Scrupulosity OCD: When Faith, Fear, and Anxiety Get Entangled & How It Can Show Up in Children

By Allison Summer, LPC | Specializing in OCD & Eating Disorders

Scrupulosity is a form of obsessive-compulsive disorder (OCD) that centers around moral, religious, or ethical fears. It’s often misunderstood as strong faith, high values, or a sensitive conscience — but at its core, scrupulosity is driven by anxiety, doubt, and a relentless need for certainty.

For both adults and children, scrupulosity can be deeply distressing — especially because it tends to hide in places that are socially praised, like devotion, responsibility, or “being good.”

What Is Scrupulosity OCD?

Scrupulosity involves obsessive fears about:

• Doing something morally wrong

• Offending God or a higher power

• Being a “bad” person

• Failing to follow religious or moral rules perfectly

• Being responsible for harm or punishment

These fears are paired with compulsions — behaviors meant to reduce anxiety or “make things right.” While the content may be religious or moral, the mechanism is OCD, not belief.

This distinction matters — especially for treatment.

How Scrupulosity Can Show Up in Children

Scrupulosity in children is often overlooked because it doesn’t always look like anxiety. It can look like obedience, devotion, or conscientiousness.

Some common signs include:

• Repeating prayers until they feel “right”

• Restarting prayers if a word is missed or a thought intrudes

• Excessive fear of sinning, lying, or breaking rules

• Asking for reassurance about whether something was “bad”

• Confessing minor or imagined wrongdoings repeatedly

• Avoiding activities out of fear of being immoral or disrespectful

• Distress if religious routines aren’t followed exactly

• Feeling responsible for bad outcomes if rituals aren’t completed

Children may not be able to articulate fear in the way adults can. Instead, you might see rigidity, distress, or a need to redo things over and over.

Why Scrupulosity Is So Easy to Miss

Scrupulosity often hides behind:

• Faith

• Family or cultural values

• Praise for being “good,” “thoughtful,” or “serious”

• Adult assumptions that a child is just being sensitive or devout

But the key difference is distress.

When beliefs are driven by OCD, they don’t bring peace or connection — they bring fear, urgency, and relief that never lasts.

Scrupulosity Is Not About Weak Faith

This is important to say clearly:

Scrupulosity is not a lack of faith.

It is also not a sign that someone is doing religion wrong.

Many people with scrupulosity care deeply about their values. OCD simply hijacks those values and turns them into a source of threat.

Treatment does not require abandoning beliefs — it focuses on changing the relationship with fear and uncertainty.

How Scrupulosity Is Treated

The gold-standard treatment for scrupulosity OCD is Exposure and Response Prevention (ERP), often combined with a values-respectful approach.

Treatment may include:

• Learning to tolerate uncertainty

• Reducing reassurance-seeking

• Allowing “imperfect” prayers or thoughts

• Separating values from anxiety

• Supporting children in resisting rituals gently and gradually

For children, this work is done with care, collaboration, and developmentally appropriate language — often involving parents as well.

When to Seek Support

If you notice that religious or moral concerns are:

• Causing significant distress

• Interfering with daily life

• Leading to repetitive behaviors or avoidance

• Driven by fear rather than meaning

It may be helpful to consult with a therapist who specializes in OCD.

Early support can prevent years of silent suffering — especially for kids who don’t yet have words for what they’re experiencing.

Final Thoughts

Scrupulosity often lives quietly.

It can look like responsibility, goodness, or devotion — while feeling like fear, pressure, and never-enough inside.

If this resonates with you or your child, know this:

You’re not broken.

You’re not doing faith or values “wrong.”

And help exists.

Allison Summer

LPC | OCD & Eating Disorder Specialist

A Brighter Day Wellness