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O'Loghlen J, McKenzie M, Lang C, Paynter J. Repetitive Behaviors in Autism and Obsessive-Compulsive Disorder: A Systematic Review. J Autism Dev Disord 2024:10.1007/s10803-024-06357-8. [PMID: 38652373 DOI: 10.1007/s10803-024-06357-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE Obsessive-compulsive disorder (OCD) and autism are characterized by the presence of repetitive behaviors. Differentiating between repetitive behaviors attributable to a diagnosis of autism, and those attributable to OCD, poses challenges for differential and co-occurring diagnosis. Differentiation is important to inform appropriate supports and interventions for phenotypically similar but functionally distinct behaviors. In this systematic review, the quantitative literature was examined to explore the similarities and differences in repetitive behaviors (including restricted and repetitive behaviors and interests, and obsessive-compulsive behaviors) in autistic individuals and those with OCD, and those with co-occurring diagnoses, in terms of: (1) expression, (2) content, and (3) associated factors. METHODS Thirty-one studies were identified that compared repetitive behaviors in autistic individuals, individuals with OCD, or individuals with both diagnoses. RESULTS The results suggest considerable overlap in the intensity and content of repetitive behaviors between groups. The findings of this review highlight that research aimed specifically at understanding similarities and differences in repetitive behaviors between autistic individuals and individuals with OCD is limited and frequently only compare at total score or composite measure levels. CONCLUSION Further research into differences in the presentation of repetitive behaviors at a subscale and item level is required to inform clearer differentiation of specific behaviors in autism versus OCD. Understanding and more accurately differentiating is essential for efficient diagnosis, effective treatment, and better outcomes.
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Affiliation(s)
- Jessica O'Loghlen
- , Building N23, -1.03, 170 Kessels Road, Nathan, QLD, 4111, Australia.
| | - Matthew McKenzie
- School of Applied Psychology, Griffith University, 58 Parklands Drive, Southport, QLD, 4215, Australia
| | - Cathryne Lang
- School of Applied Psychology, Griffith University, 58 Parklands Drive, Southport, QLD, 4215, Australia
| | - Jessica Paynter
- School of Applied Psychology, Griffith University, 58 Parklands Drive, Southport, QLD, 4215, Australia
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Morein-Zamir S, Kasese M, Chamberlain SR, Trachtenberg E. Elevated levels of hoarding in ADHD: A special link with inattention. J Psychiatr Res 2021; 145:167-174. [PMID: 34923357 PMCID: PMC7612156 DOI: 10.1016/j.jpsychires.2021.12.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 11/18/2021] [Accepted: 12/10/2021] [Indexed: 10/29/2022]
Abstract
Hoarding Disorder (HD) is under recognised and under-treated. Though HD develops by early adulthood, patients present only later in life, resulting in research based largely on samples of predominantly older females. Whilst formerly associated with Obsessive-Compulsive Disorder (OCD), it is now recognised that individuals with HD often have inattention symptoms reminiscent of Attention Deficit/Hyperactivity Disorder (ADHD). Here, we investigated HD in adults with ADHD. Patients in an ADHD clinic (n = 88) reported on ADHD, HD and OCD-related symptoms, and compared with age, gender and education matched controls (n = 90). Findings were assessed independently in an online UK sample to verify replication using a dimensional approach (n = 220). Clinically significant hoarding symptoms were found in ∼20% versus 2% of ADHD and control groups, respectively, with those with hoarding being on average in their thirties and with approximately half being male. Greater hoarding severity was noted even in the remaining patients compared with controls (d = 0.89). Inattention was the only significant statistical predictor of hoarding severity in patients. Similarly, inattention, alongside depression and anxiety were the greatest predictors of hoarding in the independent sample where 3.2% identified as having clinically significant hoarding. Patients with ADHD had a high frequency of hoarding symptoms, which were specifically linked to inattention. HD should be routinely assessed in individuals with ADHD, as they do not typically disclose associated difficulties, despite these potentially leading to impaired everyday functioning. Research in HD should also investigate adults with ADHD, who are younger and with a greater prevalence of males than typical HD samples.
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Affiliation(s)
- Sharon Morein-Zamir
- School of Psychology and Sports Science, Anglia Ruskin University, Cambridge, UK.
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Goldfarb Y, Zafrani O, Hedley D, Yaari M, Gal E. Autistic adults' subjective experiences of hoarding and self-injurious behaviors. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 25:1457-1468. [PMID: 33631948 PMCID: PMC8264636 DOI: 10.1177/1362361321992640] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
LAY ABSTRACT Hoarding and self-injurious behaviors are relatively common in autism, but knowledge about their expressions in adulthood is scarce. Through interviews collecting subjective experiences of autistic adults, these behaviors were explored, and categorized to their underlying purposes. Findings portray the occurrence of these behaviors in the lives of autistic adults, their self-regulatory purposes, and their relationship to other behaviors in the domain of Restrictive and Repetitive Behaviors and Interests.
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Affiliation(s)
| | | | | | - Maya Yaari
- La Trobe University, Australia
- GOSHEN—Community Child Health and Well-Being, Israel
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Labad J, González-Rodríguez A, Cobo J, Puntí J, Farré JM. A systematic review and realist synthesis on toilet paper hoarding: COVID or not COVID, that is the question. PeerJ 2021; 9:e10771. [PMID: 33575133 PMCID: PMC7849510 DOI: 10.7717/peerj.10771] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 12/22/2020] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To explore whether the coronavirus disease 2019 (COVID-19) pandemic is associated with toilet paper hoarding and to assess which risk factors are associated with the risk of toilet paper hoarding. DESIGN A systematic review and realist review were conducted. DATA SOURCES PubMed, Web of Science, Scopus and PsycINFO were searched (systematic review). PubMed, pre-prints and grey literature were also searched (realist review). The databases were searched from inception until October 2020. STUDY SELECTION There were no restrictions on the study design. OUTCOMES AND MEASURES For the systematic review, toilet paper hoarding was the main outcome, and pathological use of toilet paper was the secondary outcome. For the realist review, the context-mechanisms-outcome (CMO) scheme included the COVID-19 pandemic (context), four proposed mechanisms, and one outcome (toilet paper hoarding). The four potential mechanisms were (1) gastrointestinal mechanisms of COVID-19 (e.g. diarrhoea), (2) social cognitive biases, (3) stress-related factors (mental illnesses, personality traits) and (4) cultural aspects (e.g. differences between countries). ELIGIBILITY CRITERIA FOR SELECTING STUDIES All studies of human populations were considered (including general population studies and clinical studies of patients suffering from mental health problems). RESULTS The systematic review identified 14 studies (eight studies for the main outcome, six studies for the secondary outcome). Three surveys identified the role of the COVID-19 threat in toilet paper hoarding in the general population. One study pointed to an association between a personality trait (conscientiousness) and toilet paper buying and stockpiling as well as an additional significant indirect effect of emotionality through the perceived threat of COVID-19 on toilet paper buying and stockpiling. Six case reports of pathological use of toilet paper were also identified, although none of them were associated with the COVID-19 pandemic. The realist review suggested that of all the mechanisms, social cognitive biases and a bandwagon effect were potential contributors to toilet paper hoarding in the general population. The stressful situation (COVID-19 pandemic) and some personality traits (conscientiousness) were found to be associated with toilet paper hoarding. Cultural differences were also identified, with relatively substantial effects of toilet paper hoarding in several Asian regions (Australia, Japan, Taiwan and Singapore). CONCLUSIONS The COVID-19 pandemic has been associated with a worldwide increase in toilet paper hoarding. Social media and social cognitive biases are major contributors and might explain some differences in toilet paper hoarding between countries. Other mental health-related factors, such as the stressful situation of the COVID-19 pandemic, fear of contagion, or particular personality traits (conscientiousness), are likely to be involved. REGISTRATION PROSPERO CRD42020182308.
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Affiliation(s)
- Javier Labad
- Department of Mental Health, Consorci Sanitari del Maresme, Mataró, Spain
- Centro de Investigación Biomédica en Salud Mental (CIBERSAM), Madrid, Spain
- Institut d’Investigació Sanitària Parc Taulí (I3PT), Sabadell, Spain
| | - Alexandre González-Rodríguez
- Institut d’Investigació Sanitària Parc Taulí (I3PT), Sabadell, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autónoma de Barcelona, Cerdanyola del Vallès, Spain
- Department of Mental Health, Parc Taulí Hospital Universitari, Sabadell, Spain
| | - Jesus Cobo
- Centro de Investigación Biomédica en Salud Mental (CIBERSAM), Madrid, Spain
- Institut d’Investigació Sanitària Parc Taulí (I3PT), Sabadell, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autónoma de Barcelona, Cerdanyola del Vallès, Spain
- Department of Mental Health, Parc Taulí Hospital Universitari, Sabadell, Spain
| | - Joaquim Puntí
- Department of Mental Health, Parc Taulí Hospital Universitari, Sabadell, Spain
| | - Josep Maria Farré
- Department of Psychiatry, Psychology and Psychosomatics, Dexeus University Hospital, Barcelona, Spain
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Ivanov VZ, Mataix-Cols D, Serlachius E, Brander G, Elmquist A, Enander J, Rück C. The developmental origins of hoarding disorder in adolescence: a longitudinal clinical interview study following an epidemiological survey. Eur Child Adolesc Psychiatry 2021; 30:415-425. [PMID: 32306089 PMCID: PMC8019421 DOI: 10.1007/s00787-020-01527-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 03/31/2020] [Indexed: 01/16/2023]
Abstract
Hoarding disorder (HD) is hypothesized to originate in childhood/adolescence but little is known about the presentation of hoarding symptoms in youth and their natural history. In this longitudinal study, we tracked and conducted in-depth psychiatric interviews with twins who participated in an epidemiological survey and screened positive on a measure of hoarding symptoms at age 15. Twins screening positive for clinically significant hoarding symptoms at age 15 (n = 42), their co-twins (n = 33), a group of screen negative twins (n = 49), and their parents underwent a clinical assessment a median of 3 years after the initial screening. The assessment included psychiatric screening, hoarding symptoms and cognitions, in-home or photographic assessment of clutter levels, parental accommodation and familial burden. None of the participants had significant levels of clutter at follow-up and thus did not meet strict criteria for HD. However, twins meeting partial criteria (i.e., DSM-5 criteria A and B) for HD (n = 28) had more psychiatric disorders and scored significantly higher on all measures of hoarding symptoms including researcher-rated levels of clutter in their homes, compared to twins who did not meet partial criteria for HD (n = 46). As currently defined in DSM-5, HD may be rare in young people. A non-negligible proportion of young people who were screen positive on hoarding symptoms at age 15 had substantial hoarding symptoms and other psychopathology at follow-up. Whether and how many of these individuals will develop full-blown HD is unknown but the results offer unique insights about the probable origins of HD in adolescence.
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Affiliation(s)
- Volen Z Ivanov
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm Health Care Services, Stockholm County Council, Karolinska University Hospital, SE 171 76, Huddinge, Sweden.
| | - David Mataix-Cols
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm Health Care Services, Stockholm County Council, Karolinska University Hospital, SE 171 76, Huddinge, Sweden
| | - Eva Serlachius
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm Health Care Services, Stockholm County Council, Karolinska University Hospital, SE 171 76, Huddinge, Sweden
| | - Gustaf Brander
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm Health Care Services, Stockholm County Council, Karolinska University Hospital, SE 171 76, Huddinge, Sweden
| | - Anders Elmquist
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm Health Care Services, Stockholm County Council, Karolinska University Hospital, SE 171 76, Huddinge, Sweden
| | - Jesper Enander
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm Health Care Services, Stockholm County Council, Karolinska University Hospital, SE 171 76, Huddinge, Sweden
| | - Christian Rück
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm Health Care Services, Stockholm County Council, Karolinska University Hospital, SE 171 76, Huddinge, Sweden
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Hillman K, Dix K, Ahmed K, Lietz P, Trevitt J, O'Grady E, Uljarević M, Vivanti G, Hedley D. Interventions for anxiety in mainstream school-aged children with autism spectrum disorder: A systematic review. CAMPBELL SYSTEMATIC REVIEWS 2020; 16:e1086. [PMID: 37131419 PMCID: PMC8356281 DOI: 10.1002/cl2.1086] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Affiliation(s)
- Kylie Hillman
- Australian Council for Educational ResearchCamberwellVictoriaAustralia
| | - Katherine Dix
- Australian Council for Educational ResearchAdelaideSouth AustraliaAustralia
| | - Kashfee Ahmed
- Australian Council for Educational ResearchAdelaideSouth AustraliaAustralia
| | - Petra Lietz
- Australian Council for Educational ResearchAdelaideSouth AustraliaAustralia
| | - Jenny Trevitt
- Australian Council for Educational ResearchCamberwellVictoriaAustralia
| | - Elizabeth O'Grady
- Australian Council for Educational ResearchCamberwellVictoriaAustralia
| | - Mirko Uljarević
- Division of Child and Adolescent Psychiatry, Stanford Autism Center, Department of Psychiatry and Behavioral Sciences, School of MedicineStanford UniversityPalo AltoCalifornia
| | - Giacomo Vivanti
- A. J. Drexel Autism InstituteDornsife School of Public Health, Drexel UniversityPhiladelphiaPennsylvania
| | - Darren Hedley
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, College of Science, Health and EngineeringLaTrobe UniversityBundooraVictoriaAustralia
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Davidson EJ, Dozier ME, Pittman JOE, Mayes TL, Blanco BH, Gault JD, Schwarz LJ, Ayers CR. Recent Advances in Research on Hoarding. Curr Psychiatry Rep 2019; 21:91. [PMID: 31410591 PMCID: PMC7294597 DOI: 10.1007/s11920-019-1078-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PURPOSE OF REVIEW The purpose of the following paper is to review recent literature trends and findings in hoarding disorder (HD). Our goal is to highlight recent research on etiology, associated features, and empirically based treatments. RECENT FINDINGS Recent literature has added support for cognitive differences as a risk factor for HD; however, there is evidence that individuals with HD may overestimate their level of cognitive impairment. Several associated features have been highlighted in recent studies, including emotion regulation, intolerance of uncertainty and distress intolerance, and attachment. Finally, several psychotherapeutic treatments for hoarding have been recently validated, including group-based therapy and treatments using the cognitive-behavioral model. Although recent research demonstrates that hoarding can be effectively treated with available psychotherapeutic modalities, the effectiveness of current treatments is not as robust as that for other psychiatric disorders and more work is needed in treatment precision.
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Affiliation(s)
- Eliza J Davidson
- Research Service, VA San Diego Healthcare System, 3350 La Jolla Village Drive 116B, San Diego, CA, 92161, USA
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Mary E Dozier
- Research Service, VA San Diego Healthcare System, 3350 La Jolla Village Drive 116B, San Diego, CA, 92161, USA
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
- Psychology Service, South Texas Veterans Health Care System, San Antonio, TX, USA
| | - James O E Pittman
- Mental Healthcare Line, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego School of Medicine, San Diego, CA, USA
| | - Tina L Mayes
- Mental Healthcare Line, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego School of Medicine, San Diego, CA, USA
| | - Brian H Blanco
- Research Service, VA San Diego Healthcare System, 3350 La Jolla Village Drive 116B, San Diego, CA, 92161, USA
- Department of Psychiatry, University of California, San Diego School of Medicine, San Diego, CA, USA
| | - John D Gault
- Research Service, VA San Diego Healthcare System, 3350 La Jolla Village Drive 116B, San Diego, CA, 92161, USA
- Department of Psychiatry, University of California, San Diego School of Medicine, San Diego, CA, USA
| | - Lauren J Schwarz
- Research Service, VA San Diego Healthcare System, 3350 La Jolla Village Drive 116B, San Diego, CA, 92161, USA
| | - Catherine R Ayers
- Mental Healthcare Line, VA San Diego Healthcare System, San Diego, CA, USA.
- Department of Psychiatry, University of California, San Diego School of Medicine, San Diego, CA, USA.
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Højgaard DRMA, Skarphedinsson G, Ivarsson T, Weidle B, Nissen JB, Hybel KA, Torp NC, Melin K, Thomsen PH. Hoarding in children and adolescents with obsessive-compulsive disorder: prevalence, clinical correlates, and cognitive behavioral therapy outcome. Eur Child Adolesc Psychiatry 2019; 28:1097-1106. [PMID: 30656432 DOI: 10.1007/s00787-019-01276-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 01/07/2019] [Indexed: 12/27/2022]
Abstract
Hoarding, common in pediatric obsessive-compulsive disorder (OCD), has specific clinical correlates and is associated with poor prognosis. However, there are few studies of hoarding in pediatric OCD. This study estimates the occurrence of hoarding symptoms in a sample of children and adolescents with OCD, investigating possible differences in demographic and clinical variables between pediatric OCD with and without hoarding symptoms. Furthermore, the study investigates whether hoarding symptoms predict poorer treatment outcomes after cognitive behavioral therapy (CBT). The study sample comprised 269 children and adolescents with OCD, aged 7-17 years, from Denmark, Sweden, and Norway, who were all included in the Nordic long-term obsessive-compulsive disorder Treatment Study. All had an OCD diagnosis according to the DSM-IV and were treated with 14 weekly sessions of manualized, exposure-based CBT. Hoarding symptoms and OCD severity were assessed with the Children's Yale-Brown Obsessive-Compulsive Scale and group differences in treatment outcome were analyzed using linear mixed-effect modelling. Seventy-two patients (26.8%) had one or more symptoms of hoarding. Comorbid tic disorders (p = 0.005) and indecision (p = 0.024) were more prevalent among those with hoarding symptoms than those without hoarding symptoms. In addition, youth with hoarding symptoms had a different OCD symptom profile. Having symptoms of hoarding did not affect CBT outcome (p = 0.933). Results from the study suggest that CBT is equally effective for those with and without hoarding-related OCD.
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Affiliation(s)
- Davíð R M A Højgaard
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital Psychiatry, Palle Juul-Jensens Boulevard 175, Entrance K, 8200, Århus, Denmark.
| | | | - Tord Ivarsson
- The Center for Child and Adolescent Mental Health. Eastern and Southern Norway (RBUP), Oslo, Norway
| | - Bernhard Weidle
- Regional Center for Child and Youth Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Judith Becker Nissen
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital Psychiatry, Palle Juul-Jensens Boulevard 175, Entrance K, 8200, Århus, Denmark
| | - Katja A Hybel
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital Psychiatry, Palle Juul-Jensens Boulevard 175, Entrance K, 8200, Århus, Denmark
| | - Nor Christian Torp
- Division of Mental Health and Addiction, Department of Child and Adolescent Psychiatry, Vestre Viken Hospital, Drammen, Norway
| | - Karin Melin
- Department of Child and Adolescent Psychiatry, Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Per Hove Thomsen
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital Psychiatry, Palle Juul-Jensens Boulevard 175, Entrance K, 8200, Århus, Denmark.,Regional Center for Child and Youth Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
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Kajitani K, Tsuchimoto R, Nagano J, Nakao T. Relevance of hoarding behavior and the traits of developmental disorders among university students: a self-reported assessment study. Biopsychosoc Med 2019; 13:13. [PMID: 31171932 PMCID: PMC6545730 DOI: 10.1186/s13030-019-0156-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 05/22/2019] [Indexed: 11/22/2022] Open
Abstract
Background Previous studies have shown that hoarding behavior usually starts at a subclinical level in early adolescence and gradually worsens; however, a limited number of studies have examined the prevalence of hoarding behavior and its association with developmental disorders in young adults. The aims of this study were to estimate the prevalence of hoarding behavior and to identify correlations between hoarding behavior and developmental disorder traits in university students. Methods The study participants included 801 university students (616 men, 185 women) who completed questionnaires (ASRS: Adult ADHD Self-Report Scale version 1.1, AQ16: Autism-Spectrum Quotient with 16 items, and CIR: Clutter Image Rating). Results Among 801 participants, 27 (3.4%) exceeded the CIR cut-off score. Moreover, the participants with hoarding behavior had a significantly higher percentage of ADHD traits compared to participants without hoarding behavior (HB(+) vs HB(−), 40.7% vs 21.7%). In addition, 7.4% of HB(+) participants had autism spectrum disorder (ASD) traits, compared to 4.1% of HB(−) participants. A correlation analysis revealed that the CIR composite score had a stronger correlation with the ASRS inattentive score than with the hyperactivity/impulsivity score (CIR composite vs ASRS IA, r = 0.283; CIR composite vs ASRS H/I, r = 0.147). Conclusions The results showed a high prevalence of ADHD traits in the university students with hoarding behavior. Moreover, we found that the hoarding behavior was more strongly correlated with inattentive symptoms rather than with hyperactivity/impulsivity symptoms. Our results support the concept of a common pathophysiology behind hoarding behavior and ADHD in young adults.
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Affiliation(s)
- Kosuke Kajitani
- 1Center for Health Sciences and Counseling, Kyushu University, 6-1 Kasuga-koen, Kasuga, Fukuoka, 816-8580 Japan
| | - Rikako Tsuchimoto
- 1Center for Health Sciences and Counseling, Kyushu University, 6-1 Kasuga-koen, Kasuga, Fukuoka, 816-8580 Japan
| | - Jun Nagano
- 1Center for Health Sciences and Counseling, Kyushu University, 6-1 Kasuga-koen, Kasuga, Fukuoka, 816-8580 Japan
| | - Tomohiro Nakao
- 2Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, Japan
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Boerema YE, de Boer MM, van Balkom AJLM, Eikelenboom M, Visser HA, van Oppen P. Obsessive compulsive disorder with and without hoarding symptoms: Characterizing differences. J Affect Disord 2019; 246:652-658. [PMID: 30611063 DOI: 10.1016/j.jad.2018.12.115] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 12/07/2018] [Accepted: 12/24/2018] [Indexed: 11/25/2022]
Abstract
OBJECTIVE In recent years there has been some ambiguity about the way hoarding and OCD are related to each other. The present study examines the differences between persons with OCD/hoarding and OCD/non-hoarding and examines which characteristics are associated with the OCD/hoarding group. Information is established about prevalences, socio-demographical characteristics, OCD and related characteristics, OCD subtypes, comorbidity (depression, anxiety disorders and PTSD) and personality traits. METHODS Data from baseline assessment of The Netherlands Obsessive Compulsive Disorder Association (NOCDA) study are used. The NOCDA sample consists of 419 participants between 18 and 79 years of age, including participants with current or remitted full DSM-IV-TR criteria for OCD. RESULTS Results show that 58 persons (14.3%) are classified as persons with OCD/hoarding and 349 persons (85,7%) are classified as persons with OCD/non-hoarding. OCD/hoarding is independently associated with severity of autism symptoms (p<.001), living without a partner (p<.05) and being less conscientious (p<.05). Persons with OCD/hoarding are not associated with childhood trauma (p=.31), PTSD (p=.91) and AD(H)D, inattentive type (p=.22) and hyperactive type (p=.57). LIMITATIONS Causal interferences about associations between the risk indicators and hoarding symptoms were precluded since results were based on cross-sectional data. CONCLUSION This study confirmed differences between persons with OCD/hoarding and persons with OCD/non-hoarding. The most relevant outcome of this study was the association between persons with OCD/hoarding and the increased severity of autism symptoms. These results provide a better understanding of persons with OCD/hoarding and have the potential to improve treatment.
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Affiliation(s)
- Yentl E Boerema
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, The Netherlands.
| | - Mijke M de Boer
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, The Netherlands
| | - Anton J L M van Balkom
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, The Netherlands
| | - Merijn Eikelenboom
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, The Netherlands
| | - Henny A Visser
- Innova Research Centre, Mental Health Care Institute GGZ Centraal, Ermelo, The Netherlands
| | - Patricia van Oppen
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, The Netherlands
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La Buissonnière-Ariza V, Wood JJ, Kendall PC, McBride NM, Cepeda SL, Small BJ, Lewin AB, Kerns C, Storch EA. Presentation and Correlates of Hoarding Behaviors in Children with Autism Spectrum Disorders and Comorbid Anxiety or Obsessive-Compulsive Symptoms. J Autism Dev Disord 2018; 48:4167-4178. [PMID: 29974314 DOI: 10.1007/s10803-018-3645-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
We investigated the presentation and correlates of hoarding behaviors in 204 children aged 7-13 with autism spectrum disorder (ASD) and comorbid anxiety or obsessive-compulsive disorder (OCD) symptoms. Approximately 34% of the sample presented at least moderate levels, and with 7% presenting severe to extreme levels of hoarding. Child gender predicted hoarding severity. In addition, child ASD-related social difficulties together with attention-deficit and hyperactivity disorder symptom severity positively predicted hoarding controlling for child gender and restricted and repetitive behaviors. Finally, child anxiety/OCD symptoms positively predicted hoarding, controlling for all other factors. These results suggest hoarding behaviors may constitute a common feature of pediatric ASD with comorbid anxiety/OCD, particularly in girls and children with greater social difficulties and comorbid psychiatric symptom severity.
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Affiliation(s)
- Valérie La Buissonnière-Ariza
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, One Baylor Plaza - BCM350, Houston, TX, 77030, USA
| | - Jeffrey J Wood
- Departments of Education and Psychiatry, UCLA, Los Angeles, Los Angeles, CA, USA
| | - Philip C Kendall
- Department of Psychology, Temple University, Philadelphia, PA, USA
| | - Nicole M McBride
- Division of Child and Adolescent Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Sandra L Cepeda
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, One Baylor Plaza - BCM350, Houston, TX, 77030, USA
| | - Brent J Small
- School of Aging Studies, University of South Florida, Tampa, FL, USA
| | - Adam B Lewin
- Department of Psychiatry and Behavioral Sciences, University of South Florida, Tampa, FL, USA
| | - Connor Kerns
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA, USA
| | - Eric A Storch
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, One Baylor Plaza - BCM350, Houston, TX, 77030, USA.
- Department of Pediatrics, Baylor College of Medicine/Texas Children's Hospital, Houston, TX, USA.
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12
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Phenomenology of hoarding in children with comorbid attention-deficit/hyperactivity disorder (ADHD): The perceptions of parents. Compr Psychiatry 2017; 76:1-10. [PMID: 28363086 DOI: 10.1016/j.comppsych.2017.03.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 03/09/2017] [Accepted: 03/10/2017] [Indexed: 11/23/2022] Open
Abstract
Individuals with ADHD and comorbid hoarding disorder are vulnerable to severe consequences from hoarding symptoms. Despite this, and the early onset of hoarding disorder, the nature of hoarding symptoms in children with comorbid ADHD is unknown. We therefore explored the phenomenology of hoarding symptoms among ten 8-12year olds with ADHD and clinically significant hoarding symptoms through parental perceptions. Parents completed in-depth semi-structured interviews. The data was analyzed using Interpretative Phenomenological Analysis. Six superordinate themes were identified: emotional distress; parental avoidance and accommodating behaviors; family impacts of hoarding; excessive acquisition and saving; executive functioning; parental insight and intervention. In contrast to previous suggestions that emotional distress was not associated with hoarding in ADHD, these findings highlight that emotional distress appeared to be core to the hoarding disorder profile of the present sample of children with ADHD. This has important implications for health practitioners who may consider conceptualizing, assessing, and treating hoarding symptoms in children with comorbid ADHD using a cognitive behavioral model of hoarding disorder.
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13
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Park JM, Samuels JF, Grados MA, Riddle MA, Bienvenu OJ, Goes FS, Cullen B, Wang Y, Krasnow J, Murphy DL, Rasmussen SA, McLaughlin NC, Piacentini J, Pauls DL, Stewart SE, Shugart YY, Maher B, Pulver AE, Knowles JA, Greenberg BD, Fyer AJ, McCracken JT, Nestadt G, Geller DA. ADHD and executive functioning deficits in OCD youths who hoard. J Psychiatr Res 2016; 82:141-8. [PMID: 27501140 DOI: 10.1016/j.jpsychires.2016.07.024] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 06/29/2016] [Accepted: 07/28/2016] [Indexed: 10/21/2022]
Abstract
Hoarding is common among youth with obsessive compulsive disorder (OCD), with up to 26% of OCD youth exhibiting hoarding symptoms. Recent evidence from adult hoarding and OCD cohorts suggests that hoarding symptoms are associated with executive functioning deficits similar to those observed in subjects with attention deficit hyperactivity disorder (ADHD). However, while hoarding behavior often onsets during childhood, there is little information about executive function deficits and ADHD in affected children and adolescents. The study sample included 431 youths (ages 6-17 years) diagnosed with OCD who participated in the OCD Collaborative Genetics Study and the OCD Collaborative Genetics Association Study and completed a series of clinician-administered and parent report assessments, including diagnostic interviews and measures of executive functioning (Behavior Rating Inventory of Executive Functioning; BRIEF) and hoarding severity (Hoarding Rating Scale-Interview; HRS-I). 113 youths (26%) had clinically significant levels of hoarding compulsions. Youths with and without hoarding differed significantly on most executive functioning subdomains and composite indices as measured by the parent-rated BRIEF. Groups did not differ in the frequency of full DSM-IV ADHD diagnoses; however, the hoarding group had significantly greater number of inattention and hyperactivity symptoms compared to the non-hoarding group. In multivariate models, we found that overall BRIEF scores were related to hoarding severity, adjusting for age, gender and ADHD symptoms. These findings suggest an association between hoarding and executive functioning deficits in youths with OCD, and assessing executive functioning may be important for investigating the etiology and treatment of children and adolescents with hoarding and OCD.
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Affiliation(s)
- Jennifer M Park
- Stanford University School of Medicine, Department of Child and Adolescent Psychiatry, 1195 W Fremont Ave, Sunnyvale, CA, 94087, USA.
| | - Jack F Samuels
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, 1800 Orleans St, Baltimore, MD, 21287, USA
| | - Marco A Grados
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, 1800 Orleans St, Baltimore, MD, 21287, USA
| | - Mark A Riddle
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, 1800 Orleans St, Baltimore, MD, 21287, USA
| | - O Joseph Bienvenu
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, 1800 Orleans St, Baltimore, MD, 21287, USA
| | - Fernando S Goes
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, 1800 Orleans St, Baltimore, MD, 21287, USA
| | - Bernadette Cullen
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, 1800 Orleans St, Baltimore, MD, 21287, USA
| | - Ying Wang
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, 1800 Orleans St, Baltimore, MD, 21287, USA
| | - Janice Krasnow
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, 1800 Orleans St, Baltimore, MD, 21287, USA
| | - Dennis L Murphy
- Laboratory of Clinical Science, National Institute of Mental Health, National Institute of Health, 6001 Executive Boulevard, Rm 6200, MSC 9663, Bethesda, MD, 20892-9663, USA
| | - Steven A Rasmussen
- Brown Medical School, Department of Psychiatry and Human Behavior, Box G-A1, Providence, RI, 02912, USA
| | - Nicole C McLaughlin
- Brown Medical School, Department of Psychiatry and Human Behavior, Box G-A1, Providence, RI, 02912, USA
| | - John Piacentini
- University of California, Los Angeles School of Medicine, Department of Psychiatry and Biobehavioral Sciences, 757 Westwood Plaza, Los Angeles, CA, 90095, USA
| | - David L Pauls
- Massachusetts General Hospital and Harvard Medical School, Department of Psychiatry, 55 Fruit Street, Boston, MA, 02114, USA
| | - S Evelyn Stewart
- Faculty of Medicine, University of British Columbia, Department of Psychiatry, Detwiller Pavilion, 2255 Wesbrook Mall, Vancouver, BC, V6T 2A1, Canada
| | - Yin-Yao Shugart
- Unit of Statistical Genomics, Division of Intramural Research, National Institute of Mental Health, 6001 Executive Boulevard, Rm 6200, MSC 9663, Bethesda, MD, 20892-9663, USA
| | - Brion Maher
- Johns Hopkins University, Bloomberg School of Public Health, Department of Mental Health, 615 N Wolfe Street, Baltimore, MD, 21205, USA
| | - Ann E Pulver
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, 1800 Orleans St, Baltimore, MD, 21287, USA
| | - James A Knowles
- Keck School of Medicine, University of Southern California, 1975 Zonal Avenue, Los Angeles, CA, 90033, USA
| | - Benjamin D Greenberg
- Brown Medical School, Department of Psychiatry and Human Behavior, Box G-A1, Providence, RI, 02912, USA
| | - Abby J Fyer
- College of Physicians and Surgeons at Columbia University and the New York State Psychiatric Institute, Department of Psychiatry, 630 W 168th, Street, New York, NY, 10032, USA
| | - James T McCracken
- University of California, Los Angeles School of Medicine, Department of Psychiatry and Biobehavioral Sciences, 757 Westwood Plaza, Los Angeles, CA, 90095, USA
| | - Gerald Nestadt
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, 1800 Orleans St, Baltimore, MD, 21287, USA
| | - Daniel A Geller
- Massachusetts General Hospital and Harvard Medical School, Department of Psychiatry, 55 Fruit Street, Boston, MA, 02114, USA
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