Neuropsychological and neurophysiological insights into hoarding disorder

Abstract

Hoarding disorder (HD) is associated with significant personal impairment in function and constitutes a severe public health burden. Individuals who hoard experience intense distress in discarding a large number of objects, which results in extreme clutter. Research and theory suggest that hoarding may be associated with specific deficits in information processing, particularly in the areas of attention, memory, and executive functioning. There is also growing interest in the neural underpinnings of hoarding behavior. Thus, the primary aim of this review is to summarize the current state of evidence regarding neuropsychological deficits associated with hoarding and review research on its neurophysiological underpinnings. We also outline the prominent theoretical model of hoarding and provide an up-to-date description of empirically based psychological and medical treatment approaches for HD. Finally, we discuss important future avenues for elaborating our model of HD and improving treatment access and outcomes for this disabling disorder.

Differential patterns of brain activation between hoarding disorder and obsessive-compulsive disorder during executive performance

“…In addition, the prefrontal hypoactivation observed in HD extended to the precentral gyrus. Functional alterations surrounding the primary motor region are not unprecedented; however, increases rather than decreases have been reported in HD compared to OCD and HCs (Saxena et al ., 2004; Tolin et al ., 2014; Grisham and Baldwin, 2015; Hough et al ., 2016). Importantly, however, in our study, right precentral gyrus activation seems to lead to longer RT and more omission errors, and also to fewer commission errors, in HC and OCD groups, but not in HD.…”

Hoarding revisited: there is light at the end of the living room

“…Grisham & Baldwin (2015) identified three main neurocognitive areas linked to hoarding disorder: attention, memory and executive functioning. Attention deficits (‘distractibility’) seemed central to the inability to organise, manage clutter and maintain focus during exposure to organisational tasks; individuals show ‘biased memory beliefs’ and ‘a strong need’ to keep possessions in sight so that they do not forget them (Grisham 2015). Deficits in executive functioning translate into: marked difficulties with impulse inhibition, planning and decision-making; poor self-regulation; difficulties initiating and completing tasks; and problems with indecision.…”

“…Deficits in executive functioning translate into: marked difficulties with impulse inhibition, planning and decision-making; poor self-regulation; difficulties initiating and completing tasks; and problems with indecision. All of these can have a direct impact on the ability to organise or discard possessions (Grisham 2015).…”

Transtorno de acumulação: uma revisão

“…Embora essa evidência apoie a proposição de que os comportamentos de acumulação podem ser conduzidos por dificuldades emocionais, os mecanismos pelos quais alguns componentes do modelo atual contribuem para comportamentos de acumulação não são claros. 36 …”