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Hoarding in Youth with Autism Spectrum Disorders and Anxiety: Incidence, Clinical Correlates, and Behavioral Treatment Response

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Abstract

This study examined the nature and correlates of hoarding among youth with autism spectrum disorders (ASD). Forty children with ASD and a comorbid anxiety disorder were administered a battery of clinician-administered measures assessing presence of psychiatric disorders and anxiety severity. Parents completed questionnaires related to child hoarding behaviors, social responsiveness, internalizing and externalizing behaviors, and functional impairment. We examined the impact of hoarding behaviors on treatment response in a subsample of twenty-six youth who completed a course of personalized cognitive-behavioral therapy targeting anxiety symptoms. Hoarding symptoms were common and occurred in a clinically significant manner in approximately 25 % of cases. Overall hoarding severity was associated with increased internalizing and anxiety/depressive symptoms, externalizing behavior, and attention problems. Discarding items was associated with internalizing and anxious/depressive symptoms, but acquisition was not. Hoarding decreased following cognitive-behavioral therapy but did not differ between treatment responders and non-responders. These data are among the first to examine hoarding among youth with ASD; implications of study findings and future directions are highlighted.

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Notes

  1. This conceptualization predates the recent acknowledgment that hoarding symptoms could either reflect a symptom subtype of OCD or be a manifestation of a discrete condition now identified as Hoarding Disorder (American Psychiatric Association 2013).

  2. There were no differences across clinical variables between those who participated in CBT relative to those who did not.

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Acknowledgments

This work was supported by grants to the first author from the All Children’s Hospital Research Foundation and University of South Florida Internal Grants Program. The authors would like to acknowledge the contributions of Elysse Arnold, Amanda Collier, and Michael Sulkowski.

Author Contributions

E.A.S., A.B.L., and T.K.M. designed the larger study from which this data was taken. E.A.S., J.M.N., and C.J. developed the concept for the current paper. E.A.S., N.M., and P.J.M. collected the data. J.M.N. analyzed the data. E.A.S., J.M.N., C.J., K.T., and N.M. wrote sections of the paper. All authors discussed the results and implications and edited the manuscript at all stages.

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Authors and Affiliations

  1. Department of Pediatrics, Rothman Center for Neuropsychiatry, University of South Florida, Box 7523, 880 6th Street South, St. Petersburg, FL, 33701, USA

    Eric A. Storch, Joshua M. Nadeau, Carly Johnco, Nicole McBride, P. Jane Mutch, Adam B. Lewin & Tanya K. Murphy

  2. Department of Health Policy and Management, University of South Florida, Tampa, FL, USA

    Eric A. Storch

  3. Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, FL, USA

    Eric A. Storch, Adam B. Lewin & Tanya K. Murphy

  4. Department of Psychology, University of South Florida, Tampa, FL, USA

    Eric A. Storch & Adam B. Lewin

  5. Rogers Behavioral Health – Tampa Bay, Tampa, FL, USA

    Eric A. Storch & Joshua M. Nadeau

  6. All Children’s Hospital – Johns Hopkins Medicine, St. Petersburg, FL, USA

    Eric A. Storch & Tanya K. Murphy

  7. Department of Psychology, University of Miami, Miami, FL, USA

    Kiara Timpano

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  1. Eric A. Storch
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Correspondence to Eric A. Storch.

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Storch, E.A., Nadeau, J.M., Johnco, C. et al. Hoarding in Youth with Autism Spectrum Disorders and Anxiety: Incidence, Clinical Correlates, and Behavioral Treatment Response. J Autism Dev Disord 46, 1602–1612 (2016). https://doi.org/10.1007/s10803-015-2687-z

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  • DOI: https://doi.org/10.1007/s10803-015-2687-z

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