Journal of Obsessive-Compulsive and Related Disorders 1 (2012) 153–158

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Journal of Obsessive-Compulsive and Related Disorders

journal homepage: www.elsevier.com/locate/jocrd

Predictors of mental pollution: The contribution of religion,

parenting strategies, and childhood trauma
Noah C. Berman, Michael G. Wheaton, Laura E. Fabricant, Jonathan S. Abramowitz n
University of North Carolina at Chapel Hill, Campus Box #3270 (Davie Hall), Chapel Hill, NC 27599, United States

a r t i c l e i n f o abstract

Article history: One presentation of obsessive-compulsive disorder that has begun to receive research attention is
Received 12 August 2011 mental pollution, a sense of inward contamination that persists regardless of the presence of external
Received in revised form contaminants. Given the need to better understand this phenomenon, we sought to identify predictor
20 February 2012
variables that could inform theory, treatment, and prevention. A large number of undergraduate
Accepted 14 March 2012
Available online 5 May 2012
students completed a battery of self-report questionnaires assessing personal experiences, religious
variables, parenting strategies, and childhood trauma, that appear theoretically relevant to mental
Keywords: pollution. Results indicated that mental pollution was not associated with degree of religiosity, yet
Mental pollution positively associated with exposure to childhood trauma and maladaptive guilt induction strategies by
Contamination
one’s parents. Implications for the assessment and cognitive-behavioral treatment of mental pollution,
Guilt
as well as limitations of the study, are discussed.
Religion
Trauma & 2012 Elsevier Ltd. All rights reserved.

1. Introduction person, such thoughts are objectionable in a way that creates feelings
of dirtiness that can seemingly be alleviated through hand washing
Obsessive Compulsive Disorder (OCD) consists of persistent rituals. Having the intrusive thought ‘‘God is dead,’’ for example, leads
unwanted intrusive thoughts, ideas, or images that provoke to feeling ‘‘inwardly dirty’’ and an urge to wash one’s hands. Research
anxiety or distress (i.e., obsessions) and urges to perform beha- has empirically identified two components of mental pollution:
vioral or mental rituals (i.e., compulsions; American Psychiatric (a) inward feelings of contamination that are not linked to washing
Association, 2000). Although the diagnostic system (DSM-IV; APA, behaviors (e.g., feeling dirty inside) and (b) washing rituals performed
2000) currently classifies OCD as a homogenous condition, obses- in response to perceived mental pollution (Cougle, Lee, Horowitz,
sions and compulsions are thematically heterogeneous (e.g., Wolitzky-Taylor, & Telch, 2008). Lady Macbeth offers a paragon
Abramowitz et al., 2010; Mataix-Cols, Rosario-Camposand presentation of the latter: Following her murder of King Duncan,
Leckman, 2005; McKay et al, 2004). One person might have Lady Macbeth repeatedly attempts to absolve herself of guilt by
obsessional doubts related to turning off the oven and feel washing her hands (‘‘Out damned spot! Out I say’’); however,
compelled to compulsively re-check appliances, whereas another repeated washing is futile as the source of ‘‘contamination’’ is internal.
might have aggressive obsessions (e.g., stabbing a family mem- Rachman (1994, 2004, 2006) considered mental pollution as a
ber) leading to avoidance of certain stimuli (e.g., knives). Given type of contamination fear, along with fears of contracting an
this heterogeneity, it is important to conduct research focusing on illness from external sources of contamination (e.g., germs on
the various symptom presentations. doorknobs). Although contamination-related OCD symptoms gen-
One manifestation of OCD that has received increased research erally respond well to exposure-based treatment (e.g., Abramowitz,
attention is mental pollution, defined as a ‘‘sense of internal unclean- Franklin, Schwartz, & Furr, 2003), the presence of mental pollution
ness which can and usually does arise and persist regardless of the might explain some instances of non-response (Cougle et al., 2008;
presence or absence of external, observable dirt’’ (Rachman, 1994; p. Elliott & Radomsky, 2009). That is, many clinicians who observe
311). The sense of uncleanliness is usually triggered by unacceptable hand washing symptoms (a cardinal feature of OCD) are apt to
blasphemous or sexual thoughts, aggressive urges, or general feelings presume that these rituals are triggered by external stimuli, rather
of immorality (Fairbrother, Newth, & Rachman, 2005). Thus, to the than unacceptable thoughts. When exposure to tangible ‘‘contami-
nants’’ such as floors or doorknobs does not provoke fear, exposure
might be abandoned and the patient considered ‘‘treatment refrac-
n
Corresponding author at: Department of Psychology, University of North tory’’ despite not using exposures that access the patient’s actual
Carolina at Chapel Hill, Campus Box #3270 (Davie Hall), Chapel Hill, NC 27599, obsessional stimuli—unacceptable thoughts.
United States. Tel.: þ 1 919 843 8170.
E-mail addresses: [email protected] (N.C. Berman),
Given the need to better understand mental pollution it is
[email protected] (J.S. Abramowitz). important to identify variables that serve as predictors of this

2211-3649/$ - see front matter & 2012 Elsevier Ltd. All rights reserved.
http://dx.doi.org/10.1016/j.jocrd.2012.03.005
154 N.C. Berman et al. / Journal of Obsessive-Compulsive and Related Disorders 1 (2012) 153–158

phenomenon (Elliott & Radomsky, 2009). Herba and Rachman child’s autonomy; and (b) disparagement, in which the parent
(2007), for example, found that contact contamination fear, perseverates over the child’s (even minor) transgressions and
disgust sensitivity, and prior unwanted sexual contact were inappropriately places blames on the child (Donatelli, Bybee, and
significant predictors of feelings of inward contamination and Buka, 2007). Research suggests that chronic exposure to high
urges to wash. In the present study we extended this work by levels of parental guilt induction interferes with the child’s
examining the relationship between mental pollution and vari- autonomy, emotional and social growth, and management of
ables from three additional domains—religious, familial, and interpersonal conflicts (Rakow, Forehand, McKee, Coffelt, and
childhood trauma—that theoretically might influence one’s sense Fear, 2009). In a previous study, Cougle et al. (2008) found that
of internal uncleanliness and urges to wash away unacceptable feelings of guilt were associated with mental pollution; however,
thoughts. These domains are described next. guilt induction was not examined. It is possible that as a result of
One such domain is religiosity (i.e., strength of religious faith; parents instilling persistent feelings of guilt in their child, he or
Plante, & Boccaccini, 1997). Certain religious practices, such as she would develop feelings of internal dirtiness when confronted
baptism in Christianity or wudu in Islam, instruct followers that with certain thoughts or feelings. Accordingly, we hypothesized
water purification rituals can symbolically cleanse one’s body and that maladaptive parental guilt induction would positively pre-
conscience (Zhong, & Liljenquist, 2006). The Christian bible, for dict mental pollution.
example, states: ‘‘arise and be baptized and wash away your sins’’ Childhood traumas are yet another factor that could be related
(Acts 22:16). Other instructive Bible verses that reference ‘‘sin by to mental pollution (Salkovskis, Shafran, Rachman, and Freeston,
thought’’ (e.g., ‘‘I say to you that everyone who looks on a woman 1999). For example, Fairbrother and Rachman (2004) found
to lust for her has committed adultery already in his heart;’’ elevated mental pollution and post-assault washing behaviors in
Matthew 5:27–28) may also be considered religious directives a sample of sexual assault victims. Moreover, these participants
that are in line with the concept of mental pollution (e.g., having reported that the memory of the assault triggered feelings of
an ‘‘immoral’’ thought leads to feelings of internal dirtiness or dirtiness, urges to wash, and engagement in washing behavior. In
contamination). Thus, those who internalize the notion that an experimental study, Fairbrother et al. (2005) had female
negative intrusive thoughts are sinful might misinterpret such undergraduates listen to an audiotape describing a consensual
thoughts as unacceptable or impure and attempt to absolve or a nonconsensual kiss. They found that participants who heard
themselves of sin or impurity by washing. about the non-consensual kiss reported greater internal and
Numerous studies have indeed found associations between external dirtiness, greater distress, and engaged in washing of
religiosity and OC symptoms (e.g., Abramowitz, Deacon, Woods, & their hands and mouth more frequently than those who heard
Tolin, 2004; Sica, Norvara, & Sanavio, 2002); as well as with about a consensual kiss. Accordingly, we predicted that childhood
thought action fusion (TAF), a cognitive bias that underlies the trauma would predict mental pollution.
misinterpretation of intrusive thoughts as significant (Berman, Very little research has been conducted on mental pollution to
Abramowitz, Pardue, & Wheaton, 2010; Rassin & Koster, 2003; date, and elucidating variables that predict this phenomenon can
Siev & Cohen 2007; Siev, Chambless, & Huppert, 2010). Given that help shed light on possible development and maintenance factors,
TAF and mental pollution both involve overestimating the sig- as well as possible considerations for assessment, treatment, and
nificance of thoughts and are positively correlated (Cougle et al., prevention. Accordingly, in the current study we aimed to evaluate
2008), it would not be surprising if they also possessed a similar theoretically relevant religious, familial, and trauma-related factors
relationship with religion. Therefore, we hypothesized that as predictors of mental pollution. We hypothesized that mental
greater strength of religiosity would be positively related to pollution would be associated with four factors: (1) Christian
mental pollution. It should be noted that due to limited religious religiosity (2) intrinsic motivation toward the Christian religion,
variability at the study site, religious-related hypotheses only (3) parental guilt induction, and (4) childhood trauma. As in
involve members of the Christian faith. previous research on mental pollution (e.g., Elliott, & Radomsky,
In addition to one’s degree of religiosity, his or her motivation 2009; Fairbrother et al., 2005; Herba, & Rachman, 2007; Radomsky,
for religion might be related to mental pollution. Allport and Ross & Elliott, 2009), we examined our hypothesis in a large unscreened
(1967) identified two motivational orientations toward religion: sample of undergraduate students in order to maximize sample
intrinsic and extrinsic. Individuals with high levels of intrinsic size (the prevalence of mental pollution in clinical OCD samples is
motivation find their ‘‘master motive in religion’’ (Allport, & Ross, not known, but assumed to be rather small), capitalize on the fact
1967, p. 434), perceive it to be a guiding factor in their life, and that OC symptoms, such as mental pollution, occur on a continuum
believe that it offers a moral foundation. Those with high levels of of severity in the population (e.g., Haslam, Williams, Kyrios, McKay,
extrinsic motivation, on the other hand, can be seen as utilitarian, & Taylor, 2005; Olatunji, Williams, Haslam, Abramowitz, & Tolin,
assessing the importance of religion based on its relationship to 2008), and take advantage of the distribution of our predictor
external rewards (e.g., attending church in order to ‘‘fit in’’ variables in the general population. Moreover, the only psychome-
socially; Ellison, 2008; Meek, Albright, & McMinn, 1995). Given trically validated self-report measure of mental pollution, the
that intrinsic motivation is associated with the tendency to Mental Pollution Questionnaire (MPQ; Cougle et al., 2008), was
internalize religious directives (e.g., sin by thought) to a greater developed using a nonclinical sample.
degree than extrinsic motivation, we hypothesized that mental
pollution would be associated with higher levels of intrinsic, but
not extrinsic, motivation for the Christian religion. 2. Methods
Family factors, such as parenting, might also be associated
with mental pollution. Certain parenting strategies, such as guilt 2.1. Participants
induction, might mold children’s perception of morality as well as
their understanding of which thoughts and feelings are accepta- Four hundred and seventeen undergraduate students in introductory psychol-
ble. As a result, guilt induction might mirror the hypothesized ogy classes at a large university in the southeastern United States completed an
relationship between religiosity and mental pollution. Two forms online questionnaire battery. Given that the current study is interested in
variables related to religiosity, only individuals who identified themselves as
of parental guilt-induction have been identified: (a) self-serving affiliating with a major religious group were included. This yielded 265 partici-
elicitation, in which the parent over-emphasizes the sacrifices he pants (63.5% of total sample) of the following religious groups: Catholics (33.6%)
or she has made for the child while simultaneously limiting the and Protestants (66.3%). A small number of Jewish, Muslim, and Hindu
 N.C. Berman et al. / Journal of Obsessive-Compulsive and Related Disorders 1 (2012) 153–158 155

participants completed the study measures, but were not included in further 3. Data analytic strategy
analyses because of a sample size below 10. The remaining sample (72 men
[27.2%], 192 women [72.5%], and 1 non-response [.3%]) was 76.4% Caucasian, 4.9%
Hispanic, 9.6% African American, 5.3% Asian, and 3.8% reporting being of ‘‘other’’ To test our hypotheses, we first computed correlation coefficients
ethnic backgrounds. The group’s mean age was 19.46 years (SD ¼2.75). to examine zero-order relationships among our predictor variables.
We then performed two hierarchical regression analyses with the
subscales of the MPQ (washing rituals and inward contamination) as
2.2. Procedure
the respective dependent variables. In both of these analyses,
religious affiliation (dummy coded with Protestants as the reference
After signing up via an Internet based software program and providing
informed consent, participants were directed to a secure project website where group) was entered in Step 1 to control for possible group differ-
they completed a demographic questionnaire and study measures (see Measures ences within Christianity. In Step 2, we added constructs that
section) in the same order. All data were collected using Qualtrics, an online web assessed the importance of one’s religious experience (i.e., strength
survey development tool. Coles, Cook, and Blake (2007) found that the adminis- of religiosity and intrinsic, extrinsic-personal, and extrinsic-social
tration of anxiety-related self-report measures using Internet-based and paper-
and-pencil formats yield highly comparable results. Upon accessing the secure
motivational orientation). In Step 3 of the regressions, both sub-
project website, participants were presented with an ‘‘instructions page’’ on the scales of parental guilt induction (self-serving elicitation and dis-
screen. The demographic and study questionnaires then appeared on subsequent paragement) were included. Finally, in Step 4, all 5 subscales of the
pages. Participants received course credit for completing these measures. At the CTQ (physical and emotional abuse, emotional neglect, sexual abuse,
end of the last questionnaire, a debriefing statement was presented.
and physical neglect) were entered simultaneously.

2.3. Measures
4. Results
Demographics. At the onset of the online questionnaire, participants were
asked to report their gender, age, and their identified racial or ethnic group and 4.1. Sample Characteristics
religious affiliation.
Childhood Trauma Questionnaire – Short Form (CTQ-SF; Bernstein et al. 2003).
Table 1 presents the mean, standard deviation, and range for
The CTQ-SF is a 28-item self-report questionnaire that uses retrospective report to
assess for child maltreatment. Participants rate responses on a 5-point Likert-type each study measure. For these measures, the descriptive statistics
scale (0 ¼ Never True to 4 ¼Very Often True). Five subscales are included in this approximate those reported in other nonclinical samples
measure (reported reliabilities are based on community samples): physical abuse (Bernstein et al., 2003; Cougle et al., 2008; Donatelli et al.,
(e.g., ‘‘People in my family hit me so hard that it left me with bruises or marks,’’ 2007; Gorsuch & McPherson, 1989; Plante & Boccaccini, 1997).
a ¼ .83) and emotional abuse (e.g., People in my family said hurtful or insulting
things to me,’’ a ¼ .87), emotional neglect (e.g., ‘‘There was someone in my family
who helped me feel that I was important or special,’’ reverse coded, a ¼ .91), 4.2. Correlations among study Measures
sexual abuse (e.g., ‘‘Someone threatened to hurt me or tell lies about me unless I
did something sexual with them,’’ a ¼ .92), and physical neglect (e.g., ‘‘I had to Zero-order correlations among the study variables are pre-
wear dirty clothes growing up,’’ a ¼ .61). As reported, the subscales possess
moderate to high internal consistency. Although, the physical neglect subscale
sented in Table 2. As can be seen, the MPQ subscales were
demonstrates weak internal consistency and should thus be interpreted with significantly correlated with only one measure of religiosity:
caution. IER-Es. Both MGI subscales demonstrated moderately strong
Intrinsic Extrinsic – Revised (I/E - R; Gorsuch & McPherson, 1989). The I/E-R is a positive correlations with the MPQ-WR, whereas relationships
14-item self-report scale that measures intrinsic (e.g., ‘‘I try hard to live all my life
with the MPQ-IC were weaker in magnitude, but still significant.
according to my religious beliefs’’; a ¼.83) and extrinsic motivation for religion.
Two types of extrinsic motivation are assessed: social extrinsic (Es; ‘‘I go to Similarly, all CTQ subscales demonstrated strong positive correla-
religious services mostly to spend time with my friends’’; a ¼.58) and personally tions with the MPQ-WR and weaker, positive, and significant
extrinsic (Ep; ‘‘What religion offers me most is comfort in times of trouble and correlations with the MPQ-IC subscale.
sorrow’’; a ¼.57). Each item is rated on a 5-point Likert scale (1 ¼strongly disagree,
5 ¼ strongly agree). It is recognized that the reliabilities of the extrinsic scales are
not strong, but this measure of religious motivation best assesses the constructs of 4.3. Regression Analyses
interest.
Maladaptive Guilt-Induction Measure (MGI; Donatelli et al., 2007). MGI is a 12- Table 3 presents the results of the regression analysis predict-
item self-report questionnaire assessing youth’s perceived experiences with ing scores on the MPQ–WR subscale. As can be seen, in step one,
parental guilt induction. Respondents are presented with several statements
regarding guilt induction and are asked to rate the truthfulness of each statement
on a Likert scale from 1 (not at all true) to 7 (very true). The MGI has two Table 1
empirically demonstrated subscales. The disparagement subscale assesses child Descriptive statistics for study measures.
directed criticism and blame (e.g., ‘‘[My primary caregiver] makes me feel guilty
even when its not my fault’’; a ¼ .84). The self-serving elicitation subscale assesses Measure M SD Range
the frequency that parents’ exaggerate sacrifices that they have made for the child
(e.g., [My primary caregiver] always reminds me of favors and sacrifices he/she Religiosity
has made’’; a ¼.77). As demonstrated, both subscales have good internal Santa Clara Religious Faith Scale (SCRFS) 29.03 8.19 10-40
consistency. Motivational Orientation
Mental Pollution Questionnaire (MPQ; Cougle et al., 2008). MPQ is an eight-item Intrinsic 25.98 6.53 12-40
self-report questionnaire. Respondents are presented with several statements and Extrinsic – Social 7.29 2.57 3-15
are asked to rate agreement on a Likert scale from 1 (strongly disagree) to 7 Extrinsic – Personal 9.98 2.73 3-15
(strongly agree). The MPQ has two empirically supported subscales. The washing Guilt Induction
rituals subscale assesses washing rituals performed in response to perceived Disparagement 10.83 7.35 6-42
mental pollution (‘‘I wash my hands when I feel guilty’’; a ¼.86). The inward Self-Serving Elicitation 12.20 8.13 6-42
contamination subscale pertains to a sense of inward contamination not linked to Childhood Trauma
washing behaviors (‘‘Sometimes I feel dirty inside’’; a ¼ .85). Emotional Abuse 2.27 3.39 0–19
Santa Clara Religious Faith Scale (SCRFS; Plante & Boccaccini, 1997). The SCRFS Physical Abuse 1.51 2.60 0–16
is a 10-item self-report scale, which provides a reliable and valid measure of one’s Sexual Abuse .55 2.19 0–17
strength of religiosity (e.g., ‘‘I pray daily’’; ‘‘My relationship with God is extremely Emotional Neglect 7.07 6.08 0–32
important to me’’). Total scores range from 10–40, with higher scores indicating Physical Neglect 1.34 2.62 0–14
greater religiosity. Psychometric research demonstrates that scoring at or above Mental Pollution
33 indicates ‘‘high religiosity’’ (Plante & Boccaccini, 1997). The SCRFS has good Inward Contamination 11.23 6.45 4 - 27
reliability (a ¼ .92–.95) and converges with other valid measures of religiosity Washing Rituals 5.85 3.46 4-25
(Plante & Boccaccini, 1997).
156 N.C. Berman et al. / Journal of Obsessive-Compulsive and Related Disorders 1 (2012) 153–158

Table 2
Zero-Order Correlations Among Study Measures.

Variable Int M Ext - S Ext - P MGI-D MGI-SS CTQ-EA CTQ-PA CTQ-SA CTQ-EN CTQ-PN MPQ-WR MPQ-IC

SCRFS .81nn .17n .36nn  .12  .14n  .10 .06 .02  .12  .04 .07 .08
Int M  .09 .14n  .07  .10  .07 .03 .02  .09  .004 .04 .08
Ext -S - - .30nn .07 .12nn .02 .12 .16n  .09 .22nn .31nn .13n
Ext - P - - - .03 .09 .02 .14n .05  .04 .04 .12 .05
MGI-D - - - - .87nn .59nn .42nn .30nn .49nn .43nn .43nn .16n
MGI-SS - - - - - .53nn .39nn .28nn .43nn .37nn .36nn .19nn
CTQ-EA - - - - - - .72nn .48nn .62nn .58nn .37nn .25nn
CTQ-PA - - - - - - - .61nn .41nn .58nn .46nn .19nn
CTQ-SA - - - - - - - - .21nn .50nn .49nn .22nn
CTQ-EN - - - - - - - - - .61nn .29nn .13n
CTQ-PN - - - - - - - - - - .48nn .10
MPQ-WR - - - - - - - - - - - .39nn

Note. SCRFS ¼ Religiosity, Int M ¼ Intrinsic Motivation, Ext-S¼ Extrinsic Social, Ext-P ¼Extrinsic Personal, MGI-D¼ Guilt Induction-Disparagement, MGI-SS ¼Self Serving,
CTQ-EA ¼Emotional Abuse, CTQ-PA ¼Physical Abuse, CTQ ¼ SA ¼Sexual Abuse, CTQ-EN¼ Emotional Neglect, CTQ-PN¼Physical Neglect, MPQ-WR¼ Washing Rituals, MPQ-
IC¼ Inward Contamination.
nn
p ¼ o.001.
n
p o .05.

Table 3 Table 4
Regressions Predicting Washing Rituals subscale of the MPQ. Regressions Predicting Inward Contamination subscale of the MPQ.

Variable R2 ß t p Variable R2 ß t p

MPQ Washing Rituals MPQ Inward Contamination

Step 1 .001 n.s. Step 1 .001 n.s.
Catholic .03 .37 n.s. Catholic .001  .006 n.s.
Step 2 .11 o .001 Step 2 .02 n.s.
Strength of Religiosity .02 .15 n.s. Strength of Religiosity .04 .55 n.s.
Intrinsic Motivation .009 .08 n.s. Intrinsic Motivation .13 1.07 n.s.
Extrinsic-Social .33 4.88 o .001 Extrinsic-Social .11 1.56 n.s.
Extrinsic-Personal  .001  .02 n.s. Extrinsic-Personal .02 .29 n.s.
Step 3 .27 o .001 Step 3 .06 o.05
Guilt Induction - Disparagement .47 4.42 o .001 Guilt Induction – Disparagement .02 .15 n.s.
Guilt Induction – Self-Serving  .09  .80 n.s. Guilt Induction – Self-Serving .18 1.48 n.s.
Step 4 .40 o .001 Step 4 .12 o.05
Emotional Abuse  .11  1.11 n.s. Emotional Abuse .28 2.36 o.05
Physical Abuse .16 1.71 n.s. Physical Abuse  .03  .27 n.s.
Sexual Abuse .25 3.31 o .001 Sexual Abuse .15 1.59 n.s.
Emotional Neglect  .01  .12 n.s. Emotional Neglect .02 .24 n.s.
Physical Neglect .15 n.s. Physical Neglect  .16  1.57 n.s.

religious affiliation (with Protestants as the reference group) the CTQ accounted for further variance (DR2 ¼.06, p o.05). Of all
explained a negligible and nonsignificant portion of the variance the childhood trauma subscales in Step 4, only the emotional
(R2 ¼.001, p 4.05). Religious-related variables entered in Step 2, abuse subscale emerged as a significant individual predictor of
however, explained a significant amount of variance in MPQ-WR MPQ-IC scores. The final model with all variables entered,
scores (DR2 ¼.11, p o.001), with the IER-ES subscale emerging as accounted for 12% of the variance in inward contamination scores.
a significant individual predictor. In Step 3, adding the MGI
subscales accounted for a significant amount of additional var-
iance (DR2 ¼.16, p o.001), with the disparagement subscale 5. Discussion
emerging as a significant individual predictor. Finally, in Step 4,
adding the subscales of the CTQ accounted for a significant Mental pollution is an understudied presentation of OC symp-
amount of additional variance (DR2 ¼.16, po.001). Of all the toms in which the person experiences a feeling of internal
childhood trauma subscales, only the sexual abuse subscale uncleanness, often accompanied by ritualistic washing to
emerged as a significant individual predictor. The final model expunge the thought and ‘‘mental contamination.’’ As a less
with all variables entered, accounted for 40% of the variance in understood symptom presentation, mental pollution also repre-
washing rituals scores. sents a potential stumbling block for clinicians treating indivi-
In the prediction of MPQ-IC scores (Table 4), results of the duals with OCD. Accordingly, it is important to better understand
hierarchical regression analyses were as follows: In step one, experiences that predict this phenomenon. The present investiga-
religious affiliation (with Protestants as the reference group) tion examined the relationship between mental pollution and
explained a negligible and nonsignificant portion of the variance several variables that, at a conceptual level, appear to be asso-
(R2 ¼.001, p4.05). Religious-related variables entered in Step ciated with this phenomenon: degree of religiosity, motivational
2 did not explain a significant amount of additional variance orientation toward religion, parental guilt induction, and child-
(DR2 ¼.019, p4 .05). In Step 3, however, the addition of the MGI hood trauma. Given the lack of research on such relationships, our
subscales accounted for a significant amount of additional var- aim was to gain a clearer understanding of factors that explain
iance (DR2 ¼.04, p o.05). Finally, in Step 4, adding the subscales of mental pollution in hopes of providing avenues for future
 N.C. Berman et al. / Journal of Obsessive-Compulsive and Related Disorders 1 (2012) 153–158 157

research on potential risk and maintenance factors, as well as uncleanliness, which as Zhong and Liljenquist (2006) argued,
effective prevention and treatment programs. activate a need for physical cleansing. Thus, the cleansing beha-
In summary, our findings were as follows: Contrary to our viors in mental pollution might be conceptualized as attempts to
predictions, mental pollution was not associated with degree of repair one’s sense of moral integrity.
religiosity in our sample, and only to the social subtype of Childhood trauma was also positively associated with feel-
extrinsic motivation for religion—a surprising finding. As ings of inward contamination. For this dimension of mental
expected, both subscales of mental pollution were positively pollution, however, emotional abuse had the greatest predictive
associated with participant’s parents’ maladaptive guilt induction value. This relationship may be explained by the repeated
strategies, as well as with all types of childhood trauma. internalization of emotionally hurtful remarks. Given that emo-
Our regression analyses indicated that religious affiliation tional abuse tends to involve repeated statements or behaviors
(Step 1) within Christianity was not a meaningful predictor of that target the victim’s worth or sense of self (e.g., insults, verbal
either component of mental pollution. However, strength of assaults, name calling, feeling hated by family), the child victim
religiosity and motivation toward religion (entered together in might internalize the abuse and come to view the comments or
Step 2) predicted the washing rituals dimension of mental behaviors as an accurate reflection of him or herself as intrinsi-
pollution, but not inward contamination. Of these variables, being cally disgusting or worthless, leading to feelings of inward
extrinsically motivated by social factors, such as power, politics, contamination.
or friends, was found to possess unique predictive value for Inasmuch as the results of the present study can be general-
washing rituals. Maladaptive parental guilt induction (Step 3) ized to treatment-seeking individuals with clinical levels of
significantly predicted both types of mental pollution, with mental pollution and contamination-related OC symptoms, the
disparagement acting as an independent predictor of washing present study has implications for the assessment and cognitive-
rituals. Finally, childhood traumas (Step 4) significantly predicted behavioral treatment. First, it seems critical to thoroughly assess
both types of mental pollution, with sexual abuse emerging as a for mental pollution in patients with contamination-related OC
significant predictor of washing rituals and emotional abuse as a symptoms. This is likely overlooked by clinicians trained to assess
predictor of inward contamination. for largely external ‘‘contaminants’’ that might contain germs or
Whereas our hypotheses relating to religiosity were not poisons, such as bathrooms, door knobs, chemicals, and the like.
supported, the results of the present study generally provided Second, in patients with mental pollution, clinicians should assess
support for our other predictions regarding correlates of mental for possible childhood trauma (specifically emotional and sexual
pollution. Unexpectedly, an extrinsic motivation for religion, abuse), and inquire about exposure to parenting strategies that
wherein individuals utilize their faith to enhance social support involve maladaptive guilt induction (e.g., blaming the child for
or power, predicted greater engagement in hand washing follow- negative outcomes when he/she was not at fault). Interventions
ing thoughts of inward contamination. This relationship may be addressing guilt and shame associated with these events might
due to each constructs’ observable nature that functions to elicit a help the patient engage in, and benefit from, imaginal exposures
favorable judgment from oneself and others. Washing rituals are to intrusions that provoke mental pollution (e.g., asking the
overt behaviors that, by definition, are observable. Thus, one patient to write statements that evoke feelings of mental pollu-
might be motivated to allow others to see them washing their tion; Rachman, 2004). If the patient is still living with his or her
hands in order to be perceived as a ‘‘good person.’’ Similarly, family and high levels of parental guilt induction are present, it
observable behaviors are the crux of an extrinsically motivated might be useful to utilize family-based therapy approaches to
individual (e.g., wanting to be ‘‘seen’’ at church), thus, being seen increase effective communication strategies (Dattilio, & Epstein,
by others while going to church might also lead to being 2004).
perceived as a good and moral person. For a number of reasons, caution is warranted regarding the
Contrary to the hypotheses related to religion, our prediction that conclusions drawn from the present findings. First, although
parental maladaptive guilt induction would be positively associated mental pollution appears to exist on a continuum of severity in
with mental pollution (both inward contamination and washing the general population, the use of a nonclinical sample potentially
rituals) was supported. In fact, guilt induction was the strongest limits the generalizability of our findings to clinical populations.
independent predictor of inward contamination. This is consistent Additional studies with those seeking treatment for obsessional
with Cougle et al.’s (2008) findings that general feelings of guilt problems are warranted. Second, the current study used a
were strongly correlated with inward contamination, as well as with correlational design, which limits conclusions regarding causality.
Salkovskis et al.’s (1999) assertion that rigid rules within the home Longitudinal designs or experimental manipulations are neces-
contribute to the development of dysfunctional beliefs and mis- sary next steps to better understand how the experiences that we
interpretations of intrusive thoughts, feelings, and behaviors. More- examined relate to mental pollution.
over, Zhong and Liljenquist (2006) demonstrated that threats to Third, only self-report measures were used. As it is optimal to
one’s moral image (e.g., blaming the child inappropriately for moral have multiple measures or assessment modalities (Kazdin, 2002),
transgressions) could lead to the psychological need to engage in in vivo measures of mental pollution (Elliott, & Radomsky, 2009) or
cleansing behaviors. In this vein, persistent or intensified feelings of guilt induction (e.g., Donatelli et al., 2007) would improve the study
guilt, perhaps induced by parents, would lead to stronger urges or of these psychological constructs. In a similar vein, the use of
attempts to morally cleanse themselves (Zhong & Liljenquist, 2006). retrospective self-report questionnaires for assessing childhood
This hypothesis, however, requires further study. traumas and childrearing practices is problematic. Bernstein et al.
Our hypotheses related to childhood trauma were also gen- (1994) note that retrospective report of trauma can be influenced by
erally supported, indicating that experiences with childhood repression, denial, or embarrassment. Thus, additional assessments
trauma positively predict mental pollution and explain the great- could be used to corroborate or objectively verify reports, such as
est amount of variance in mental pollution-related washing the Childhood Trauma Interview (Fink, Bernstein, Foote, Lovejoy,
rituals. Consistent with findings from Fairbrother and Rachman Ruggiero, & Handelsman, 1993) or examining Child Protective
(2004), Fairbrother et al. (2005), and Olatunji, Elwood, Williams, Service records. Fourth, the limited types of religious affiliations
and Lohr (2008), thoughts related to sexual trauma in particular restricted a thorough investigation of the relationship between
predicted mental pollution, specifically engagement in washing religion and mental pollution. The current study only examined
rituals. Perhaps this type of trauma elicits feelings of moral religious group differences between Protestants and Catholics.
158 N.C. Berman et al. / Journal of Obsessive-Compulsive and Related Disorders 1 (2012) 153–158

Consequently, the relationship between strength of religiosity and Donatelli, J., Bybee, & Buka, S. (2007). What do mothers make adolescents feel
motivational orientation towards religion is only relevant for indi- guilty about? Incidents, reactions, and relation to depression. Journal of Child
and Family Studies, 16, 859–875.
viduals who affiliate with these branches of Christianity. The current Elliott, C. M., & Radomsky, A. S. (2009). Analyses of mental contamination: Part I,
study only examined individuals affiliating with Christianity, there- experimental manipulations of morality. Behavior Research and Therapy, 47,
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predict OCD-related cognitive processes when compared to other Fairbrother, N., Newth, S. J., & Rachman, S. (2005). Mental pollution: Feelings of
religious faiths (Siev et al., 2010; Berman et al., 2010), we hypothe- dirtiness without physical contact. Behavior Research and Therapy, 43,
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would not be significant predictors of mental pollution. In order to sexual assault. Behavior Research and Therapy, 40, 173–189.
empirically evaluate this question, future research is needed. Fink, U., Bernstein, D., Foote, J., Lovejoy, M., Ruggiero, J., & Handelsman, U. (1993).
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Haslam, N., Williams, B., Kyrios, M., McKay, D., & Taylor, S. (2005). Subtyping
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