What is scrupulosity?

The conscientiousness Is a manifestation of the obsessive compulsive disorder that represents a psychological disorder mainly characterized by the expression of a deep fault and feeling of unrest related to moral and religious matters 1.

This feeling of guilt can become strongly disabling, conditions to situations of an important level of stress And it avoids a good development in daily life, having therefore affectation in the quality of life Of people who suffer from it 2 .

Scrupulous reading

History of the concept"scrupulosity"

Looking closely at the history, we find that the use of the term"scrupulosity"comes from the 12th century, when reference was made to individuals who had an obsessive preoccupation with their own sins and who demonstrated compulsive execution of religious devotion 4 .

The first description of scrupulosity as a medical disorder was made in 1691 by an Englishman named John Moore, who called it"religious melancholy": a feeling that occurs when what is done is defective and unfit to be presented to God 5 .

Studies in the mid-twentieth century reported that scrupulosity was a major problem among US Catholics, with 25% of high school students affected 6 . From the twentieth century, individuals with scrupulousness in the United States and Britain began to seek out psychiatrists, rather than religious counselors to be helped with their condition. At this point psychiatry begins to form a fundamental part in the study and treatment of this pathology.

Symptoms of Scrupulous People

Many of the people who are affected by this do not know that what they feel is an illness, but every day their quality of life deteriorates, they begin to isolate themselves and very few seek help. It is usually by family affair that these people seek help or are taken to a psychiatrist or professional help .

Scrupulous people may present obsessions or compulsions that consume time and energy, generate other situations of emotional stress and present more strongly in periods of psychological pressure and stress Referring to Fig. .

When we speak of an"obsession,"we mean a persistent, intrusive thought, image, idea, or impulse that results in anguish or marked anxiety.

Among the most common obsessions of scrupulosity are: the feeling that whatever is done is being observed and judged by God or a divine entity, moral guilt and sense of dislike for any thought of sexual content, the discomfort generated by activities Social events such as night gatherings, in a local or bar of the city, difficulty in interacting with individuals who differ from their religion or moral customs, and in general any activity that the person considers morally or religiously incorrect.

On the other hand, compulsion describes a repetitive behavior or mental act that takes place in response to an obsession, ie an obsession leads to a compulsion. The act is performed to try to alleviate the anxiety caused by thinking. In spite of this, the act performed does not bring pleasure to the person, since he often experiences shame and tries to keep his condition in secret because he knows that these thoughts or actions are excessive or unreasonable.

The most common compulsions in scrupulosity are: Repeated persignation, uncontrollable washing of the hands, repetition of a high number of sentences and avoidance of social contact 7 .

The development of these symptoms are more frequent during adolescence and in early adulthood and there is no distinction between gender.

Causes of scrupulosity

In the development of the disease there is a strongly marked genetic component, but also environmental factors and specifically family factors. The development of the scrupulosity is evidenced mainly in individuals with families very clinging to religious customs and with models of moral character very strongly marked.

Upbringing with these behaviors often taught exaggeratedly represents a very important risk factor in the development of symptoms, society also influences this and often an individual with a genetic predisposition that is related to a strictly religious family and In a strongly moralistic social context is the perfect recipe for the development of the disease Referring to Fig. .

Associated disorders

Almost 90% of the patients who suffer from it suffer from other associated psychiatric disorders 7 : Anxiety disorders, major depression, eating disorders and personality disorders.

Of all these disorders, what is most commonly associated is the Major depression , Where it is observed that approximately 2/3 of patients with scrupulosity present it at some point in their life.

References

  1. Greenberg, D., Witztum, E. and Pisante, J. (1987), Scrupulosity: Religious attitudes and clinical presentations. British Journal of Medical Psychology, 60: 29-37.
  2. Miller CH, Hedges DW. Scrupulosity disorder: an overview and introductory analysis.J Anxiety Disord. 2008; 22 (6): 1042-58.
  3. Ciarrocchi JW. The Doubting Disease: Help for Scrupulosity and Religious Compulsions. Mahwah, NJ: Paulist Press; 1995. ISBN 0-8091-3553-1. Scruples: common and uncommon. P. 32-47.
  4. López-Ibor JJ Jr, López-Ibor Alcocer MI.Religious experience and psychopathology [PDF]. In: Verhagen P, Van Praag HM, López-Ibor JJ Jr, Cox J, Moussaoui D, editors. Religion and Psychiatry: Beyond Boundaries. Wiley; 2010. ISBN 978-0-470-69471-8. P. 211-33.
  5. Bourke J. Divine madness: the dilemma of religious scruples in twentieth-century America and Britain.J Soc Hist. 2009; 42 (3): 581-603.
  6. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC: American Psychiatric Association; 2000.
  7. Morgan LA, Kirkwood CK. Anxiety disorders. In: Linn WD, Wofford MR, O'Keefe ME, Posey LM, eds. Pharmacotherapy in Primary Care . New York, NY: McGraw Hill Medical; 2009: 255-261.
  8. Mohammad Ali Besharat, Zeynab Sadat Kamali. (2016). Predicting obsessions and compulsions according to superego and ego characteristics: A comparison between scrupulosity and non-religious obsessive-compulsive symptoms.
  9. Leckman JF, Denys D, Simpson HB, et al. Obsessive-compulsive disorder: a review of the diagnostic criteria and possible subtypes and dimensional specifiers for DSM-V. Depress Anxiety . 2010; 27: 507-527.
  10. Stein DJ, Denys D, Gloster AT, et al. Obsessive-compulsive disorder: diagnostic and treatment issues. Psychiatr Clin N Am . 2009; 32: 665-685.


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