In modern times, scrupulosity is often considered to be a religious expression of obsessive-compulsive disorder, or the unrelated obsessive-compulsive personality disorder. The scrupulous person lacks a balanced religious outlook, veering to the extreme. Often the person has a morbid feeling that they are rejected by God and doomed to damnation despite rigid adherence to rituals or rules of conduct. The over-scrupulous person may refuse to acknowledge the verdict of otherwise accepted religious authorities that he or she is being excessively concerned with moot religious points.
In Catholicism, scrupulosity in itself is not considered to be sinful; some well-known saints, including Ignatius Loyola, and Alphonsus Liguori struggled with scrupulosity. Some Catholic scholars have speculated that Martin Luther, whose ideas and writings helped give rise to the Protestant Reformation, suffered from scrupulosity and broke with the Catholic Church because he could not accept Catholic assurances of grace in the face of his feelings of sinfulness.
Protestants are likely to disagree that scrupulosity was the basis for Luther's actions, but some agree that he suffered from scrupulosity. Some Protestants also find traces of scrupulosity in the writings of the 17th century Puritan pastor and author John Bunyan.
In overcoming scrupulosity, medical treatment for OCD may be used alongside religious counseling, wherein a member of the clergy will counsel the subject to focus on positive, objective messages of religious faith rather than subjective feelings of sinfulness and objection; he or she may also advise the person to avoid typical scrupulous behaviors, which can include repeating past confessions or constant bathing.