Patterns of Clinically Significant Cognitive Impairment in Hoarding Disorder

Abstract

OBJECTIVES The cognitive characteristics of individuals with Hoarding Disorder (HD) are not well understood. Existing studies are relatively few and somewhat inconsistent but suggest that individuals with HD may have specific dysfunction in the cognitive domains of categorization, speed of information processing, and decision-making. However, there have been no studies evaluating the degree to which cognitive dysfunction in these domains reflects clinically significant cognitive impairment (CI). METHODS Participants included 78 individuals who met DSM-V criteria for HD and 70 age- and education-matched controls. Cognitive performance on measures of memory, attention, information processing speed, abstract reasoning, visuospatial processing, decision-making, and categorization ability was evaluated for each participant. Rates of clinical impairment for each measure were compared, as were age and education corrected raw scores for each cognitive test. RESULTS HD participants showed greater incidence of CI on measures of visual memory, visual detection, and visual categorization relative to controls. Raw score comparisons between groups showed similar results with HD participants showing lower raw score performance on each of these measures. In addition, in raw score comparisons HD participants also demonstrated relative strengths compared to control participants on measures of verbal and visual abstract reasoning. CONCLUSIONS These results suggest that HD is associated with a pattern of clinically significant CI in some visually mediated neurocognitive processes including visual memory, visual detection, and visual categorization. Additionally these results suggest HD individuals may also exhibit relative strengths, perhaps compensatory, in abstract reasoning in both verbal and visual domains.

Value-based decision making under uncertainty in hoarding and obsessive- compulsive disorders

“…Individuals with HD may have difficulties processing information in complex real word scenarios but be able to cope with the demands of a simple laboratory task. This is consistent with a number of studies reporting very limited evidence of decision making impairments in HD in a variety of other laboratory tasks (Grisham et al, 2010; Frost et al, 2011; Morein-Zamir et al, 2014; Mackin et al, 2015; Sumner et al, 2015). …”

Comparison of brain activation patterns during executive function tasks in hoarding disorder and non-hoarding OCD

“…Individuals with hoarding behaviors exhibit deficits on measures of executive function such as categorization, set-shifting (Ayers et al, 2013; Mackin et al, 2011; Mackin et al, 2016; McMillan et al, 2013; Morein-Zamir et al, 2014), and sustained attention and inhibition (Blom et al, 2011; Raines et al, 2014; Tolin et al, 2011). In several studies, the severity of these executive function deficits was associated with the severity of hoarding symptoms (Ayers et al, 2013; Raines et al, 2014; Tolin et al, 2011), although the data are not always consistent across studies (Grisham et al, 2010; Tolin et al, 2011).…”

Atomoxetine for Hoarding Disorder: A Preclinical and Clinical Investigation

“…Finally, a large epidemiological study showed that childhood inattention (but not hyperactivity) is associated with lifetime hoarding symptoms (Fullana et al, 2013) and a recent family study showed a common load for inattention and hoarding symptoms (Dijk et al, 2016). Although one study (Sumner et al, 2015) showed normal attentional performance, the majority of data show attentional impairments in HD subjects compared to controls (Mackin et al, 2016, Tolin et al, 2011b, Grisham et al, 2007. In these studies, hoarding patients showed worse performances respect to healthy subjects on sustained attention tasks, visual detection and visual memory tasks (Mackin et al, 2016;Tolin et al, 2011b, Grisham et al, 2007.…”

“…Although one study (Sumner et al, 2015) showed normal attentional performance, the majority of data show attentional impairments in HD subjects compared to controls (Mackin et al, 2016, Tolin et al, 2011b, Grisham et al, 2007. In these studies, hoarding patients showed worse performances respect to healthy subjects on sustained attention tasks, visual detection and visual memory tasks (Mackin et al, 2016;Tolin et al, 2011b, Grisham et al, 2007. Three distinct but interconnected networks have been proposed to form the human attention network (Raz and Buhle, 2006;Petersen and Posner, 2012).…”