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.     

Conferring humanness: The role of anthropomorphism in hoarding

Hoarding is characterized by a persistent and extreme difficulty with discarding one’s possessions, often resulting in cluttered living spaces and marked distress or impairment. Despite being increasingly recognized as a substantial public health burden, much remains unknown about the etiology. One facet within the cognitive-behavioral model of hoarding that remains poorly understood is the strong emotional attachment to possessions. The tendency to anthropomorphize (i.e., see human-like qualities in non-human entities) may be one possible mechanism contributing to this emotional attachment. The current report is the first empirical study to examine the association between anthropomorphism and hoarding. Non-clinical participants (n = 72) completed a battery of self-report measures focused on hoarding symptoms, saving cognitions, anthropomorphism, and emotional attachments to personal and novel items. Anthropomorphic tendencies were significantly associated with greater saving behaviors and the acquisition of free things. Levels of anthropomorphism moderated the relationship between specific hoarding beliefs and acquiring tendencies, as well as the emotional attachment towards a novel item. Results are discussed with regard to future research directions, and implications for the cognitive-behavioral model of hoarding.     

The Relationship between Hoarding Symptoms,Intolerance of Uncertainty,and Error-Related Negativity

Individuals who hoard report poor tolerance for uncertainty. They also exhibit error-monitoring abnormalities and increased activation of the anterior cingulate during possession-relevant decision-making, potentially reflecting a context-dependent error sensitivity. Together, these underlying vulnerabilities may lead individuals who hoard to avoid uncertain acquiring and discarding decisions. The current study explored electrophysiological indices of error-monitoring (error-related negativity; ERN) in possession-related and possession-unrelated contexts, and how this related to self-reported intolerance of uncertainty (IU). Undergraduate students (N = 29) completed self-report measures of hoarding symptoms and intolerance of uncertainty, and then engaged in a Go/NoGo task and a novel Discard/NoDiscard task with concurrent EEG measurement. Regression analyses revealed that hoarding symptoms predicted ERN amplitude for possession-related errors but not possession-unrelated errors, and that this relationship was influenced by IU in possession-related contexts. These findings have theoretical implications for understanding vulnerability in hoarding.     

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.     

Inattention, but not OCD, predicts the core features of hoarding disorder

Hoarding Disorder (HD), defined as the acquisition of and failure to discard large volumes of possessions, resulting in clutter that precludes normal use of living spaces, is a common and debilitating condition. Although hoarding has historically been conceptualized as a variant of obsessive-compulsive disorder (OCD), increasing evidence suggests that hoarding might be more closely associated with the symptoms of attention deficit-hyperactivity disorder (ADHD). The aim of the present study was to clarify the relationship between the core features of hoarding (clutter, difficulty discarding, acquiring), OCD symptoms, and ADHD symptoms. HD (N = 39), non-hoarding OCD (N = 26), and healthy control (N = 36) participants underwent careful diagnostic interviewing and completed standardized self-report measures of the core features of hoarding (clutter, difficulty discarding, acquiring), OCD symptoms, negative affect, and the inattentive and hyperactive/impulsive symptoms of ADHD. Multiple linear regressions demonstrated that after controlling for global negative affect, OCD symptoms did not significantly predict any of the core features of HD. Conversely, the inattentive (but not hyperactive/impulsive) symptoms of ADHD significantly predicted severity of clutter, difficulty discarding, and acquiring. These results challenge current conceptualizations of hoarding as a subtype of OCD, and suggest an association with neurocognitive impairment.     

Implicit self-esteem is associated with higher levels of trait gratitude in women but not men

ABSTRACT

Higher levels of trait gratitude have been associated with measures of greater self-reported self-esteem. However, such self-report measures may be influenced by self-report biases. In this study we investigated for the first time whether implicit measures of self-esteem would be associated with greater trait gratitude in a sample of 88 undergraduate students (41 female). We observed that, in women (but not men), higher levels of trait gratitude were associated with higher implicit self-esteem (r = .26, p = .05), even when accounting for depressive symptoms. This finding may be of particular importance, as implicit measures of self-esteem have been more strongly associated with psychological health than explicit measures. Future research should further investigate whether the experience of gratitude affects self-esteem differently in men and women, as this knowledge may be important in informing the design of future gratitude interventions aimed at improving psychological health in men and women.     

Brain Function Associated with Cooccurring Trauma and Depression Symptoms in College Students

The goal of this pilot study was to determine if functional brain differences are present among individuals with high and low cooccurring trauma and depression symptoms. This pilot study examined how the P300 latency component of event-related potentials (ERPs), measured using electroencephalography (EEG) while participants performed a go/no-go task, might be associated with cooccurring self-report of trauma and depression symptoms in a sample of college students (N = 38). Alpha-corrected independent sample t tests revealed statistically significant differences in ERP P300 peak latencies between those in the high cooccurring trauma and depression symptoms group (n = 12) and those in the low group (n = 26) for all 3 midline electrode sites (Fz, Cz, and Pz). This pilot study provides preliminary evidence of differential brain functioning in individuals experiencing cooccurring trauma and depression symptoms. Accordingly, these findings support future research examining brain functioning in cooccurring symptoms.     

Sport participation,body satisfaction and depressive symptoms in adolescence: a moderated-mediation analysis of gender differences

This research aimed to analyse the partial mediating role of body satisfaction in the relationship between sport participation and depressive symptoms, as well as to examine the moderating role of gender in these associations. A cross-sectional study was conducted with a sample of 1810 adolescents aged 13–18 years old who completed self-report measures regarding sport participation, body satisfaction and depressive symptoms. The results indicated that a higher frequency of sport participation was associated with a lower presence of depressive symptoms, both directly and through greater body satisfaction, although gender differences were found in this partial mediation model. It was detected that sport participation had a greater effect on positive body satisfaction among boys, whereas body dissatisfaction indicated a greater presence of depressive symptoms among girls. The results emphasize the need to implement gender-specific programmes to improve psychological adjustment in adolescents by promoting sport practice and body acceptance.     

The Association Between Self-Control and Hoarding: A Case Report

The capacity to exert control over one's behavior is known as self-control, and this ability to self-regulate is a necessary component for directing personal behavior toward achieving a specific goal. Baumeister and colleagues have suggested that self-control operates within a resource model such that an individual may strengthen this resource through directed practice. Hoarding is one syndrome wherein self-control may play a substantial role. Within a translational research framework, two separate case studies sought to determine if practicing self-control in a non-hoarding-related domain might have an impact on an individual's hoarding symptoms and their readiness for treatment. Two individuals diagnosed with hoarding were enrolled in a self-control practice condition. Both self-control levels and hoarding symptoms were measured at pre– and post–time points using self-report and behavioral indices. Findings in support of a favorable effect of self-control on mitigating behavioral hoarding symptoms were mixed, with 1 patient experiencing marked improvement in symptoms and the other not. We also found that self-control practice was associated with both increased motivation for treatment and overall level of self-awareness. The implications of self-control for hoarding are discussed from a disease-reduction and prevention standpoint, along with the role self-control might play within more traditional cognitive behavioral interventions.     

Frequency of Interpersonal Trauma Types,Avoidant Attachment,Self-Compassion,and Interpersonal Competence: A Model of Persisting Posttraumatic Symptoms

Given limited knowledge about how psychosocial factors interact to modulate posttraumatic stress symptoms, this study evaluated an integrative model proposing that experiencing more interpersonal trauma types (e.g., abuse, assault, rape, etc.) leads to greater avoidant attachment and lower self-compassion, which limits the development and use of effective interpersonal skills. In turn, lower levels of self-compassion and interpersonal competence perpetuate posttraumatic symptoms. Anonymous trauma-experienced adults (n = 132) completed self-report measures in an online study hyperlinked on trauma support websites. Data were subjected to confirmatory factor analysis and structural equation modeling, which provided support for the hypothesized model. Specifically, higher frequency of interpersonal trauma types experienced was linked to higher avoidant attachment and lower self-compassion, which in turn were associated with lower interpersonal competence, which correlated with greater posttraumatic stress symptoms. Although cross-sectional data cannot address directionality of associations, this study’s findings emphasize the potential utility of future longitudinal research designed to examine possible causal relationships among these specific psychosocial factors. For example, study findings suggest that those who experience more types of interpersonal trauma and who are characterized by avoidant attachment and lower self-compassion and interpersonal competence may be the most susceptible to experiencing severe posttraumatic symptoms. However, findings also suggest that efforts to increase self-compassion and interpersonal skills may help reduce symptoms.     

Co-Occurring Traumatic Brain Injury,PTSD Symptoms,and Alcohol Use in Veterans

Traumatic brain injury (TBI) has been identified as a significant health problem among veterans. Recent research demonstrates the potential interaction and magnification of symptoms of posttraumatic stress disorder (PTSD) and substance use disorders (SUD) in veterans with a history of TBI; however, there is very limited research on the co-occurrence of the three conditions. Veterans (N = 115) with comorbid PTSD and SUD completed a baseline assessment for enrollment into a larger treatment study. As part of that assessment, participants completed a TBI screener as well as self-report measures for pain and physical health, affective symptoms, and substance use. Almost half of the sample (48 %) endorsed a history of a previous head trauma with loss of consciousness (LOC). Participants with and without head trauma with LOC were compared across various measures of functioning. Increased severity of physical health complaints and affective symptoms were reported by the TBI group compared to controls. However, the increases in affective symptoms were relatively small. No group differences were observed for alcohol use. Together, the findings suggest that treatment-seeking veterans with a history of head trauma with LOC may present with roughly equivalent symptoms of PTSD and SUD to those without said history.     

Identification of Oppositional Defiant Disorder in Young Adult College Students

Long-considered a disorder restricted to children and adolescents, more research is needed to understand how oppositional defiant disorder (ODD) affects adults. Recent research suggests that symptoms of ODD persist into adulthood and are associated with specific negative functional outcomes. This current study seeks to investigate the prevalence and associated impairments of ODD symptoms in young adults. Two large samples of college students between the ages of 18–24 years old (N =?1792; N =?1497) completed self-report measures of ODD symptoms, ADHD symptoms, psychiatric diagnoses, and functional impairments. Rates and internal consistency of ODD symptoms were calculated, and multiple regression was used to estimate the association between high levels of ODD severity scores and social and authority-related impairments, as well as online antagonistic behavior. In the two samples, the proportion of individuals reporting four or more symptoms of ODD was estimated to be 3.39 and 4.12% respectively, and did not vary significantly by gender. Higher ODD severity was associated with social impairment, online antagonistic behavior, and greater conflict with authority figures, even after controlling for ADHD symptoms and self-reported depression or anxiety diagnoses. ODD symptoms measured in college students demonstrate acceptable reliability and are uniquely associated with specific impairments. The findings from this study support greater consideration of ODD symptoms in adult populations.     

Trait Procrastination,Hoarding, and Continuous Performance Attention Scores

We examined the relationship between chronic procrastination, hoarding, attention deficit hyperactivity disorder (ADHD), and a computer measure of continuous performance with 84 adult patients evaluated for diagnoses. Patients were administered the General Procrastination Inventory, the Saving Inventory-Revised, the Adult ADHD Self-Report Scale and the IVA + Plus Continuous Performance Test. Procrastination scores correlated negatively with auditory attention scores, while self-reported hoarding tendencies correlated negatively with visual attention. Measures of procrastiation, hoarding, and ADHD were positively correlated. Implications and limitations of findings are discussed as well as directions for futher research.     

Comparing Holographic Reprocessing and Prolonged Exposure for Women Veterans with Sexual Trauma: A Pilot Randomized Trial

This pilot study compares an emerging evidence-based treatment, holographic reprocessing (HR) to prolonged exposure (PE) versus a person-centered (PC) control group to treat symptoms of distress in female Veterans with sexual trauma. In contrast to PE, HR does not include exposure to a target event of trauma. Instead, HR focuses on healing the internal working model or type of attachment style that may form as a result of interpersonal trauma or maltreatment. The model reveals how people perceive themselves and others. These perceptions set in motion emotional, cognitive, and behavioral tendencies wherein people unconsciously replicate similar types of relationships that reinforce their worldview. Fifty-one female Veterans with sexual trauma were randomly assigned to one of three treatments and completed pre- and post-treatment measures of psychiatric symptoms (anxiety, depression, and PTSD) and post-traumatic cognitions. ANOVAs found significant decreases on all variables. Post-hoc comparisons revealed that HR and PE treatments demonstrated significantly greater decreases in symptoms compared to the PC control group. Chi square analyses revealed that HR produced a significantly lower dropout rate 1 (6 %) compared to PE 7 (41 %) and PC 6 (35 %). These initial results are promising and further investigation of HR is warranted.     

Behavioral Inhibition and Risk for Posttraumatic Stress Symptoms in Latino Children Exposed to Violence

Latino children in urban contexts marked by poverty are at high risk of being exposed to violence and developing posttraumatic stress disorder (PTSD). Nonetheless, there is great variability in individual responses to violence exposure. This study examines risk for developing re-experiencing, avoidance, and arousal symptoms of PTSD as a function of individual differences in behavioral inhibition and exposure to community violence. Participants were 148 Latino students (M age =11.43 years, SD?=?0.69; 55 % girls) living in an area marked by poverty and crime. Children completed self-report measures of behavioral inhibition and posttraumatic stress symptoms during a baseline assessment. During a follow-up interview 6 months later, children completed self-report measures of exposure to community violence since the baseline assessment and posttraumatic stress symptoms. Structural equation models revealed that behavioral inhibition at baseline was positively associated with PTSD avoidance and arousal symptoms at follow-up, after controlling for symptoms at baseline. Furthermore, behavioral inhibition moderated the association between violence exposure and symptoms such that violence was more strongly associated with the development of PTSD avoidance symptoms as behavioral inhibition increased. Results suggest that individual differences in behavioral inhibition contribute to risk for specific PTSD symptoms and are important for understanding variation in responses to trauma exposure. By examining diathesis-­stress models within a disorder, we may be better able to elucidate the etiology of a disorder and translate this improved understanding into personalized intervention approaches that maximize effectiveness.     

Ambivalence About Interpersonal Problems and Traits Predicts Cross‐Situational Variability of Social Behavior

Multiple theoretical perspectives suggest that maladjusted personality is characterized by not only distress, but also opposing or “ambivalent” self‐perceptions and behavioral lability across social interactions. However, the degree to which ambivalence about oneself predicts cross‐situational variability in social behavior has not been examined empirically. Using the interpersonal circumplex (IPC) as a nomological framework, the present study investigated the extent to which endorsing opposing or “ambivalent” tendencies on IPC measures predicted variability in social behavior across a range of hypothetical interpersonal scenarios (Part 1; N = 288) and naturalistic social interactions (Part 2; N = 192). Ambivalent responding for interpersonal problems and traits was associated with measures of distress, maladaptive interpersonal tendencies, and greater variability of social behavior across both hypothetical and daily social interactions, though more consistently for interpersonal problems. More conservative tests suggested that ambivalence predicted some indexes of behavioral variability even when accounting for mean levels and squared means of social behaviors, vector length, gender, and depressive symptoms. Results suggest that processes theorized as typifying personality disorder may apply more broadly to personality maladjustment occurring outside of clinical samples.     

Intolerance of uncertainty,causal uncertainty,causal importance,self-concept clarity and their relations to generalized anxiety disorder

Although numerous studies have provided support for the notion that intolerance of uncertainty plays a key role in pathological worry (the hallmark feature of generalized anxiety disorder (GAD)), other uncertainty-related constructs may also have relevance for the understanding of individuals who engage in pathological worry. Three constructs from the social cognition literature, causal uncertainty, causal importance, and self-concept clarity, were examined in the present study to assess the degree to which these explain unique variance in GAD, over and above intolerance of uncertainty. N = 235 participants completed self-report measures of trait worry, GAD symptoms, and uncertainty-relevant constructs. A subgroup was subsequently classified as low in GAD symptoms (n = 69) or high in GAD symptoms (n = 54) based on validated cut scores on measures of trait worry and GAD symptoms. In logistic regressions, only elevated intolerance of uncertainty and lower self-concept clarity emerged as unique correlates of high (vs. low) GAD symptoms. The possible role of self-concept uncertainty in GAD and the utility of integrating social cognition theories and constructs into clinical research on intolerance of uncertainty are discussed.     

Obsessive-compulsive symptoms and cigarette smoking: an initial cross-sectional test of mechanisms of co-occurrence

ABSTRACT

Tobacco addiction and obsessive-compulsive symptoms (OCS; intrusive thoughts or impulses that cause distress and rituals) are both mediated by compulsivity and negative reinforcement. Little evidence exists to guide theory, research, treatment, and population-based prevention of this co-occurrence. We propose a conceptual model of OCS-smoking co-occurrence in which smokers with elevated OCS capitalize on smoking to assuage OCS. This secondary analysis examined associations between OCS levels and self-reported smoking motives that are model-concordant: i) negative reinforcement—smoking for relief; ii) sensorimotor—benefits of behaviors and sensations of the tobacco self-administration ritual; and iii) habitual—smoking without conscious control. A community sample of cigarette smokers enrolled in a cessation trial (N = 458; 47.2% female; M _age = 36.9; SD = 13.6) completed pre-quit self-report measures of OCS levels and smoking motives. Regression models adjusted for sociodemographic covariates and non-OCS psychopathologies indicated that OCS level was positively associated with each model-concordant motive. OCS level was also correlated with tobacco dependence severity and greater withdrawal symptom severity experienced during previous quit attempts. Those with higher OCS report greater motivation to smoke for negative reinforcement, sensorimotor behavioral-ritualistic, habit/automaticity, and stimulation reasons. Further examination of the proposed model of OCS-smoking co-occurrence is warranted to guide theory and intervention for this population.     

Past Trauma and Current Stress and Coping: Toward a General Model

Studies find trauma to both sensitize and steel its victims to subsequent stress, but results are specific to certain populations, traumas, or indices of stress and coping. Here, a general population sample (N = 255) completed comprehensive measures of trauma, stress, and coping to suggest a general model of their relationships. Regressions showed childhood—but not lifetime—trauma linked to avoidant coping and greater stress, indicating a partial mediation model. Structural equation modeling (SEM) verified that childhood trauma predicted adult stress both directly and through avoidance. Limitations of present methods, and suggestions for continuing the development of a general trauma-coping-stress model, are discussed.     

Frequency and impact of trauma in older women: A military and nonmilitary sample

Understanding the impact of trauma on late-life functioning in older females is needed in order to provide best care. We explored the impact of trauma on late-life psychological and physical health and functioning among older women (n = 48) who served in the military, or participated in a military lifestyle. Eleven of these women were not veterans, but married to military personnel. Number of traumatic exposures and types of events experienced was associated with increased trauma symptom severity. Trauma symptom severity was associated with decreased physical functioning and increased pain. Increased numbing and avoidance was significantly associated with poorer physical functioning and increased pain. Older women in this study remained at risk of experiencing negative consequences of trauma in terms of increased quantity and severity of trauma symptoms and physical decline and pain. Clinical and research implications are discussed.