Categorization and cognitive deficits in compulsive hoarding

According to the cognitive-behavioural model of compulsive hoarding, information-processing deficits in the areas of attention, memory, decision-making, and categorization contribute to hoarding behaviour. The purpose of the current study was to examine whether individuals with compulsive hoarding exhibited impairment on executive functioning and categorization tasks. Three groups of participants were recruited (N = 60): individuals with compulsive hoarding syndrome, individuals with an Axis I mood or anxiety disorder, and non-clinical control participants. All participants completed self-report measures of cognitive difficulties, neuropsychological tests of executive functioning and decision-making, and four categorization tasks. Results suggested that hoarding participants reported more cognitive failures and more problems with attention and decision-making than non-clinical control participants. In addition, hoarding participants performed worse than both control groups on the Stockings of Cambridge (SOC), a neuropsychological test of planning ability, and were slower and more anxious during a categorization task. These findings suggest that specific deficits in executive functioning may be associated with the difficulties hoarding patients have organizing their possessions.     

Categorization in compulsive hoarding

Based on hypothesizing about the role of information processing, and in particular, underinclusive categorization in compulsive hoarding, this study examined categorization processes in people with clinically significant compulsive hoarding problems. Twenty-one participants with primary compulsive hoarding, 21 with OCD without hoarding, and 21 non-psychiatric controls completed three categorization tasks. Hoarding and OCD participants reported significantly more distress prior to each of the three tasks than did controls. On tasks sorting common household items, the groups did not differ on the number of piles created nor on the amount of time taken to sort. However, on a task sorting personally relevant items, hoarding participants took more time, created more piles, and reported more anxiety than non-psychiatric controls. Hoarders also took more time than the OCD group, and tended to create more piles. Hoarding severity was correlated with the number of piles created, but only when the objects were personally relevant. Results support under-inclusive categorizing for people with compulsive hoarding, but the effect was largely confined to objects of personal relevance.     

信息时代的“数字占有”——数字囤积及其相关研究

数字囤积是指数字文件的积累致使个体降低目标检索能力,最终导致个体的压力和混乱,与实物囤积有联系但有所不同。数字囤积者的认知表现、情感特点、行为动机可分别从自我损耗、禀赋效应、进化的视角进行理解。未来研究应完善测量工具,并考虑文化背景,针对不同数字囤积人群,考察其行为的潜在动机和前因后果,同时应采用不同的研究方法,加强该领域的量化研究。     

Trait Versus Task-Induced Emotional Reactivity and Distress Intolerance in Hoarding Disorder: Transdiagnostic Implications

Evidence from analogue samples suggests that deficits in emotional functioning, namely elevated emotional reactivity and distress intolerance, are implicated in the development and maintenance of hoarding disorder. We aimed to extend previous research in this area by investigating emotional reactivity and distress intolerance in a sample of individuals diagnosed with hoarding disorder (n = 24) in comparison to clinical controls (n = 21) and nonclinical community controls (n = 26) using a combination of self-report, physiological, and behavioral measures. We found that trait distress intolerance was significantly and independently associated with greater hoarding severity. The hoarding and clinical control groups reported more trait emotional reactivity and distress intolerance than the community control group, but did not differ from each other on these traits. The hoarding group reported more subjective distress before beginning a frustrating behavioral task, but did not evidence more physiological arousal. Moreover, the hoarding group experienced similar increases in distress during the task and did not differ from either group in regard to time persisting on this task. The clinical control group, however, terminated the frustrating task significantly faster than the community control group, who tended to persist until the task timed out. Lastly, trait distress intolerance evidenced a small-to-moderate but nonstatistically significant independent relationship with task persistence time. Given the desynchrony between subjective distress and physiological arousal, we encourage researchers to utilize multimodal assessment in the future. We also suggest that clinicians start to use behavioral experiments, as has been done with other psychological disorders, to improve distress intolerance among persons who experience hoarding disorder.     

Relationships among compulsive hoarding, trauma, and attention-deficit/hyperactivity disorder

The current study investigated aspects of post-traumatic stress disorder and attention deficit/ hyperactivity disorder (ADHD) among hoarders. Compared to a sample of 36 controls, hoarders (n=26) reported a significantly greater number of different types of trauma, more frequent traumatic experiences, more symptoms of inattention, hyperactivity, and greater comfort derived from possessions. These findings are consistent with previous reports of extensive comorbidity associated with hoarding behaviors, and may reflect the potential usefulness of assessing PTSD and ADHD symptoms at the outset of hoarding treatments, as well as considering alternative pharmacological interventions.     

Do traumatic events influence the clinical expression of compulsive hoarding?

Traumatic experiences have been posited as one potential catalyst for the abrupt onset of obsessive-compulsive symptoms including compulsive hoarding. To determine whether traumatic life events (TLEs) might influence the expression of compulsive hoarding in obsessive-compulsive disorder (OCD), interview responses to the Posttraumatic Stress Disorder module of the Structured Clinical Interview for DSM-IV (SCID) were examined in 180 individuals with OCD. Compared to individuals with OCD who did not meet criteria for hoarding, participants classified as hoarders (24% of the sample) were significantly more likely to have reported at least one TLE in their lifetime. Patients who met criteria for hoarding and who had also experienced TLEs had significantly greater hoarding symptom severity than those hoarders not exposed to trauma. This association was found to be robust. That is, the relationship between TLEs and hoarding symptom severity was not better accounted for by age, age of OCD onset, depressive symptoms, general OCD symptomatology, or mood and anxiety comorbidity. Closer examination revealed that the clutter factor of compulsive hoarding (and not difficulty discarding or acquisitioning) was most strongly associated with having experienced a traumatic event.     

Examining the Link Between Hoarding Symptoms and Cognitive Flexibility Deficits

Executive functioning deficits have been found to underlie primary symptoms of hoarding, such as difficulty discarding belongings and significant clutter. Cognitive flexibility—the ability to inhibit irrelevant material and attend flexibly between different mental sets—may be impaired as well, as individuals experience difficulty staying on task and are often distracted by specific possessions that tend to evoke an exaggerated emotional response. The present study investigated cognitive flexibility deficits via eye-tracking technology as a novel approach. Participants (N = 69) with high and low self-reported hoarding symptoms were asked to respond to a series of auditory cues requiring them to categorize a small target number superimposed on one of three distractor image types: hoarding, nature, or a blank control. Across a range of behavioral and eye-tracking outcomes (including reaction time, accuracy rate, initial orientation to distractors, and viewing time for distractors), high hoarding participants consistently demonstrated greater cognitive inflexibility compared to the low hoarding group. However, high hoarding participants did not evidence context-dependent deficits based on preceding distractor types, as performance did not significantly differ as a function of hoarding versus nature distractors. Current findings indicate a pervasive, more global deficit in cognitive flexibility. Those with hoarding may encounter greater difficulty disengaging from previous stimuli and attending to a given task at hand, regardless of whether the context of the distractor is specifically related to hoarding. Implications and future directions for clarifying the nature of cognitive inflexibility are discussed.     

The influence of anthropomorphic tendencies on human hoarding behaviours

Hoarding is the excessive acquisition of and failure to discard possessions. Previous research has shown a link between anthropomorphism (the tendency to ascribe human characteristics to non-human objects) and hoarding. Here we assess the psychometric properties of a new Anthropomorphism Questionnaire (AQ) in a nonclinical sample of 264 adults. A further sample of 93 participants was then recruited to assess relationships between hoarding behaviours and cognitions, scores on the AQ, an existing anthropomorphism questionnaire (Individual Differences in Anthropomorphism Questionnaire: IDAQ), and a measure of social anxiety. Regression analyses revealed the AQ but not the IDAQ to be a significant predictor for hoarding behaviours. Women showed stronger childhood anthropomorphising behaviours than men, and younger participants showed stronger anthropomorphising and hoarding cognitions and behaviours. We conclude that the AQ better supports the predicted relationship between anthropomorphism and hoarding than the IDAQ. We also suggest that age and sex need to be more carefully considered in future studies on anthropomorphism and hoarding.     

An exploration of economic reasoning in hoarding disorder patients

Current models of hoarding disorder (HD) emphasize problems of decision-making. Evidence for neuropsychological impairment in HD, however, has been mixed. The present study examined whether HD patients show problems of economic reasoning that could be associated with decision-making problems. Forty-two HD patients, 29 obsessive-compulsive disorder (OCD) patients, and 36 healthy control participants completed the Iowa gambling task (IGT), a computerized card playing game that assesses participants' ability to learn and utilize a rule of sacrificing short-term gain for long-term gain, and a cognitive dissonance reduction task that measured changes in preference for items (art prints) after selecting or rejecting them. Results showed no deficits on the IGT for HD participants, and no difference in dissonance reduction results after selecting or rejecting items on the dissonance reduction task. Furthermore, performance on these two tasks was unrelated to hoarding symptom severity or self-reported indecisiveness. It is suggested that the problems of cognitive processing in HD patients may be largely related to as-yet understudied processes, including idiosyncratic categorization problems for personally-owned items as well as other aspects of economic reasoning.     

An Experimental Investigation of the Effect of Stress on Saving and Acquiring Behavioral Tendencies: The Role of Distress Tolerance and Negative Urgency

Stress has been implicated as a risk factor for hoarding, although past research has relied on cross-sectional and self-report designs. Using experimental methods and objective hypothetical behavioral hoarding paradigms, we investigated the direct effect of stress on in-the-moment saving and acquiring behavioral tendencies. We also evaluated whether distress tolerance (DT) and negative urgency interacted with stress to predict saving and acquiring behavioral tendencies. A sample of young adults (N = 80) completed questionnaires about DT and negative urgency. Participants were randomized to either a psychosocial stressor or nonstressful control task prior to completing two hypothetical behavioral hoarding paradigms. The discarding task asked participants to choose between saving and disposing of items. For the acquiring task, participants completed a computer-simulated shopping spree that measured items acquired. Unexpectedly, participants in the stress condition saved and acquired fewer items than those in the control condition. As hypothesized, stress interacted with DT to predict saving tendencies. The current study should be replicated in a clinical sample. Longitudinal studies are needed to further examine the long-term effect of stress on hoarding. This is the first examination of the direct effect of stress on saving and acquiring tendencies. Although some study hypotheses were not supported, several results are consistent with our predictions and suggest a complex relationship between stress and hoarding. If findings are replicated in a clinical sample, it may be that hoarding patients could benefit from treatments incorporating DT strategies.     

Is the fluency of language outputs related to individual differences in intelligence and executive function?

There has been little research on the fluency of language production and individual difference variables, such as intelligence and executive function. In this study, we report data from 106 participants who completed a battery of standardized cognitive tasks and a sentence production task. For the sentence production task, participants were presented with two objects and a verb and their task was to formulate a sentence. Four types of disfluency were examined: filled pauses (e.g. uh, um), unfilled pauses, repetitions, and repairs. Repetitions occur when the speaker suspends articulation and then repeats the previous word/phrase, and repairs occur when the speaker suspends articulation and then starts over with a different word/phrase. Hierarchical structural equation modeling revealed a significant relationship between repair disfluencies and inhibition. Conclusions focus on the role of individual differences in cognitive ability and their role in models and theories of language production.     

Working memory, attention control, and the N-back task: a question of construct validity

The N-back task requires participants to decide whether each stimulus in a sequence matches the one that appeared n items ago. Although N-back has become a standard "executive" working memory (WM) measure in cognitive neuroscience, it has been subjected to few behavioral tests of construct validity. A combined experimental- correlational study tested the attention-control demands of verbal 2- and 3-back tasks by presenting n = 1 "lure" foils. Lures elicited more false alarms than control foils in both 2- and 3-back tasks, and lures caused more misses to targets that immediately followed them compared with control targets, but only in 3-back tasks. N-back thus challenges control over familiarity-based responding. Participants also completed a verbal WM span task (operation span task) and a marker test of general fluid intelligence (Gf; Ravens Advanced Progressive Matrices Test; J. C. Raven, J. E. Raven, & J. H. Court, 1998). N-back and WM span correlated weakly, suggesting they do not reflect primarily a single construct; moreover, both accounted for independent variance in Gf. N-back has face validity as a WM task, but it does not demonstrate convergent validity with at least 1 established WM measure.     

Neuropsychological impairment associated with compulsive hoarding

A group of patients with compulsive hoarding (n=30) was compared to a mixed clinical group (n=30) and a nonclinical community group (n=30) on laboratory tests of information-processing features hypothesized to be central to hoarding (memory, attention, and decision-making). Hoarding patients demonstrated slower and more variable reaction time, increased impulsivity, greater difficulty distinguishing targets and nontargets, and worse spatial attention relative to comparison groups. Multiple regression analyses demonstrated that slower reaction time and increased impulsivity were significantly related to hoarding symptoms over and above the effect of depression, schizotypy, and other obsessive-compulsive disorder (OCD) symptoms. There were no group differences on a test of emotion-based decision-making. Results are discussed in terms of previous findings and theoretical models of compulsive hoarding.     

Hoarding in obsessive-compulsive disorder: results from the OCD Collaborative Genetics Study

Hoarding behavior occurs frequently in obsessive-compulsive disorder (OCD). Results from previous studies suggest that individuals with OCD who have hoarding symptoms are clinically different than non-hoarders and may represent a distinct clinical group. In the present study, we compared 235 hoarding to 389 non-hoarding participants, all of whom had OCD, collected in the course of the OCD Collaborative Genetics Study. We found that, compared to non-hoarding individuals, hoarders were more likely to have symmetry obsessions and repeating, counting, and ordering compulsions; poorer insight; more severe illness; difficulty initiating or completing tasks; and indecision. Hoarders had a greater prevalence of social phobia and generalized anxiety disorder. Hoarders also had a greater prevalence of obsessive-compulsive and dependent personality disorders. Five personality traits were independently associated with hoarding: miserliness, preoccupation with details, difficulty making decisions, odd behavior or appearance, and magical thinking. Hoarding and indecision were more prevalent in the relatives of hoarding than of non-hoarding probands. Hoarding in relatives was associated with indecision in probands, independently of proband hoarding status. The findings suggest that hoarding behavior may help differentiate a distinct clinical subgroup of people with OCD and may aggregate in some OCD families. Indecision may be a risk factor for hoarding in these families.     

Preliminary Psychometric Evidence for Distinct Affective and Cognitive Mechanisms Mediating Contamination Aversion

Contamination aversion is implicated in a range of psychological disorders, such as obsessive-compulsive disorder and health anxiety. Despite broad implications, the core mechanisms mediating contamination aversion are mixed and have not clearly been elucidated. The present studies are psychometric investigations of the components of contamination aversion and tests of the different mechanisms that mediate the severity of these components. In Study 1, items from existing measures of contamination aversion were compiled into one measure and administered to a large sample of nonclinical participants (N?=?1,286). Exploratory factor analyses demonstrated a two-factor structure, with one factor comprised of items related to intrinsically (direct) contaminated objects and the other factor comprised of items related to extrinsically (indirect) contaminated objects. In Study 2, items were added and confirmatory factor analyses supported a two-factor model in another large nonclinical sample (N?=?612). In Study 3 (N?=?471), structural modeling demonstrated distinct relations between the two factors and affective and cognitive constructs. Affective constructs related more to aversions toward more directly contaminated objects and situations while cognitive constructs related more to aversions toward more indirectly contaminated objects and situations. The present studies help clarify and articulate the unique roles of cognition and affect in specific contamination aversions, and, as such, have important implications for conceptual modeling of contamination-related psychopathology.     

Selective attention, memory bias, and symptom perception in idiopathic environmental intolerance and somatoform disorders

Idiopathic environmental intolerance (IEI) refers to a polysymptomatic condition, similar to somatoform disorders. Various processes seem to contribute to its yet unknown etiology. Attention and memory for somatic symptom and IEI-trigger words was compared among participants with IEI (n = 54), somatoform disorders (SFD; n = 44) and control participants (n = 54). Groups did not differ in a dot-probe task. However, in an emotional Stroop task, attention was biased in IEI and SFD groups toward symptom words but not toward IEI-trigger words. Only the IEI group rated trigger words as more unpleasant and more arousing, and participants remembered them better in a recognition task. These implicit and explicit cognitive abnormalities in IEI and SFD may maintain processes of somatosensory amplification.     

Inhibition in task switching: The reliability of the n − 2 repetition cost

The n???2 repetition cost seen in task switching is the effect of slower response times performing a recently completed task (e.g. an ABA sequence) compared to performing a task that was not recently completed (e.g. a CBA sequence). This cost is thought to reflect cognitive inhibition of task representations and as such, the n???2 repetition cost has begun to be used as an assessment of individual differences in inhibitory control; however, the reliability of this measure has not been investigated in a systematic manner. The current study addressed this important issue. Seventy-two participants performed three task switching paradigms; participants were also assessed on rumination traits and processing speed—measures of individual differences potentially modulating the n???2 repetition cost. We found significant n???2 repetition costs for each paradigm. However, split-half reliability tests revealed that this cost was not reliable at the individual-difference level. Neither rumination tendencies nor processing speed predicted this cost. We conclude that the n???2 repetition cost is not reliable as a measure of individual differences in inhibitory control.     

Cognitive associations of bimanual haptico-visual recognition in preschoolers.

We have investigated the relation between haptico-visual recognition of objects and cognitive tasks in two large samples of preschoolers (n = 534; n = 750). Children aged 6 years completed a cross-modal task in which they have first to haptically explore an object and second to visually recognize it; they also performed phonological, verbal semantic, and visual tasks. For two consecutive years, bimanual haptico-visual recognition was significantly correlated to performance at all the cognitive tasks. The meaning of this relationship is discussed. The study supports the view that haptico-visual recognition tasks should be used as screening tools for early identification of children at risk of learning difficulties.     

Inhibiting irrelevant information in adult children of people with alcoholism

Adult children of people with alcoholism (ACAs; n = 21) and adults with no family history of alcoholism (non-ACAs; n = 24) completed a task designed to test inhibitory ability using a reaction-time based negative priming task. Although participants in the ACA group responded more slowly overall, they did not differ on this task as compared with participants in the non-ACA group. This pattern of results suggests that inhibitory ability is preserved in ACAs, at least within the context of the current negative priming task. The authors discuss study limitations and inconsistencies in the ACA literature.     

The Adaptable Mind in Design: Relating Personality,Cognitive Style,and Creative Performance

This study examined domain-specific relationships between creative personality traits, cognitive styles, and creative performance in design. Design students (n = 39) completed the Adjective Check List (ACL) and the Herrmann Brain Dominance Instrument (HBDI) to gauge personality and cognitive style, respectively. The ACL was scored using Domino's Creativity Scale (ACL-Cr) to identify creative personality traits. The sample also completed a design task that was evaluated for creativity using the Consensual Assessment Technique (CAT). Findings indicated that participants showing flexibility between cerebral, limbic, right, and left modes of thinking had significantly higher mean scores on creative personality than did those who exhibited a more entrenched cognitive style. Creative personality traits (ACL-Cr) significantly predicted creative performance on the design task. While cognitive style (HBDI) did not predict creative performance, flexibility between styles was significantly correlated to the creative personality. In sum, individuals exhibiting adaptable thinking appear to possess the flexibility necessary to design creatively and potentially transform the domain with original and imaginative solutions.