An Examination of the Association Between Subjective Distress and Functional Connectivity During Discarding Decisions in Hoarding Disorder

Levy, Hannah C.; Poppe, Andrew; Hiser, Jaryd; Wootton, Bethany M.; Hallion, Lauren S.; Tolin, David F.; Stevens, Michael C.

doi:10.1016/j.bpsc.2020.12.014

Cited by 3 publications

(10 citation statements)

References 45 publications

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“…The distress of discarding items in persons with HD is associated with functional changes in the brain in areas regulating anxiety and sadness when compared to controls [11]. Although the precise cause of hoarding disorder is unknown, this statistically significant difference may help explain the distress caused to the patient by his wife's efforts.…”

Section: Discussionmentioning

confidence: 98%

A Case of Coexisting Depression and Hoarding Disorder

Kancherla¹,

Garlapati²,

Sowkhya³

et al. 2022

Cureus

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A hoarding disorder manifests as difficulty in discarding or letting go of items irrespective of their actual worth and persistent acquisition of items. Increasing numbers of possessions clutter active living spaces to the point where their intended use is no longer possible, leading to significant functional impairment. In the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), it is classified under the category obsessivecompulsive and related disorders. First considered to be a part of obsessive-compulsive disorder, compulsive hoarding was subsequently classified as an additional dimension of the obsessive-compulsive disorder spectrum. Hoarding disorder had been largely ignored clinically until recently, despite negative consequences on individuals, families, and communities. Comorbid conditions like anxiety, depression, obsessive-compulsive disorder, post-traumatic stress disorder, and panic disorder are well known to accompany hoarding disorder. This study illustrates the case of a 35-year-old married man who was referred to a psychiatrist by his primary care physician for collecting many different objects of little or no importance. These objects were lying unorganized throughout his house and cluttering most of his living space. Some of these things were discarded by his wife, which, according to him, contributed to his emotional distress. The pattern of behavior began about 10 years earlier, and it became increasingly problematic with time. Although hoarding disorder is often underreported, it is vital to diagnose this condition as it significantly affects the individual and their family and friends. Severe hoarding can pose a number of health and safety risks, including fire hazards, tripping hazards, and health code violations.

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Section: Discussionmentioning

confidence: 98%

A Case of Coexisting Depression and Hoarding Disorder

Kancherla¹,

Garlapati²,

Sowkhya³

et al. 2022

Cureus

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“…The ATR is a corticothalamic and thalamocortical projection fiber bundle that connects the medial thalamic nuclei to the dlPFC, vlPFC, and OFC bilaterally via the ALIC and ACR (Jang and Yeo, 2014). Previous MRI studies have shown evidence of abnormal neural activity and volumetric changes in the dlPFC, vlPFC, OFC, and thalamus in patients with HD (An Hough et al, 2016;Levy et al, 2019Levy et al, , 2021Sunol et al, 2020;Tolin et al, 2009Tolin et al, , 2014Yamada et al, 2018). Patients with HD were found to have both WM tract alterations in the ATR and ALIC in the current study and abnormal neural activity in the PFC and thalamus according to preliminary research, which are anatomically connected by the ATR; therefore, patients with HD may have dysfunction in the frontothalamic circuit, which is thought to play an important role in executive functions, including working memory (Mamah et al, 2010), attention (Jagtap and Diwadkar, 2016), reward processing (Coenen et al, 2012), and decision-making (Sieveritz et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

“…The third branch (SLF III) connects the intraparietal sulcus and inferior parietal lobule to the inferior frontal gyrus (BA 44,45,47)" (Thiebaut de Schotten et al, 2012). Previous MRI studies indicated that patients with HD showed different task-related or resting-state activation in these brain regions, including the precuneus and superior, middle, and inferior frontal gyri, which are connected by the SLF (Hough et al, 2016;Levy et al, 2019Levy et al, , 2021Stevens et al, 2020;Sunol et al, 2020;Tolin et al, 2009Tolin et al, , 2014. The SLF contributes to a broad range of cognitive functions, including visuospatial processing, attention, and working memory (Nakajima et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

“…The UF is an association fiber bundle that reciprocally connects the OFC and FPC to the anterior temporal lobes (temporal pole, uncus, parahippocampal gyrus, and amygdala) via the EC (Catani et al, 2002;Von Der Heide et al, 2013). Several neuroimaging studies have found that individuals with HD show abnormal functional connectivity in the left orbital gyrus, parahippocampal gyrus, and amygdala (Levy et al, 2019) and abnormal task-induced activity in the left FPC, OFC, superior temporal gyrus, and amygdala (An et al, 2009;Hough et al, 2016;Levy et al, 2021;Tolin et al, 2009Tolin et al, , 2014. The UF, variously called 'the frontotemporal circuit' (Ramnani et al, 2004), 'temporo-amygdala-orbitofrontal network' (Catani et al, 2013), or 'frontolimbic pathway' (Tromp et al, 2012), plays an important role in emotional regulation, episodic memory, object-reward association learning, and reversal learning (Von Der Heide et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

“…During the stop-signal and switch-signal tasks, patients with HD showed greater activation in the right OFC during successful response switching and less activation in the right dlPFC, OFC, precentral gyrus, and bilateral dorsomedial prefrontal cortex during error processing (Sunol et al, 2020). Moreover, Levy et al found that their study participants with HD had abnormal functional activation in the bilateral dlPFC, OFC, FPC, medial and lateral temporal cortices, and amygdala during discarding decisions that provoked subjective distress (Levy et al, 2021). Using resting state fMRI, they demonstrated that subjects with HD had less functional connectivity in the left orbital and rectal gyri, amygdala, thalamus, and insula in comparison with non-hoarders but greater functional connectivity in the bilateral superior and middle frontal gyri and precuneus (Levy et al, 2019).…”

Section: Introductionmentioning

confidence: 97%

See 2 more Smart Citations

Abnormal white matter structure in hoarding disorder

Mizobe¹,

Ikari²,

Tomiyama³

et al. 2022

Journal of Psychiatric Research

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Are hoarding disorder and buying-shopping disorder behavioural addictions? A conceptual review.

Pickering¹,

Norberg²

2023

Clinical Psychology: Science and Practice

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There is considerable conceptual debate about how hoarding disorder (HD) and buying-shopping disorder (BSD) can be best classified. In this article, we reason that these disorders may represent behavioral addictions by mapping evidence to the Components Model of Addiction and the Interaction of Person-Affect-Cognition-Execution (I-PACE) model for addictive behaviors. Our review identifies phenomenological, psychological, and neurobiological evidence to support both disorders as behavioral addictions. However, limitations of the extant literature prevent strong conclusions from being made about the conceptual status of HD and BSD as behavioral addictions. By applying addiction theory to HD and BSD, we generate testable predictions for future research and open potential new avenues for psychological treatment advances. Public Health Significance StatementThe classification of hoarding disorder and buying-shopping disorder as behavioral addictions has significant implications for how these mental disorders are understood and treated. This review article highlights potentially fruitful new areas for research and novel applications of addiction treatments that could improve outcomes for individuals suffering from these debilitating and chronic conditions.

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An Examination of the Association Between Subjective Distress and Functional Connectivity During Discarding Decisions in Hoarding Disorder

Cited by 3 publications

References 45 publications

A Case of Coexisting Depression and Hoarding Disorder

A Case of Coexisting Depression and Hoarding Disorder

Abnormal white matter structure in hoarding disorder

Are hoarding disorder and buying-shopping disorder behavioural addictions? A conceptual review.

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