Investigating the mechanisms of hoarding from an experimental perspective

Preston, Stephanie D.; Muroff, Jordana; Wengrovitz, Steven M.

doi:10.1002/da.20417

Cited by 47 publications

(31 citation statements)

References 49 publications

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“…[45,62] Characteristics, such as perfectionism and uncertainty, are common to both compulsive hoarding and OCD. [25,39,45,46,50,64] Unlike OCD, however, compulsive hoarding patients display no exaggerated beliefs associated with the importance of or control over thoughts. [45,65] Overlapping with some symmetryrelated obsessions, touching or moving possessions without permission provokes great distress in hoarding patients and reflects an excessive desire to maintain control over possessions.…”

Section: Should Hoarding Continue To Be Mentioned As a Symptom Of Anomentioning

confidence: 99%

Hoarding disorder: a new diagnosis for DSM-V?

et al. 2010

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This article provides a focused review of the literature on compulsive hoarding and presents a number of options and preliminary recommendations to be considered for DSM-V. In DSM-IV-TR, hoarding is listed as one of the diagnostic criteria for obsessive-compulsive personality disorder (OCPD). According to DSM-IV-TR, when hoarding is extreme, clinicians should consider a diagnosis of obsessive-compulsive disorder (OCD) and may diagnose both OCPD and OCD if the criteria for both are met. However, compulsive hoarding seems to frequently be independent from other neurological and psychiatric disorders, including OCD and OCPD. In this review, we first address whether hoarding should be considered a symptom of OCD and/or a criterion of OCPD. Second, we address whether compulsive hoarding should be classified as a separate disorder in DSM-V, weighing the advantages and disadvantages of doing so. Finally, we discuss where compulsive hoarding should be classified in DSM-V if included as a separate disorder. We conclude that there is sufficient evidence to recommend the creation of a new disorder, provisionally called hoarding disorder. Given the historical link between hoarding and OCD/OCPD, and the conservative approach adopted by DSM-V, it may make sense to provisionally list it as an obsessive-compulsive spectrum disorder. An alternative to our recommendation would be to include it in an Appendix of Criteria Sets Provided for Further Study. The creation of a new diagnosis in DSM-V would likely increase public awareness, improve identification of cases, and stimulate both research and the development of specific treatments for hoarding disorder.

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Section: Should Hoarding Continue To Be Mentioned As a Symptom Of Anomentioning

confidence: 99%

Hoarding disorder: a new diagnosis for DSM-V?

et al. 2010

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“…Most studies of the behavioral and cognitive aspects of HD have utilized neutral contexts that did not test decisions about discarding actual items, or modeled discarding using imaginary scenarios (Frost et al, 1998; Preston, Muroff, & Wengrovitz, 2009) without testing actual discarding behavior. Only Tolin and colleagues (Tolin et al, 2009; Tolin, Stevens, Villavicencio, et al, 2012) used an experimental discarding task involving personal possessions; they found that HD participants showed different patterns of neural activity while discarding compared to healthy controls.…”

Section: Hypothesismentioning

confidence: 99%

Behavioral and emotional consequences of thought listing versus cognitive restructuring during discarding decisions in hoarding disorder

Frost

Ong

Steketee

et al. 2016

Behaviour Research and Therapy

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An essential criterion for hoarding disorder (HD) is difficulty discarding or parting with possessions, yet few studies have examined reactions to actual discarding behaviors. The present study examined whether individuals with HD differed from non-hoarding community controls (CC) in discarding behavior and emotional reactions to discarding. A second purpose was to examine the course of experienced distress following discarding. A third purpose was to determine whether HD participants responded differently to a simple thought listing (TL) instruction or to a cognitive restructuring (CR) protocol. Participants were asked to decide whether to keep or discard (a) a personal possession and (b) a newly acquired object (magazine). HD participants anticipated more and longer distress and reported stronger attachment motives than community controls, but they did not differ significantly from community controls in actual discarding behavior. TL was somewhat more effective than CR in improving discarding behavior and reducing negative emotions and attachments to discarded objects among HD participants. Reductions in distress were observed for both HD-TL and HD-CR groups. Thought listing may have reduced avoidance of decision-making about discarding or perhaps CR, but not TL, provoked therapeutic reactance. Discarding was not related to reductions in distress or hoarding-related beliefs.

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“…Future studies might investigate the temporal dynamics of decision making to examine changes in neural activity from earlier to later stages, using behavioral tasks that are well suited for that purpose. 67 …”

Section: Commentmentioning

confidence: 99%

Neural Mechanisms of Decision Making in Hoarding Disorder

Tolin¹,

Stevens²,

Villavicencio³

et al. 2012

Arch Gen Psychiatry

149

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Context Hoarding disorder (HD), previously considered a subtype of obsessive-compulsive disorder (OCD), has been proposed as a unique diagnostic entity in DSM-5. Current models of HD emphasize problems of decision-making, attachment to possessions, and poor insight, whereas previous neuroimaging studies have suggested abnormalities in frontal brain regions. Objective To examine the neural mechanisms of impaired decision making in HD in patients with well-defined primary HD compared with patients with OCD and healthy control subjects (HCs). Design We compared neural activity among patients with HD, patients with OCD, and HCs during decisions to keep or discard personal possessions and control possessions from November 9, 2006, to August 13, 2010. Setting Private, not-for-profit hospital. Participants A total of 107 adults (43 with HD, 31 with OCD, and 33 HCs). Main Outcome Measures Neural activity as measured by functional magnetic resonance imaging in which actual real-time and binding decisions had to be made about whether to keep or discard possessions. Results Compared with participants with OCD and HC, participants with HD exhibited abnormal activity in the anterior cingulate cortex and insula that was stimulus dependent. Specifically, when deciding about items that did not belong to them, patients with HD showed relatively lower activity in these brain regions. However, when deciding about items that belonged to them, these regions showed excessive functional magnetic resonance imaging signals compared with the other 2 groups. These differences in neural function correlated significantly with hoarding severity and self-ratings of indecisiveness and “not just right” feelings among patients with HD and were unattributable to OCD or depressive symptoms. Conclusions Findings suggest a biphasic abnormality in anterior cingulate cortex and insula function in patients with HD related to problems in identifying the emotional significance of a stimulus, generating appropriate emotional response, or regulating affective state during decision making.

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Investigating the mechanisms of hoarding from an experimental perspective

Abstract: Future research with this experimental task can separately investigate the role of acquisition, retention, impulsivity, and sensitivity to constraints in clinical hoarding to inform our understanding of this disorder.

Cited by 47 publications

References 49 publications

Hoarding disorder: a new diagnosis for DSM-V?

Hoarding disorder: a new diagnosis for DSM-V?

Behavioral and emotional consequences of thought listing versus cognitive restructuring during discarding decisions in hoarding disorder

Neural Mechanisms of Decision Making in Hoarding Disorder

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