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Compr Psychiatry. 2018 Feb;81:53-59. doi: 10.1016/j.comppsych.2017.11.009. Epub 2017 Nov 28.

Self-reported executive function and hoarding in adults with obsessive-compulsive disorder.

Author information

1
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address: jacks@jhmi.edu.
2
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
3
Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
4
Department of Psychiatry and Human Behavior, Brown Medical School, Butler Hospital, Providence, RI, USA.
5
Department of Psychiatry, College of Physicians and Surgeons at Columbia University and the New York State Psychiatric Institute, New York City, NY, USA.
6
Department of Psychiatry, University of Southern California School of Medicine, Los Angeles, CA, USA.
7
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, School of Medicine, Los Angeles, CA, USA.
8
Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
9
Department of Psychiatry and Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
10
Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
11
Laboratory of Clinical Science, National Institute of Mental Health, National Institute of Health, Bethesda, MD, USA.
12
Unit of Statistical Genomics, Division of Intramural Research, National Institute of Mental Health, Bethesda, MD, USA.

Abstract

BACKGROUND:

Hoarding behavior may distinguish a clinically and possibly etiologically distinct subtype of obsessive-compulsive disorder (OCD). Little is known about the relationship between executive dysfunction and hoarding in individuals with OCD.

METHODS:

The study sample included 431 adults diagnosed with DSM-IV OCD. Participants were assessed by clinicians for Axis I disorders, personality disorders, indecision, and hoarding. Executive functioning domains were evaluated using a self-report instrument, the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A). We compared scores on these domains in the 143 hoarding and 288 non-hoarding participants, separately in men and women. We used logistic regression to evaluate relationships between executive function scores and hoarding, and correlation and linear regression analyses to evaluate relationships between executive function scores and hoarding severity, in women.

RESULTS:

In men, the hoarding group had a significantly higher mean score than the non-hoarding group only on the shift dimension. In contrast, in women, the hoarding group had higher mean scores on the shift scale and all metacognition dimensions, i.e., those that assess the ability to systematically solve problems via planning and organization. The relationships in women between hoarding and scores on initiating tasks, planning/organizing, organization of materials, and the metacognition index were independent of other clinical features. Furthermore, the severity of hoarding in women correlated most strongly with metacognition dimensions.

CONCLUSIONS:

Self-reported deficits in planning and organization are associated with the occurrence and severity of hoarding in women, but not men, with OCD. This may have implications for elucidating the etiology of, and developing effective treatments for, hoarding in OCD.

KEYWORDS:

Executive function; Hoarding; OCD; Obsessive-compulsive disorder

PMID:
29268152
DOI:
10.1016/j.comppsych.2017.11.009
[Indexed for MEDLINE]

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