Norberg Melissa M, Meares Susanne, Stevenson Richard J, Tame Jack, Wong Gary, Aldrich Paul, Olivier Jake
1Centre for Emotional Health, Macquarie University, Australia.
2Macquarie University, Australia.
J Behav Addict. 2023 Sep 28;12(3):827-39. doi: 10.1556/2006.2023.00053.
The prominent cognitive-behavioral model of hoarding posits that information processing deficits contribute to hoarding disorder. Although individuals with hoarding symptoms consistently self-report attentional and impulsivity difficulties, neuropsychological tests have inconsistently identified impairments. These mixed findings may be the result of using different neuropsychological tests, tests with poor psychometric properties, and/or testing individuals in a context that drastically differs from their own homes.
One hundred twenty-three participants (hoarding = 63; control = 60) completed neuropsychological tests of sustained attention, focused attention, and response inhibition in cluttered and tidy environments in a counterbalanced order.
Hoarding participants demonstrated poorer sustained attention and response inhibition than the control group (CPT-3 Omission and VST scores) and poorer response inhibition in the cluttered environment than when in the tidy environment (VST scores). CPT-3 Detectability and Commission scores also indicated that hoarding participants had greater difficulty sustaining attention and inhibiting responses than the control group; however, these effect sizes were just below the lowest practically meaningful magnitude. Posthoc exploratory analyses demonstrated that fewer than one-third of hoarding participants demonstrated sustained attention and response inhibition difficulties and that these participants reported greater hoarding severity and greater distress in the cluttered room.
Given these findings and other studies showing that attentional difficulties may be a transdiagnostic factor for psychopathology, future studies will want to explore whether greater sustained attention and response inhibition difficulties in real life contexts contribute to comorbidity and functional impairment in hoarding disorder.
囤积行为突出的认知行为模型认为，信息处理缺陷会导致囤积障碍。尽管有囤积症状的个体一直自我报告存在注意力和冲动控制方面的困难，但神经心理学测试结果却不一致。这些混合的结果可能是由于使用了不同的神经心理学测试、心理测量特性较差的测试，和/或在与他们自己家截然不同的环境中对个体进行测试。
123名参与者（囤积组 = 63人；对照组 = 60人）以平衡顺序在杂乱和整洁的环境中完成了持续注意力、集中注意力和反应抑制的神经心理学测试。
囤积组参与者在持续注意力和反应抑制方面表现比对照组差（连续性能测试-3遗漏和视觉搜索测试分数），且在杂乱环境中的反应抑制比在整洁环境中差（视觉搜索测试分数）。连续性能测试-3的可检测性和错误分数也表明，囤积组参与者在持续注意力和抑制反应方面比对照组更困难；然而，这些效应量略低于实际有意义的最低水平。事后探索性分析表明，不到三分之一的囤积组参与者存在持续注意力和反应抑制困难，且这些参与者报告在杂乱房间中的囤积严重程度更高、痛苦更大。
鉴于这些发现以及其他研究表明注意力困难可能是精神病理学的一个跨诊断因素，未来的研究将想要探讨在现实生活情境中更大的持续注意力和反应抑制困难是否会导致囤积障碍的共病和功能损害。
