Development and initial validation of the Fear of Guilt Scale for obsessive-compulsive disorder (OCD)

Although people with obsessive-compulsive disorder (OCD) often report devastating feelings of guilt, to date, a clear link between guilt and OCD symptoms has not been established. Researchers are currently exploring the extent to which individuals with OCD fear the feeling of guilt (e.g., for harm they might have caused, averted, or minimised) and behave compulsively in consequence. However, no self-report measures of the fear of guilt construct exist, which limits our ability to examine its role in OCD. We therefore developed a 17-item Fear of Guilt Scale (FOGS), culled from a larger, 49-item pool following exploratory and confirmatory factor analyses, to measure fear of guilt in OCD. Psychometric analyses were conducted across three large, nonclinical undergraduate samples and suggest the FOGS consists of two factors: Punishment (drive to punish oneself for feelings of guilt) and Harm Prevention (drive to proactively prevent guilt). The FOGS demonstrated strong internal consistency and convergent and divergent validity. It also significantly predicted OCD symptom severity over measures of neuroticism, depression, trait guilt, and inflated responsibility beliefs. Thus, fear of guilt, as measured by the FOGS, is an important and distinct construct in understanding OCD. Implications for future use of the scale are discussed.