Fear of sin and fear of God: Scrupulosity predicts women's daily experiences of mental contamination following sexual trauma

Abstract

Mental contamination refers to feelings of dirtiness in response to thoughts, images, or memories. Mental contamination is frequently reported after sexual trauma and is associated with symptoms of posttraumatic stress disorder (PTSD). Differences in individuals’ views about morality and purity may influence the severity of mental contamination, though this has been studied primarily outside of samples assessed for trauma and/or PTSD. The present study addressed this gap by investigating scrupulosity as a prospective predictor of daily sexual trauma–related mental contamination and PTSD symptoms. Participants included 40 adult women with a history of sexual trauma and current sexual trauma–related mental contamination who completed baseline diagnostic interviews and questionnaires followed by two assessments every day for 2 weeks. The results indicate that scrupulosity was positively correlated with PTSD symptom severity and sexual trauma–related mental contamination at baseline. Scrupulosity was also a prospective predictor of increased daily sexual trauma–related mental contamination, B = 0.19, SE = 0.07, p = .010, but not daily PTSD symptoms, B = −0.10, SE = .08, p = .198. The findings indicate that scrupulosity may be an important factor in understanding recovery from sexual assault.

Assessment of Comorbid Obsessive-Compulsive Disorder and Posttraumatic Stress Disorder

“…Shame or guilt that arises due to the content of intrusive thoughts (e.g., ''because I have intrusive thoughts about harming my child, I am a terrible parent'') is common in OCD, especially when intrusive thoughts are deemed immoral, repugnant, or taboo (e.g., aggressive or sexual obsessions; Visvalingam et al, 2022). Such instances are common among OCD patients with scrupulosity obsessions, but recent work does suggest that scrupulosity may also influence posttraumatic stress symptoms, particularly among individuals exposed to sexual assault (Jones et al, 2023). In PTSD, posttraumatic shame is more commonly experienced by those exposed to sexual assault than those exposed to physical assault, a transportation accident, or illness/injury (Amstadter & Vernon, 2008).…”