(PS7-C72) Guilt Partially Mediates the Effect of Religiosity on Scrupulosity Symptoms

Pathological guilt is a core feature of scrupulosity (Shapiro & Stewart, 2011) and data support a positive empirical correlation between guilt and scrupulosity symptoms (Inozu et al., 2020). Guilt also is positively associated with religiosity (Inozu et al., 2012). Finally, there is a well-established positive association between religiosity and scrupulosity (Abramowitz et al., 2002; Huppert & Fradkin, 2016). However, the impact of guilt on this association has not been investigated. The current study aimed to extend the extant literature by evaluating guilt as a potential mediator of the relationship between religiosity and scrupulosity.

Participants (n = 718) consisted of well-rated Mechanical Turk workers who live in the United States and identified as Christian (n = 274), Muslim (n = 243), or Jewish (n = 201). They completed a series of questionnaires, including the Positive and Negative Affect Schedule Negative Affect subscale (PANAS-NA; Watson et al., 1988), the Santa Clara Strength of Religious Faith Questionnaire (SCSRFQ; Plante & Boccaccini, 1997), and the revised Penn Inventory of Scrupulosity (PIOS-R; Olatunji et al., 2007).

A simple mediation analysis was conducted utilizing PROCESS Macro for SPSS (Hayes, 2012). This revealed that guilt (as measured by Item 3 on PANAS-NA) partially mediated the relationship between religiosity (SCSRFQ) and scrupulosity (PIOS-R total score). Participants who endorsed higher levels of religiosity endorsed higher levels of guilt (a = .02, t₍₇₀₉₎ = 3.29, p = .001). When participants endorsed equal levels of religiosity, participants who endorsed higher levels of guilt also endorsed more scrupulosity symptoms (b = 7.44, t₍₇₀₉₎ = 23.38, p < .001). Further, participants who endorsed higher levels of religiosity endorsed higher levels of scrupulosity symptoms (c = .82, t₍₇₀₉₎ = 10.34, p < .001). Although the estimated direct effect of religiosity on scrupulosity symptoms accounted for a portion of the total effect (c’ = .64, t₍₇₀₉₎ = 10.79, p < .001), a bootstrap confidence interval for the indirect effect (ab = .17) based on 5,000 bootstrap samples was above zero (.07 to .27), indicating that guilt partially mediated the relationship between religiosity and scrupulosity symptoms.

These results extend the extant literature by revealing that guilt partially mediates the effect of religiosity on scrupulosity symptoms. Notably, previous research has associated both guilt and scrupulosity with greater symptom severity and increased treatment resistance. Since guilt mediated the relationship between religiosity and scrupulosity symptoms in these data, guilt may interfere with successful treatment. Better understanding the causal mechanisms of scrupulosity symptoms is essential and may reveal novel approaches to targeting scrupulosity’s treatment resistance—such as via emotion regulation strategies and perhaps specifically by targeting undue feelings of guilt. Additional research should evaluate these hypotheses to explore ways of treating scrupulosity more effectively.