Moderate Concept Summary: Scrupulosity, Causes, Treatments

ED 304: Ed Psych and Human Development

Author: Cole Rosenbalm/Piper Corbett

Validated by: Macey Mattson 3/14/2023

Disclosure: ChatGPT3 was used in the creation of this resource.

Summary

   Scrupulosity is found in two forms, moral and religious scrupulosity. This is important to note, as the moral and religious nature of the disorder makes it distinct and separate from other types of obsessive-compulsive disorder (OCD) and perfectionism. Moral scrupulosity is a subtype of OCD characterized by excessive and irrational doubts and fears about committing ethical or moral transgressions. These doubts and fears lead to the performance of compulsive rituals, such as confessing perceived past wrongs, in an attempt to alleviate the anxiety caused by the doubts. These rituals can consume a significant amount of time and interfere with daily functioning, causing significant distress and impairment in the individual's life.

   Individuals with moral scrupulosity may experience intense guilt and shame for perceived past wrongs and may engage in compulsive confession or penance in an attempt to make amends for these perceived wrongs. They may also experience excessive doubts and fears about committing actions that may cause harm to others and may engage in compulsive behaviors such as excessive checking or apologizing to alleviate these fears. It is important to note that scrupulosity can also manifest in a religious form, characterized by excessive doubts and fears about committing sins or offending God, and both types of scrupulosity share similar characteristics and may co-occur.

Symptoms of Scrupulosity: 

1. Obsessive thoughts about committing immoral acts
2. Excessive guilt and self-blame for minor or imagined transgressions
3. Feeling a constant need to adhere to religious rituals and rules perfectly
4. Compulsive behaviors related to religious rituals or seeking reassurance from religious authorities
5. Fear of punishment due to perceived moral failings
6. Difficulty making decisions due to fear of making the wrong moral choice
7. Distorted beliefs about the severity of moral transgressions or the need for absolute moral purity

   The causes of scrupulosity, like other forms of OCD, are not fully understood. However, research suggests that a combination of genetic, neurological, and environmental factors may play a role. Studies have shown that individuals with scrupulosity tend to have a family history of OCD, suggesting a genetic component. Additionally, brain imaging studies have shown that certain areas of the brain, such as the basal ganglia and the anterior cingulate cortex, are hyperactive in individuals with scrupulosity, suggesting a neurological component.

   In addition to genetic and neurological factors, environmental factors may also play a role in the development of scrupulosity. For example, some individuals with scrupulosity may have experienced traumatic events or abuse, which can increase their risk of developing the disorder. Additionally, certain religious or cultural environments may emphasize strict adherence to religious or moral codes, which may contribute to the development of scrupulosity in some individuals. These factors alone or in combination may contribute to the development of scrupulosity, but research is still ongoing to understand the underlying causes of the disorder.

Common Treatment Practices

1. Cognitive-behavioral therapy (CBT) - This type of therapy focuses on identifying and changing negative thought patterns and behaviors that contribute to scrupulosity. Techniques such as exposure and response prevention (ERP) and cognitive restructuring may be used to help individuals learn to manage and reduce their fears and doubts.
2. Medications - Selective serotonin reuptake inhibitors (SSRIs) are often used to treat scrupulosity. These medications can help to reduce the symptoms of OCD and improve the effectiveness of other treatments.
3. Mindfulness-based approaches - Mindfulness and acceptance-based therapies aim to help individuals develop a non-judgmental awareness of their thoughts and feelings. This can help them to manage their symptoms and reduce the impact of scrupulosity on their lives.
4. Religious or spiritual counseling - some individuals may benefit from counseling with a religious or spiritual leader who can help them understand and navigate the relationship between their faith and their disorder.
5. Family therapy - Family therapy can help to educate family members about the disorder and how they can support the individual in their recovery.

A. Which of the following students are showing signs of scrupulosity?

1. Robert gets a low grade on a test and cannot fall asleep as he is frustrated with himself.
2. Scarlett is too hard on herself and says she deserves greater punishment for breaking the school honor code.
3. Chris has two younger siblings he wants to take care of. He takes their bad grades as his responsibility.
4. Elizabeth cheats on a test, and for the following weeks struggles to focus as she worries about her spiritual well-being.

B. How might an educator address a situation where a student is struggling due to scrupulosity?

1. Help students learn that it is ok to make mistakes by allowing them to retake tests and redo assignments.
2. Privately inform their parents that their child is dealing with scrupulosity and that it is affecting their performance in school
3. Encourage students to use mindfulness techniques to manage their symptoms of stress and function in class.
4. Keep tasks in the classroom easy enough to not induce extra stress on the students.

Answers explained

1. The scenarios with Robert and Chris are incorrect because their struggles are NOT centered on religious or moral issues, and would be classified as perfectionism instead.
2. The correct answer is to teach mindfulness techniques, as that is one of the treatments mentioned above. Making the class easier would not alleviate the problem, as curiosity is not coursework-induced. B is not correct; while teachers often should inform parents if they see behavior impacting school work, they are NOT qualified to make a diagnosis and present it to parents.

Sources

https://pubmed.ncbi.nlm.nih.gov/18226490/#:~:text=Scrupulosity%20is%20a%20psychological%20disorder,is%20highly%20distressing%20and%20maladaptive.

https://iocdf.org/faith-ocd/what-is-ocd-scrupulosity/