Predicting the Intensity of Scrupulosity based on Image of God and Thought Control Strategies in Obsessive-Compulsive Patients

Document Type : Original Article (s)

Authors

1 Department of Clinical Psychology, School of Education and Psychology, Shiraz University, Shiraz, Iran

2 Associate Professor, Department of Clinical Psychology, School of Education and Psychology, Shiraz University, Shiraz, Iran

3 Assistant Professor, Department of Clinical Psychology, School of Education and Psychology, Shiraz University, Shiraz, Iran

4 Professor, Department of Clinical Psychology, School of Education and Psychology, Shiraz University, Shiraz, Iran

5 Psychiatrist, Department of Psychiatry, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

Abstract

Background: Scrupulosity is one of the mental disorders with a history richer than any other disorder. However, much of the published literature lacks a thorough clinical coverage of the issue. Based on previous studies, most patients with scrupulosity particularly follow dysfunctional thinking patterns related to moral and religious issues. The main goal of this study was to examine the role of God's image and thought control strategies in prediction of scrupulosity intensity in people with obsessive-compulsive disorder (OCD).Methods: Available sampling was used to select sixty patients with OCD (confirmed according to DSM-IV criteria and through clinical interviews) from the persons that referred to counseling centers, clinics and psychiatric clinics in Shiraz. In this correlational study, patients were tested via God Image Scale (GIS), Thought Control Strategies (TCS), Peen Inventory of Scrupulosity (PIOS) and Beck Depression Scale-II. Thus, the intensity of scrupulosity, as the criterion variable, was predicted by image of God and strategies of intrusive thought control. In addition, depression, education and marital status of patients were statistically controlled. The correlations between variables were analyzed using Pearson's correlation coefficient and hierarchical regression analysis in SPSS16.Findings: The mean age of subjects was 25.35 ± 6.91. While Bachelor's degree was the most prevalent educational level (53.33%), 23.3% of subjects had high school diploma, 15% had a master's degree and 8.4% had not even finished high school. The majority of subjects were single (65%). The results showed that the combination of acceptance (B: 0.58, P ≤ 0.001) and God's presence (B: -0/38, P ≤ 0.011) along with punishment strategy (B: 0.33, P ≤ 0.005) could predict 44% of the intensity of scrupulosity in people with OCD. Conclusion: This study provided psychologists and psychotherapists with an opportunity to that consider the type of image and attitudes patients have toward God. As we know, thinking of God as accepting increases the intensity of scrupulosity while considering him as present decreases the problem. In addition, with punishment strategy being identified as the only scrupulosity-related strategy, it needs to be replaced by healthier methods to inhibit and control the intrusive thoughts in patients.

Keywords


  1. Koenig HG, McCullogh ME, Larson DB. Handbook of Religion and Health. New York: Oxford University Press; 2001. p. 53-60.
  2. Vaillant G, Templeton J, Ardelt M, Meyer SE. The natural history of male mental health: health and religious involvement. Soc Sci Med 2008; 66(2): 221-31.
  3. Dadfar M. The role of religion on mental health and psychotherapeutic processes. Naghd va Nazar, 2004; 35-36: 84-121.
  4. Karimelahi M, Aghamohammadi M. The relationship between religious beliefs and depression in Ardabil Medical Sciences University students. Journal of Teb va Tazkyeh 2005; 53: 62-5.
  5. Sadeghi M. Study of Relationship between the Religious Education Methods with Image of God in Students [MA Thesis]. Tehran: Shahid Beheshti University; 2006.
  6. Hoffman L, Hoffman JL, Dillard K, Clark J, Acoba R, Williams F, et al. Diversity and the God image: Examining ethnic differences in the experience of God for a college-age population. Journal of Psychology and Theology 2008; 36: 26–41.
  7. Bradshaw M, Ellison CG, Flannelly KJ. Prayer, God imagery, and symptoms of psychopathology. Journal for the Scientific Study of Religion 2008; 47(4): 644-59.
  8. Yossifova M, Loewenthal KM. Religion and the judgement of obsessionality. Mental Health, Religion & Culture 1999; 2(2): 145-51.
  9. Abramowitz JS, Huppert JD, Cohen AB, Tolin DF, Cahill SP. Religious obsessions and compulsions in a non-clinical sample: the Penn Inventory of Scrupulosity (PIOS). Behav Res Ther 2002; 40(7): 825-38.
  10. Steketee G, Quay S, White K. Religion and guilt in OCD patients. Journal of Anxiety Disorders 1991; 5(4): 359-67.
  11. Clark DA. Cognitive-Behavioral Therapy for OCD. New York: The Guilford Press; 2006.
  12. Abramowitz JS, Whiteside S, Kalsy SA, Tolin DF. Thought control strategies in obsessive-compulsive disorder: a replication and extension. Behav Res Ther 2003; 41(5): 529-40.
  13. Gharabaghi H, Ablolazade H, Pourjafari P. Preliminary standardization of obsessive compulsive peen inventory and study of scrupulosity in student of Tabriz university. Proceedings of the 3rd Seminar of Students Mental Health; 2006 Jun 7-8; Tehran, Iran.
  14. Lawrence RT. Measuring the image of God: The God image inventory and the God image scales. Journal of Psychology and Theology 1997; 25: 214-26.
  15. Mazaheri MA, Sadeghi M, Shahabizade F, Yavari F. Study of relationship between attachment styles and attachment to God with image of God. Tehran: Family Research Institude; 2005.
  16. Wells A, Davies MI. The thought control questionnaire: A measure of individual differences in the control of unwanted thoughts. Behaviour Research and Therapy 1994; 32(8): 871-8.
  17. Goodarzi MA, Esmaili Torkanburi Y. The relationship between strategies of intrusive thought control and severity of OCD symptoms. Jornal of Hakim Research 2005; 8: 45-51.
  18. Fazile F, KHajemogehi N, Shanesaz A.H, Paksirat S. Study of Used Strategies of Control Thought in Patients with Obsessive-Compulsive Disorder and Comparison it with Healthy Individuals [PhD Thesis]. Ahvaz: Jondi Shahpour Medical University; 2005.
  19. Beck AT, Steer RA, Brown GK. Manual for the Beck Depression Inventory-II. 2nd ed. San Antonio: Harcourt Assessment; 1996.
  20. Harris CA, D'Eon JL. Psychometric properties of the Beck Depression Inventory--second edition (BDI-II) in individuals with chronic pain. Pain 2008; 137(3): 609-22.
  21. Dabson KS, Mohamadkhani P. Mental coordinates of Depression Beck-II Inventory in patients with major depression disorder in partial remission. Journal of Rehabilitation 2007: 8(2); 80-6.
  22. Schaap-Jonker H, Elisabeth HM, Eurelings-Bontekoe B, Hetty Zock C, Evert J. Development and validation of the Dutch Questionnaire God Image: Effects of mental health and religious culture. Mental Health, Religion& Culture 2008; 11(5): 501-15.
  23. Flannelly K, Galek K, Ellison C, Koenig H. Beliefs about God, Psychiatric Symptoms, and Evolutionary Psychiatry. Journal of Religion and Health 2010; 49(2): 246-61.
  24. Phillips RE, Lynn QK, Crossley, CD, Pargament KI. Self-directing religious coping: a deistic god, abandoning god, or no god at all? Journal for the Scientific Study of Religion 2004; 43(3): 409–418.
  25. Gilbert P. Evolutionary approaches to psychopathology: the role of natural defences. Australian and New Zealand Journal of Psychiatry 2001; 35(1): 17-27.
  26. Nelson EA, Abramowitz JS, Whiteside SP, Deacon BJ. Scrupulosity in patients with obsessive-compulsive disorder: relationship to clinical and cognitive phenomena. J Anxiety Disord 2006; 20(8): 1071-86.
  27. Miller CH, Hedges DW. Scrupulosity disorder: an overview and introductory analysis. J Anxiety Disord 2008; 22(6): 1042-58.
  28. Flannelly KJ, Koenig HG, Ellison CG, Galek K, Krause N. Belief in life after death and mental health: findings from a national survey. J Nerv Ment Dis 2006; 194(7): 524-9.
  29. Salkovskis PM. Cognitive-behavioural factors and the persistence of intrusive thoughts in obsessional problems. Behav Res Ther 1989; 27(6): 677-82.
  30. Belloch A, Morillo C, Garcia-Soriano G. Strategies to Control Unwanted Intrusive Thoughts: Which are Relevant and Specific in Obsessive-Compulsive Disorder? Cognitive Therapy and Research 2009; 33(1): 75-89.
  31. Abramowitz JS, Tolin DF, Street GP. Paradoxical effects of thought suppression: a meta-analysis of controlled studies. Clin Psychol Rev 2001; 21(5): 683-703.