Scrupulosity is a subtype of OCD that is defined by a prevalence of moral and religious obsessions and compulsions. Scrupulosity affects 1 in 20 of Western OCD sufferers; in some cultures, more than half of OCD sufferers have some sort of religious obsessions. Existing research has shown worse treatment outcomes associated with scrupulosity, and many clinicians struggle to work effectively with clients when these symptoms are prominent. An information-processing model of OCD sees symptoms as the result of problematic processing of information seen as threatening, the difficulty that comes from separating from a perceived threat, and difficulty with attention.
In this study, Dr. Siev and his team explored how people with scrupulosity process information using attentional process tests and assessments, comparing them with individuals with contamination OCD and a healthy control group. Compared with these two conditions, scrupulosity was associated with more severe symptoms of depression and anxiety, as well as a higher likelihood of obsessive compulsive personality disorder (OCPD; a personality disorder characterized by rigidity, perfectionism, hyper-control, and over-focus on details) and schizotypal personality disorder (SPD; a personality disorder characterized by magical thinking, strange beliefs, unusual perceptual experiences, and interpersonal discomfort and suspiciousness). However, on attentional tasks that measured response inhibition (the ability to suppress or cancel learned associations and responses) and attentional bias (heightened attention to threatening stimuli), people with scrupulosity performed the same as the other groups; all three groups did not have deficits for both tasks.
Siev, J., Rasmussen, J., Sullivan, A. D. W., & Wilhelm, S. (2021). Clinical features of scrupulosity: Associated symptoms and comorbidity. Journal of Clinical Psychology, 77, 173-188.
Rasmussen, J., Siev, J., Abramovitch, A., & Wilhelm, S. (2016). Scrupulosity and contamination OCD are not associated with deficits in response inhibition. Journal of Behavior Therapy and Experimental Psychiatry, 50, 120-126.