A Multifaceted Assessment of Emotional Tolerance and Intensity in Hoarding

Hoarding is characterized by emotionally reinforced saving behaviors, which often combine with excessive acquisition to give rise to clutter, distress, and impairment. Despite the central role emotional processes are thought to play in hoarding, very little research has directly examined this topic. There is suggestive evidence linking hoarding with several facets of emotional intolerance and avoidance, though one key limitation of this past research has been the exclusive reliance on self-report questionnaires. The aim of the current study was to conduct a multimethod investigation of the relationship between hoarding and perceptions of, and cognitions about, negative emotional states. A large unselected sample of nonclinical young adults (N = 213) completed questionnaires, behavioral tasks, and a series of negative mood inductions to assess distress tolerance (DT), appraisals of negative emotions, and emotional intensity and tolerance. Hoarding symptoms were associated with lowered tolerance of negative emotions, as well as perceiving negative emotions as more threatening. Individuals high in hoarding symptoms also experienced more intense emotions during the mood inductions than individuals low in hoarding symptoms, though there was no association with poorer performance on a behavioral index of DT. Across measures, hoarding was consistently associated with experiencing negative emotions more intensely and reporting lower tolerance of them. This relationship was particularly pronounced for the difficulty discarding and acquiring facets of hoarding. Our results offer initial support for the important role of emotional processes in the cognitive-behavioral model of hoarding. A better understanding of emotional dysfunction may play a crucial role in developing more effective treatments for hoarding.     

Maternal ADHD: Parent-Child Interactions and Relations With Child Disruptive Behavior

This study examined how ADHD symptoms in mothers of children with ADHD relate to their behavior during parent-child interactions and to their children's disruptive behavior. Findings indicated that mothers’ retrospective self-ratings of ADHD symptoms were related to their present negativity during parent-led play. Mothers’ self-ratings of current inattentive symptoms were related to their impatience during child-led play. Maternal ADHD symptoms were also related to their ratings of their children's ADHD and oppositional-defiant behaviors. Identifying relations between maternal psychopathology, such as ADHD symptomatology, and behaviors during parent-child interactions may yield clues to additional parent behavioral changes that would enhance treatment outcomes for young children with ADHD.     

欺骗判断与欺骗行为中自我控制的影响

欺骗判断与欺骗行为有着不同的心理机制, 正确认识二者之间的关系有助于增强人际间的信任和团队的长远利益。采用行为学实验从两种视角下考察自我控制对欺骗的影响。实验1采用材料评定的方法考察了识别他人自我控制能力状况对欺骗判断的影响, 结果发现对比高自我控制能力的人, 被试更倾向于认为低自我控制能力的人更有可能为了自己的利益产生欺骗行为和欺骗倾向。实验2采用颜色Stroop任务考察了识别他人自我控制资源衰竭状况对欺骗判断的影响, 结果发现当识别他人自我控制资源衰竭时, 在评价他人为自己利益去欺骗、为他人利益去欺骗以及在特定情境中欺骗倾向上, 没有发现任何显著的主效应或交互作用。实验3采用视觉−感知任务来考察不同水平的自我控制能力对欺骗行为的影响, 结果发现, 对比高自我控制组, 低自我控制组有更多的欺骗行为和欺骗倾向。实验4采用颜色Stroop任务和视觉−感知任务来考察自我控制资源对欺骗行为的影响, 结果发现, 对比控制组, 自我控制资源衰竭组有更多的欺骗行为和欺骗倾向。这些研究结果表明, 在进行欺骗判断时, 相比自我控制资源状况, 个体会优先识别他人的自我控制能力水平来判断其是否具有欺骗动机或欺骗倾向。在欺骗行为中, 高自我控制能力的个体, 能够更好地抑制自私动机, 更多的考虑长远利益, 出于自身利益去欺骗的可能性会更小; 自我控制资源充足的个体, 更有可能会经得住诱惑, 自私自利的欺骗行为发生的可能性也会更小。     

Treating Elders With Compulsive Hoarding: A Pilot Program

Hoarding among elderly clients can have serious health and safety consequences, including death. Because medications and standard behavioral treatments have yielded limited benefits for people with serious hoarding problems, we employed a specialized cognitive behavioral treatment (CBT) based on Frost and colleagues' model of hoarding problems. Of 11 elderly clients who met screening criteria for hoarding at a community mental health center, 6 completed an average of 35 sessions of therapy administered by a B.A.-level therapist trained and supervised in CBT methods. Treatment consisted of weekly home visits that included motivational interviewing, organizing and decision-making skills, cognitive therapy regarding hoarding and related beliefs, and practice sorting, discarding, and not acquiring. Modest improvement was evident in ratings of clutter, risky situations in the home, and functioning. Clients were generally satisfied with treatment. Challenges in treating hoarding in elderly clients include health and safety risks as well as reduced physical capacity that required problem-solving strategies.     

自我控制的能量模型:证据、质疑和展望

自我控制的能量模型是解释自我控制的一个重要理论模型。该模型认为,所有的自我控制行为依赖一种共同且有限的能量,执行自我控制会消耗这种能量,导致自我损耗效应的产生,但能量也可以通过一些方法得以恢复和提升。该模型得到大量行为和生理层面研究的支持,但也有研究者从疲劳、情绪、动机、血糖指标、时间知觉等方面提出质疑。未来研究可从自我能量的性质、总量等角度进一步完善能量模型,同时结合我国文化探讨理想、信念、价值观对提升我国国民意志力的作用。     

Preschoolers’ Motor and Verbal Self-Control Strategies During a Resistance-to-Temptation Task

Although prior research has shown that young children exhibit enhanced self-control when they use verbal strategies provided through adult instructions, little work has examined the role of children's spontaneous verbalizations or motor behavior as strategies for enhancing self-control. The present study examined the usefulness of spontaneous verbal and motor strategies for 39 3- and 4-year-old children's ability to exercise self-control during a resistance-to-temptation task. After a 2-min play period, participants were asked by an experimenter not to touch an attractive train set while he was out of the room. Children were videotaped during the 3-min waiting period and videos were coded for frequency and duration of touches, motor movements, and verbalizations. Results indicated that self-control was improved by using both motor and verbal strategies. Children who were unable to resist touching the forbidden toy used limited motor or verbal strategies. These findings add to the growing literature demonstrating the positive role of verbalizations on cognitive control and draw attention to motor behaviors as additional strategies used by young children to exercise self-control.     

自我控制与自我控制资源

自我控制是人适应社会的重要功能, 近十年来, 心理学家主要围绕有限自制力理论展开其研究。事实上, 用于自我控制的资源十分有限, 在它严重被消耗时会引发个体的自我衰竭, 这将对个体的情绪、认知及行为等方面都造成不良的影响。个体的情绪调节、思想抑制和分心控制等行为都可能导致其处于自我衰竭的状态, 但通过睡眠、放松或积极情绪诱导等方式则可有效促进自我控制资源的恢复。未来的研究需进一步明确自我衰竭的心理与生理机制, 并深入挖掘自我衰竭与其它影响自控行为的因素之间的内在关联。     

Self-control,parenting, and problem behavior in early childhood: A multi-method,multi-informant study

BackgroundEarly childhood self-control and parenting are suggested to play key roles in the development of child problem behavior. The current study aims to 1) replicate earlier work by examining the unique and combined effects of child self-control and parenting on child problem behavior and 2) extend earlier work by including both mother and father reports.MethodsData were used from 107 Dutch families: mothers, fathers, and their two-year old child. Child self-control was measured using both father’s and mother’s reports of effortful control and with an observed behavioral task (i.e., gift-in-bag task). Similarly, parenting (i.e., emotional availability and discipline) and child problem behavior (i.e., externalizing and internalizing problems) were measured by using both father’s and mother’s reports.ResultsChild self-control reported by fathers and mothers, but not observed self-control, was related to fewer externalizing and (mother-reported) internalizing problems. Paternal emotional availability showed a modest association with fewer child externalizing problems, maternal emotional availability was related to fewer internalizing problems. Finally, there was an interaction between father- (but not mother) reported self-control and paternal emotional availability in the prediction of child internalizing problems. No main or interaction effect was revealed for discipline.ConclusionFindings confirm prior work on self-control, parenting, and child problem behavior. Most importantly however, the current study adds to the literature by highlighting the need for additional research including maternal as well as paternal data. Specifically, insight in the unique role of fathers may shed light on aspects of child adjustment not covered by mother reports alone.     

The role of developmental features,environmental crises,and personal resources (self-control and social support) in adolescents' aggressive behavior

Aggression among adolescents is a social problem that has sharply escalated in recent years, instigating research into related factors. This article outlines the characteristics of adolescents' aggressive behavior in line with Buss and Perry's (1992) theory linking it to the tendency to develop hostile thoughts and angry emotions. Aggressive behavior may be described as a possible outcome of normal development on the one hand, and as a result of exposure to crisis and trauma on the other. Thus, developmental characteristics highlight the role of age and sex in adolescents' aggressive behavior. In addition, possible external crises and distress (e.g., war, divorce) may contribute to adolescents' aggression. This article also identifies two possible resources that may contribute to a reduction in aggressive behavior under normal and crisis conditions: social support as an environmental resource, and self-control as a personal resource. We conclude with suggestions for reducing aggression through a unified intervention setting that integrates developmental features, environmental and family components, as well as personal components.     

Learning to stand tall: Idiopathic scoliosis,behavioral electronics,and technologically-assisted patient participation in treatment,c. 1969–1992

Drawing on the archives of American learning psychologist Neal E. Miller, this article investigates the role of instrumentation in the expansion and diversification of the behavior therapy domain from the late 1960s to the early 1990s. Through the case of Miller's research on the use of biofeedback to treat idiopathic scoliosis, it argues that the post-World War II adoption of electronic technology by behavioral psychologists contributed to extending their subject matter to include physiological processes and somatic conditions. It also enabled a technologically-instrumented move outside the laboratory through the development of portable ambulatory treatment devices. Using the example of the Posture-Training Device that Miller and his collaborators invented for the behavioral treatment of idiopathic scoliosis, this paper considers how electromechanical psychological instrumentation illustrated a larger and ambiguous strategic shift in behavior therapy from an orientation toward external control to one of self-control.     

The Impact of Childhood Physical Abuse and Age of Sexual Initiation on Women's Maladaptive Posttraumatic Cognitions

Child abuse survivors often exhibit long-standing maladaptive beliefs. Sexual risk-taking could contribute to the maintenance of such beliefs by reinforcing cognitions that originally resulted from child abuse. In this study, 64 community women, most with elevated posttraumatic stress disorder symptoms, completed measures of childhood abuse, sexual risk-taking, and posttraumatic cognitions. Age of first consensual sexual intercourse mediated the relationship between childhood physical abuse and maladaptive posttraumatic cognitions in adulthood. Thus, age of sexual intercourse initiation might play an important role in women's recovery from childhood physical abuse. Clinicians should consider the possible impact of women's sexual history when challenging their cognitions during trauma-based cognitive behavioral therapy. Further, decreasing risky sexual behavior might partially protect against the negative effects of trauma.     

父母控制与儿童心理适应的关系：儿童自我控制的中介作用

以555名小学四到六年级儿童为被试,采用问卷调查法考察父母控制与儿童心理适应的关系,以及儿童自我控制在两者关系间的中介作用。结果发现：（1）六年级儿童的自我控制水平显著高于四年级,且情绪症状显著多于四、五年级;男生多动−注意缺陷水平显著高于女生;（2）父母行为控制对儿童积极心理适应具有显著正向预测作用,对儿童消极心理适应具有显著负向预测作用;而父母心理控制对儿童积极心理适应具有显著负向预测作用,对儿童消极心理适应具有显著正向预测作用;（3）儿童自我控制在父母控制（行为控制和心理控制）与儿童多动−注意缺陷和亲社会行为的关系间起显著中介作用,在父母控制与儿童情绪症状关系间中介作用不显著。     

Evaluation of sensorimotor training in children with ADHD

Reduced ability to regulate motor behavior seems to be an essential aspect of Attention-Deficit Hyperactivity Disorder (ADHD) and may reflect deficits in behavioral response inhibition. In this respect, pragmatic clinical experience over the last two decades, in daily practice, training of motor control has played an important role within multimodal treatment approaches, although an adequate proof of its efficacy is still lacking. Therefore, to examine the efficacy of sensorimotor training, 12 children with ADHD (two groups of six) were treated with both sensorimotor training and (as control) cognitive behavioral training using a within-subject cross-over design. Each treatment had a duration of 4 months (20 sessions), yielding a total of 40 sessions for the completed cross-over design. Results showed that Sensorimotor Training improved sensorimotor coordination slightly, while Cognitive Behavioral Training ameliorated cognitive impulse control. Hyperactivity and anxious-depressive/aggressive behavior were markedly reduced by Sensorimotor Training but not by Cognitive Behavioral Training. In conclusion, a combined treatment may be recommended since compensation and regulation of inhibitory deficits in ADHD come into play within the framework of both kinds of training.     

Cognitive processes in hoarding: The role of rumination

Rumination, defined as an individual's repetitive negative cognitions of upsetting symptoms in response to distress, has been established as an important cognitive vulnerability factor within various forms of psychopathology. Despite compelling data to suggest that rumination is associated with a number of mood and anxiety-related conditions, no research to date has examined the relationship between rumination and hoarding. Participants consisted of 275 undergraduate students as well as 106 individuals recruited from the community to participate in a larger randomized clinical trial investigating the effects of a computerized treatment targeting specific risk factors associated with anxiety and suicide. Consistent with initial prediction, results indicated that rumination was a significant predictor of hoarding severity, even after controlling for overall general levels of depression. These findings add to a growing body of literature identifying various cognitive vulnerability factors important for the development and maintenance of hoarding. Increasing our knowledge of cognitive vulnerability factors has import implications for the prevention and treatment of anxiety disorders.     

Hoarding Disorder and a Systematic Review of Treatment with Cognitive Behavioral Therapy

Until recently, compulsive hoarding has been treated as a type of obsessive-compulsive disorder with mixed results. Little research exists on the efficacy of behavioral interventions specifically designed to treat hoarding disorder, and most existing research is limited with regard to the numbers of participants, their ethnic and cultural diversity, and study replication; therefore, the generalizability of findings is limited. This article reviews the prevalence of hoarding disorder, cognitive behavioral therapy treatment approaches, and measurement of symptoms. A systematic review compares the efficacy of various CBT methods, with particular attention to comparing therapy that is traditionally used to treat OCD with those designed specifically to treat hoarding disorder. Only clinical studies using CBT interventions designed to treat hoarding associated with OCD or hoarding disorder were included. Studies included participants of all ages, and articles were published in peer-reviewed journals. Case studies were excluded. After a comprehensive search and removing duplicates from databases and references, 65 articles were reviewed, of which 12 met criteria for review. Preliminary results demonstrate improvement in hoarding symptoms with CBT interventions that are both for OCD and those designed to specifically treat hoarding disorder; however, when compared to each other, the efficacy of these treatments is inconclusive, thus more research is needed.     

Group cognitive-behavioral therapy for hoarding disorder: an open trial

Although cognitive-behavioral therapy (CBT) appears to be a promising treatment approach for hoarding disorder, treatment to date has been quite labor intensive. The goal of this study, therefore, was to assess the potential effectiveness of group CBT for hoarding, without home visits by the clinician. Forty-five individuals with hoarding disorder enrolled in either a 16 or 20 session program of group CBT; 30 (67%) completed treatment. Using mixed-effects models to account for missing data, we report data from 35 (78%) participants who provided enough data for analysis. Participants demonstrated significant improvements in hoarding symptoms, as well as symptoms of depression and anxiety, and quality of life. Improvements in hoarding symptoms were comparable to two published clinical trials on individual CBT for hoarding disorder. Results of this study suggest that group CBT for hoarding, without home discarding sessions by the clinician, may be an effective treatment option with the potential advantage of increasing treatment access by reducing clinician burden and cost of treatment.     

Treatment of Diogenes Syndrome with Risperidone

Diogenes syndrome is characterized by shameless neglect of the body and personal environment, hoarding, and the rejection of any help. It occurs among patients with and without other psychiatric disorders. The initial treatment should be a behavioral program, but there is no information about the pharmacological treatment of this syndrome. We report the case of a 77-year-old woman with symptoms of Diogenes syndrome. After an unsuccessful behavioral program, treatment with risperidone initially improved the behavioral symptoms but impaired cognitive function, and was followed by marked global deterioration, fulfilling criteria for dementia.     

Hoarding in obsessive compulsive disorder: results from a case-control study

Hoarding occurs relatively frequently in obsessive-compulsive disorder (OCD), and there is evidence that patients with hoarding symptoms have more severe OCD and are less responsive to treatment. In the present study, we investigated hoarding symptoms in 126 subjects with OCD. Nearly 30% of the subjects had hoarding symptoms; hoarding was twice as prevalent in males than females. Compared to the 90 non-hoarding subjects, the 36 hoarding individuals had an earlier age at onset of, and more severe, obsessive-compulsive symptoms. Hoarders had greater prevalences of symmetry obsessions, counting compulsions, and ordering compulsions. Hoarders also had greater prevalences of social phobia, personality disorders, and pathological grooming behaviors (skin picking, nail biting, and trichotillomania). Hoarding and tics were more frequent in first-degree relatives of hoarding than non-hoarding probands. The findings suggest that the treatment of OCD patients with hoarding symptoms may be complicated by more severe OCD and the presence of co-occurring disorders. Hoarding appears to be transmitted in some OCD families and may differentiate a clinical subgroup of OCD.     

Delivery of internet treatment for compulsive hoarding (D.I.T.C.H.)

This study tested the effectiveness of an existing private online CBT-based group intervention designed to help people with hoarding. Web-group participants were hypothesized to show more improvement in hoarding symptoms over time compared to those placed on a naturalistic waitlist. This web-based self-help group (N = 106 members, N = 155 waitlisted) includes a formal application process and requires that participants post action steps and progress at least once monthly. Members have access to educational resources on hoarding, cognitive strategies, and a chat-group. Potential research participants were invited to complete an anonymous web-based survey about their hoarding behaviors and clinical improvement on five occasions (3 months apart). The sample was mainly middle-aged, female and White. Regression analyses show that Recent members reported greater improvement and less clutter at 6 months (than Waitlist). Long-term members reported milder hoarding symptoms than Recent ones, suggesting benefits from group participation over time. All members showed reductions in clutter and hoarding symptoms over 15 months. Less posting activity was associated with greater hoarding severity. Online CBT-based self-help for hoarding appears to be a promising intervention strategy that may extend access to treatment. Evaluating the benefits of internet self-help groups is critical given growing popularity of and demand for web-based interventions.