title: Deontological guilt and obsessive compulsive disorder.
abstract: OBJECTIVE
  The emotion of guilt plays a pivotal role in the genesis and maintenance of Obsessive-Compulsive Disorder (OCD). But what kind of guilt do OC patients want to prevent? Several studies suggest the existence of two different types of guilt emotions, namely deontological and altruistic guilt. This research suggests that the former, more than the latter, is involved in OCD. Studies in which people must hypothetically choose between killing one person to save a few (consequentialist choice) or take no action and allow things to take their course (omission choice), have found that the latter is consistent with the "Do not play God" moral principle whereas the former is consistent with altruistic motivations. This paper is aimed at verifying whether both OC patients, with no induction, and nonclinical participants, after the induction of deontological guilt prefer omission more often than a consequentialist option. It is hypothesized that people with OCD will be motivated to avoid feeling deontological guilt and thus will be more likely to opt for omission. Similarly, nonclinical participants who receive a deontological guilt induction will also be more likely to choose omission.
  
  
  METHODS
  In two studies participants were given seven scenarios (four moral dilemmas, three control scenarios). Twenty patients with OCD, 20 anxious controls, and 20 healthy participants took part in study 1. In study 2, we recruited 70 healthy participants who were randomly assigned to receive a deontological guilt or a control induction.
  
  
  RESULTS
  Consistent with hypotheses, in Study 1 OC patients preferred omission, instead of the consequentialist option, moreso than did the clinical and nonclinical controls. In Study 2, the group receiving the deontological guilt induction preferred omission to a greater extent than did the altruistic group.
  
  
  CONCLUSIONS
  The present study cannot establish that the goal of preventing or neutralizing deontological guilt actually drives obsessions and compulsions.
  
  
  CONCLUSIONS
  These results provide further evidence that people with OCD are more sensitive to deontological guilt, compared to other people. They thus contribute to improve the moral appraisal theory of OCD.
authors.affiliation: Scuola di Specializzazione in Psicoterapia Cognitiva (SPC), Viale Castro Pretorio, 116, 00185 Roma, Italy. Electronic address: mancini@apc.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Mancini
authors.affiliation: Dipartimento di Scienze Cognitive, University of Messina, Via Concezione, 6/8, 98121 Messina, Italy. Electronic address: gangemia@unime.it.
authors.forename: Amelia
authors.initials: A
authors.lastname: Gangemi
mesh_terms: D000293:Adolescent; D000328:Adult; D001008:Anxiety Disorders / Q000523:psychology; D002755:Choice Behavior; D005260:Female; D006167:Guilt; D006801:Humans; D008297:Male; D008875:Middle Aged; D009013:Morale; D009771:Obsessive-Compulsive Disorder / Q000150:complications / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D011795:Surveys and Questionnaires; D064232:Visual Analog Scale; D055815:Young Adult
keywords: Altruistic guilt emotion; Deontological guilt emotion; Moral trolley dilemma; Obsessive-compulsive disorder