# Deontological Guilt Differentially Affects Moral Behaviour in Participants With and Without Obsessive–Compulsive Disorder (OCD)

## TL;DR

People with OCD react differently to guilt based on rules (deontological guilt) compared to guilt from harming others (altruistic guilt), which affects their moral choices.

## Contribution

The study reveals that deontological guilt uniquely disrupts moral behavior in OCD, offering new insights for targeted psychotherapy.

## Key findings

- Deontological guilt increased self-serving lies in OCD participants but decreased them in controls.
- Altruistic guilt reduced lying in all participants, promoting prosocial behavior.
- Distinguishing guilt subtypes is crucial for OCD treatment and moral behavior understanding.

## Abstract

Obsessive–compulsive disorder (OCD) is characterised by a dysfunctional sensitivity to a sense of guilt that significantly interferes with everyday functioning and is believed to be a key mechanism in symptom maintenance. Mounting evidence indicates that individuals with OCD are particularly sensitive to deontological guilt, which stems from the perception of violating an internalised rule, as opposed to altruistic guilt, which arises from the feeling of having harmed others. Here, we assess the impact of deontological vs. altruistic guilt on moral behaviour in participants with OCD. Twenty participants with OCD and 20 gender‐ and age‐matched comparison participants took part in a social game in which they could choose to lie for a personal reward (self‐gain lie) or to benefit the other player (other‐gain lie). During the game, they were exposed to stimuli designed to evoke one of three emotional states: deontological guilt (DG), altruistic guilt (AG) or a neutral state. Self‐report ratings of DG and AG evoked by the stimuli were also recorded. Exposure to stimuli that evoke the anticipation of AG was associated with a decrease in self‐gain lies and an increase in altruistic lies in all participants. When individual emotional ratings were taken into account, we found that stronger AG elicited by the stimuli was associated with fewer lies. In contrast, higher DG ratings were associated with a decrease in self‐gain lies in controls but with an increase in self‐gain lies in OCD participants. Our results support the notion that DG is particularly crucial for OCD participants and reveal that it can be particularly disruptive for them, suggesting that this emotion should be a primary target of psychotherapeutic intervention.

Deontological guilt may have paradoxical effects in OCD. In individuals with obsessive–compulsive disorder, higher levels of deontological guilt—especially when intertwined with disgust—may paradoxically increase self‐serving and morally questionable behaviours, rather than promoting moral restraint.
Not all guilt is clinically equivalent. Altruistic guilt appears to foster prosocial behaviour across both clinical and non‐clinical populations. In contrast, deontological guilt shows maladaptive effects specifically in OCD, highlighting the importance of distinguishing between different guilt subtypes in assessment and treatment.
Clinical interventions should target deontological guilt processes. Psychotherapeutic approaches for OCD may benefit from explicitly addressing deontological guilt and related self‐disgust processes, as reducing excessive moral self‐condemnation may help prevent maladaptive coping strategies and vicious cycles of guilt‐driven behaviour.

Deontological guilt may have paradoxical effects in OCD. In individuals with obsessive–compulsive disorder, higher levels of deontological guilt—especially when intertwined with disgust—may paradoxically increase self‐serving and morally questionable behaviours, rather than promoting moral restraint.

Not all guilt is clinically equivalent. Altruistic guilt appears to foster prosocial behaviour across both clinical and non‐clinical populations. In contrast, deontological guilt shows maladaptive effects specifically in OCD, highlighting the importance of distinguishing between different guilt subtypes in assessment and treatment.

Clinical interventions should target deontological guilt processes. Psychotherapeutic approaches for OCD may benefit from explicitly addressing deontological guilt and related self‐disgust processes, as reducing excessive moral self‐condemnation may help prevent maladaptive coping strategies and vicious cycles of guilt‐driven behaviour.