An Inferential-Based Model of Scrupulosity and Obsessive-Compulsive Disorder Across Cultures: The Roles of Fear of...

Although inferential confusion (IC), fear of self (FOS), and obsessive beliefs have each been linked to obsessive-compulsive disorder (OCD), they have rarely been examined together within the inferential-based approach (IBA) or considered across different cultural contexts. This study examined a cross-sectional model in which IC was associated with scrupulosity, mental contamination, and OCD symptom dimensions via indirect paths involving FOS and obsessive beliefs in undergraduate samples from the United States and Turkey. Participants were 903 undergraduate students (347 US, 556 Turkish) who completed measures of IC, FOS, obsessive beliefs, scrupulosity, mental contamination, and OCD symptoms. Path analyses provided stronger support for the modified final model in the Turkish sample, whereas the US model showed more limited overall fit and should therefore be interpreted cautiously. Within this context, significant indirect associations between IC and scrupulosity, mental contamination, and most OCD dimensions were observed through FOS and/or obsessive beliefs in one or both samples. Indirect pathways through FOS were significant for scrupulosity, mental contamination, and unacceptable thoughts in both samples, whereas other OCD dimensions showed sample-specific patterns: responsibility for harm and symmetry were significant only in the Turkish sample, and contamination was significant only in the US sample. Indirect pathways through obsessive beliefs were significant for scrupulosity, mental contamination, responsibility for harm, unacceptable thoughts, contamination, and symmetry in both samples. These findings suggest that an IBA-consistent pattern may be present in both US and Turkish samples, although the role of self-related concerns and obsessive beliefs may vary across symptom domains and samples. However, given the limited fit of the US model and the nonidentical final models, cross-sample comparisons should be considered exploratory rather than confirmatory.