A cognitive-behavioral model of compulsive hoarding

Frost, Randy O.; Hartl, Tamara L.

doi:10.1016/0005-7967(95)00071-2

Cited by 679 publications

(727 citation statements)

References 20 publications

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“…This finding accords with data showing that patients with OCD hoarding problems exhibit ''underinclusion'' and indecision when organizing their possessions (Frost & Hartl, 1996). The nonclinical hoarders also found the task more stressful than did the control participants.…”

Section: Discussionsupporting

confidence: 89%

“…The nonclinical hoarders categorized the objects into more groups than did the nonhoarders, consistent with the underinclusion hypothesis which holds that hoarders tend to see each object as unique in some way, making it difficult to classify with other objects (Frost & Hartl, 1996).…”

Section: Discussionsupporting

confidence: 76%

“…OCD hoarding is characterized by (1) the acquisition and retention of many possessions having limited or no value; (2) living quarters so cluttered as to prevent their normal use; and (3) marked distress or impairment resulting from hoarding (Frost & Hartl, 1996). The homes of hoarders can become so littered with useless junk that they become sanitation and fire hazards.…”

Section: Introductionmentioning

confidence: 99%

“…Frost and Hartl (1996) noted that hoarders seem to exhibit a specific cognitive abnormality they termed underinclusiveness. When attempting to group objects into categories, hoarders seem to underscore the uniqueness of each object, making it difficult for them to categorize.…”

Section: Introductionmentioning

confidence: 99%

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Cognitive aspects of nonclinical obsessive–compulsive hoarding

Luchian

McNally

Hooley

2007

Behaviour Research and Therapy

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Research on the cognitive variables associated with obsessive-compulsive hoarding is scarce. In this study, we investigated cognitive variables that may contribute to the maintenance and possibly etiology of hoarding. College students who characterized themselves as either ''packrats'' (nonclinical hoarders; n ¼ 21) or not (control participants; n ¼ 20) completed questionnaires assessing hoarding behavior and beliefs about hoarding, and completed a task requiring them to categorize diverse objects and trinkets of minimal value into groups. The results revealed that nonclinical hoarders, relative to control participants, rated the categorization task as significantly more stressful and difficult. Relative to control participants, hoarders took longer to complete the task and sorted objects into more categories. These findings suggest that underinclusiveness and indecisiveness, characteristic of clinical hoarders, are evident in nonclinical hoarders as well. r

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 76%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Cognitive aspects of nonclinical obsessive–compulsive hoarding

Luchian

McNally

Hooley

2007

Behaviour Research and Therapy

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“…18 These findings are consistent with the hypothesis of VMPFC involvement in compulsive hoarding and also agree with the clinical observations and questionnaire studies that have led Frost and colleagues 1,19 to postulate that difficulties in decisionmaking are landmark features of the 'compulsive hoarding syndrome '. This symptom provocation study builds upon previous work by our group 13,15 and aimed to examine the neural substrates of hoarding symptoms in OCD. To achieve this, we recruited new samples of OCD patients with (n = 13) and without (n = 16) prominent hoarding symptoms and healthy volunteers (n = 21) and studied their patterns of brain activity during the provocation of both hoarding-related and symptomunrelated anxiety using a previously validated symptom provocation paradigm.…”

Section: Introductionsupporting

confidence: 78%

To discard or not to discard: the neural basis of hoarding symptoms in obsessive-compulsive disorder

et al. 2008

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Preliminary neuroimaging studies suggest that patients with the 'compulsive hoarding syndrome' may be a neurobiologically distinct variant of obsessive-compulsive disorder (OCD) but further research is needed. A total of 29 OCD patients (13 with and 16 without prominent hoarding symptoms) and 21 healthy controls of both sexes participated in two functional magnetic resonance imaging experiments consisting of the provocation of hoarding-related and symptom-unrelated (aversive control) anxiety. In response to the hoarding-related (but not symptom-unrelated) anxiety provocation, OCD patients with prominent hoarding symptoms showed greater activation in bilateral anterior ventromedial prefrontal cortex (VMPFC) than patients without hoarding symptoms and healthy controls. In the entire patient group (n = 29), provoked anxiety was positively correlated with activation in a frontolimbic network that included the anterior VMPFC, medial temporal structures, thalamus and sensorimotor cortex. Negative correlations were observed in the left dorsal anterior cingulate gyrus, bilateral temporal cortex, bilateral dorsolateral/medial prefrontal regions, basal ganglia and parieto-occipital regions. These results were independent from the effects of age, sex, level of education, state anxiety, depression, comorbidity and use of medication. The findings are consistent with the animal and lesion literature and several landmark clinical features of compulsive hoarding, particularly decision-making difficulties. Whether the results are generalizable to hoarders who do not meet criteria for OCD remains to be investigated.

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Neural Mechanisms of Decision Making in Hoarding Disorder

Tolin¹,

Stevens²,

Villavicencio³

et al. 2012

Arch Gen Psychiatry

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144

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Context Hoarding disorder (HD), previously considered a subtype of obsessive-compulsive disorder (OCD), has been proposed as a unique diagnostic entity in DSM-5. Current models of HD emphasize problems of decision-making, attachment to possessions, and poor insight, whereas previous neuroimaging studies have suggested abnormalities in frontal brain regions. Objective To examine the neural mechanisms of impaired decision making in HD in patients with well-defined primary HD compared with patients with OCD and healthy control subjects (HCs). Design We compared neural activity among patients with HD, patients with OCD, and HCs during decisions to keep or discard personal possessions and control possessions from November 9, 2006, to August 13, 2010. Setting Private, not-for-profit hospital. Participants A total of 107 adults (43 with HD, 31 with OCD, and 33 HCs). Main Outcome Measures Neural activity as measured by functional magnetic resonance imaging in which actual real-time and binding decisions had to be made about whether to keep or discard possessions. Results Compared with participants with OCD and HC, participants with HD exhibited abnormal activity in the anterior cingulate cortex and insula that was stimulus dependent. Specifically, when deciding about items that did not belong to them, patients with HD showed relatively lower activity in these brain regions. However, when deciding about items that belonged to them, these regions showed excessive functional magnetic resonance imaging signals compared with the other 2 groups. These differences in neural function correlated significantly with hoarding severity and self-ratings of indecisiveness and “not just right” feelings among patients with HD and were unattributable to OCD or depressive symptoms. Conclusions Findings suggest a biphasic abnormality in anterior cingulate cortex and insula function in patients with HD related to problems in identifying the emotional significance of a stimulus, generating appropriate emotional response, or regulating affective state during decision making.

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A cognitive-behavioral model of compulsive hoarding

Cited by 679 publications

References 20 publications

Cognitive aspects of nonclinical obsessive–compulsive hoarding

Cognitive aspects of nonclinical obsessive–compulsive hoarding

To discard or not to discard: the neural basis of hoarding symptoms in obsessive-compulsive disorder

Neural Mechanisms of Decision Making in Hoarding Disorder

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