Category: Obsessive Compulsive and Related Disorders

PS1- #B36 - Assessing Decision-Making Impairments in Hoarding Disorder Through Laboratory-Based Functional Tasks

Friday, Nov 17
8:30 AM – 9:30 AM
Location: Indigo Ballroom CDGH, Level 2, Indigo Level

Keywords: Hoarding | Assessment | Clinical Utility

The aim of this study was to examine whether hoarding disorder patients (HD) and healthy control subjects (HC) differed significantly in their tendencies to acquire or save common objects. Patients with hoarding disorder (HD; N=58 to date; anticipated N=80) and healthy control subjects (HC; N=21 to date; anticipated N=40) completed two functional tasks adapted from Preston et al (Depression and Anxiety, 26, 425-437) during which they were shown pictures of common objects. In the first task, participants were instructed to imagine that they are shopping and given the option to either take or leave each item. In the second task, participants were instructed to imagine that they are spring cleaning and given the option to either keep or discard each item. A subset of HD participants (N=30 to date) completed these tasks a second time 16 weeks after their initial visit, without receiving treatment. Variables of interest were response latency for decisions, the percentage of items acquired during the shopping task, and the percentage of items saved during the spring cleaning task. Test-retest reliability was calculated by correlating scores at Time 1 and Time 2 for the subset of HD participants (N=30). Correlations were high for average reaction time during the shopping task (r = .74), moderate for percentage of items acquired overall (= .56), high for average reaction time during the spring cleaning task (= .76), and high for percentage of items saved overall (r = .70).

Criterion-related validity was established by comparing HD and HC participants. During the shopping task, HD participants exhibited significantly longer average reaction time [t(77) = 3.7, = 0 < .001, =1.04] and a higher percentage of items acquired [t(77) = 1.65, = .102, = .43]. During the spring cleaning task, HD participants exhibited significantly longer average reaction time [t(69) = 4.73, = 0 < .001, = 1.02] and a significantly higher percentage of items saved [t(78) = 2.6, = 0.009, d = 0.73]. We divided the items in each task based on high versus low objective value, and found that reaction times for both types of items, for both shopping and spring cleaning tasks, were higher for HD than for HC participants. However, group differences in item acquisition or maintenance were only seen for low-value items, in which HD participants acquired [z = -1.94, = .05, = .56] and saved [= -3.90, = 0, = 1.15] significantly more low-value items than HC participants. These results are consistent with the presence of decision-making impairments in HD, and suggest the utility of this laboratory-based task for assessing HD.

Katrina Aberizk

Research Assistant
Olin Neuropsychiatry Research Center, The Institute of Living
Hartford, Connecticut

Hannah Levy

Post Doctoral Fellow
Anxiety Disorders Center, The Institute of Living
Hartford, Connecticut

Amber Billingsley

Research Assistant
Anxiety Disorders Center, The Institute of Living
Hartford, Connecticut

Akanksha Das

Research Assistant
Anxiety Disorders Center, The Institute of Living
Hartford, Connecticut

Krishna Pancholi

Clinical Data Analyst
Olin Neuropsychiatry Research Center, The Institute of Living
Hartford, Connecticut

Gretchen Diefenbach

Psychologist
Anxiety Disorders Center, The Institute of Living
Hartford, Connecticut

Michael C. Stevens

Senior Research Scientist
Olin Neuropsychiatry Research Center, The Institute of Living
Hartford, Connecticut

David F. Tolin

Director
Anxiety Disorders Center, The Institute of Living
Hartford, Connecticut