![]() Scrupulosity is a modern-day psychological problem that echoes a traditional use of the term scruples in a religious context, e.g. 1691–1703) was the first to describe the disorder, calling it "religious melancholy". and Singapore, to 40–60% in traditional Muslim and orthodox Jewish populations. There are large regional differences in the percentage of OCD patients who have religious obsessions or compulsions, ranging from 0–7% in countries like the U.K. No association between OCD and depth of religious beliefs has been demonstrated, although data are scarce. Available data suggest that the prevalence of obsessive–compulsive disorder does not differ by culture, except where prevalence rates differ for all psychiatric disorders. ![]() Available data do not permit reliable estimates, and available analyses mostly disregard associations with age or with gender, and have not reliably addressed associations with geography or ethnicity. The prevalence of scrupulosity is speculative. Treatment of scrupulosity in children has not been investigated to the extent it has been studied in adults, and one of the factors that makes the treatment difficult is the fine line the therapist must walk between engaging and offending the client. Although serotonergic medications are often used to treat OCD, studies of pharmacologic treatment of scrupulosity in particular have produced so few results that even tentative recommendations cannot be made. Little evidence is available on the use of medications to treat scrupulosity. Religious counseling may be an additional way to readjust beliefs associated with the disorder, though it may also stimulate greater anxiety. Other therapy strategies include noting contradictions between the compulsive behaviors and moral or religious teachings, and informing individuals that for centuries religious figures have suggested strategies similar to ERP. Cognitive therapy may be appropriate when ERP is not feasible. For example, ERP is not appropriate for a man obsessed by feelings that God has rejected and is punishing him. However, ERP is considerably harder to implement than with other disorders, because scrupulosity often involves spiritual issues that are not specific situations and objects. For example, with ERP a person obsessed by blasphemous thoughts while reading the Bible would practice reading the Bible. ERP is based on the idea that deliberate repeated exposure to obsessional stimuli lessens anxiety, and that avoiding rituals lowers the urge to behave compulsively. Exposure and response prevention (ERP), a form of behavior therapy, is widely used for OCD in general and may be promising for scrupulosity in particular. ![]() ![]() Treatment is similar to that for other forms of obsessive–compulsive disorder. In addition, while religiosity may affect how OCD is manifested, there is no proven causality between the severity of OCD and religiosity, and only small associations between the latter and scrupulosity. Not all obsessive–compulsive behaviors related to religion are instances of scrupulosity: strictly speaking, for example, scrupulosity is not present in people who repeat religious requirements merely to be sure that they were done properly. Although it can affect nonreligious people, it is usually related to religious beliefs. In scrupulosity, a person's obsessions focus on moral or religious fears, such as the fear of being an evil person or the fear of divine retribution for sin. It is sometimes called "scrupulousness", but that word properly applies to the positive trait of having scruples. Īs a personality trait, scrupulosity is a recognized diagnostic criterion for obsessive–compulsive personality disorder. Scrupulosity was formerly called scruples in religious contexts, but the word scruple now commonly refers to a troubling of the conscience rather than to the disorder. It is typically conceptualized as a moral or religious form of obsessive–compulsive disorder (OCD), The term is derived from the Latin scrupus, a sharp stone, implying a stabbing pain on the conscience. It is personally distressing, dysfunctional, and often accompanied by significant impairment in social functioning. Scrupulosity is characterized by pathological guilt/anxiety about moral or religious issues. ![]() For related terms, see Scruple (disambiguation). This article is about pathological guilt over religious or moral issues. ![]()
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