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Should I Keep It? Thoughts Verbalized During a Discarding Task

  • Christiana BratiotisEmail author
  • Gail Steketee
  • JoAnn Dohn
  • Carole A. Calderon
  • Randy O. Frost
  • David F. Tolin
Original Article

Abstract

An essential criterion for hoarding disorder (HD) is difficulty parting with possessions, but relatively little research has been conducted on responses by people with HD during actual efforts to discard objects. Frost et al. (Behav Res Therapy 85:13–22, 2016) reported quantitative findings from a discarding task comparing those with HD to community control participants without significant hoarding symptoms (CC) on discarding behavior. The present study used qualitative data analysis of the verbal statements made by HD and CC participants while talking aloud about whether to discard or keep a personal object of low monetary value. Data were coded and analyzed using Atlas.ti software via an iterative process in order to examine thoughts reported during decision-making. Findings indicated that participants made more comments about reasons for saving than discarding and that HD participants reported more reasons to save and fewer reasons to discard than did CC participants. They also voiced more thoughts about emotions, both negative and positive, than did controls, especially for anxiety, anger and guilt and general distress. HD participants expressed more ambivalence about discarding compared to controls. Findings are discussed in relation to the cognitive and behavioural model for hoarding, previous findings regarding reasons for saving, and treatment implications.

Keywords

Hoarding Cognitions Thought-listing Discarding task 

Notes

Funding

This study was funded by Grants from the National Institute of Mental Health to Randy Frost (R01 MH068008) and Gail Steketee (R01 MH068007).

Compliance with Ethical Standards

Conflicts of Interest

Christiana Bratiotis, Gail Steketee, Randy O. Frost, and David F. Tolin have received royalties from Oxford University Press. JoAnn Dohn and Carole A. Calderon have no conflicts of interests to disclose.

Informed Consent

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

Animal Rights

No animal studies were carried out by the authors for this article.

References

  1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Association.CrossRefGoogle Scholar
  2. Ayers, C. R., Wetherell, J. L., Golshan, S., & Saxena, S. (2011). Cognitive-behavioral therapy for geriatric compulsive hoarding. Behaviour Research and Therapy, 49, 689–694.  https://doi.org/10.1016/j.brat.2011.07.002.CrossRefGoogle Scholar
  3. Brown, T. A., Di Nardo, P. A., & Barlow, D. H. (1994). Anxiety disorders interview schedule for DSM-IV: Adult version. New York: Oxford University Press.Google Scholar
  4. Brown, T. A., Di Nardo, P. A., Lehman, C. L., & Campbell, L. A. (2001). Reliability of DSM-IV anxiety and mood disorders: Implications for the classification of emotional disorders. Journal of Abnormal Psychology, 110, 49–58.  https://doi.org/10.1037/0021-843X.110.1.49.CrossRefGoogle Scholar
  5. Chasson, G. S., Carpenter, A., Ewing, J., Gibby, B., & Lee, N. (2014). Empowering families to help a loved one with hoarding disorder: Pilot study of family-as-motivators training. Behaviour Research and Therapy, 63, 9–16.  https://doi.org/10.1016/j.brat.2014.08.016.CrossRefGoogle Scholar
  6. DeRubeis, R. J., Evans, M. D., Hollon, S. D., Garvey, M. J., Grove, W. M., & Tuason, V. B. (1990). How does cognitive therapy work? Cognitive change and symptom change in cognitive therapy and pharmacotherapy for depression. Journal of Consulting and Clinical Psychology, 58, 862–869.  https://doi.org/10.1037/0022-006X.58.6.862.CrossRefGoogle Scholar
  7. Frost, R. O., & Gross, R. (1993). The hoarding of possessions. Behaviour Research and Therapy, 31, 367–382.  https://doi.org/10.1016/0005-7967(93)90094-B.CrossRefGoogle Scholar
  8. Frost, R. O., & Hartl, T. L. (1996). A cognitive-behavioral model of compulsive hoarding. Behaviour Research and Therapy, 34, 341–350.  https://doi.org/10.1016/0005-7967(95)00071-2.CrossRefGoogle Scholar
  9. Frost, R. O., Hartl, T., Christian, R., & Williams, N. (1995). The value of possessions in compulsive hoarding: Patterns of use and attachment. Behaviour Research and Therapy, 33, 897–902.  https://doi.org/10.1016/0005-7967(95)00043-W.CrossRefGoogle Scholar
  10. Frost, R. O., Kim, H. J., Morris, C., Bloss, C., Murray-Close, M., & Steketee, G. (1998). Hoarding, compulsive buying and reasons for saving. Behaviour Research and Therapy, 36, 657–664.  https://doi.org/10.1016/S0005-7967(98)00056-4.CrossRefGoogle Scholar
  11. Frost, R. O., Ong, C., Steketee, G., & Tolin, D. F. (2016). Behavioral and emotional consequences of thought listing versus cognitive restructuring during discarding decisions in hoarding disorder. Behaviour Research and Therapy, 85, 13–22.  https://doi.org/10.1016/j.brat.2016.08.003.CrossRefGoogle Scholar
  12. Frost, R. O., & Shows, D. L. (1993). The nature and measurement of compulsive indecisiveness. Behaviour Research and Therapy, 31, 683–692.  https://doi.org/10.1016/0005-7967(93)90121-A.CrossRefGoogle Scholar
  13. Frost, R. O., & Steketee, G. (2010). Stuff: Hoarding and the meaning of things. New York: Houghton Mifflin Harcourt.Google Scholar
  14. Frost, R. O., Steketee, G., & Grisham, J. (2004). Measurement of compulsive hoarding: Saving Inventory-Revised. Behaviour Research and Therapy, 42, 1163–1182.  https://doi.org/10.1016/j.brat.2003.07.006.CrossRefGoogle Scholar
  15. Frost, R. O., Steketee, G., & Tolin, D. F. (2011a). Comorbidity in hoarding disorder. Depression and Anxiety, 28, 876–884.  https://doi.org/10.1002/da.20861.CrossRefGoogle Scholar
  16. Frost, R. O., Steketee, G., Tolin, D. F., Sinopoli, N., & Ruby, D. (2015). Motives for acquiring and saving in hoarding disorder, OCD, and community controls. Journal of Obsessive-Compulsive and Related Disorders, 4, 54–59.  https://doi.org/10.1016/j.jocrd.2014.12.006.CrossRefGoogle Scholar
  17. Frost, R. O., Tolin, D. F., & Maltby, N. (2010). Insight-related challenges in the treatment of hoarding. Cognitive and Behavioral Practice, 17, 404–413.  https://doi.org/10.1016/j.cbpra.2009.07.004.CrossRefGoogle Scholar
  18. Frost, R. O., Tolin, D. F., Steketee, G., & Oh, M. (2011b). Indecisiveness and hoarding. International Journal of Clinical Psychotherapy, 4, 253–262.  https://doi.org/10.1521/ijct.2011.4.3.253.Google Scholar
  19. Furby, L. (1978). Possessions: Toward a theory of their meaning and function throughout the life cycle. In P. B. Baltes (Ed.), Life span development and behavior (pp. 297–336). New York: Academic Press.Google Scholar
  20. Grisham, J. R., Brown, T. A., Savage, C. R., Steketee, G., & Barlow, D. H. (2007). Neuropsy- hological impairment associated with compulsive hoarding. Behaviour Research and Therapy, 45, 1471–1483.  https://doi.org/10.1016/j.brat.2006.12.008.CrossRefGoogle Scholar
  21. Grisham, J. R., Norberg, M. M., Williams, A. D., Certoma, S. P., & Kadib, R. (2010). Categorization and cognitive deficits in compulsive hoarding. Behaviour Research and Therapy, 48, 866–872.  https://doi.org/10.1016/j.brat.2010.05.011.CrossRefGoogle Scholar
  22. Hartl, T. L., Frost, R. O., Allen, G. J., Deckersbach, T., Steketee, G., Duffany, S. R., et al. (2004). Actual and perceived memory deficits in individuals with compulsive hoarding. Depression and Anxiety, 20, 59–69.  https://doi.org/10.1002/da.20010.CrossRefGoogle Scholar
  23. Hofmann, S. G., Meuret, A. E., Rosenfield, D., Suvak, M. K., Barlow, D. H., Gorman, J. M., et al. (2007). Preliminary evidence for cognitive mediation during cognitive-behavioral therapy of panic disorder. Journal of Consulting and Clinical Psychology, 75, 374–379.  https://doi.org/10.1037/0022-006X.75.3.374.CrossRefGoogle Scholar
  24. Kyrios, M. (2014). Psychological models of hoarding. In R. O. Frost & G. Steketee (Eds.), Handbook of hoarding and acquiring (pp. 206–220). New York: Oxford University Press.Google Scholar
  25. Meyer, J. F., Frost, R. O., Brown, T. A., Steketee, G., & Tolin, D. F. (2013). A multitrait-multimethod matrix investigation of hoarding. Journal of Obsessive-Compulsive and Related Disorders, 2, 273–280.  https://doi.org/10.1016/j.jocrd.2013.03.002.CrossRefGoogle Scholar
  26. Muroff, J., Steketee, G., Bratiotis, C., & Ross, A. (2012). Group cognitive and behavioral therapy and bibliotherapy for hoarding: A pilot trial. Depression and Anxiety, 29, 597–604.  https://doi.org/10.1002/da.21923.CrossRefGoogle Scholar
  27. Patton, M. Q. (1990). Qualitative evaluation and research methods (2nd ed.). Thousand Oaks, CA: Sage.Google Scholar
  28. Rodriguez, C. I., Hermon, D., Alcon, J., Chen, S., Tannen, A., Essock, S., et al. (2012). Prevalence of hoarding disorder in individuals at potential risk of eviction in New York City: A pilot study. Journal of Nervous and Mental Disease, 200, 91–94.  https://doi.org/10.1097/NMD.0b013e31823f678b.CrossRefGoogle Scholar
  29. Saxena, S. (2008). Neurobiology and treatment of compulsive hoarding. CNS Spectrums, 13(Suppl 14), 29–36.  https://doi.org/10.1017/S1092852900026912.CrossRefGoogle Scholar
  30. Smits, J. A., Rosenfield, D., McDonald, R., & Telch, M. J. (2006). Cognitive mechanisms of social anxiety reduction: An examination of specificity and temporality. Journal of Consulting and Clinical Psychology, 74, 1203–1212.  https://doi.org/10.1037/0022-006X.74.6.1203.CrossRefGoogle Scholar
  31. Steketee, G., & Frost, R. O. (2003). Compulsive hoarding: Current status of the research. Clinical Psychology Review, 23, 905–927.  https://doi.org/10.1016/j.cpr.2003.08.002.CrossRefGoogle Scholar
  32. Steketee, G., & Frost, R. O. (2014). Treatment for hoarding disorder: Therapist guide (2nd ed.). New York: Oxford University Press.Google Scholar
  33. Steketee, G., Frost, R. O., Tolin, D. F., Rasmussen, J., & Brown, T. A. (2010). Waitlist-controlled trial of cognitive behavior therapy for hoarding disorder. Depression and Anxiety, 27, 476–484.  https://doi.org/10.1002/da.20673.CrossRefGoogle Scholar
  34. Timpano, K. R., Broman-Fulks, J. J., Glaesmer, H., Exner, C., Rief, W., Olatunji, B. O., et al. (2013). A taxometric exploration of the latent structure of hoarding. Psychological Assessment, 25, 194–203.  https://doi.org/10.1037/a0029966.CrossRefGoogle Scholar
  35. Timpano, K. R., & Shaw, A. M. (2013). Conferring humanness: The role of anthropomorphism in hoarding. Personality and Individual Differences, 54, 383–388.  https://doi.org/10.1016/j.paid.2012.10.007.CrossRefGoogle Scholar
  36. Tolin, D. F., Fitch, K. E., Frost, R. O., & Steketee, G. (2010a). Family informants’ perception of insight in compulsive hoarding. Cognitive Therapy and Research, 34, 69–81.  https://doi.org/10.1007/s10608-008-9217-7.CrossRefGoogle Scholar
  37. Tolin, D., Frost, R., & Steketee, G. (2010b). A brief interview for assessing compulsive hoarding: The Hoarding Rating Scale. Psychiatry Research, 178, 147–152.  https://doi.org/10.1016/j.psychres.2009.05.001.CrossRefGoogle Scholar
  38. Tolin, D. F., Frost, R. O., Steketee, G., Gray, K. D., & Fitch, K. E. (2008). The economic and social burden of compulsive hoarding. Psychiatry Research, 160, 200–211.  https://doi.org/10.1016/j.psychres.2007.08.008.CrossRefGoogle Scholar
  39. Tolin, D. F., Frost, R. O., Steketee, G., & Muroff, J. (2015). Cognitive behavioral therapy for hoarding disorder: A meta-analysis. Depression and Anxiety, 32, 158–166.  https://doi.org/10.1002/da.22327.CrossRefGoogle Scholar
  40. Tolin, D. F., Kiehl, K. A., Worhunsky, P., Book, G. A., & Maltby, N. (2009). An exploratory study of the neural mechanisms of decision making in compulsive hoarding. Psychological Medicine, 39, 325–336.  https://doi.org/10.1017/S0033291708003371.CrossRefGoogle Scholar
  41. Tolin, D. F., Stevens, M. C., Villavicencio, A. L., Norberg, M. M., Calhoun, V. D., Frost, R. O., et al. (2012). Neural mechanisms of decision making in hoarding disorder. Archives of General Psychiatry, 69, 832–841.  https://doi.org/10.1001/archgenpsychiatry.2011.1980.CrossRefGoogle Scholar
  42. Tolin, D. F., & Villavicencio, A. (2011). An exploration of economic reasoning in hoarding disorder patients. Behaviour Research and Therapy, 49, 914–919.  https://doi.org/10.1016/j.brat.2011.09.005.CrossRefGoogle Scholar
  43. Tolin, D. F., Villavicencio, A., Umbach, A., & Kurtz, M. M. (2011). Neuropsychological functioning in hoarding disorder. Psychiatry Research, 189, 413–418.  https://doi.org/10.1016/j.psychres.2011.06.022.CrossRefGoogle Scholar
  44. Warren, L. W., & Ostrom, J. C. (1988). Pack rats: World class savers. Psychology Today, 22, 58–62.Google Scholar
  45. Wincze, J. P., Steketee, G., & Frost, R. O. (2007). Categorization in compulsive hoarding. Behaviour Research and Therapy, 45, 63–72.  https://doi.org/10.1016/j.brat.2006.01.012.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Christiana Bratiotis
    • 1
    Email author
  • Gail Steketee
    • 2
  • JoAnn Dohn
    • 3
  • Carole A. Calderon
    • 2
  • Randy O. Frost
    • 4
  • David F. Tolin
    • 5
  1. 1.School of Social WorkThe University of British ColumbiaVancouverCanada
  2. 2.Boston UniversityBostonUSA
  3. 3.Portland State UniversityPortlandUSA
  4. 4.Smith CollegeNorthamptonUSA
  5. 5.Hartford HospitalYale University School of MedicineNew HavenUSA

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