Religiosity and obsessive–compulsive behavior in Israeli Jews

"God is a painter": How Jewish Ultra-Orthodox art therapists and clients perceive mental health treatment

The current study examined the ways in which 14 art therapists and adult clients from the Ultra-Orthodox sector in Israel perceive mental health and mental health treatment. Semi-structured interviews were subjected to an interpretative phenomenological analysis to capture the meaning ascribed to the treatment and its challenges. Four themes emerged: the perception of mental health as related to the centrality of functioning, purposefulness, and emotional balance; the specific challenges of therapy, in terms of suspicion regarding treatment and difficulties in establishing intimacy and self-disclosure; the interplay between the worlds of therapy and religion; and the intersection of art and religion. The discussion centers on an interpretation of the findings in light of the ontological typology of individualism versus collectivism.

A reliability generalization meta-analysis of the child and adolescent perfectionism scale

BACKGROUND

Perfectionism is a prevalent disposition of personality involved in the development and maintenance of a wide range of psychological disorders. The Child and Adolescent Perfectionism Scale (CAPS) is the most usually applied test to assess perfectionism in children and adolescents. This study aimed: (a) to conduct a reliability generalization meta-analysis to estimate the average reliability of the CAPS scores and to search for characteristics of the studies that may explain the variability among reliability estimates, and (b) to estimate the reliability induction rate of the CAPS.

METHOD

An exhaustive search allowed to select 56 studies that reported alpha coefficients with the data at hand for the CAPS.

RESULTS

The average alpha coefficients were 0.87, 0.84 and 0.83, respectively for the CAPS total score and its two subscales, Socially Prescribed Perfectionism (SPP) and Self-Oriented Perfectionism (SOP). Regarding O'Connor's version, the average reliability coefficients were 0.82, 0.74 and 0.73, respectively, for SPP, SOP-Critical and SOP-Strivings. Some study characteristics (ethnicity, language, mean age and standard deviation of the scores, psychometric vs applied) showed a statistical association with the reliability coefficients of SPP and SOP. The reliability induction rate was 29.8%.

LIMITATIONS

Due to the scarcity of studies, we could not examine the reliability scores of other versions of the CAPS and test-retest reliability.

CONCLUSIONS

In terms of reliability, the original version of the CAPS present better results than O'Connor's version. The original version of the CAPS is a reliable instrument to be employed with general research purposes, but not for clinical practice.

Influence of Culture in Obsessive-compulsive Disorder and Its Treatment

Background

The aspects of cultural identity and its impact on obsessive-compulsive disorder (OCD) have been un-derstudied. There are different opinions, ranging from the idea that culture does not affect the symptoms of this condition to the idea that cultures with high religiosity may have more severity of OCD. Also, the concept of OCD has considerably var-ied across history and cultures, from being considered an issue related to lack of control of blasphemous ideas, and a part of anxious issues, to the description of complex neurobiological systems in its causation.

Objective

The aim of this review was to address OCD as a well-characterized disorder with a proposed neurobiological ba-sis which may or may not have variations depending on cultural diversity. The question that was asked in this review is whether or not there are cultural differences in the manifestations of the OCD symptomatology and which factors of cultural diversity have a major influence on such manifestations along with the differences among some cultures regarding OCD is-sues, where the difference among countries has also been highlighted.

Methods

A review of the literature was conducted that includes the following words: obsessive-compulsive disorder, cul-ture, cultural identity and religion in a period of 10 years.

Conclusion

Cultural variations do not seem to differ from symptomatic clusters of OCD, which may be indicating that a se-ries of adaptive behaviors is evolutionarily evolving to be constantly altered, perhaps by well-determined pathophysiological mechanisms. Some aspects that have been related to some dimensions of OCD symptomatology are religion and religiosity, affecting the content of obsessions and the severity of manifestations. Properly evaluating the education background, access to health services, food, and the genetic structure of populations, using investigational instruments sensitive to these cultural elements, will increase our understanding of the importance of culture on OCD and its treatment.

Young Children's Ritualistic Compulsive-Like Behavior and Executive Function: A Cross Sectional Study

The goal of this study was to test whether the development of executive function in young children could add to the explained variance in child ritualistic behavior beyond child and maternal traits previously found to have explanatory power. Routinized, ritualistic behavior is common and normative in young children between the ages of 2 and 5, after which it subsides. In this cross-sectional study, maternal reports on 1345 children between the ages of 2 and 6 included child variables such as temperament, fears, and behavioral problems. Mother's characteristics included perfectionism, her attachment style, and trait anxiety. The sample included ultra-orthodox families, an understudied minority, and thus it was possible to compare their ritualistic behavior with that of children from other rearing environments. Ultraorthodox children had more ritualistic behavior than age-matched children. This finding offers support for an environmental influence on level of ritualistic behavior in children. For the entire sample, we found that young children's ritualistic behavior was associated with shy and emotional temperament, fears, pervasive developmental behavioral problems, and that executive function delays in shifting and emotion regulation had an additional contribution. Ritualistic child behavior was only weakly related to maternal variables. The results were consistent with a maturational process for the trajectory of ritualistic behavior, rather than with an environmentally induced behavior. The development of executive function may be the process mediating the decline of ritualistic behavior over development.

Obsessive-Compulsive Symptomatology, Religiosity Levels and the Illusion-of-Control Paradigm in a Non-Clinical Undergraduate Sample

The present research employed the illusion-of-control paradigm to investigate the relationships between Obsessive-Compulsive disorder (OCD) symptoms, religiosity levels, and illusory sense of control (SC). An opportunistic sample of 60 undergraduate students was presented with a pre-programmed series of neutral visual stimuli (i.e. lines) and was expected to try to control the sequence through the use of keyboard presses. Participants assessed their perceived level of control twice throughout the computerised task. In addition, the study was interested at examining the relationship between religiosity and OC behaviour and the Santa Clara Strength of Religious Faith Questionnaire (SCSRF) was employed. In proportion to predictions, OCD symptoms were correlated with higher illusory SC; furthermore, religiosity levels were related to some degree to OCD symptoms. The essential role of mental control in OCD is discussed, particularly the significant clinical implications of such an association. Furthermore, the possible contribution of religious affiliations to the maintenance of OC behaviour is further discussed.

Imagine no religion: Heretical disgust, anger and the symbolic purity of mind

Immoral actions, including physical/sexual (e.g., incest) and social (e.g., unfairness) taboos, are often described as disgusting. But what about immoral thoughts, more specifically, thoughts that violate religious beliefs? Do heretical thoughts taint the purity of mind? The present research examined heretical disgust using self-report measures and facial electromyography. Religious thought violations consistently elicited both self-reported disgust and anger. Feelings of disgust also predicted harsh moral judgement, independent of anger, and were mediated by feelings of "contamination". However, religious thought violations were not associated with a disgust facial expression (i.e., levator labii muscle activity) that was elicited by physically disgusting stimuli. We conclude that people (especially more religious people) do feel disgust in response to heretical thoughts that is meaningfully distinct from anger as a moral emotion. However, heretical disgust is not embodied in a physical disgust response. Rather, disgust has a symbolic moral value that marks heretical thoughts as harmful and aversive.

Influence of religious aspects and personal beliefs on psychological behavior: focus on anxiety disorders

The current paper presents literature relevant to the relationship of religiosity, spirituality, and personal beliefs with mental health and, in particular, anxiety disorders as an empirical narrative review, providing an overview on the most important and clinically relevant research results on the topic. The relationship between religiosity/spirituality, personal beliefs (ie, magical ideation and paranormal beliefs), and mental health has lately been studied extensively, and results have indicated significant associations among these variables. However, scientific approaches to this field are complex and multidimensional, partly leading to poor operationalization, incomparable data, and contradictory results. Literature demonstrates that higher religiosity/spirituality and magical ideation scores have often been associated with increased obsessive–compulsive traits. Similar results could not be confidently replicated for other anxiety disorders. However, it is still unclear if these differences suggest a specific association with obsessive–compulsive traits and reflect deviating etiopathogenetic and cognitive aspects between obsessive–compulsive disorder and other anxiety disorders, or if these results are biased through other factors. Religiosity/spirituality and personal beliefs constitute important parameters of human experience and deserve greater consideration in the psychotherapeutic treatment of psychiatric disorders.

Religiosity, magical ideation, and paranormal beliefs in anxiety disorders and obsessive-compulsive disorder: a cross-sectional study

The relation between religiosity/spirituality (R/S), personal beliefs, and mental health has been extensively studied. However, concerning anxiety disorders (ADs), empirical evidence is scarce. This study investigated the differences in R/S and magical/paranormal ideation among obsessive-compulsive disorder patients (OCD; n = 49), patients with other ADs (n = 36), and healthy controls (HCs; n = 35). Our results suggest negative religious coping as being the only parameter showing significantly higher scores in OCD and AD participants in comparison with HCs. Negative religious coping reflects negative functional expressions of R/S in stressful situations. Logistic regression also suggested negative religious coping as the strongest predictor of group affiliation to the nonhealthy group. Further results show no significant differences between other R/S, magical, and paranormal ideation traits among groups. This study underlines an important role of negative religious coping in ADs yet does not clearly indicate a specific causality. Religious-sensitive treatment targeting cognitive aspects of negative religious coping are discussed.

Religious involvement and obsessive compulsive disorder among African Americans and Black Caribbeans

Prior research is equivocal concerning the relationships between religious involvement and obsessive-compulsive disorder (OCD). The literature indicates limited evidence of denomination differences in prevalence of OCD whereas findings regarding OCD and degree of religiosity are equivocal. This study builds on prior research by examining OCD in relation to diverse measures of religious involvement within the National Survey of American Life, a nationally representative sample of African American and Black Caribbean adults. Bivariate and multivariate analyses (logistic regression) examine the relationship between lifetime prevalence of OCD and religious denomination, service attendance, non-organizational religiosity (e.g., prayer, religious media) subjective religiosity, and religious coping. Frequent religious service attendance was negatively associated with OCD, whereas Catholic affiliation (as compared to Baptist) and religious coping (prayer when dealing with stressful situations) were both positively associated with OCD. With regard to demographic factors, persons of older age and higher education levels were significantly less likely to have OCD.

Vulnerability factors in OCD symptoms: cross-cultural comparisons between Turkish and Canadian samples

Recent findings have suggested some potential psychological vulnerability factors for development of obsessive-compulsive (OC) symptoms, including cognitive factors of appraisal and thought control, religiosity, self-esteem and personality characteristics such as neuroticism. Studies demonstrating these associations usually come from Western cultures, but there may be cultural differences relevant to these vulnerability factors and OC symptoms. The present study examined the relationship between putative vulnerability factors and OC symptoms by comparing non-clinical samples from Turkey and Canada, two countries with quite different cultural characteristics. The findings revealed some common correlates such as neuroticism and certain types of metacognition, including appraisals of responsibility/threat estimation and perfectionism/need for certainty, as well as thought-action fusion. However, culture-specific factors were also indicated in the type of thought control participants used. For OC disorder symptoms, Turkish participants were more likely to utilize worry and thought suppression, while Canadian participants tended to use self-punishment more frequently. The association with common factors supports the cross-cultural validity of some factors, whereas unique factors suggest cultural features that may be operative in cognitive processes relevant to OC symptoms.

OCD cognitions and symptoms in different religious contexts

Religious themes commonly feature in obsessions. Some theorists view religiosity as a potential risk factor, due to the hypothesized influence of religious acculturation on appraisals of unwanted intrusive thoughts. Several studies revealed that the relationship between religiosity and some OCD cognitions might change among various religions, possibly because of the differences in religious doctrines and teachings. The present study examined the relationship between religiosity and OCD symptoms and cognitions in different religious contexts. In this study, Muslim and Christian subjects from Turkey and Canada, respectively, were compared on OCD features by taking their level of religiosity into consideration. The results showed that having scored higher in OCD symptoms, Muslim participants reported more concerns on their thoughts and controlling them, and they also seemed to use worry strategy to manage their unwanted thoughts. On the other hand, regardless of religion category, high religious subjects reported to experience more obsessional thoughts and checking, while sensitivity on thoughts and emphases on control of thoughts and psychological fusion in morality were more salient for this group. Indeed, degree of religiosity also made a significant difference on thought-action fusion in morality domain especially for Christian subjects. In line with previous findings, the results of the present study support the association between religiosity and OCD even across two monotheistic religions. Besides, the characteristics of the religion might account for the differences in OCD cognitions and symptoms across both religions.

Anorexia nervosa, perfectionism, and dopamine D4 receptor (DRD4)

The dopamine D4 receptor (DRD4), a well-characterized, polymorphic gene, is an attractive candidate for contributing risk to disordered eating and anorexia nervosa (AN). We tested association using UNPHASED for 5 DRD4 polymorphic loci, 3 promoter region SNPs (C-521T, C-616G, A-809G), the 120 bp promoter region tandem duplication and the exon III repeat, in 202 AN trios and 418 control families. Since perfectionism characterizes AN, we tested these five loci for association with the Child and Adolescent Perfectionism Scale (CAPS) in the AN and control groups. Single locus analysis showed significant association between the 'C' C-521T allele and AN. Haplotype analysis also showed significant association, particularly a 4-locus haplotype (exon III&120 bp repeat&C-521T&A-809G). Association was also observed between DRD4 and CAPS scores both for AN and control subjects. The insulin-like growth factor 2 (IGF2) and the arginine vasopressin 1a receptor (AVPR1a), previously shown to be associated with disordered eating, were also associated with CAPS scores. Three genes associated with AN were also associated with perfectionism. Personality traits are potential endophenotypes for understanding the etiology of eating disorders and one of the several pathways to eating pathology may be mediated by the impact of DNA sequences on perfectionism.

When religion and obsessive–compulsive disorder collide: Treating scrupulosity in ultra-orthodox Jews

Evidence-based practice suggests that clinicians should integrate the best available research with clinical judgment and patient values. Treatment of religious patients with scrupulosity provides a paradigmatic example of such integration. The purpose of this study is to describe potential adaptations to make exposure and response prevention, the first-line treatment for obsessive-compulsive disorder, acceptable and consistent with the values of members of the Ultra-Orthodox Jewish community. We believe that understanding these challenges will enhance the clinician's ability to increase patient motivation and participation in therapy and thereby provide more effective treatment for these and other religious patients.

How Anorexic-like Are the Symptom and Personality Profiles of Aesthetic Athletes?

PURPOSE

We tested the hypothesis that aesthetic athletes (AA) have anorexic-like eating attitudes and behaviors, share personality characteristics such as perfectionism and obsessiveness, and are at high risk of eating disorders.

METHODS

We compared symptomatology, personality variables typical of anorexia nervosa, and lifetime eating disorder prevalence across four groups of Israeli women: 31 anorexics, 111 AA (mostly dancers), 68 nonaesthetic athletes (NAA), and 248 controls. All participants completed self-report measures of symptomatology, harm avoidance, perfectionism, obsessiveness, self-esteem, and self-rated facial attractiveness and were screened for eating disorders. Those screening positively were interviewed and diagnosed using the structured clinical interview for DSM-IV.

RESULTS

Scores of the anorexic women differed from those of the three other groups in the expected direction on all variables. NAA scored similarly to controls, but had greater body satisfaction and less drive for thinness. Surprisingly, the AA did not differ from control women on any self-report measure. However, significantly more AA (11.7%) than NAA (5.8%) and controls (4.4%) had a lifetime diagnosis of eating disorder not otherwise specified (EDNOS). The eating attitudes and behavior of the 13 AA with a lifetime history of EDNOS fell intermediately between the anorexic women and the controls, whereas their personality profile resembled that of controls.

CONCLUSIONS

Being a nonaesthetic female athlete in Israel appears to promote body esteem and offer some protection from a preoccupation with dieting. AA also appear to enjoy excellent psychological health; however, a subgroup has EDNOS and appears not to receive appropriate treatment for it. These results lend credibility to the existence of the diagnostic entity of anorexia athletica, proposed to be a subclinical, environmentally influenced eating disorder with a favorable prognosis.