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An Investigation of Executive Functioning, Attention and Working Memory in Compulsive Hoarding

Published online by Cambridge University Press:  02 November 2012

Sandra G. McMillan ,
Clare S. Rees  and
Carmela Pestell
Sandra G. McMillan*
Affiliation:
Curtin University, Perth, Australia
Clare S. Rees
Affiliation:
Curtin University, Perth, Australia
Carmela Pestell
Affiliation:
North Metropolitan Area Mental Health Service, Perth, Australia
*
Reprint requests to Sandra McMillan, Psychiatry Department, Royal Perth Hospital, GPO Box X2213, Perth, Western Australia6001. E-mail: sandra.mcmillan@health.wa.gov.au
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Abstract

Background: Compulsive Hoarding involves the acquisition of, and failure to discard, a large number of possessions that appear to be useless or of limited value, cluttered living spaces and significant distress or impairment in functioning (Frost and Hartl, 1996). The problem is multifaceted and appears best explained by a cognitive-behavioural framework. Aims: This study set out to test one aspect of Frost and Hartl's (1996) cognitive-behavioural model of compulsive hoarding by investigating theorized cognitive deficits in executive functioning, such as working memory and attention. Method: 24 participants with compulsive hoarding were tested on the Digit Span, Spatial Span and the Wisconsin Card Sorting Tests (WCST). Results: On the WCST, the hoarding group had a significantly higher number of perseveration errors (t = 1.67, p = .005) and significantly lower numbers of categories completed (t = −2.47, p = .001) than test norms. Only “failure to maintain set” was significantly correlated with hoarding severity (r = .435, p < .05). Conclusions: These findings lend support to the theory that people who compulsively hoard have executive dysfunction, which impacts on their ability to process information. Deficits relate to difficulties in forming effective strategies, inadequate feedback response, problems in concept formation, and impulsivity. Difficulties in sustained attention also appeared to be a factor in hoarding severity. These findings are important in directing more targeted clinical interventions.

Keywords

Hoardingcompulsiveneuropsychologicalobsessive-compulsive disordercognitive-behavioural models
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 41 , Issue 5 , October 2013 , pp. 610 - 625
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2012 

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References

American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR. Washington, DC: APA.Google Scholar
An, S. K., Mataix-Cols, D., Lawrence, N. S., Wooderson, S., Gaimpietro, V., Speckens, A., et al. (2008). To discard or not to discard: the neural basis of hoarding symptoms in obsessive-compulsive disorder. Molecular Psychiatry, advanced online publication 8 January 2008. http://www.nature.com/mp/journal/vaop/ncurrent/abs/4002129a.htmlGoogle Scholar
Boes, A. D., Bechara, A., Tranel, D., Anderson, S. W., Richman, L. and Nopoulos, P. (2008). Right ventromedial prefrontal cortex: a neuroanatomical correlate of impulse control in boys. Social Cognitive and Affective Neuroscience, advance access published 19 October 2008. http://scan.oxfordjournals.org/papbyrecent.dtlGoogle Scholar
Bowden, S. C., Weiss, L. G., Holdnack, J. A., Bardenhagen, F. J. and Cook, M. J. (2008). Equivalence of a measurement model of cognitive abilities in US standardization and Australian neuroscience samples. Assessment, 15, 132–144.CrossRefGoogle ScholarPubMed
Conners, C. K. (2000). Conners’ Continuous Performance Test Computer Program for Windows Technical Guide and Software Manual. Toronto, ON: Multi Health Systems Inc.Google Scholar
Eling, P., Derckx, K. and Maes, R. (2008). On the historical and conceptual background of the Wisconsin Card Sorting Test. Brain and Cognition, 67, 247–253.CrossRefGoogle ScholarPubMed
First, M. B., Spitzer, R. L, Gibbon, M. and Williams, J. B. W. (1996). Structured Clinical Interview for DSM-IV Axis I Disorders, Clinician Version (SCID-CV). Washington, DC: American Psychiatric Press.Google Scholar
Foa, E. B., Huppert, J. D., Leiberg, S., Langner, R., Kichic, R., Hajcak, G., et al. (2002). The obsessive-compulsive inventory: development and validation of a short version. Psychological Assessment, 14, 485–496.CrossRefGoogle ScholarPubMed
Foa, E. B., Kozak, M. J., Salkovskis, P. M., Coles, M. E. and Amir, N. (1998). The validation of a new obsessive-compulsive disorder scale: the obsessive-compulsive inventory. Psychological Assessment, 10, 206–214.CrossRefGoogle Scholar
Frost, R. O. and Gross, R. C. (1993). The hoarding of possessions. Behavior Research and Therapy, 31, 367–381.CrossRefGoogle ScholarPubMed
Frost, R. O. and Hartl, T. L. (1996). A cognitive-behavioral model of compulsive hoarding. Behavior Research and Therapy, 34, 341–350.CrossRefGoogle ScholarPubMed
Frost, R. O. and Steketee, G. (1999). Issues in the treatment of compulsive hoarding. Cognitive and Behavioural Practice, 6, 397–407.CrossRefGoogle Scholar
Frost, R. O., Steketee, G. and Greene, K. A. I. (2003). Cognitive and behavioural treatment of compulsive hoarding. Brief Treatment and Crisis Intervention, 3, 323–337.CrossRefGoogle Scholar
Frost, R. O., Steketee, G. and Grisham, J. R. (2004). Measurement of compulsive hoarding: saving inventory revised. Behavior Research and Therapy, 42, 1163–1182.CrossRefGoogle ScholarPubMed
Frost, R. O., Steketee, G., Williams, L. F. and Warren, R. (2000). Mood, personality disorder symptoms and disability in obsessive compulsive hoarders: a comparison with clinical and nonclinical controls. Behaviour Research and Therapy, 38, 1071–1081.CrossRefGoogle ScholarPubMed
Frost, R. O., Tolin, D. F., Steketee, G., Fitch, K. E. and Sebo-Bruns, A. (2009). Excessive acquisition in hoarding. Journal of Anxiety Disorders, 23, 632–639.CrossRefGoogle ScholarPubMed
Golden, C. J., Espe-Pfeifer, P. and Wachsler-Felder, J. (2000). Neuropsychological Interpretations of Objective Psychological Tests. New York: Plenum Publishers.Google Scholar
Goldman, B. L., Martin, E. D., Calamari, J. E., Woodard, J. L., Chik, H. M., Messina, M. G., et al. (2008). Implicit learning, thought-focused attention and obsessive-compulsive disorder: a replication and extension. Behavior Research and Therapy, 46, 48–61.CrossRefGoogle ScholarPubMed
Greve, K. W., Ingram, F. and Bianchini, K. J. (1998). Latent structure of the Wisconsin Card Sorting Test in a clinical sample. Archives of Clinical Neuropsychology, 7, 597–609.CrossRefGoogle Scholar
Grisham, J. R. and Barlow, D. H. (2005). Compulsive hoarding: current research and theory. Journal of Psychopathology and Behavioral Assessment, 27, 45–52.CrossRefGoogle Scholar
Grisham, J. R., Brown, T. A., Savage, C. R., Steketee, G. and Barlow, D. H. (2007). Neuropsychological impairment associated with compulsive hoarding. Behavior Research and Therapy, 45, 1471–1483.CrossRefGoogle ScholarPubMed
Grisham, J. R., Frost, R. O., Steketee, G., Kim, H. and Hood, S. (2006). Age of onset of compulsive hoarding. Anxiety Disorders, 20, 675–686.CrossRefGoogle ScholarPubMed
Grisham, J. R., Norberg, M. M., Williams, A. D., Certoma, A. D. and Kadib, R. (2010). Categorization and cognitive deficits in compulsive hoarding. Behavior Research and Therapy, 48, 866–872.Google Scholar
Groth-Marnat, G. (2003). Handbook of Psychological Assessment. New York: John Wiley and Sons.Google Scholar
Groth-Marnat, G., Gallagher, R. E., Hale, J. B. and Kaplan, E. (2000). The Wechsler intelligence scales. In Groth-Marnat, G. (Ed.), Neuropsychological Assessment in Clinical Practice (pp.129–184). New York: John Wiley and Sons.Google Scholar
Hartl, T. L., Duffany, S. R., Allen, G. J., Steketee, G. and Frost, R. O. (2005). Relationships among compulsive hoarding, trauma and attention-deficit/hyperactivity disorder. Behavior Research and Therapy, 43, 269–276.CrossRefGoogle ScholarPubMed
Hartl, T. L., Frost, R. O., Allen, G. J., Deckersbach, T., Steketee, G., Duffany, S. R., et al. (2004). Actual and perceived memory deficits in individuals with compulsive hoarding. Depression and Anxiety, 20, 59–69.CrossRefGoogle ScholarPubMed
Heaton, R. K., Chelune, G. J., Talley, J. L., Kay, G. G. and Curtiss, G. (1993). Wisconsin Card Sorting Test Manual: revised and expanded. Odessa, FL: Psychological Assessment Resources.Google Scholar
Kaplan, G. B., Sengor, N. S., Gurvit, H., Genc, I. and Guzelis, C. (2006). A composite neural network model for perseveration and distractability in the Wisconsin card sorting test. Neural Networks, 19, 375–387.CrossRefGoogle ScholarPubMed
Kuelz, A. K., Hohagen, F. and Voderholzer, U. (2004). Neuropsychological performance in obsessive-compulsive disorder: a critical review. Biological Psychology, 65, 185–236.CrossRefGoogle ScholarPubMed
Lawrence, N. S., Wooderson, S., Mataix-Cols, D., David, R., Speckens, A. and Phillips, M. L. (2006). Decision making and set shifting impairments are associated with distinct symptom dimensions in obsessive-compulsive disorder. Neuropsychology, 20, 409–419.CrossRefGoogle ScholarPubMed
Leshem, R. and Glicksohn, J. (2007). The construct of impulsivity revisited. Personality and Individual Differences, 43, 681–691.CrossRefGoogle Scholar
Mackin, R. S., Arean, P. A., Delucchi, K. L. and Mathews, C. A. (2010). Cognitive functioning in individuals with severe compulsive hoarding behaviours and late life depression. International Journal of Geriatric Psychiatry, 26, 314–321.Google Scholar
Olley, A., Malhi, G. and Sachdev, P. (2007). Memory and executive functioning in obsessive-compulsive disorder: a selective review. Journal of Affective Disorders, 104, 15–23CrossRefGoogle ScholarPubMed
Pertusa, A., Frost, R. O., Fullana, M. A., Samuels, J., Steketee, G., Tolin, D., et al. (2010). Refining the diagnostic boundaries of compulsive hoarding: a critical review. Clinical Psychology Review, 30, 371–386.CrossRefGoogle ScholarPubMed
Rachman, S., Elliot, C. M., Shafran, R. and Radomsky, A. S. (2009). Separating hoarding from OCD. Behaviour Research and Therapy, 47, 520–522.Google Scholar
Saxena, S., and Maidment, K. M. (2004). Treatment of compulsive hoarding. Journal of Clinical Psychology, 60, 1143–1154.CrossRefGoogle ScholarPubMed
Simpson, H. B., Rosen, W., Huppert, J. D., Lin, S., Foa, E. B. and Liebowitz, M. R. (2006). Are there reliable neuropsychological disorders in obsessive-compulsive disorder? Journal of Psychiatric Research, 40, 247–257.CrossRefGoogle ScholarPubMed
Steketee, G. and Frost, R. O. (2007). Compulsive Hoarding and Acquiring: therapist guide. New York: Oxford University Press.Google Scholar
Strauss, E., Sherman, E. M. S. and Spreen, O. (2006). A Compendium of Neuropsychological Tests (3rd ed.). New York: Oxford University Press.Google Scholar
Tolin, D. F., Frost, R. O. and Steketee, G. (2007). An open trial of cognitive-behavioural therapy for compulsive hoarding. Behaviour Research and Therapy, 45, 1461–1470.Google Scholar
Tolin, D. F. and Villaviencio, A. (2011). Inattention, but not OCD, predicts the core features of Hoarding Disorder. Behaviour Research and Therapy, 49, 120–125.CrossRefGoogle Scholar
Wechsler, D. (1987). Wechsler Memory Scale – Revised. San Antonio, TX: Psychological Corporation.Google Scholar
Wechsler, D. (1997a). WAIS-III: administration and scoring manual. San Antonio, TX: Psychological Corporation.Google Scholar
Wechsler, D. (1997b). WMS-III: administration and scoring manual. San Antonio, TX: Psychological Corporation.Google Scholar
Wechsler, D. (2009). WMS-IV: technical and interpretive manual. San Antonio, TX: Pearson.Google Scholar
Wincze, J. P., Steketee, G. and Frost, R. O. (2007). Categorization in compulsive hoarding. Behavior Research and Therapy, 45, 63–72.CrossRefGoogle ScholarPubMed
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