe uzanan obsesif kompulsif bozuklukların (OKB) modern kavramlarına evrilmesi 19. yüzyılda gerçekleşmiştir. OKB’nin ruhsal kökeni hakkındaki ilk bilimsel görüşler S. Freud’a aittir. Freud, OKB’deki ruhsal nedenlerin diğer ruhsal bozukluklardan farklı olduğunu gözlemleyerek obsesyonu, ayrı ve özgün bir bozukluk olarak incelemiştir. Zamanla OKB’nin oldukça yaygın bir rahatsızlık olduğu anlaşılmıştır. Amerikan Psikiyatri Birliği (APA) yayımladığı Ruhsal Bozuklukların Tanısal ve İstatiksel El Kitabı’nın son sürümü (DSM-5)’de OKB’yi anksiyete bozuklukları kategorisi içinden çıkartarak bağımsız bir başlık altında tasnif etmiştir. OKB, takıntılı fikir ve düşünce gibi zihinsel eylemler (obsesyon) ve/veya yineleyici ve zorlantılı davranışlardan (kompulsiyon) meydana gelen ruhsal bir bozukluktur. Hasta çoğu kez bu türlü düşünce ve davranışlarının mantıksız ve saçma olduğunun bilincindedir. Bu nedenle inançlarına, görüşlerine, ahlaki değerlerine ve mantığına ters bulduğu obsesif düşünceleri zihinden uzaklaştırılmaya çalışır. Fakat o çabaladıkça obsesif düşünceler daha da çoğalır, sıklaşır ve kişide büyük bir bunaltı meydana getirir. Hasta hissettiği bunaltıyı hafifletmek veya ondan tamamen kurtulmak için bu kez kompulsiyonlara başvurur. Kompulsiyonları tekrar ettikçe de bunaltısı artar ve kısır bir döngü içine girer. Bireyin yaşam kalitesini ciddi şekilde düşüren OKB’nin pek çok semptom alt grubu bulunmaktadır. Bunlardan birisi ve hatta en bunaltıcı olanı dini obsesyonlardır. Psikoloji literatüründe din ve OKB arasında uzun zamandır bir ilişki olduğu düşünülmüş ve bu ilişkiyi açıklığa kavuşturmayı amaçlayan bazı dikkat çekici çalışmalar yapılmıştır. Bireyin ruhsal sağlık bütünlüğünün korunmasında dinin vazgeçilmez bir unsur olduğunu gösteren pek çok araştırma bulgusu bulunmakla birlikte bazı dini anlayış biçimleri ve dini deneyimler sonucu edinilen kimi tecrübeler OKB ile ilgili kaygıları etkileyebilmektedir. Dindarlığın bu aşaması, OKB’nin bazı alt semptom gruplarıyla yakından ilişkilidir. Psikanaliz yönteminin kurucusu Freud ve takipçilerinin açıklamaları, OKB’nin anlaşılmasına büyük katkı sağlamıştır. Ancak psikanalitik yöntemin kuramsal açıdan dine karşı indirgemeci bir yaklaşım sergilemesi nedeniyle kişinin dine olan bağlılığının daha başlangıçta bir patoloji ya da en azından önemli bir içgörü engeli olarak değerlendirilmesi söz konusudur. Günümüzde bilişsel davranışçı psikoterapiler, OKB üzerinde en etkili psikolojik tedavi yöntemi olarak kabul edilir fakat onların da dini OKB’lerin tedavisinde başarı oranları düşüktür. Dini OKB kaygıları, genellikle somut tekrarlanabilir durumlar yerine manevi konuları içerdiğinden davranışçı yöntemlerin dini OKB tedavisinde uygulanması oldukça zor olabilir. Dolayısıyla geleneksel psikoterapi yaklaşımları, açıkça dine karşı olmasalar bile genellikle dini boyutu ihmal ettiklerinden dini obsesyonları bulunan bireylerin hayatlarındaki ıztırabı dindirmede yetersiz kalmaktadırlar. Ruhsal tedavilerin seküler yaklaşımlarla sınırlı tutulmasından doğan boşluk nedeniyle dindar hastalar, dini duyguları istismar eden kişilerin illegal uygulamalarının tehdidiyle karşı karşıyadırlar. Klinik anlamda dini obsesyonlar daha kaygı verici ve bunaltıcıdır. Dolayısıyla tedavileri de diğerlerinkinden daha zordur. OKB’nin tedavisinde farklı bilim disiplinlerin bir arada kullanıldığı, dini inanç ve değerler etrafında esneyebilecek, seçmeci yaklaşımlar daha etkili tedavi modelleri ortaya çıkartabilir. Böylece dini OKB’nin tedavisindeki başarı oranı tıp, psikoloji ve ilahiyat disiplinlerinin uygun işbirliği sayesinde üst düzeylere taşınabilir. İlahiyat disiplinleri açısından bu işbirliğini destekleyebilecek zengin bir dini kültürel miras bulunmaktadır. Bir örnek olarak Ebû Zeyd el-Belhî (322/934), Mesalihu’l-Ebdan ve’l-Enfüs adlı eserinde, Freud’dan yaklaşık on asır önce, nevrozlar ve psikozlar arasında muhtemelen ilk defa açık bir ayrım yapmış ve nevrotik bozuklukları sınıflandırmıştır. Ayrıca eserinde, bu bozuklukların her birinin tedavisi için rasyonel ve manevi bilişsel terapilerin nasıl kullanılacağını ayrıntılı bir şekilde göstermiştir. Bu çalışmada dini obsesyonlara hem psikolojik bir rahatsızlık hem de teolojik bir problem olarak bütüncül bir yöntemle yaklaşılmasının önemi vurgulanmaktadır. Bu nedenle dini OKB’nin tedavisinde psikiyatrik ve psikolojik yaklaşımların manevi danışmanlık ve rehberlikle işbirliği önerilmektedir. Dindar bir kişide görülen belirtilerin dini yaşantıya ait normal, tabii dini düşünce ve davranışlar mı yoksa dini kılıfa bürünmüş anormal görünümler mi olduğunun ayrıştırılmasındaki güçlük disiplinler arası bu işbirliğini zorunlu kılmaktadır.

The paper focuses on the problem of scrupulosity in the context of cognitive-behavioural therapy. The disorder has long aroused the curiosity of both psychologists and theologians. Advances in clinical psychology have directed the attention of researchers and therapists to the aetiology and nosological classification of this psychological/moral phenomenon. For many years, the variety of psychological approaches and the ambiguities of treatment strategies have aroused controversy, with treatment outcomes considered only negligible, resulting in scepticism among patients. The change was brought about by the conceptualisation of the disorder in the cognitive-behavioural paradigm. This paper briefly discusses the evolution of therapeutic models and techniques used in patients diagnosed with scrupulosity. Reference was made to the epidemiology of the phenomenon in the context of its place in the group of obsessive-compulsive disorders. The changes in the conceptualisation of problems experienced by scrupulous individuals are also presented, taking into account the cognitive-behavioural models of an obsessive-compulsive disorder, the subtype of which is nowadays scrupulosity, most often cited in psychological-medical literature. The cognitive-behavioural model of the disorder, which is not widely discussed in Polish literature, and its implications for clinical practice, as well as modifications in the standard protocol for treating patients diagnosed with obsessivecompulsive disorder, introduced to adjust for the needs of patients presenting with the moral-religious aspect of the disease, are also discussed. The aim of the article is also to promote knowledge about scrupulosity among therapists, priests and scientists, thereby inspiring creative work and improvement of the quality of everyday functioning of patients [ABSTRACT FROM AUTHOR]

Introduction: The aim of the present study was to compare the effectiveness of cognitive behavior therapy based on exposure and response prevention on the patients with contamination obsessive-compulsive disorder (OCD) and scrupulosity. Methods: The method was semi-experimental pretest-posttest design by control group. Sixty OCD participants who were suffering from scrupulosity and contamination OCD were diagnosed by means of diagnostic interviewing, Yale-Brown Obsessive-Compulsive Scale and Penn inventory of scrupulosity. They were selected through convenience sampling method and were assigned in two experimental groups and one control group (each group 20). The cognitive behavioral therapy based on exposure and response prevention was performed on the subjects in nine individual sessions for 45 minutes for each experimental group. The data were analyzed using SPSS Inc., Chicago, IL; Version 16 by the multivariate analysis of covariance. Results: The results of multivariate analysis of covariance and Bonferroni post hoc tests showed that cognitive behavioral therapy based on exposure and response prevention were effective in decreasing OCD in the experimental groups compared to the control group (0.001≥ P). Bonferroni post hoc test showed that there was a significant difference between the scrupulosity group and the contamination group and control group on the obsession variable (0.05 < P). There was no significant difference between the contamination group and the scrupulosity group on the compulsion variable (0.15 < p). Conclusion: The findings suggest that cognitive behavioral therapy based on exposure and response prevention could help alleviate symptoms of obsessive-compulsive disorder in both religious and contamination OCD.

Medieval theologians considered that it was a mortal sin to act against one’s conscience, even though they knew that conscience sometimes erred. This article inquires how they, as pastors, nevertheless engaged with the laity’s real-world experiences of conscience and with problems that this involved. In focus of the inquiry are pastoral tracts written by Jean Gerson (d. 1429). In these tracts, Gerson described troubling behaviour that he associated with malfunctions of conscience, and he observed how the precept that conscience obliged was a burden that some individuals could not handle. Gerson offered an analysis of these problems as well as alleviating pastoral advice. He agreed that one should obey one’s conscience, but this article argues that his analysis and advice went far towards circumscribing the force of this precept.

Scrupulous obsessions are a prominent presentation of obsessive-compulsive disorder (OCD). Previous conceptualizations of scrupulosity have indicated that it belongs to the unacceptable thoughts dimension, which pertains to sexual, violent, and religious obsessive themes. However, research suggests that scrupulous symptoms may differ from other unacceptable thoughts symptoms, necessitating the need for targeted and thorough assessment. We added a Scrupulous or Religious Thoughts subscale (DOCS-SR) to the Dimensional Obsessive-Compulsive Scale (DOCS) and tested its factorial structure, psychometric properties, and clinical correlates in a nonclinical and clinical sample. In the first study, nonclinical participants (N = 203) completed the DOCS-SR, which was subjected to an exploratory factor analysis. Analyses revealed that the DOCS-SR reflected a one-factor solution and possessed acceptable internal consistency, as well as strong convergent validity with clinical correlates of OCD. In the second study, we administered the DOCS, as well as the DOCS-SR to a clinical sample (N = 314). An exploratory factor analysis and confirmatory factor analysis both suggested that the four subscales and additional DOCS-SR represented a five-factor solution. Internal consistency and convergent validity were strong. The DOCS Unacceptable Thoughts subscale and the DOCS-SR shared a moderate correlation but evidenced differences in associations with other correlates. This suggested both convergent and divergent validity. Collectively, our results support the utility of examining the individual components of the unacceptable thoughts dimension of OCD for effective assessment and treatment planning. [ABSTRACT FROM AUTHOR]

New Spain was the site not only of one of the largest-scale missionary enterprises in Christian history, but also of a prolonged encounter among diverse medical traditions of Mesoamerican, African, and European origin in which male missionaries were central. Given the paucity of licensed physicians in the colony, religious involvement in medical practice remained significant throughout the colonial period. This paper considers the confluence of religion and medicine in the encounters that friars and inquisitors had with women, arguing that in these encounters, missionaries and inquisitors participated in the translation, circulation, and creation of medical knowledge and positioned themselves as both theological and medical authorities, as proponents and translators of Galenic medical theory, and as "confessor-physicians" rather than "confessor-judges." Women thus played a crucial interlocutory role in the articulation of a colonial religio-medical regime whose primary framers were not physicians, but clergymen. [ABSTRACT FROM AUTHOR]

The purpose of this study was to develop and provide a preliminary validation of a new measure of scrupulosity, the Scrupulous Thoughts and Behaviours Questionnaire (STBQ). More specifically, the STBQ was designed to assess a range of scrupulosity-related thoughts/obsessions and behaviours/compulsions. Following item development, a sample of non-referred college students completed the STBQ along with numerous validation measures. Based on factor analyses, a two-factor solution was retained. The first factor consisted of items that measure scrupulosity-themed obsessions and thoughts, and the second factor consisted of items that measure scrupulosity-themed compulsions and related behaviours. Support was found for the validity of STBQ, as both subscales were significantly and positively associated with measures of relevant constructs, including the Pennsylvania Inventory of Scrupulosity-Revised, the only other self-report measure of scrupulosity, thought–action fusion, religiosity, and obsessive–compulsive disorder symptoms. As the first known self-report measure to assess scrupulosity obsessions and compulsions, the STBQ has a potential utility in clinical practice and research. [ABSTRACT FROM AUTHOR]

Scrupulosity is a phenomenon of the intersection between religiosity and obsessive-compulsive disorder. It could be regarded as an interactive effect of religiosity, religious internal conflicts, cognitive distortions associated with thought processing and self-reference, and obsessiveness. The present study investigated scrupulosity in the network of religious/spiritual struggles, obsessive-compulsive disorder (OCD) symptoms, self-compassion, and religiosity in order to better describe a position of scrupulosity in the dimensions of mental health and illness. Two hundred and ninety-two religious individuals from Poland (two hundred and two women) between the ages of 18 and 83 (M = 39.3; SD = 13.7) participated in the study. We applied the Self-Compassion Scale, Religious and Spiritual Struggle Scale, Obsessive-Compulsive Inventory-Revised, Pennsylvania Inventory of Scrupulosity, and posed questions concerning identification with religious beliefs, the role of religion in one’s identity, and religious attendance. Using correlation analysis and a network analysis, we demonstrated that scrupulosity was positively correlated with religious/spiritual struggles (mostly with moral struggles and religious doubts) and with obsessing as an OCD symptom. The bridge strength analysis indicated that scrupulosity may be regarded as a bridge symptom between religious/spiritual struggles and OCD symptoms. Pastoral and psychological counselling could use these results in order to design efficient treatments for people suffering from religious scruples.

Scrupulosity is characterized by an excessive anxiety against sinning and it is found to be common in Muslim societies. Spirituality plays a significant role in its presentation and management. The role of Islamic spirituality is examined by revealing the relevance of Islamic spiritual values e.g. acceptance (rida), patience (sabr), to the therapy. Five cases where these values are integrated into the therapy are described. Limitations on the available evidence are addressed. This study proposes the integration of these spiritual values, supports the use of psychotherapeutic discourse and contributes to the field of healthcare through practical conceptual applications in the therapy. [ABSTRACT FROM AUTHOR]

Introduction Religious obsessions constitute an interesting component of the phenomenology of obsessive-compulsive disorder(OCD). Scrupulosity can be phenomenologically similar to other OCD subtypes but the ultimate feared consequence is religious or moral in nature. Objectives To develop a reflexion about religion, belief and its interaction with psychopathology, focusing on a clinical case. Methods Review of the clinical case and literature. Results 37-year-old female patient with 4 prior psychiatric admissions. Stable until May 2020. After a brief online relationship patient develops subsequent guilt, anxiety and obsessive images with religious/sexual content. Abruptly, on the day of admission to the ER, the patient eats garlic in penitence and self-flagellate. At inpatient-unit she presented in mutism and total oral refusal, needing nasogastric tube for feeding and medication administration. She was medicated with diazepam and olanzapine, being added fluoxetine later on. In later interviews, a primordial idea based on the prevailing religious beliefs was found: “sex before marriage is a mortal sin”. This itself generated doubt “have I been forgiven” with compulsions of verification/purification (eg. repeated confession) and punishment, and this doubt almost reached a delirious character during the acute episode. Partial egodistonia, lived with suffering although with some continuity with her beliefs. At discharge patient showed insight for the unrealism of this dyad, though the primary idea remained immovable. Conclusions Although the pharmacological approach managed to control the most disturbing symptoms presented by the patient, it’s worthwhile to review and to reflect on this report in a wider perspective, within in the light of the relevance to the clinical practice. Disclosure No significant relationships.

This study examined the roles of religiosity, shame, obsessive–compulsive symptoms, and scrupulosity in perceived pornography addiction. We theorized that religiosity causes pornography users to feel shame regarding their use, and in turn, self-identify as addicted to pornography, especially for individuals high on one of several proposed moderators. Participants were 645–646 pornography users who believe in a theistic God. Confirmatory analyses indicated that religious primes did not have indirect or moderated indirect effects on perceived addiction. However, exploratory analyses revealed that religious primes were associated with higher shame, and in turn, perceived addiction among individuals high on both organizational religiosity and Obsessive-Compulsive Disorder compulsivity subscales. Additionally, self-reported religiosity had indirect effects on perceived addiction via shame, especially among individuals high on scrupulosity or moral disapproval of pornography. [ABSTRACT FROM AUTHOR]

Objective: Scrupulosity is a manifestation of obsessive‐compulsive disorder (OCD) characterized by religious or moral core fears. Clinicians often struggle to treat scrupulosity, which may be associated with several features known to predict poor treatment outcome. The purpose of this study was to examine these features in participants with scrupulous OCD, contamination OCD, and healthy controls. Method: A total of 68 participants (57.4% women, agemean = 34.01) completed diagnostic interviews, and measures of symptoms and quality‐of‐life. Results: Relative to comparison groups, scrupulous participants had higher rates of obsessive‐compulsive personality disorder, more severe schizotypal symptoms, and more severe symptoms of depression. In addition, OCD severity was strongly associated with poor insight in the scrupulous group. Both OCD groups reported poorer quality of life than did healthy controls. Conclusions: Clinicians working with scrupulous individuals may enhance the efficacy of treatment in this challenging population by assessing carefully for these features, and incorporating treatment elements that address them. [ABSTRACT FROM AUTHOR]

Obsessive–compulsive disorders (OCDs) are one of the top 10 contributors of debilitating medical illnesses and are the fourth most common psychiatric disorder. Blasphemous thoughts, also known as scrupulosity, as an obsessional theme has piqued curiosities long before it was considered a neurosis. Such obsessions may or may not have an accompanying compulsion and comprise 5% of the patients of OCD. The case series is of three patients suffering from repetitive, intrusive, ego-dystonic, and distressing blasphemous thoughts, which are extremely distressing to them, rendering them unable to perform any other activity. The symptoms also indicate the presence of comorbid depressive and anxiety disorders, developing secondary to the blasphemous thoughts. Inadequate knowledge in this subtype of OCD mandates the need for more studying and research, especially with new texts suggesting the implementation of faith-assisted psychotherapy in addition to the conventional psychotherapy and pharmacotherapy. [ABSTRACT FROM AUTHOR]

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There is a growing literature suggesting disgust plays a major role in religiosity. However, the relationships between specific domains of disgust sensitivity and general religious fundamentalism or religious scrupulosity remains unknown and a lack of experimental data prevents the drawing of causal inferences about the potential effects of disgust on religiosity. Two studies are reported that examined the relationship between specific types of disgust sensitivity (i.e., pathogen, sexual, and moral disgust) and specific religious beliefs (i.e., fear of sin and fear of God). In the first study it was found that sexual disgust and pathogen disgust were significantly correlated with fear of sin and fear of God, respectively. In the second study the experimental induction of disgust led to greater fear of sin but not to the fear of God. These findings suggest that pathogen and sexual disgust sensitivities may serve as effective mechanisms for inflated scrupulosity. Taken together the outcomes from both studies converge on a greater understanding of the ‘Human Behavioral Immune System’ model that can account for social behavior with the evolution of adaptive benefit and perhaps more importantly highlights the possible drivers of specific religious behavior.

Neuroticism and religiosity are distal vulnerability factors for OCD phenomenon. The present study aimed to examine the roles of obsessive beliefs (OBs), thought-control strategies, and guilt in the relationship between these vulnerability factors and obsessive–compulsive symptoms (OCSs), specifically scrupulosity symptoms in a Muslim sample via SEM. The sample consisted of 273 university students who filled out a set of questionnaires. The results indicated that neuroticism and the degree of religiosity predict OBs that are positively associated with guilt and self-punishment both of which predict scrupulosity and other OCSs. Findings of the present study were discussed in the context of the related literature. [ABSTRACT FROM AUTHOR]

There is a growing literature suggesting disgust plays a major role in religiosity. However, the relationships between specific domains of disgust sensitivity and general religious fundamentalism or religious scrupulosity remains unknown and a lack of experimental data prevents the drawing of causal inferences about the potential effects of disgust on religiosity. Two studies are reported that examined the relationship between specific types of disgust sensitivity (i.e., pathogen, sexual, and moral disgust) and specific religious beliefs (i.e., fear of sin and fear of God). In the first study it was found that sexual disgust and pathogen disgust were significantly correlated with fear of sin and fear of God, respectively. In the second study the experimental induction of disgust led to greater fear of sin but not to the fear of God. These findings suggest that pathogen and sexual disgust sensitivities may serve as effective mechanisms for inflated scrupulosity. Taken together the outcomes from both studies converge on a greater understanding of the 'Human Behavioral Immune System' model that can account for social behavior with the evolution of adaptive benefit and perhaps more importantly highlights the possible drivers of specific religious behavior. [ABSTRACT FROM AUTHOR]

The positive association between religiosity and well-being is well supported in the literature. However, the documented relationship between religiosity and negative emotions such as fear, guilt, and shame suggest that religion may also suppress well-being via alternative mediational pathways. This study examined the possibility that scrupulous fears—a subclinical tendency to experience anxiety pertaining to sin—negatively mediate the otherwise positive relationship between religiosity and well-being. This hypothesis was tested in a cross-sectional analysis of data derived from an ethnically diverse, multi-religious sample in South East Asia. The hypothesis was partially supported. The negative indirect effect of religiosity on flourishing via scrupulosity was found to be significant, while the negative indirect effect of religiosity on satisfaction with life via scrupulosity was found to be non-significant. These results provide first evidence of religiosity exerting an indirect negative effect on aspects of well-being and affirm the importance of expanding research on this complex relationship. [ABSTRACT FROM AUTHOR]

Background: Scrupulosity is a common yet understudied presentation of obsessive compulsive disorder (OCD) that is characterized by obsessions and compulsions focused on religion. Despite the clinical relevance of scrupulosity to some presentations of OCD, little is known about the association between scrupulosity and symptom severity across religious groups. Aims: The present study examined the relationship between (a) religious affiliation and OCD symptoms, (b) religious affiliation and scrupulosity, and (c) scrupulosity and OCD symptoms across religious affiliations. Method: One-way ANOVAs, Pearson correlations and regression-based moderation analyses were conducted to evaluate these relationships in 180 treatment-seeking adults with OCD who completed measures of scrupulosity and OCD symptom severity. Results: Scrupulosity, but not OCD symptoms in general, differed across religious affiliations. Individuals who identified as Catholic reported the highest level of scrupulosity relative to individuals who identified as Protestant, Jewish or having no religion. Scrupulosity was associated with OCD symptom severity globally and across symptom dimensions, and the magnitude of these relationships differed by religious affiliation. Conclusions: Findings are discussed in terms of the dimensionality of scrupulosity, need for further assessment instruments, implications for assessment and intervention, and the consideration of religious identity in treatment. [ABSTRACT FROM AUTHOR]

Parent–child interactions shape children's internal working models (IWMs) i.e., their understanding of themselves, others, and close relationships, including with the Divine. Positive IWM are related to less interpersonal and intrapersonal distress. The quality of a child's IWM is also related to various aspects of religion/spirituality (r/s). While r/s benefit many people, some experience struggle around r/s issues. Our study explores the relationship between perceived parenting style and r/s struggles among Catholic college students (n = 464). Results suggest that increased parental warmth, involvement, and autonomy support are related to decreases in overall r/s struggle. Regression analyses found that maternal warmth was the strongest unique predictor of overall r/s struggle as well as each subscale, except Demonic. Subsequent analyses regrading Moral struggles found that increases in both subscales of scrupulosity (Fear of God's Punishment and Fear of Having Sinned) independently predicted more Moral struggle. Clinical implications are discussed and parenting considerations are proposed. [ABSTRACT FROM AUTHOR]

The experience of obsessive-compulsive disorder (OCD) symptoms that have a religious theme is common. Recent research has found that religious participants with religious OCD symptoms frequently turn to religious advisors, such as imams or clergy, for help to understand and alleviate their symptoms. As such, the advice provided by imams or clergy may have an important impact on the response of the person seeking help. This study examined the attitudes, beliefs and experiences of 64 Muslim imams with mosque-goers who had religious OCD symptoms, particularly scrupulosity. This study also examined imams' familiarity with first-line psychological treatments for OCD such as Exposure and Response Prevention (ERP). Sunni imams from Australia and Shia imams from Iran completed an online survey based on the research of Deacon, Vincent, and Zhang (2012), which was conducted with Christian clergy in the United States. Results showed that the majority of imams were unfamiliar with scrupulosity as a possible symptom of a mental health problem, such as OCD, and with ERP as a recognised treatment for OCD. While 37% of participants reported having been approached by mosque-goers for help with scrupulosity, only 9% referred mosque-goers to mental health professionals, and only one imam reported having referred a mosque-goer for ERP. Sunni imams located in Australia were more likely to provide advice inconsistent with the ERP approach and were also significantly less likely than Shia imams located in Iran to recommend referral to a mental health professional who was not affiliated with their own religious denomination. Finally, Sunni imams had significantly higher scores than Shia imams on Thought Action Fusion (TAF) subscales. Results of multiple regression analysis revealed that TAF explained a considerable amount of the variance related to ERP-inconsistent advice. Research implications and limitations are discussed. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the relevance of the mindfulness and thought suppression to scrupulosity, or religious obsessions. It was hypothesized that scrupulosity would be negatively associated trait mindfulness and positively associated with thought suppression. It was also hypothesized that thought suppression and mindfulness would mediate the association between scrupulosity and symptoms of obsessive–compulsive disorder (OCD). A survey-based study was conducted to test these hypotheses in a large, nonreferred sample. In particular, undergraduate university students completed a number of self-report measures, including the Pennsylvania Inventory of Scrupulosity (PIOS), the Five Facet Mindfulness Questionnaire- Short Form (FFMQ-SF), and the White Bear Suppression Inventory (WBSI) in exchange for extra credit. As anticipated, mindfulness was significantly associated with scrupulosity, with a particularly strong and negative association found between the PIOS and the nonjudging subscale of the FFMQ-SF. Further, thought suppression was found to be significantly and positively associated scores on the PIOS, with correlations in the moderate to strong range. Further, as anticipated, mindfulness and thought suppression mediated the relation between scrupulosity and thought suppression. Overall, the findings provide insight into the cognitive processes related to persistent and disruptive levels of scrupulosity. [ABSTRACT FROM AUTHOR]

Scrupulosity is a religiously themed sub-type of obsessive-compulsive disorder. Religious individuals with scrupulosity tend to first turn to clergy for assistance rather than to mental health professionals. This is particularly relevant for Ultra-Orthodox Jewish patients, whose rabbis arbitrate a wide variety of life issues. In the current qualitative study, 15 Ultra-Orthodox rabbis were interviewed regarding their views on scrupulosity and their responses were analysed via grounded theory and thematic networks theory. All rabbis were familiar with scrupulosity and distinguished it from normative behaviors. Their conceptualizations regarding etiology were mostly psychological in nature, as opposed to religious or spiritual. Rabbis were generally supportive of psychology as a professional field and open to collaborating with therapists, although some controversies were raised. Given their isolated lifestyle, these findings are somewhat surprising and encouraging. Results suggest collaboration with Ultra-Orthodox rabbis can be fruitful and at times essential when dealing with scrupulosity. [ABSTRACT FROM AUTHOR]

Acceptance and commitment therapy (ACT) is a modern form of cognitive behavior therapy (CBT) with growing support for treating obsessive-compulsive disorder (OCD). We present a case wherein a client presented with scrupulosity-related OCD. We briefly review scrupulosity, explain the theory behind ACT, and present a case, the treatment process, and desired outcomes. Exposure and response prevention (ERP) is described from an ACT perspective and discussed as an option for people with OCD who may be reluctant to engage in more traditional forms of ERP. [ABSTRACT FROM AUTHOR]

Obsessive-compulsive symptom profiles vary widely among individuals and may be affected by cultural backgrounds. In the case of scrupulosity, moral and religious principles are the target of obsessive-compulsive symptoms. Cognitive biases and beliefs have special relevance in the origin and maintenance of obsessive scrupulosity. In addition, rigid and exaggerated beliefs about morality are held by these patients. Moral and religious principles are mainly transmitted by family. These influences may be more prominent in cultures, such as the Spanish culture, where family and religion are important values for individuals. The authors describe the treatment of a Spanish patient with obsessive scrupulosity. Family therapy strategies were integrated into exposure-based CBT in order to facilitate the modification of beliefs, behaviors, and pathological family relationships. The patient exhibited clinically significant improvements in OCD symptoms. Findings from this case show the need for individualized interventions that take into consideration cultural, social, and family factors. [ABSTRACT FROM AUTHOR]

Research suggests that religious/paranormal beliefs are related to symptoms of obsessive-compulsive disorder (OCD), including scrupulosity (i.e., religious/moral obsessions and compulsions). However, the mechanisms that underlie these relationships are not well understood. This study focused on examining whether dysfunctional beliefs (DBs) mediate the relationships between: i) religiosity and OCD, ii) religiosity and scrupulosity, iii) paranormal beliefs and OCD, as well as iv) paranormal beliefs and scrupulosity. Students (n = 775) completed a survey measuring religiosity, paranormal beliefs, OCD, scrupulosity, DBs (inflated sense of responsibility and over-estimation of threat [RT], intolerance of uncertainty and perfectionism [PC], and importance of and the need to control thoughts [ICT]), as well as depression and anxiety. Mediation analyses revealed that RT and ICT mediated all four relationships and PC mediated three of the four relationships. This suggests that paranormal and religious beliefs are associated with DBs which in turn may contribute to the severity of OCD. [ABSTRACT FROM AUTHOR]

Abstract Objective Recent evidence suggests that avoiding waste may be a prominent motive to save in hoarding disorder. Such beliefs are reminiscent of scrupulosity obsessions in OCD. This paper reports on three studies examining scrupulosity-like beliefs in hoarding and the development and validation of a measure of material scrupulosity. Methods Study one examined the reliability and validity of a measure of material scrupulosity (MOMS) and its relationship to hoarding in a college student sample, as well as the relationship between hoarding and OCD-base scrupulosity. Study 2 examined the psychometric properties of the MOMS in a replication of study 1 with a sample of people with hoarding problems. Study 3 examined the reliability and validity of the MOMS in a large nonclinical/community sample. Results Findings across the studies provided evidence for the reliability and validity of the MOMS. It was highly correlated with hoarding symptoms, especially difficulty discarding, and hoarding related beliefs, especially responsibility beliefs. It accounted for significant variance in hoarding symptoms independent of other correlates, including other hoarding beliefs. OCD-based scrupulosity was correlated with hoarding in sample 1, but not in the hoarding sample in study 2. Conclusions Material Scrupulosity refers to an exaggerated sense of duty or moral/ethical responsibility for the care and disposition of possessions to prevent their being harmed or wasted. It appears to be distinct from other hoarding-related beliefs and a significant predictor of hoarding symptoms. The MOMS appears to possess good reliability and validity in both clinical and nonclinical samples. Highlights • A measure of material scrupulosity (MOMS) was reliable and correlated with hoarding symptoms and beliefs. • Material scrupulosity accounted for variance in hoarding symptoms independent of other variables. • Material scrupulosity and excessive responsibility for possessions were greater in men than women. • OCD-based scrupulosity was associated with hoarding in a nonclinical, but not a clinical sample. [ABSTRACT FROM AUTHOR]

The time period from 1840 to 1950 was one of rapid, dramatic change in the experience of suffering from and receiving treatment for obsessional disorder in the United States. Several patient case histories are discussed in detail, including those of a theology professor’s acquaintance (1844), a wealthy gentleman (1880), a hosiery shop proprietor (1938), and a former college student (1949). Although the focus here is on the patients’ experience, many broader aspects of the history of obsessional disorder are also explored. [ABSTRACT FROM AUTHOR]

Scrupulosity is one of the most common of the variations of obsessive-compulsive disorder (OCD). This includes obsessions and compulsions related to religiously and morality, and the Pennsylvania Inventory of Scrupulosity - Revised (PIOS-R) appears to be the only validated measure designed specifically to assess this construct. The purpose of the current study was to examine the psychometric properties of the first known Spanish version of the PIOS-R (PIOS-R-SV). In particular, the PIOS-R-SV in Spanish and its psychometric properties were examined with a sample of 361 participants from mixed religious backgrounds. Results showed good psychometric properties for the PIOS-R-SV and suggested a single-factor solution. The PIOS-R-SV was a significant predictor of OCD symptoms as measured by the Yale-Brown Obsessive-Compulsive Scale - Self-Report Version. In addition, it reported good convergent validity with the Thought-Action Fusion Scale Moral subscale and religiously assessed by the Santa Clara Strength of Religious Faith Questionnaire. [ABSTRACT FROM AUTHOR]

Obsessive-compulsive disorder (OCD) is a chronic mental illness affecting 2%–3% of the population worldwide. Scrupulosity (an OCD dimension) is centered on religious and/or moral intrusive thoughts followed by repetitive actions and frequently restrains functioning. Secondary data was analyzed for this study. Our findings suggest that non-Catholic Christians and Muslims may be more likely to endorse scrupulosity compared to other religious individuals. Individuals with scrupulosity have higher levels of OCD severity and disability overall. Future studies should address the increased level of severity and disability for individuals with scrupulosity. [ABSTRACT FROM PUBLISHER]

Background and objectives The present study investigated the role of scrupulosity, a rigid religious understanding characterized by fear of God and sinning, in the relationship between disgust and contamination-related OCD in a Muslim sample. Method The sample was composed of 209 university students. After an initial screening study, the high (N = 33) and low scrupulous (N = 29) groups were formed. After filling out a self-report questionnaire battery consisting of measures of disgust propensity, obsessive beliefs, and contamination-related cognitions and symptoms, participants were randomly assigned to view either 10 highly disgusting or neutral pictures while imagining themselves in the situation depicted in the picture. After the manipulation, they rated the unpleasantness of the image, emotions, urge to wash and avoid, and also their mood. In the last phase, participants performed a fear provocation task. Results The results indicated that the intensity of disgusting stimuli was positively associated with contamination-related ratings. As expected, high scrupulous participants showed higher disgust propensity and contamination-related symptoms after exposure to the disgust inducing pictures and the fear provocation task. Conclusions High disgust propensity may be a vulnerability factor for contamination based OCD symptoms in highly scrupulous Muslims. [ABSTRACT FROM AUTHOR]