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September 24, 1997

A Thousand Frightening Fantasies: Understanding and Healing Scrupulosity and Obsessive Compulsive Disorder

Author Affiliations

University of Illinois at Chicago (emerita)

JAMA. 1997;278(12):1038-1039. doi:10.1001/jama.1997.03550120098051

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William Van Ornum, a professor of psychology at Marist College in New York, has written this book for persons who suffer from scrupulosity, a spectrum of symptoms expressive of obsessive-compulsive disorder (OCD) that tends to affect individuals with religious affiliations, especially, but not exclusively, Roman Catholics and Orthodox Jews. The focus of their obsessions—recurrent, anxietyprovoking, intrusive, and inappropriate thoughts—and their compulsions—driven, repetitive behaviors to counteract the obsessions—are usually the beliefs, rituals, and behaviors that reinforce or express the tenets of the religion.

Until the mid 1980s, OCD was generally perceived as rare and poorly responsive to treatment. With the advent of large-scale epidemiological studies and more precise diagnostic criteria, a far greater number of the population have been identified as suffering from OCD, with perhaps a lifetime prevalence of 2% to 3%. Many individuals with symptoms may not recognize it as a known disorder or seek professional evaluation or