When hoarding is a symptom of OCD: A case series and implications for DSM-V

Hoarding, the excessive collection and failure to discard objects of apparently little value, can represent a serious psychiatric problem and pose a threat to public health. Hoarding has traditionally been considered a symptom (or symptom dimension) of Obsessive-Compulsive Disorder (OCD), but its nosological status has recently been debated. Mounting evidence suggests that, once other primary causes are ruled out, hoarding may be a discrete diagnostic entity, recently named Hoarding Disorder. However, hoarding can sometimes be a genuine OCD symptom. This can be confusing and clinicians may sometimes struggle making the differential diagnosis. To illustrate this, we describe 10 OCD patients with severe hoarding behavior that is better conceptualized as a symptom of OCD. We focus on the motivations for hoarding and the overlapping of hoarding with other obsessive-compulsive symptom dimensions. We estimate that this clinical presentation is relatively rare and accounts for a minority of severe hoarding cases. We discuss the unique characteristics of hoarding as a symptom of OCD and the implications for DSM-V.     

An examination of the potential lingering effects of smartphone use on cognition

Smartphones might offer an extension of our own cognitive abilities, potentially preventing practice of certain forms of cognition. Our first study established that heavier usage of smartphones was negatively correlated with social problem solving and delayed gratification, as well as positively correlated with some aspects of critical thinking. Studies 2 and 3 involved experiments where participants were assigned to either a lower or higher smartphone usage group. In both experiments, higher usage of smartphones led only to a diminished ability to interpret and analyze the deeper meaning of information. However, Study 3 showed that, after a 4‐week interval, the difference in the ability to interpret and analyze meaning between lower and higher phone usage groups was no longer evident. The findings of this study suggest that, even in the rare cases where smartphones might alter cognition, this effect is likely transitory.     

Functional neuroimaging studies of reading and reading disability (developmental dyslexia)

Converging evidence from a number of neuroimaging studies, including our own, suggest that fluent word identification in reading is related to the functional integrity of two consolidated left hemisphere (LH) posterior systems: a dorsal (temporo-parietal) circuit and a ventral (occipito-temporal) circuit. This posterior system is functionally disrupted in developmental dyslexia. Reading disabled readers, relative to nonimpaired readers, demonstrate heightened reliance on both inferior frontal and right hemisphere posterior regions, presumably in compensation for the LH posterior difficulties. We propose a neurobiological account suggesting that for normally developing readers the dorsal circuit predominates at first, and is associated with analytic processing necessary for learning to integrate orthographic features with phonological and lexical-semantic features of printed words. The ventral circuit constitutes a fast, late-developing, word identification system which underlies fluent word recognition in skilled readers.     

La langue et les Lèvres: cross-language influences on bimodal speech perception.

Previous research in speech perception has yielded two sets of findings which are brought together in the present study. First, it has been shown that normal hearing listeners use visible as well as acoustical information when processing speech. Second, it has been shown that there is an effect of specific language experience on speech perception such that adults often have difficulty identifying and discriminating non-native phones. The present investigation was designed to extend and combine these two sets of findings. Two studies were conducted using six consonant-vowel syllables (/ba/, /va/, /alpha a/, /da/, /3a/, and /ga/ five of which occur in French and English, and one (the interdental fricative /alpha a/) which occurs only in English. In Experiment 1, an effect of specific linguistic experience was evident for the auditory identification of the non-native interdental stimulus by French-speakers. In Experiment 2, it was shown that the effect of specific language experience extends to the perception of the visible information in speech. These findings are discussed in terms of their implications for our understanding of cross-language processes in speech perception and for our understanding of the development of bimodal speech perception.     

Processing lexical ambiguity and visual word recognition in a deep orthography

We investigated the effect of semantic and phonemic ambiguity on lexical decision and naming performance in the deep Hebrew orthography. Experiment 1 revealed that lexical decisions for ambiguous consonant strings are faster than those for any of the high- or low-frequency voweled alternative meanings of the same strings. These results suggested that lexical decisions for phonemically and semantically ambiguous Hebrew consonant strings are based on the ambiguous orthographic information. However, a significant frequency effect for both ambiguous and unambiguous words suggested that if vowels are present, subjects do not ignore them completely while making lexical decisions. Experiment 2 revealed that naming low-frequency voweled alternatives of ambiguous strings took significantly longer than naming the high-frequency alternatives or the unvoweled strings without a significant difference between the latter two string types. Voweled and unvoweled unambiguous strings, however, were named equally fast. We propose that semantic and phonological disambiguation of unvoweled words in Hebrew is achieved in parallel to the lexical decision, but is not required by it. Naming Hebrew words usually requires a readout of phonemic information from the lexicon.     

A developmentally keyed scheme for the placement of gay men into psychotherapy groups

Patients can meet their needs for intimacy and individuation within the context of long-term psychotherapy groups. This is especially true for gay male patients as they work toward the development of a positive gay identity. Coming out is a social phenomenon, which is why groups are especially suited to the tasks involved. Historically, mixed groups of gay and nongay men and women have not been a safe or neutral treatment atmosphere for gay men due to therapists' prejudicial assumptions and a lack of understanding of gay male development. A developmental scheme will be presented which is keyed to the particular needs of gay men depending on their developmental stage of functioning. This scheme should serve as a more rational and appropriate guide for the diagnosis, treatment planning, and assigning of gay men to long-term psychotherapy groups.     

The Ethical Inclusion of Children With Psychotic Disorders in Research: Recommendations for an Educative,Multimodal Assent Process

This article addresses the issue of properly assenting children with psychotic disorders to participate in clinical research. Due to the protective concerns with such a vulnerable population, additional precautions are necessary to ensure that youth with psychotic disorders assent to research with an appropriate level of understanding regarding study procedures. Current literature suggests that positive/negative symptoms and minor cognitive deficits do not interfere with the ability to comprehend study-related information for adults with psychosis if the study information is presented through an educative process. Similarly, youth benefit from repeated presentation of procedures and periodic assessment of their comprehension. An integrated educative process is proposed that emphasizes the importance of an interactive consent through repetition and participant/investigator feedback.     

Depression,restraint and eating behavior

Contrary to the belief that weight loss is a principal symptom of depression, several recent studies have suggested that certain people gain rather than lose weight when depressed. The present experiment concerned the effects of experimentally induced mood states on the eating behavior of high- and low-restraint persons. Sixty-eight female undergraduates were randomly assigned to one of three groups each designed to induce a different mood state (depressed, neutral or elated), and were classified as high or low restraint based on their responses to a questionnaire. During the mood induction procedure subjects were provided with the opportunity to eat. High-restraint persons induced into a depressed mood ate significantly more than high-restraint persons induced into neutral or elated moods, and more than low-restraint persons induced into a depressed mood. This effect was most prominent among subjects who scored high on the weight-fluctuation factor of the restraint scale. There was no evidence that this effect occurred among subjects who scored high on the concern for dieting factor. The role of emotional arousal on the self-control over eating behavior of high weight-fluctuation persons, and the implications of these findings for the evaluation of depression were discussed.