A systematic review of obsessive-compulsive disorder symptomatology in religious people of Abrahamic faiths: implications for clinical practice 

Critical Review of the Literature This Systematic Literature Review aimed to synthesise literature reporting on symptoms of Obsessive-Compulsive Disorder in Christians, Jews, and Muslims to provide an in-depth understanding of scrupulosity symptom presentation. Keywords related to ‘religion’, ‘scrupulosity’, and ‘OCD’, were searched using electronic databases (PsychINFO, MEDLINE, PUBMED, CINAHL, Embase, and GlobalHealth) in March 2023. Studies which reported information about OCD symptoms on adult Christian, Jewish, or Muslim participants with scrupulosity were included. Quantitative or qualitative methodologies including case studies were screened. Studies that did not report original peer-reviewed research written in English were excluded. The quality of evidence was appraised using The Standard Quality Assessment Criteria for Evaluating Primary Research Papers, and the Joanna Briggs Institute Critical Appraisal Checklists for Case Reports, and for Qualitative Research. A narrative approach was taken to summarise obsessions and compulsions. This study is registered on PROSPERO, number CRD42023395834. Of the 4,314 records identified, 27 were eligible. The risk of overall bias varied. Differences in OCD presentations reflected theological differences in the Abrahamic faiths. In Christian samples, obsessions related to ‘correct’ thought and intention, in Jewish samples there was a focus on behavioural rituals, and in Muslim samples there was a focus on behavioural rituals accompanied with obsessional thoughts about faith. This review highlights the need for clinicians to be familiar with salient religious beliefs and practices when treating scrupulosity OCD.
Service Improvement Project The Neonatal Care Unit is a challenging environment for parents. Previous literature documents the need for increased and more specialised understanding of support for fathers. There remains a dearth of literature on the experiences of ethnic minority fathers in particular, who may be less likely to access psychological support available. This project aimed to understand the barriers ethnic minority fathers faced when accessing psychology support at a Neonatal Care Unit in England. Seven fathers from ethnic minority backgrounds participated in semi-structured interviews after their babies were discharged. Data were analysed using a Reflexive Thematic Analysis approach. Three main themes were identified: ‘Psychology is a Threat’, ‘It’s Not Really Talked About in our Culture’, and ‘A Space for Mum, Not Me’. These themes are discussed in reference to the extant literature, and recommendations are provided to improve access to support. There is a need to recognise interacting influences of gender and cultural norms in supporting these fathers, including understanding the role of psychology, consideration of stigma, and knowing families in relation to their cultural context.
Theory Driven Research Project The underrepresentation of British Muslims in UK mental health services necessitates an understanding of barriers and facilitators to engagement in therapy. This mixed-methods online study explored the impact of explicitly acknowledging religion on anticipated alliance, treatment credibility, and expectations of therapy in British Muslims. A videovignette experimental design was used in which participants who self-reported as either high or low in religiosity were randomly allocated to receiving information about Cognitive Behavioural Therapy either with or without an explicit mention of religion as a value in the therapeutic process. The results suggest that acknowledging religion does not impact upon anticipated alliance, the primary dependent variable. However, scores on the closely related secondary variables, perceived credibility of therapy and treatment expectation, were significantly higher when religion was explicitly mentioned by the ‘therapist’. A thematic analysis of free text across all participants found three main themes: ‘We are Too Different’, ‘It’s not Worth the Risk’, and ‘What we Need for Therapy to Work’. These findings suggest that mentioning religion as a value to be considered in therapy positively impacts upon how therapy is perceived by British Muslims.

Advisor: Churchard, A
Salkovskis, P
Lack, S
Thew, G
Mann, J