Decision making and set shifting impairments are associated with distinct symptom dimensions in obsessive-compulsive disorder.

Lawrence, Natalia; Wooderson, Sarah C.; Mataix‐Cols, David; David, Rhodri; Speckens, Anne; Phillips, Mary L.

doi:10.1037/0894-4105.20.4.409

Cited by 248 publications

(229 citation statements)

References 60 publications

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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: 84%

“…We have recently reported that compulsive hoarders experience difficulties on a laboratory-based task of decision-making, the Iowa Gambling Task, despite intact performance on other neuropsychological tests. 18 It is therefore possible that the strong correlation between Figure 2 Brain regions significantly more activated in hoarders than in non-hoarders and controls (shown in red in (a) and (b)), and in healthy controls more than in hoarders and non-hoarders (shown in blue in (b) and (c)) during symptom provocation. The functional data are superimposed on a high-resolution anatomical template using the MRIcro software.…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Introductionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

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

et al. 2008

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“…This is consistent with a study of patients with primary OCD which found that hoarding was unrelated to WCST performance. 38 The lack of relationship between WCST performance and severity of non-clinical OCS is consistent with several studies that have failed to observe a relationship between the WCST and OCS in schizophrenia. 11–13 …”

Section: Discussionsupporting

confidence: 88%

“…37 That overall OCS severity was correlated with cognitive flexibility is consistent with studies implicating this executive function in patients with primary OCD. 38 }…”

Section: Discussionmentioning

confidence: 99%

Nonclinical Obsessive-Compulsive Symptoms and Executive Functions in Schizophrenia

Kumbhani¹,

Roth²,

Kruck³

et al. 2010

Journal of Neuropsychiatry

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The impact of non-clinical obsessive compulsive symptoms (OCS) on neuropsychological functioning in schizophrenia has received little investigation. We evaluated whether severity and subtype of OCS are associated with executive functioning in schizophrenia. Twenty-nine patients with schizophrenia and 32 healthy subjects completed questionnaire and performance-based measures of executive functioning Overall OCS severity in patients was associated with poorer monitoring and cognitive flexibility per a questionnaire. Obsessing, hoarding, and checking were related to poorer executive functioning in daily life. Performance-based scores showed few correlations with OCS. Findings indicate that severity of non-clinical OCS subtypes contribute to the heterogeneity of executive functions in schizophrenia.

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“…Moreover, there is evidence for linkage of OCD to several chromosomal regions, including the X chromosome, in families with multiple hoarding relatives (Samuels et al, 2007b). Several studies have found different neurocognitive deficits in OCD-affected individuals with and without hoarding behavior (Hartl et al, 2004;Lawrence et al, 2006;Luchian., 2007), and functional imaging studies have identified differential activation of specific brain regions in OCD patients with and without hoarding (Saxena et al, 2004;Mataix-Cols et al, 2004; An et al., in press). Whether these characteristics of hoarding behavior are sex-specific, and how they relate to sex-specific clinical and genetic differences, are important questions for future research.…”

mentioning

confidence: 99%

Sex-specific clinical correlates of hoarding in obsessive-compulsive disorder

Samuels

Bienvenu

Pinto

et al. 2008

Behaviour Research and Therapy

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Little is known about whether the clinical correlates of hoarding behavior are different in men and women with obsessive-compulsive disorder (OCD). In the current study, we evaluated the association of hoarding with categories of obsessions and compulsions, psychiatric disorders, personality dimensions, and other clinical characteristics separately in 151 men and 358 women with OCD who were examined during the OCD Collaborative Genetics Study. We found that, among men but not women, hoarding was associated with aggressive, sexual, and religious obsessions and checking compulsions. In men, hoarding was associated with generalized anxiety disorder and tics whereas, among women, hoarding was associated with social phobia, post-traumatic stress disorder, body dysmorphic disorder, nail biting, and skin picking. In women but not men, hoarding was associated with schizotypal and dependent personality disorder dimensions, and with low conscientiousness. These findings indicate that specific clinical correlates of hoarding in OCD are different in men and women and may reflect sex-specific differences in the course, expression, and/or etiology of hoarding behavior in OCD. KeywordsObsessive-compulsive disorder; hoarding; comorbidity; personality disorders; personality; sex differences *Corresponding author: Jack Samuels, Ph.D., Department of Psychiatry and Behavioral Sciences, Johns Hopkins, University School of Medicine, 600 N. Wolfe Street, Meyer 4-181, Baltimore, MD 21287-7228. Phone: 410-614-4942; Fax: 410-614-8137, E-mail address: jacks@jhmi.edu. NIH Public Access NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptHoarding behavior has been called "pathological collecting" and is characterized by the acquisition of, and unwillingness or inability to discard, large quantities of seemingly useless objects (Greenberg, Witztum & Levy, 1990;Frost & Gross, 1993). The behavior can lead to significantly cluttered living space in the home and can cause considerable distress and impairment in functioning for individuals and their family members (Tolin et al., 2008). The clutter may interfere with the normal use of space for basic household activities and increase the risk of injuries due to fire and falling, and illnesses due to poor sanitation, as well as legal citations and evictions from home by public health authorities . Although hoarding behavior can occur in several psychiatric conditions, including dementia, mental retardation, schizophrenia, and eating disorders (Damecour & Charron, 1998), it appears to occur most frequently in the context of obsessive-compulsive disorder (OCD), presenting in 20-30% or more of patients with this condition (Rasmussen & Eisen, 1992; Frost, Krause, & Steketee, 1996).Over the past decade, considerable evidence has accumulated that OCD-affected individuals with hoarding behavior show clinical differences from those without hoarding behavior. These differences include greater severity of OCD, as measured by the Yale-Brown Obsessive Compulsive Scale (YBOCS) (Goo...

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Decision making and set shifting impairments are associated with distinct symptom dimensions in obsessive-compulsive disorder.

Cited by 248 publications

References 60 publications

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

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

Nonclinical Obsessive-Compulsive Symptoms and Executive Functions in Schizophrenia

Sex-specific clinical correlates of hoarding in obsessive-compulsive disorder

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