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Moroń M, Niedbała D, Matychniak N, Stabla P, Broda T. Religious scrupulosity and early maladaptive schemas: a network analysis. Cogn Behav Ther 2024:1-15. [PMID: 39225192 DOI: 10.1080/16506073.2024.2395827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Accepted: 08/13/2024] [Indexed: 09/04/2024]
Abstract
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.
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Affiliation(s)
- Marcin Moroń
- Institute of Psychology, University of Silesia in Katowice, Grażyńskiego 53, Katowice 43-126, Poland
| | - Dariusz Niedbała
- Department of Social Sciences, University of Silesia in Katowice, Katowice, Poland
| | - Natalia Matychniak
- Department of Social Sciences, University of Silesia in Katowice, Katowice, Poland
| | - Paulina Stabla
- Department of Social Sciences, University of Silesia in Katowice, Katowice, Poland
| | - Tadeusz Broda
- Department of Social Sciences, University of Silesia in Katowice, Katowice, Poland
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Mazur LB. "A dim recognition." Religion as a font of psychological innovation. Integr Psychol Behav Sci 2024; 58:845-854. [PMID: 39039333 DOI: 10.1007/s12124-024-09858-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2024] [Indexed: 07/24/2024]
Abstract
While religion constituted one of the main topics of interest for early social scientists, faith traditions have silently slipped from this central role. When religion now appears in psychological research, it is usually relegated to the position of either the object of psychological investigation (which psychology purports to "explain") or a static piece in the empirical puzzle (as one variable among many when explaining clinical or social outcomes). In either case, religion is generally no longer seen as an equal partner to the social sciences in our attempts to better understand of the human condition. However, there are and have been voices within psychology that see this as unnecessarily myopic. James Jackson Putnam (1846-1918), an early supporter of the emerging field of psychoanalysis, advocated that psychology take seriously philosophy, metaphysics, and religion. Putnam's objections to the narrowing of our view of human life in the spirit of scientism fell largely on deaf ears, and his call for psychology to include that which lies beyond the walls of empirical naturalism and reductionism remains relevant today. In as far as theoretical innovation in psychology is more of a creative recognition than true scientific discovery, philosophy and religion constitute tremendously rich, and unfortunately underappreciated, fonts of inspiration. Putnam saw in religion the "dim recognition" of "the creative spirit of the universe." We briefly reflect on the example of obsessive-compulsive disorder and the much older religious concept of scruples, including approaches to mindfulness. This example is suggestive of the richness of psychological insights to be found in religion.
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Affiliation(s)
- Lucas B Mazur
- Jagiellonian University, Kraków, Poland.
- Sigmund Freud University, Berlin, Germany.
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Miller CH, Hedges DW, Brown B, Olsen J, Baughan EC. Development of the scrupulosity inventory: A factor analysis and construct validity study. J Behav Ther Exp Psychiatry 2024; 83:101926. [PMID: 38070454 DOI: 10.1016/j.jbtep.2023.101926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 11/04/2023] [Accepted: 11/20/2023] [Indexed: 02/25/2024]
Abstract
BACKGROUND AND OBJECTIVES Scrupulosity, despite its considerable prevalence and morbidity, remains under-investigated. The present study develops and examines the psychometric properties of a comprehensive assessment tool, the Scrupulosity Inventory (SI). METHODS The SI, along with other measures of obsessive-compulsive disorder (OCD) and perfectionism, were administered to a sample (N = 150) of college undergraduates similar in size to other scale development studies of related measures. We conducted exploratory and confirmatory factor analyses of the SI, examined its convergent and divergent validity, and assessed its ability to predict categorical diagnoses of scrupulosity using a receiver operator characteristic analysis. RESULTS We found a well-fitting confirmatory bifactor model (RMSEA = 0.049) with a strong general Scrupulosity factor ( [Formula: see text] ) and specific factors for Personal Violations ( [Formula: see text] ), Ritualized Behavior ( [Formula: see text] ), Interference with Life ( [Formula: see text] ), and Problem Pervasiveness ( [Formula: see text] ). As predicted, we also found the strongest convergence (r = 0.63) between the SI and the Penn Inventory of Scrupulosity (PIOS), intermediate convergence (r = 0.54) between the SI and Perfectionism Inventory (PI), and weaker convergence (r = 0.47) between the SI and YBOCS. Finally, we found that a categorical diagnosis of scrupulosity was highly predicted by the SI (AUC = 0.84), less well-predicted by the PIOS (AUC = 0.75) and less well predicted by the YBOCS (AUC = 0.69). LIMITATIONS This study was conducted among a sample of undergraduates at a religiously affiliated university. CONCLUSIONS These results suggest utility in using the SI to measure the severity of scrupulosity symptoms and that scrupulosity and OCD may present significantly different clinical features.
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Affiliation(s)
- Chris H Miller
- California State University, Department of Psychology, Fresno, CA 93619, USA.
| | - Dawson W Hedges
- Brigham Young University, Department of Psychology, Provo, UT 84604, USA.
| | - Bruce Brown
- Brigham Young University, Department of Psychology, Provo, UT 84604, USA.
| | - Joseph Olsen
- Brigham Young University, Department of Psychology, Provo, UT 84604, USA.
| | - Elijah C Baughan
- Brigham Young University, Department of Psychology, Provo, UT 84604, USA.
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Altwaijri Y, Stein DJ, Akkad M, Bilal L, Talal Naseem M, Al-Subaie A, Al-Habeeb A, Kessler RC. The epidemiology of obsessive-compulsive disorder in the Kingdom of Saudi Arabia: Data from the Saudi National Mental Health Survey. J Anxiety Disord 2024; 103:102856. [PMID: 38554604 DOI: 10.1016/j.janxdis.2024.102856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 02/27/2024] [Accepted: 03/07/2024] [Indexed: 04/01/2024]
Abstract
AIMS There is ongoing debate about the extent to which the epidemiology of OCD is similar across the world, given the lack of nationally representative data from key regions like the Middle East and North Africa. Using the nationally representative dataset from the Saudi National Mental Health Survey (SNMHS), we aimed to delineate the epidemiological profile of OCD in the Saudi population. METHODS A subsample of 1981 participants from the SNMHS was assessed. Prevalence estimates and correlates of OCD were determined using logistic regressions and cross tabulations. RESULTS The lifetime, 12-month, and 30-day prevalence estimates for OCD were 4.2%, 1.8%, and 1.6%, respectively, with hoarding being the most common symptom dimension. The mean age-of-onset of OCD was 16.8 years. In over two-thirds of respondents with lifetime (72.2%) or 12-month (71.2%), OCD was accompanied by comorbid mental disorder, particularly impulse control, anxiety, and mood disorders. Among individuals with 12-month OCD, 77.5% reported severe impairment, and only 9.2% received treatment. CONCLUSIONS In Saudi Arabia, OCD is a prevalent and persistent condition, characterized by early onset, high odds of mental comorbidity, and significant associated impairment. These findings emphasize the universality of OCD epidemiology and the need for improved diagnosis and treatment globally.
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Affiliation(s)
- Yasmin Altwaijri
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist, Hospital and Research Centre, Riyadh, Saudi Arabia; Research Department, King Salman Center for Disability Research, Riyadh, Saudi Arabia; SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia.
| | - Dan J Stein
- SAMRC Unit on Risk & Resilience in Mental Disorders, Dept of Psychiatry & Neuroscience Institute, University of Cape Town, South Africa
| | - Marya Akkad
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist, Hospital and Research Centre, Riyadh, Saudi Arabia; Research Department, King Salman Center for Disability Research, Riyadh, Saudi Arabia; SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Lisa Bilal
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist, Hospital and Research Centre, Riyadh, Saudi Arabia; Research Department, King Salman Center for Disability Research, Riyadh, Saudi Arabia; SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mohammad Talal Naseem
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist, Hospital and Research Centre, Riyadh, Saudi Arabia; Research Department, King Salman Center for Disability Research, Riyadh, Saudi Arabia; SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah Al-Subaie
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia; Department of Psychiatry, Edrak Medical Center, Riyadh, Saudi Arabia
| | - Abdulhameed Al-Habeeb
- National Center for Mental Health Promotion, Ministry of Health, Riyadh, Saudi Arabia
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, United States
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Lee SW, Choi M, Lee SJ. A randomized controlled trial of group-based acceptance and commitment therapy for obsessive-compulsive disorder. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2022. [DOI: 10.1016/j.jcbs.2022.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Nikjoo A, Wright C, Kheriaty A. A Case Report of Scrupulosity Presenting as Catatonia in a Patient With Both OCD and OCPD. J Psychiatr Pract 2022; 28:265-269. [PMID: 35511105 DOI: 10.1097/pra.0000000000000629] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We present the case of a woman in her 40s with a history of hypothyroidism, a differential diagnosis of major depressive disorder with psychotic features versus bipolar I disorder, catatonia, and anorexia nervosa. The patient was admitted to the hospital for poor oral intake, mutism, and social withdrawal. Administration of lorazepam successfully treated these presenting symptoms. However, on subsequent days, she was found to be reading the Bible almost constantly during waking hours, at the expense of engaging in treatment or interacting with others. The patient's history and presentation supported the idea that her hyper-religiosity stemmed not from bipolar disorder or psychosis, as previously thought, but rather from a subtype of obsessive-compulsive disorder referred to as scrupulosity. This report summarizes the characteristics of scrupulosity and discusses this potentially deceptive mimic of more commonly seen conditions.
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Affiliation(s)
- Arya Nikjoo
- NIKJOO, WRIGHT, and KHERIATY: University of California, Irvine Medical Center, Orange, CA
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Thayer KK, DeRiso M, Warren J, Wilson A, Vance S. What therapists need to know about the treatment of OCD when disgust is part of the clinical presentation. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021. [DOI: 10.1016/j.jadr.2021.100209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Inozu M, Kahya Y, Yorulmaz O. Neuroticism and Religiosity: The Role of Obsessive Beliefs, Thought-Control Strategies and Guilt in Scrupulosity and Obsessive-Compulsive Symptoms Among Muslim Undergraduates. JOURNAL OF RELIGION AND HEALTH 2020; 59:1144-1160. [PMID: 29550922 DOI: 10.1007/s10943-018-0603-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
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.
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Affiliation(s)
- Mujgan Inozu
- Psychology Department, Hacettepe University, Ankara, Turkey.
| | - Yasemin Kahya
- Psychology Department, Hacettepe University, Ankara, Turkey
| | - Orcun Yorulmaz
- Psychology Department, Dokuz Eylül University, Izmir, Turkey
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Stein DJ, Costa DLC, Lochner C, Miguel EC, Reddy YCJ, Shavitt RG, van den Heuvel OA, Simpson HB. Obsessive-compulsive disorder. Nat Rev Dis Primers 2019; 5:52. [PMID: 31371720 PMCID: PMC7370844 DOI: 10.1038/s41572-019-0102-3] [Citation(s) in RCA: 313] [Impact Index Per Article: 62.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/27/2019] [Indexed: 12/15/2022]
Abstract
Obsessive-compulsive disorder (OCD) is a highly prevalent and chronic condition that is associated with substantial global disability. OCD is the key example of the 'obsessive-compulsive and related disorders', a group of conditions which are now classified together in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and the International Classification of Diseases, 11th Revision, and which are often underdiagnosed and undertreated. In addition, OCD is an important example of a neuropsychiatric disorder in which rigorous research on phenomenology, psychobiology, pharmacotherapy and psychotherapy has contributed to better recognition, assessment and outcomes. Although OCD is a relatively homogenous disorder with similar symptom dimensions globally, individualized assessment of symptoms, the degree of insight, and the extent of comorbidity is needed. Several neurobiological mechanisms underlying OCD have been identified, including specific brain circuits that underpin OCD. In addition, laboratory models have demonstrated how cellular and molecular dysfunction underpins repetitive stereotyped behaviours, and the genetic architecture of OCD is increasingly understood. Effective treatments for OCD include serotonin reuptake inhibitors and cognitive-behavioural therapy, and neurosurgery for those with intractable symptoms. Integration of global mental health and translational neuroscience approaches could further advance knowledge on OCD and improve clinical outcomes.
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Affiliation(s)
- Dan J Stein
- Department of Psychiatry, University of Cape Town and SA MRC Unit on Risk & Resilience in Mental Disorders, Cape Town, South Africa.
| | - Daniel L C Costa
- OCD Research Program, Instituto de Psiquiatria, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Christine Lochner
- Department of Psychiatry, Stellenbosch University and SA MRC Unit on Risk & Resilience in Mental Disorders, Stellenbosch, South Africa
| | - Euripedes C Miguel
- OCD Research Program, Instituto de Psiquiatria, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Y C Janardhan Reddy
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Roseli G Shavitt
- OCD Research Program, Instituto de Psiquiatria, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Odile A van den Heuvel
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam, Netherlands
- Department of Anatomy & Neurosciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam, Netherlands
| | - H Blair Simpson
- Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, NY, USA
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10
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Scrupulosity, Religious Affiliation and Symptom Presentation in Obsessive Compulsive Disorder. Behav Cogn Psychother 2019; 47:478-492. [PMID: 30642412 DOI: 10.1017/s1352465818000711] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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.
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Abstract
This article reviews the clinical features and neurochemical hypotheses of obsessive-compulsive disorder (OCD) with a focus on the serotonin system. In DSM-5, OCD was moved from the anxiety disorders to a new category of Obsessive-Compulsive and Related Disorders. OCD is a common, typically persistent disorder marked by intrusive and disturbing thoughts (obsessions) and repetitive behaviors (compulsions) that the person feels driven to perform. The preferential efficacy of serotonin reuptake inhibitors (SRIs) in OCD led to the so-called serotonin hypothesis. However, direct support for a role of serotonin in the pathophysiology (e.g., biomarkers in pharmacological challenge studies) of OCD remains elusive. A role of the glutamatergic system in OCD has been gaining traction based on imaging data, genomic studies and animal models of aberrant grooming behavior. These findings have spurred interest in testing the efficacy of medications that modulate glutamate function. A role of glutamate is compatible with circuit-based theories of OCD.
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Affiliation(s)
- Wayne K Goodman
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY 10029, USA.
| | - Dorothy E Grice
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY 10029, USA
| | - Kyle A B Lapidus
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY 10029, USA
| | - Barbara J Coffey
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY 10029, USA
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Besiroglu L, Karaca S, Keskin I. Scrupulosity and obsessive compulsive disorder: the cognitive perspective in Islamic sources. JOURNAL OF RELIGION AND HEALTH 2014; 53:3-12. [PMID: 22395755 DOI: 10.1007/s10943-012-9588-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
A moral/religious subtype of obsessive compulsive disorder has been termed as scrupulosity by mental health professionals. Since ultimate feared consequence in scrupulous individuals is religious or moral in nature, it also presents interesting and difficult issue for religious authorities. This article focuses on various aspects of scrupulosity that have until now been poorly conceptualized in Islamic world and provides a conceptual cognitive framework and analysis of scrupulosity according to Islamic sources.
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Affiliation(s)
- Lutfullah Besiroglu
- Department of Psychiatry, Faculty of Medicine, Yuzuncu Yil University, 65200, Van, Turkey,
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Greenberg D. Religion and mental health: a double-edged sword or a life-giving medicine? World Psychiatry 2013; 12:40-1. [PMID: 23471797 PMCID: PMC8478327 DOI: 10.1002/wps.20012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Inozu M, Clark DA, Karanci AN. Scrupulosity in Islam: a comparison of highly religious Turkish and Canadian samples. Behav Ther 2012; 43:190-202. [PMID: 22304890 DOI: 10.1016/j.beth.2011.06.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2010] [Revised: 06/01/2011] [Accepted: 06/07/2011] [Indexed: 01/25/2023]
Abstract
Scrupulosity is a form of obsessive-compulsive disorder (OCD) characterized by a tendency to have persistent doubts about God, sin, and the adequacy of one's religious behaviors and devotion. To date, no published studies have compared scrupulosity in high- and low-religious Muslim and Christian samples. In the present study religious school students as well as high- and low-religious university students in Turkey and Canada were compared on the Penn Inventory of Scrupulosity (PIOS), Obsessive Beliefs Questionnaire (OBQ-44), and symptom measures of obssesionality and negative affect. Between-group comparisons revealed that the highly religious Turkish sample scored significantly higher than the highly religious Canadian students on the PIOS Fear of God but not the Fear of Sin subscale. Separate multiple regression analyses revealed that the Clark-Beck Obsessive Compulsive Inventory (CBOCI) Obsessions subscale, OBQ-44 Importance and Control of Thoughts subscale, and guilt were significant unique predictors of PIOS scrupulosity. These findings suggest that subtle differences exist in how scrupulosity is manifested in Islamic and Christian believers.
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