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Scrupulosity, Religious Affiliation and Symptom Presentation in Obsessive Compulsive Disorder

Published online by Cambridge University Press:  15 January 2019

Jennifer L. Buchholz ,
Jonathan S. Abramowitz ,
Bradley C. Riemann ,
Lillian Reuman ,
Shannon M. Blakey ,
Rachel C. Leonard  and
Katherine A. Thompson
Jennifer L. Buchholz*
Affiliation:
University of North Carolina at Chapel Hill, Davie Hall, Campus Box 3270, Chapel Hill, NC 27599, USA
Jonathan S. Abramowitz
Affiliation:
University of North Carolina at Chapel Hill, Davie Hall, Campus Box 3270, Chapel Hill, NC 27599, USA
Bradley C. Riemann
Affiliation:
Rogers Memorial Hospital, 34700 Valley Road, Oconomowoc, WI 53066, USA
Lillian Reuman
Affiliation:
University of North Carolina at Chapel Hill, Davie Hall, Campus Box 3270, Chapel Hill, NC 27599, USA
Shannon M. Blakey
Affiliation:
University of North Carolina at Chapel Hill, Davie Hall, Campus Box 3270, Chapel Hill, NC 27599, USA
Rachel C. Leonard
Affiliation:
Rogers Memorial Hospital, 34700 Valley Road, Oconomowoc, WI 53066, USA
Katherine A. Thompson
Affiliation:
University of North Carolina at Chapel Hill, Davie Hall, Campus Box 3270, Chapel Hill, NC 27599, USA
*
Correspondence to Jennifer Buchholz, University of North Carolina at Chapel Hill, Department of Psychology and Neuroscience, Chapel Hill, NC 27599-3270, USA. E-mail: [email protected]
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Abstract

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.

Keywords

obsessive compulsive disorderreligionreligious obsessionsscrupulosity
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 47 , Issue 4 , July 2019 , pp. 478 - 492
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2019 

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References

Abramowitz, J. S., Deacon, B. J., Olatunji, B. O., Wheaton, M. G., Berman, N. C., Losardo, D. et al. (2010). Assessment of obsessive-compulsive symptom dimensions: Development and evaluation of the Dimensional Obsessive-Compulsive Scale. Psychological Assessment, 22, 180. https://doi.org/10.1037/a0018260.Google Scholar
Abramowitz, J. S., Huppert, J. D., Cohen, A. B., Tolin, D. F. and Cahill, S. P. (2002). Religious obsessions and compulsions in a non-clinical sample: The Penn Inventory of Scrupulosity (PIOS). Behaviour Research and Therapy, 40, 824–838. https://doi.org/10.1016/S0005-7967(01)00070-5Google Scholar
Abramowitz, J. S. and Jacoby, R. J. (2014). Scrupulosity: a cognitive-behavioral analysis and implications for treatment. Journal of Obsessive-Compulsive and Related Disorders, 3, 140–149. https://doi.org/10.1016/j.jocrd.2013.12.007Google Scholar
Antony, M. M., Downie, F. and Swinson, R. P. (1998). Diagnostic issues and epidemiology in obsessive–compulsive disorder. In Swinson, R. P., Antony, M. M., Rachman, S. J. and Richter, M. A. (eds), Obsessive-Compulsive Disorder: Theory, Research and Treatment. (pp. 3–32). New York, NY, US: Guilford Press.Google Scholar
Berman, N. C., Abramowitz, J. S., Pardue, C. M. and Wheaton, M. G. (2010). The relationship between religion and thought–action fusion: use of an in vivo paradigm. Behaviour Research and Therapy, 48, 670–674.Google Scholar
Cohen, A. B. and Rozin, P. (2001). Religion and the morality of mentality. Journal of Personality and Social Psychology, 81, 697.Google Scholar
Foa, E. B. and Kozak, M. J. (1995). DSM-IV field trial: obsessive-compulsive disorder. The American Journal of Psychiatry, 152, 90.Google Scholar
Greenberg, D. (1984). Are religious compulsions religious or compulsive: a phenomenological study. American Journal of Psychotherapy, 38, 524.Google Scholar
Greenberg, D. and Huppert, J. D. (2010). Scrupulosity: a unique subtype of obsessive-compulsive disorder. Current Psychiatry Reports, 12, 282–289.Google Scholar
Greenberg, D. and Shefler, G. (2002). Obsessive compulsive disorder in ultra-orthodox Jewish patients: a comparison of religious and non-religious symptoms. Psychology and Psychotherapy: Theory, Research and Practice, 75, 123–130.Google Scholar
Hayes, A. F. (2013). Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based Approach. New York: Guilford Press.Google Scholar
Hayes, A. F. and Montoya, A. K. (2017). A tutorial on testing, visualizing, and probing an interaction involving a multicategorical variable in linear regression analysis. Communication Methods and Measures, 11, 1–30.Google Scholar
Huppert, J. D. and Fradkin, I. (2016). Validation of the Penn Inventory of Scrupulosity (PIOS) in scrupulous and nonscrupulous patients: revision of factor structure and psychometrics. Psychological Assessment, 28, 639.Google Scholar
Huppert, J. D. and Siev, J. (2010). Treating scrupulosity in religious individuals using cognitive-behavioral therapy. Cognitive and Behavioral Practice, 17, 382–392.Google Scholar
Huppert, J. D., Siev, J. and Kushner, E. S. (2007). When religion and obsessive–compulsive disorder collide: treating scrupulosity in ultra-orthodox Jews. Journal of Clinical Psychology, 63, 925–941.Google Scholar
Inozu, M., Clark, D. A. and Karanci, A. N. (2012). Scrupulosity in Islam: a comparison of highly religious Turkish and Canadian samples. Behavior Therapy, 43, 190–202.Google Scholar
Kaviani, S., Eskandari, H. and Ebrahimi Ghavam, S. (2015). The relationship between scrupulosity, obsessive-compulsive disorder and its related cognitive styles. Practice in Clinical Psychology, 3, 47–60.Google Scholar
Kozak, M. J. and Coles, M. E. (2005). Treatment for OCD: unleashing the power of exposure. In Concepts and Controversies in Obsessive-Compulsive Disorder (pp. 283–315). Springer. Retrieved from: http://link.springer.com.libproxy.lib.unc.edu/chapter/10.1007/0-387-23370-9_15Google Scholar
Lee, H.-J. and Kwon, S.-M. (2003). Two different types of obsession: autogenous obsessions and reactive obsessions. Behaviour Research and Therapy, 41, 11–29.Google Scholar
Lee, I. A. and Preacher, K. J. (2013). Calculation for the test of the difference between two dependent correlations with one variable in common [computer software]. Available at: http://quantpsy.org (accessed 25 March 2018).Google Scholar
Mataix-Cols, D., Marks, I. M., Greist, J. H., Kobak, K. A. and Baer, L. (2002). Obsessive-compulsive symptom dimensions as predictors of compliance with and response to behaviour therapy: results from a controlled trial. Psychotherapy and Psychosomatics, 71, 255–262.Google Scholar
McKay, D., Abramowitz, J. S., Calamari, J. E., Kyrios, M., Radomsky, A., Sookman, D. et al. (2004). A critical evaluation of obsessive–compulsive disorder subtypes: symptoms versus mechanisms. Clinical Psychology Review, 24, 283–313. https://doi.org/10.1016/j.cpr.2004.04.003Google Scholar
Murray-Swank, A. B., McConnell, K. M. and Pargament, K. I. (2007). Understanding spiritual confession: a review and theoretical synthesis. Mental Health, Religion and Culture, 10, 275–291.Google Scholar
Nelson, E. A., Abramowitz, J. S., Whiteside, S. P. and Deacon, B. J. (2006). Scrupulosity in patients with obsessive-compulsive disorder: relationship to clinical and cognitive phenomena. Journal of Anxiety Disorders, 20, 1071–1086.Google Scholar
Okasha, A. (2004). OCD in Egyptian adolescents: the effect of culture and religion. Psychiatric Times, 21, 1–5.Google Scholar
Olatunji, B. O., Abramowitz, J. S., Williams, N. L., Connolly, K. M. and Lohr, J. M. (2007). Scrupulosity and obsessive-compulsive symptoms: confirmatory factor analysis and validity of the Penn Inventory of Scrupulosity. Journal of Anxiety Disorders, 21, 771–787.Google Scholar
Rachman, S. (1998). A cognitive theory of obsessions: elaborations. Behaviour Research and Therapy, 36, 385–401.Google Scholar
Rachman, S. (1997). A cognitive theory of obsessions. Behaviour Research and Therapy, 35, 793–802.Google Scholar
Rassin, E. and Koster, E. (2003). The correlation between thought–action fusion and religiosity in a normal sample. Behaviour Research and Therapy, 41, 361–368.Google Scholar
Salkovskis, P., Shafran, R., Rachman, S. and Freeston, M. H. (1999). Multiple pathways to inflated responsibility beliefs in obsessional problems: possible origins and implications for therapy and research. Behaviour Research and Therapy, 37, 1055–1072.Google Scholar
Shafran, R., Thordarson, D. S. and Rachman, S. (1996). Thought-action fusion in obsessive compulsive disorder. Journal of Anxiety Disorders, 10, 379–391.Google Scholar
Siev, J., Baer, L. and Minichiello, W. E. (2011a). Obsessive-compulsive disorder with predominantly scrupulous symptoms: clinical and religious characteristics. Journal of Clinical Psychology, 67, 1188–1196.Google Scholar
Siev, J., Chambless, D. L. and Huppert, J. D. (2010). Moral thought–action fusion and OCD symptoms: the moderating role of religious affiliation. Journal of Anxiety Disorders, 24, 309–312. https://doi.org/10.1016/j.janxdis.2010.01.002Google Scholar
Siev, J. and Cohen, A. B. (2007). Is thought–action fusion related to religiosity? Differences between Christians and Jews. Behaviour Research and Therapy, 45, 829–837.Google Scholar
Siev, J., Steketee, G., Fama, J. M. and Wilhelm, S. (2011b). Cognitive and clinical characteristics of sexual and religious obsessions. Journal of Cognitive Psychotherapy, 25, 167–176.Google Scholar
Steiger, J. H. (1980). Tests for comparing elements of a correlation matrix. Psychological Bulletin, 87, 245.Google Scholar
Steketee, G., Frost, R. and Bogart, K. (1996). The Yale-Brown obsessive compulsive scale: interview versus self-report. Behaviour Research and Therapy, 34, 675–684.Google Scholar
Tolin, D. F., Abramowitz, J. S., Kozak, M. J. and Foa, E. B. (2001). Fixity of belief, perceptual aberration, and magical ideation in obsessive–compulsive disorder. Journal of Anxiety Disorders, 15, 501–510.Google Scholar
Wheaton, M. G., Abramowitz, J. S., Berman, N. C., Riemann, B. C. and Hale, L. R. (2010). The relationship between obsessive beliefs and symptom dimensions in obsessive-compulsive disorder. Behaviour Research and Therapy, 48, 949–954.Google Scholar
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