Clinical features of scrupulosity: Associated symptoms and comorbidity

Obsessive-Compulsive Disorder with a Religious Focus: An Observational Study

Background: Obsessive-compulsive disorder (OCD) is a psychiatric disorder with poorly detailed subtypes/dimensions, such as religious OCD (ROCD). To date, little is known about ROCD characteristics. This work aimed to describe the sociodemographic and clinical characteristics, along with the religiosity and spirituality, of Lebanese Muslim citizens diagnosed with OCD and exhibiting religious symptoms. Methods: Participants were Lebanese Muslims, outpatients with OCD and religious symptoms, aged 18 or above, who could complete a questionnaire. Exclusion criteria were as follows: other psychiatric disorders and cognitive or physical impairments preventing participation. They completed a questionnaire including the 25-item Arabic Scale of Obsessions and Compulsions (10 questions addressing obsessions, 10 questions addressing compulsions, and 5 filler items, all of which were rated on a 4-point Likert scale, with higher total scores indicating increasing severity), the 26-item Spiritual Involvement and Beliefs Scale (rated on a 5-point Likert scale, with higher scores indicating higher spirituality), and questions assessing sociodemographic, clinical, and religiosity variables. Results: Fifty adults (62% females, 52% aged between 18 and 29 years) completed the study. They had mild (26%), moderate (48%), and severe (26%) OCD symptoms. The majority attended religious school at least at one point in their life and described a moderate to very high degree of self-religiosity and parental religiosity. Group comparisons (patients with mild vs. moderate vs. severe OCD symptoms) showed significant differences with regard to a family history of psychiatric disorders (p = 0.043), the frequency of self-questioning if they prayed correctly (p = 0.005), a higher rating of partial ablution repetition (p = 0.006), and the frequency of partial ablution repetitions (p = 0.041). No significant group differences were noted with regard to sociodemographic or spirituality outcomes. The prevalence of religious doubts (i.e., self-questioning if praying correctly) and specific rituals (partial ablution repetition) among severe OCD patients were 100% (13/13) and 77% (10/13), respectively. Conclusions: The results suggest a link between specific religious practices and OCD severity, underscoring the need for culturally sensitive approaches in diagnosing and treating ROCD.

Formal vs. intuitive categorization and obsessive-compulsive symptoms

BACKGROUND AND OBJECTIVES

Obsessive-compulsive disorder (OCD) is often characterized by rigidity regarding rules and perfectionism, which suggests a formal reasoning style. However, other characterizations suggest an overreliance on internal cues for behavior termination, which suggests a more intuitive reasoning style. We examine reasoning styles in OCD by assessing categorization preferences traditionally classified to rule-based and family resemblance categorization.

METHOD

An initial study (n = 41) and an online replication (n = 85) were conducted. In both studies, groups scoring high and low on OCD symptoms were compared. Categorization preferences and confidence ratings were examined via a modification of a classic categorization task. The task was administered in three conditions: under time limits, with no time limits, and with explicit explanation of both categorization styles.

RESULTS

Aggregating results from both studies showed that obsessive-compulsive symptoms were associated with a reduced preference for rule-based categorization reflecting a tendency towards a more intuitive, non-formal reasoning style. This preference was apparent even when rules were explicitly described. Group differences regarding confidence were inconclusive.

LIMITATIONS

Generalizing results to the clinical population requires further research, and specificity to OC symptoms should be determined.

CONCLUSIONS

Challenging the expected association between OCD and rigidity and perfectionism, findings support suggestions that OCD reasoning strays from formal reasoning. This may explain some of the subjective and idiosyncratic rules adopted by individuals with OCD.

An examination of obsessive-compulsive symptom domains, depression, and quality of life within an online survey sample

Obsessive-compulsive disorder (OCD) is a heterogeneous and highly impairing disorder that is frequently comorbid with other conditions. Participants in this study were 212 individuals recruited through Mechanical Turk who filled out validated measures of obsessive-compulsive symptoms, quality of life (QoL), generalized anxiety, and depressive symptoms. Analyses examined the influences of each symptom variable on QoL and the mediating role of depression as an indirect link between unacceptable thoughts (UT) and QoL. Depressive symptoms had a significant negative relationship with multiple domains of functioning. Generalized anxiety was not significant. Higher endorsement of UT symptoms was related to lower physical, emotional, and social QoL. Depression partially mediated the relationship between UT symptoms and physical, emotional, and social health. Depressive symptoms are important to consider in clinical work surrounding OCD. The significant associations between UT symptoms and QoL in a nonclinical population illustrate a relevant area for future intervention, public awareness, and education.