Hoarding behaviors among nonclinical elderly adults: correlations with hoarding cognitions, obsessive-compulsive symptoms, and measures of general psychopathology

This study examines correlates of hoarding behaviors among nonclinical elderly adults, focusing upon hoarding cognitions, obsessive–compulsive symptoms, and measures of general psychopathology. Two hundred and sixty-nine adults aged 56–93 years (M = 72.49 years) completed the Saving Inventory-Revised, Savings Cognitions Inventory-Revised, Obsessive Compulsive Inventory-Revised, Social Interaction Anxiety Scale, Penn State Worry Questionnaire, and Beck Depression Inventory. Our geriatric sample evidenced significantly greater severity of hoarding behaviors than did a younger community sample (24–72 years; M = 44.4 years; Frost, Steketee, & Grishman, 2004). Within our sample, moderate correlations were found between hoarding behaviors and hoarding cognitions; however, controlling for obsessive–compulsive and depressive symptoms resulted in reduced-magnitude associations. As well, relationships between obsessive–compulsive symptoms and both hoarding behaviors and hoarding cognitions were generally strong, with most relationships diminishing after controlling for depressive symptoms. Associations between hoarding symptoms and symptoms of social anxiety, general worry, and depression were generally moderate. A significant regression model showed depressive symptoms explaining the most unique variance in hoarding behaviors. Findings confirm a relatively greater severity of hoarding behaviors in older adults (as compared to younger adults) and suggest that related psychopathology plays a critical role in hoarding expression among older adults. As well, the current study contributes to the ongoing investigation of the diagnostic categorization of compulsive hoarding.     

Cognitive behavior therapy in medication non-responders with obsessive-compulsive disorder: a prospective 1-year follow-up study

Evidence of efficacy of cognitive behavior therapy (CBT) in obsessive–compulsive disorder (OCD) non-responsive to multiple trials of serotonin reuptake inhibitors (SRI) is limited. We examined the efficacy of CBT in 31 adult patients with DSM-IV OCD who were non-responders to at least two SRI trials. They received 20–25 sessions of CBT over 3-month duration. The primary outcome measure was “response” to treatment [Clinical Global Impressions-Improvement score 1 or 2 and ≥35% reduction in Yale-Brown Obsessive–Compulsive Scale (Y-BOCS) severity score]. Patients were assessed at baseline, post-treatment and at 3-, 6- and 12-month follow-up. Twenty-six (84%) patients completed treatment and number of responders at post-treatment, 3-, 6- and 12-month follow-up were 23 (74%), 20 (64%), 20 (64%) and 19 (61%) respectively. Quality of homework compliance and baseline Y-BOCS severity predicted remission (Y-BOCS < 16) to CBT. CBT is useful in OCD non-responsive to multiple trials of SRI.     

Association of the candidate gene SLC1A1 and obsessive–compulsive disorder in Han ChinesePopulation

This case–control study enrolled 578 obsessive–compulsive disorder (OCD) patients and 649 controls and genotyped rs10491734, rs2228622, rs301430 and rs301443 to replicate association of the SLC1A1 gene with OCD in ethnic Han Chinese. The G-A-C-G and G-G-T-C haplotypes were found to be significantly associated with OCD in overall samples, male samples and female samples.     

An initial investigation of the relationships between hoarding and smoking

Cigarette smokers have increased rates of mood and anxiety-related conditions. Hoarding is another anxiety-related condition that has yet to be examined in relation to smoking behavior. The current investigation sought to examine smoking rates among a sample of individuals with hoarding disorder and individuals with non-hoarding obsessive–compulsive disorder (OCD). Additionally, we examined the relationship between hoarding symptoms and reasons for smoking. Participants in Study 1 consisted of 57 individuals with non-hoarding OCD or hoarding disorder. Participants in Study 2 consisted of 661 adult daily smokers. Results revealed that a significantly greater proportion of individuals diagnosed with hoarding were current smokers compared to the non-hoarding OCD group. Additionally, hoarding severity was associated with negative affect reduction expectancies. These results provide important information regarding smoking behaviors within hoarding disorder. Given the poor treatment outcomes and negative health risks associated with hoarding, this information could inform future research and treatment programs.     

Emotional processing in obsessive-compulsive disorder

The aim of the present study was to investigate whether there are differences in emotional processing among people with obsessive–compulsive disorder, using Lang's dimensional model of emotions. A total of 22 individuals with obsessive–compulsive disorder participated in the study and were compared to a control group (n = 25). All participants assessed a set of photographs with emotional content (pleasant, neutral, unpleasant, and with obsessive–compulsive content) using the Self-Assessment Manikin pictorial scales for rating emotional valence (pleasant/unpleasant), arousal (calm/aroused) and dominance (controlling/controlled). The results show significant differences in the processing of emotional images among individuals with obsessive–compulsive disorder and the high predictive value of dominance for diagnosis.     

Overlapping and Distinctive Features of Hypochondriasis and Obsessive–Compulsive Disorder

The spectrum of obsessive–compulsive disorders has received a great deal of theoretical attention, but there has been relatively little associated empirical research. The purpose of this study was to compare three groups of patients; those diagnosed with hypochondriasis (HC, a proposed spectrum condition), obsessive–compulsive disorder (OCD) and those with both OCD and HC (OCD/HC). The results show that patients with HC scored highest on a measure of overvalued ideas, and that the HC and HC/OCD groups scored significantly higher on measures of panic and agoraphobic cognitions. The groups also differed significantly for symptoms associated with compulsions. The patient groups were not different for measures of obsessions, depression, and anxiety. The results provide partial support for inclusion of HC in the spectrum of obsessive–compulsive disorders, but also provide indirect support for the association between HC and panic disorder. These results are interpreted in light of distinguishing characteristics among obsessive–compulsive spectrum conditions.     

Associations between obsessive–compulsive symptoms,revenge, and the perception of interpersonal transgressions

Anger and aggression have only recently gained center stage in research on obsessive–compulsive disorder (OCD). An investigation of obsessive–compulsive (OC) symptoms focusing on the outcome of unresolved anger (i.e., revenge), however, is absent from the literature. The objective of the present research was therefore to provide a first step towards filling this gap and, hence, to systematically examine the associations between OC symptoms and different aspects of revenge (i.e., attitudes, dispositions, motivations). In three independent studies with nonclinical participants (N=504), we tested the hypothesis that OC symptoms relate to greater revenge. Individuals high in OC symptoms reported more positive attitudes toward revenge (Study 1), scored higher on a measure of trait revenge (Study 2), and reported increased revenge motivation regarding a real-life transgressor (Study 3). Furthermore, Study 4 (N=175) demonstrated that individuals high in OC symptoms perceived interpersonal transgressions more frequently in their daily lives. OC symptoms were positively related to the number of transgressions that respondents disclosed. Our results suggest that revenge and interpersonal hurt play a significant role in OCD.     

Differences between early and late drop-outs from treatment for obsessive-compulsive disorder

To examine characteristics of drop-outs from treatment for obsessive–compulsive disorder (OCD), we studied 121 participants who underwent exposure or cognitive treatment, either alone or with fluvoxamine. OCD symptoms were assessed at pre-treatment, post-treatment, and at every session. No differences in attrition were found between treatment conditions. Drop-outs from treatment (n = 31) were divided into early (before session 6) and late (session 6 or after) drop-outs. We found that early drop-outs had more severe OCD symptoms at termination compared to completers, whereas late drop-outs did not differ from treatment completers. Higher levels of depressive symptoms were associated with early drop-outs, and lower levels with completers. These findings suggest that individuals with high levels of pretreatment depression are at risk for early drop-out with elevated OCD symptoms. Conversly, late drop-outs may be treatment responders who drop out after experiencing substantial improvement. Implications for allocation of resources for attrition prevention are discussed.     

Family accommodation of obsessional symptoms and naturalistic outcome of obsessive–compulsive disorder

Accommodation of symptoms by families and expressed emotion (EE) may have a negative impact on the outcome of obsessive–compulsive disorder (OCD). The study examines the effect of family accommodation (FA) and EE on the 1-year naturalistic outcome of OCD. Patients with OCD who met the criteria for the Diagnostic and Statistical Manual of Mental Disorders-IV, text revision (DSM-IV TR; N=94) were followed up for 1 year and assessed every 3 months. Assessments included measurement of symptom severity, FA, EE and family burden. By the 12th month, the cumulative probability of remission was 58%. Non-remitters compared with remitters had a significantly higher FA, EE and family burden at the baseline and did not report significant reductions on any of the family variables over the year. In a Cox proportional hazard regression analysis, a higher FA at the baseline significantly predicted time to remission. FA of symptoms has a significant negative impact on the naturalistic outcome of OCD. This emphasises the need to design specific interventions to reduce FA for a better outcome.     

OCD with comorbid OCPD: a subtype of OCD?

OBJECTIVE: The current study examined the validity of using comorbid obsessive-compulsive personality disorder (OCPD) to identify a subtype of individuals with obsessive-compulsive disorder (OCD). METHOD: Data for the current study were drawn from an ongoing, longitudinal study of the course of OCD and include intake assessments for 238 subjects with primary and current DSM-IV OCD who were treatment seeking. RESULTS: More than one fourth of the subjects (N=65, 27%) met criteria for comorbid OCPD. As compared to OCD-OCPD subjects, the OCD+OCPD subjects had a significantly younger age at onset of first OC symptoms (p=0.013), and a higher rate of symmetry and hoarding obsessions, and cleaning, ordering, repeating, and hoarding compulsions (all p's<0.01). Individuals with OCD+OCPD had higher rates of comorbid anxiety disorders (p=0.007) and avoidant personality disorder (p=0.006). The OCD+OCPD subjects also had significantly lower ratings of global functioning (p=0.001) and more impaired social functioning (p=0.004), despite a lack of significant differences on overall severity of OCD symptoms. CONCLUSIONS: Our findings indicate that individuals with both OCD and OCPD have distinct clinical characteristics in terms of age at onset of initial OC symptoms, the types of obsessions and compulsions they experience, and psychiatric comorbidity. Our findings, coupled with data from family studies showing a higher than expected frequency of OCPD in first degree relatives of OCD probands, suggest that OCD associated with OCPD may represent a specific subtype of OCD. Additional research is warranted to further establish the validity of this subtype.