Perfectionism In Obsessive-Compulsive Disorder Patients

Considerable theory and anecdotal evidence has suggested that patients with Obsessive-Compulsive Disorder (OCD) are more perfectionistic. Evidence with non-clinical populations supports this hypothesis. However, no data are available on levels of perfectionism among patients diagnosed with OCD. The present study extends findings on perfectionism and OCD by comparing perfectionism levels of OCD-diagnosed patients with those of non-patients and a group of patients diagnosed with panic disorder with agoraphobia (PDA). As predicted, patients with OCD had significantly elevated scores on Total Perfectionism, Concern Over Mistakes, and Doubts About Actions compared to non-patient controls. However, they did not differ from patients with PDA on Total Perfectionism or Concern Over Mistakes. Patients with OCD did have higher Doubts About Actions scores than those with PDA. The implications for the role of perfectionism in OCD and other anxiety disorders are discussed

Comparison of Object and Animal Hoarding

Recent research has highlighted the prevalence and harmful consequences of hoarding,1 and investigators have proposed inclusion of hoarding disorder in DSM-5.2 An unanswered question about the proposed disorder is whether people who hoard animals would meet diagnostic criteria for it. This article discusses the similarities and differences between object and animal hoarding. People who hoard animals appear to meet the basic diagnostic criteria for hoarding disorder. Their homes are cluttered, disorganized, and dysfunctional. They have great difficulty relinquishing animals to people who can more adequately care for them, and they form intense attachments (urges to save) that result in significant impairment. However, they differ from people who hoard objects in several ways. These differences are significant enough to warrant comment in the text description accompanying the diagnostic criteria and consideration as a subtype of hoarding disorder. More research is necessary to determine the exact relationship between object and animal hoarding. © 2011 Wiley-Liss, Inc

Hoarding By Elderly People

Although hoarding has been studied in adults, little is known about problems of hoarding by elderly people. This study used a structured telephone interview with elder services providers to investigate hoarding behaviors in relation to functional impairment, cognitive deficits, and physical and psychological conditions in 62 elderly clients. Most elderly hoarders were female, unmarried, and lived alone. Extensive clutter was associated with significant impairment, interfering with basic hygiene, and posing a serious physical threat for many elderly clients. Clients were rarely insightful about their collecting and often resisted change, rendering interventions generally ineffective. Never-married status was associated with more severe hoarding and greater impairment and possibly with worse outcomes of intervention efforts. Health and mental health implications of hoarding by elderly people and implications for treatment are discussed

A Brief Interview for Assessing Compulsive Hoarding: The Hoarding Rating Scale-Interview

This article describes the development and validation of the Hoarding Rating Scale-Interview (HRS-I), a brief (5-10 min) five-item semi-structured interview that assesses the features of compulsive hoarding (clutter, difficulty discarding, acquisition, distress and impairment). Trained interviewers administered the HRS-I to 136 adults (73 compulsive hoarding, 19 OCD, 44 non-clinical controls) along with a battery of self-report measures. An initial assessment was conducted in the clinic, and a second assessment was conducted in participants\u27 homes. The HRS-I showed high internal consistency and reliability across time and context. The HRS-I clearly differentiated hoarding and non-hoarding participants, and was strongly associated with other measures of hoarding. It is concluded that the HRS-I is a promising measure for determining the presence and severity of compulsive hoarding

A comparison of cognitive restructuring and thought listing for excessive acquiring in hoarding disorder

Excessive acquiring is a common symptom of hoarding disorder (HD). Little is known about subjective distress associated with acquiring in HD. The present study examined acquiring- related distress and reactions to cognitive restructuring (CR) in 92 individuals with HD and 66 community control (CC) participants. All participants identified an item of interest at a high-risk acquiring location and then decided whether or not to acquire the item. HD participants completed the acquiring task while receiving a CR-based intervention or a thought-listing (TL) control condition. Results showed that HD participants reported more severe distress and greater urges to acquire the item of interest than did CC participants. Nevertheless, subjective distress decreased in both groups following the acquiring task. There were no differences in acquiring- related distress between the CR and TL conditions. The findings indicate that subjective distress may decrease after relatively short periods of time in individuals with HD, but that a single session of CR may not alleviate acquiring-related distress in HD participants.R01 MH068007 - NIMH NIH HHS; R01 MH068008 - NIMH NIH HHSAccepted manuscrip

Development and Validation of the Frost Multidimensional Perfectionism Scale–Brief

Twenty-five years ago, one of the first empirically validated measures of perfectionism, the Frost et al. Multidimensional Perfectionism Scale (F-MPS) was published. Since that time, psychometric studies of the original F-MPS have provided a plethora of evidence to support the potential development of a shorter yet still psychometrically robust version of the measure. Using confirmatory factor analyses across community and clinical samples, the current study identifies an eight-item F-MPS-Brief with two dimensions (i.e., striving and evaluative concerns) that evidences good internal consistency, measurement equivalence across ethnicities, and concurrent and convergent validity. This new, short version of the F-MPS captures well the bidimensional model of perfectionism that has emerged across studies over the past two decades and is suggested for use when a short yet high-performing assessment tool for this model is desired

Indecisiveness And Hoarding

Hoarding behavior and the problems associated with it have been the subject of an increasing amount of research. Early theorizing has suggested that problems with decision-making constitute a core feature, yet relatively few studies have examined this in depth. In the present study, indecisiveness was examined in large samples of adults who self-identified as having significant hoarding problems (n = 887), adult children of such individuals (n = 295), and spouses of such individuals (n = 120). People with hoarding problems reported more decision-making problems than children or spouses, and considerably more than community controls from other studies. Adult children of people with hoarding reported more indecisiveness than spouses, suggesting that this characteristic runs in families. Among the hoarding group, decision-making problems were correlated with all three core features of hoarding (excessive acquisition, difficulty discarding, clutter/disorganization), and the associations were independent of depression, anxiety, and obsessive-compulsive (OC) symptoms. Higher indecisiveness scores were also associated with earlier age of onset of hoarding independent of hoarding severity. Depression was associated mainly with the negative consequences of hoarding, while OC symptoms were related to the excessive acquisition of free things. Indecisiveness may be an important marker or nonhoarding endophenotype for hoarding and deserves closer examination

Activities of Daily Living Scale in Hoarding Disorder

Research on hoarding over the last two decades has shown that hoarding disorder appears to be a distinct disorder that burdens the individual, the community and the families of people who hoard. Although hoarding clearly interferes with the daily functioning, especially in the context of extensive clutter, no validated measures of this interference have been developed. The present research examined the psychometric properties of the Activities of Daily Living in Hoarding scale (ADL-H) in two large samples of individuals with significant hoarding problems, one identified through the internet (n=363) and a second through clinical diagnostic interviews (n=202). The ADL-H scale test-retest (1-12 weeks), interrater and internal reliabilities ranged from .79 to .96. Convergent and discriminant validity were established through analyses of correlational data collected for measures of hoarding severity and non-hoarding psychopathology (obsessive-compulsive disorder [OCD], moodstate, attention deficit, and perfectionism/uncertainty), as well as through comparisons of scores among individuals with hoarding, hoarding plus OCD, OCD without hoarding, and community controls. The ADL-H scale appears to have strong psychometric properties and to be useful in clinical and research settings. Suggestions are made for expansion of the scale, and study limitations are noted

Compulsive Hoarding In Children: Six Case Studies

Semi-structured interviews were conducted with the parents of six children who showed signs of compulsive hoarding. The cases revealed a wide variety of hoarding behaviors. Hoarding manifested in difficulties in discarding and maintaining control over possessions. Few cases had problems with clutter or excessive acquisition. In three cases hoarding was episodic and stress-related. Most of the cases showed overlapping ADHD symptoms and a majority demonstrated problems with perfectionism. Only two had clear obsessive-compulsive disorder, although concerns about others touching or moving possessions, which was present in all of the cases, may represent a form of ordering and arranging compulsions. None of the cases demonstrated clear insight, and several showed abnormal personification of inanimate objects and exaggerated “essentialism.

Group And Individual Treatment of Compulsive Hoarding: a Pilot Study

Treatment of compulsive hoarding has rarely been described in the literature, apart from standard treatments for obsessive compulsive disorder of which hoarding is thought to be a subset. This paper presents preliminary findings from seven patients treated with cognitive and behavioral interventions derived from Frost and Hartl\u27s (1996) theoretical model of hoarding. Six clients attended 15 group treatment sessions over 20 weeks plus individual home treatment sessions and one client received 20 weekly-sessions of individual treatment only. After 20 weeks, treatment resulted in noticeable improvement in several hoarding symptoms for five of the seven patients, especially reduction in excessive acquisition of possessions, although problems with clutter persisted. Three of four clients who continued in treatment for approximately 1 year showed substantial further improvement, although none felt entirely recovered. Findings are discussed in light of the model of hoarding and possible modifications to treatment to enhance motivation and benefits