Judgments about passive harm and the moral consequence of thoughts in obsessive -compulsive disorder: Examinations of omission bias and religion

Abstract

Individuals with obsessive-compulsive disorder (OCD) seem to judge harm caused actively and passively as morally equivalent. In contrast, others choose harm by omission over harm by commission, a propensity known as omission bias. Two studies, one with a student population and one comparing individuals who report having OCD and those without OCD, examined the hypothesis that OCD is associated with less omission bias. In both, OCD was associated with less omission bias about scenarios targeting common OCD fears, and the relationship between OCD and omission bias for those scenarios was mediated by thought-action fusion (TAF) and inflated responsibility. In neither study was general omission bias related to OCD. These results support the idea that individuals with elevated OCD symptoms distinguish less than others between acts of omission and commission for harm relevant to typical OCD concerns. ^ Two additional studies evaluated the relationship between moral TAF and OCD as a function of religion. In the first, Christians scored higher than Jews on moral TAF, a large effect not explainable by differences in religiosity. Jewish groups (Orthodox, Conservative, and Reform) did not differ from each other. Furthermore, religiosity was associated with TAF only within the Christian group, suggesting that Christian religious adherence is related to beliefs about the moral import of thoughts. In the second study, (a) Christians endorsed higher levels of moral TAF than did Jews independent of OCD symptoms; (b) religiosity was correlated with moral TAF in Christians but not in Jews; and (c) moral TAF was related to OCD symptoms only in Jews. That is, for Christians, moral TAF was related to religiosity but not OCD symptoms, and for Jews, moral TAF was related to OCD symptoms but not religiosity. These results imply that moral TAF is only a marker of pathology when such beliefs are not culturally normative. More generally, these results qualify the presumed associations between religiosity, obsessive cognitions, and OCD symptoms, which depend on religious affiliation. Furthermore, group differences in a supposed maladaptive construct without corresponding differences in prevalence rates call into question the assumption that the construct always marks pathology. ^