Behavioral and experiential avoidance in patients with hoarding disorder

Ayers, Catherine R.; Castriotta, Natalie; Dozier, Mary E.; Espejo, Emmanuel P.; Porter, Ben

doi:10.1016/j.jbtep.2014.04.005

Cited by 42 publications

(29 citation statements)

References 28 publications

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“…Although no group differences were identified between HD patients and healthy controls on an overarching measure of emotional intelligence (Grisham et al, 2008), several non-clinical studies have found that more severe hoarding symptoms are associated with greater negative urgency (i.e., tendency to act impulsively under negative affective states; Timpano et al, 2013) and lower distress tolerance (i.e., capacity to tolerate distress; Timpano et al, 2009, Timpano et al, 2011b, Timpano, Shaw, 2014a). Greater hoarding symptoms have also been connected with higher levels of experiential avoidance (i.e., tendency to avoid negative internal states; Ayers et al, 2014, Wheaton et al, 2011, Williams, 2012), though findings have been somewhat mixed (de la Cruz et al, 2013). In sum, the broader research literature on how hoarding symptoms relate to various types of emotion regulation difficulties supports the idea that hoarding symptoms would be associated with experiencing negative emotions more acutely.…”

Section: Introductionmentioning

confidence: 99%

Hoarding and emotional reactivity: The link between negative emotional reactions and hoarding symptomatology

Shaw

Timpano

Steketee

et al. 2015

Journal of Psychiatric Research

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Hoarding disorder (HD) is characterized by difficulty discarding, clutter, and frequently excessive acquiring. Theories have pointed to intense negative emotional reactions (e.g., sadness) as one factor that may play a critical role in HD’s etiology. Preliminary work with an analogue sample indicated that more intense negative emotions following emotional films were linked with greater hoarding symptoms. Symptom provocation imaging studies with HD patients have also found evidence for excessive activation in brain regions implicated in processing emotions. The current study utilized a sample with self-reported serious hoarding difficulties to examine how hoarding symptoms related to both general and hoarding-related emotional reactivity, taking into account the specificity of these relationships. We also examined how two cognitive factors, fear of decision-making and confidence in memory, modified this relationship. 628 participants with self-identified hoarding difficulties completed questionnaires about general emotional reactivity, depression, anxiety, decision-making, and confidence in memory. To assess hoarding-related emotional reactivity, participants reported their emotional reactions when imagining discarding various items. Heightened general emotional reactivity and more intense emotional reactions to imagined discarding were associated with both difficulty discarding and acquisition, but not clutter, controlling for age, gender, and co-occurring mood and anxiety symptoms. Fear of decision-making and confidence in memory interacted with general emotional reactivity to predict hoarding symptoms. These findings provide support for cognitive-behavioral models of hoarding. Experimental research should be conducted to discover whether emotional reactivity increases vulnerability for HD. Future work should also examine whether emotional reactivity should be targeted in interventions for hoarding.

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Section: Introductionmentioning

confidence: 99%

Hoarding and emotional reactivity: The link between negative emotional reactions and hoarding symptomatology

Shaw

Timpano

Steketee

et al. 2015

Journal of Psychiatric Research

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“…Several studies have provided initial support for the hypothesized avoidance function of hoarding (Ayers, Castriotta, Dozier, Espejo, & Porter, 2014;Wheaton, Abramowitz, Franklin, Berman, & Fabricant, 2011;Wheaton, Fabricant, Berman, & Abramowitz, 2013). One study has found acquiring is linked to both urges and distress, providing some support for both positive automatic and negative automatic functions being relevant (Raines, Allan, Oglesby, Short, & Schmidt, 2015).…”

Section: An Ecological Momentary Assessment Study Investigating the Fmentioning

confidence: 99%

An Ecological Momentary Assessment Study Investigating the Function of Hoarding

et al. 2020

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This study examined the function of hoarding behaviors and the relations between hoarding and a series of cognitive and affective processes in the moment using ecological momentary assessment. A matched-groups design was used to compare college students with higher hoarding symptoms (n = 31) and matched controls (n = 29). The two groups did not differ in what function they reported acquiring served, and positive automatic reinforcement was the most commonly reported function in both groups. Engaging in hoarding-relevant behaviors did not predict change in positive or negative affect when controlling for previous affect. Emotional reactivity and experiential avoidance in the moment were both elevated in the higher hoarding group compared to controls, while momentary mindfulness and negative affect differentiation were lower. Overall, these findings support the importance of emotion regulation processes in hoarding. They also suggest individuals may not be successfully regulating affect in the moment with hoarding behaviors, despite efforts to do so. It may be useful to evaluate processes such as striving for positive affect in hoarding disorder in the future.

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“…Consistent with exposure paradigms for anxiety, trauma, and obsessive-compulsive-based disorders, exposure sessions for HD are designed to help the patient to assess the correct threat level of the feared situation (e.g., if they throw away something "valuable" there is a low likelihood of a negative consequence) as well as to learn that they are capable of enduring the distress of the situation. Furthermore, research suggests that within HD patients, hoarding symptom severity is associated with behavioral avoidance even when controlling for comorbid symptoms of anxiety and depression [31] .…”

Section: Attachment Beliefs Behaviors and Emotionsmentioning

confidence: 99%

The Etiology of Hoarding Disorder: A Review

Dozier

Ayers²

2017

Psychopathology

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This article will review the evidence of various proposed factors that contribute to the onset and maintenance of hoarding disorder (HD). Data suggests that hoarding is a chronic condition that starts early in life and does not remit if left untreated. There is emerging evidence that a number of factors contribute to the expression of HD symptoms, including genetics, neurocognitive functioning, attachments to possessions, beliefs, avoidance, personality factors, and life events. The extent to which each etiological factor uniquely contributes to hoarding is still unknown. Other demographic factors, such as socioeconomic status, age, and gender, may impact hoarding severity. Research on the causes and characteristics of hoarding has recently started making progress into understanding this newly recognized disorder, yet we still have a ways to go in understanding the biological and environmental causes. This paper will synthesize available literature on the etiology of HD.

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Behavioral and experiential avoidance in patients with hoarding disorder

Cited by 42 publications

References 28 publications

Hoarding and emotional reactivity: The link between negative emotional reactions and hoarding symptomatology

Hoarding and emotional reactivity: The link between negative emotional reactions and hoarding symptomatology

An Ecological Momentary Assessment Study Investigating the Function of Hoarding

The Etiology of Hoarding Disorder: A Review

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