Acquisition and impulsivity in compulsive hoarding
Rasmussen, Jessica L.
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Compulsive hoarding is a serious disorder that causes significant impairment in the home. While compulsive hoarding has been traditionally associated with obsessive-compulsive disorder (OCD), standard OCD treatments have been mostly ineffective for hoarding. Recent research has provided evidence that hoarding has a distinct profile that could indicate a separate disorder. Further understanding of hoarding may advance classification and treatment. One understudied aspect of hoarding is excessive acquisition. Acquisition behaviors in hoarding appear to share similarities with impulse control disorders. While preliminary research has suggested elevated impulsivity in those who hoard, prior studies have been inconsistent in their measurement of impulsivity. Also, the relationship between impulsivity and excessive acquisition behaviors remains unexplored. This study assessed impulsivity in hoarding (n = 32) and anxiety disorder (n = 32) participants using a multi-dimensional model of impulsivity. Participants underwent a diagnostic assessment and completed self-report forms and neuropsychological tasks measuring impulsivity. Participants also completed an experimental task to assess acquiring behaviors after a mood induction. Participants completed measures of affect and state impulsivity, before and after a negative or neutral mood induction. There were no significant differences between diagnostic groups on self-reported impulsivity levels. Significant between-group differences were found on several neuropsychological tasks. Those with hoarding had significantly poorer response inhibition and lowered levels of adaptive and maladaptive risk-taking than participants with anxiety disorders. A diagnosis of hoarding predicted these outcomes independent of social phobia, generalized anxiety disorder, and major depressive disorder. In the acquisition task, the hoarding group acquired significantly more items than the anxiety disorder group but there was not a significant interaction effect with mood induction condition. The hoarding group had a significantly greater increase in state impulsivity across time but there was also not an interaction effect with mood induction condition. An analysis designed to assess whether state impulsivity mediated the relationship between negative affect and acquisition behaviors failed to find a significant indirect effect. Overall, study findings suggest differences in impulsivity for those who hoard as compared to those with an anxiety disorder. A continued emphasis on understanding impulsivity in hoarding could further diagnostic classification and treatment development.
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