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The Impact of Symptomatic Hoarding in OCD and its Treatment

Published online by Cambridge University Press:  15 February 2010

Catherine Seaman ,
Victoria B. Oldfield ,
Olivia Gordon ,
Elizabeth Forrester  and
Paul M. Salkovskis
Catherine Seaman*
Affiliation:
Institute of Psychiatry, King's College London, UK
Victoria B. Oldfield
Affiliation:
South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, King's College London, UK
Olivia Gordon
Affiliation:
Institute of Psychiatry, King's College London, UK
Elizabeth Forrester
Affiliation:
South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, King's College London, UK
Paul M. Salkovskis
Affiliation:
South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, King's College London, UK
*
Reprint requests to Catherine Seaman, The Royal Marsden NHS Foundation Trust, The Royal Marsden Hospital, Compton House, Department of Paediatric Psychological Medicine, Downs Road, Sutton, Surrey SM2 5PT, UK. E-mail: [email protected]
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Abstract

Background: The value of defining subtypes in obsessive compulsive disorder (OCD) has become an important issue for recent debate. Probably the most robust example of subtyping is the identification of hoarding as being different both in terms of psychopathology and response to treatment. Aims: To identify differences in psychopathology and treatment response in OCD patients with and without additional hoarding symptoms. Method: Patients who had undertaken CBT for OCD were selected as falling into either a high or a low hoarding group. The high hoarding group (n = 18) was selected on the basis of a high score on the hoarding subscale of a self-report measure of OCD symptoms in addition to reaching clinician judged “threshold” on the hoarding item of the Obsessive Compulsive Personality Disorder (OCPD) SCID-II module. The low hoarding group (n = 20) was selected on the basis of a low score on the hoarding subscale and a clinician judgement that the hoarding item of the OCPD SCID-II module was “absent”. Results: On some measures of pre-treatment psychopathology, patients with OCD with hoarding symptoms were more severely affected than those without hoarding symptoms. It was found that there was no difference in eventual treatment outcome between the two groups, although there was some evidence that the hoarding group showed greater symptom decreases. Conclusions: The presence of hoarding symptoms does not negatively impact on the treatment of OCD.

Keywords

Obsessive compulsive disorderhoardingobsessive compulsive personality disordercognitive behavioural therapy
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 38 , Issue 2 , March 2010 , pp. 157 - 171
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2010

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References

Abramowitz, J. S., Franklin, M. E., Schwartz, S. A. and Furr, J. M. (2003). Symptom presentation and outcome of cognitive-behavioural therapy for obsessive-compulsive disorder. Journal of Consulting and Clinical Psychology, 71, 1049–1057.CrossRefGoogle ScholarPubMed
Abramowitz, J. S., Wheaton, M. G. and Storch, E. (2008). The status of hoarding as symptom of obsessive-compulsive disorder. Behaviour Research and Therapy, 46, 1026–1033.CrossRefGoogle ScholarPubMed
American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington, DC: American Psychiatric Association.Google Scholar
An, S. K., Mataix-Cols, D., Lawrence, N. S., Wooderson, S., Giampietro, V., Speckens, A., Brammer, M. J. and Phillips, M. L. (2009). To discard or not to discard: the neural basis of hoarding symptoms in Obsessive-Compulsive Disorder. Molecular Psychiatry, 14, 318–331.CrossRefGoogle ScholarPubMed
Beck, A. T., Epstein, N., Brown, G. and Steer, R. A. (1988). An inventory for measuring clinical anxiety: psychometric properties. Journal of Consulting and Clinical Psychology, 56, 893–897.CrossRefGoogle ScholarPubMed
Beck, A. T. and Steer, R. A. (1988). Manual for the Beck Depression Inventory. San Antonio, TX: Psychological Corporation.Google Scholar
Coles, M. E., Frost, R. O, Heimberg, R. G. and Steketee, G. (2003). Hoarding behaviours in a large college sample. Behaviour Research and Therapy, 41, 179–194.CrossRefGoogle Scholar
First, M. B., Gibbon, M., Spitzer, R. L., Williams, J. B. W. and Benjamin, L. S. (1997). User's Guide for the Structured Clinical Interview for DSM-IV Axis II Personality Disorders. Washington, DC: American Psychiatric Press.Google Scholar
First, M. B., Spitzer, R. L., Gibbon, M. and Williams, J. B. W. (1997). Structured Clinical Interview for DSM-IV Axis I Disorders (SCID), Clinician Version. Washington, DC: American Psychiatric Press.Google Scholar
Foa, E. B., Kozak, M. J., Salkovskis, P. M., Coles, M. E. and Amir, A. (1998). The validation of a new obsessive-compulsive inventory. Psychological Assessment, 10, 206–214.CrossRefGoogle Scholar
Frost, R. O. and Hartl, T. (1996). A cognitive behavioural model of compulsive hoarding. Behaviour Research and Therapy, 34, 341–350.CrossRefGoogle ScholarPubMed
Frost, R. O., Krause, M. S. and Steketee, G. (1996). Hoarding and obsessive-compulsive symptoms. Behavior Modification, 20, 116–132.CrossRefGoogle ScholarPubMed
Frost, R. O., Steketee, G. and Greene, K. A. I. (2003). Cognitive and behavioral treatment of compulsive hoarding. Brief Treatment and Crisis Intervention, 3, 323–337.CrossRefGoogle Scholar
Frost, R. O., Steketee, G., Williams, L. and Warren, R. (2000). Mood, disability, and personality disorder symptoms in hoarding, obsessive compulsive disorder, and control subjects. Behaviour Research and Therapy, 38, 1071–1082.CrossRefGoogle Scholar
Grisham, J. R., Brown, T. A., Liverant, G. I. and Campbell-Sills, (2005). The distinctiveness of compulsive hoarding from obsessive-compulsive disorder. Anxiety Disorders, 19, 767–779.CrossRefGoogle ScholarPubMed
Lomax, C. L., Oldfield, V. B. and Salkovskis, P. M. (2009). Clinical and treatment comparisons between adults with early- and late-onset obsessive-compulsive disorder. Behaviour Research and Therapy, 47, 99–104.CrossRefGoogle ScholarPubMed
Mataix-Cols, D., Marks, I., Greist, J. H., Kobak, K. A. and Baer, L. (2002). Obsessive-compulsive symptoms dimensions as predictors of compliance with and response to behaviour therapy: results from a controlled trial. Psychotherapy and Psychosomatics, 71, 255–262.CrossRefGoogle ScholarPubMed
Mataix-Cols, D., Rosario-Campos, M. C. and Leckman, J. F. (2005). A multi-dimensional model of obsessive-compulsive disorder. American Journal of Psychiatry, 162, 228–238.CrossRefGoogle Scholar
Oldfield, V. B., Salkovskis, P. M. and Forrester, E. (in preparation). Cognitive-behavioural conceptualization of hoarding with implications for treatment.Google Scholar
Rachman, S. J. (1993). Obsessions, responsibility and guilt. Behaviour Research and Therapy, 31, 149–154.CrossRefGoogle ScholarPubMed
Rachman, S., Elliott, C. M., Shafran, R. and Radomsky, A. S. (2009). Separating hoarding from OCD. Behaviour Research and Therapy, 47, 520–522.CrossRefGoogle ScholarPubMed
Rufer, M., Fricke, S., Moritz, S., Kloss, M. and Hand, I. (2006). Symptom dimensions in obsessive-compulsive disorder: prediction of cognitive-behaviour therapy outcome. Acta Psychiatrica Scandinavica, 113, 440–446.CrossRefGoogle Scholar
Salkovskis, P. M. (1985). Obsessional-compulsive problems: a cognitive-behavioural analysis. Behaviour Research and Therapy, 23, 571–584.CrossRefGoogle ScholarPubMed
Salkovskis, P. M. (1999). Understanding and treating obsessive-compulsive disorder. Behaviour Research and Therapy, 37 (Suppl 1), 529–552.CrossRefGoogle ScholarPubMed
Salkovskis, P. M., Forrester, E., Richards, H. C. and Morrison, N. (1998). The devil is in the detail: conceptualizing and treating obsessional problems. In Tarrier, N., Wells, A. and Haddock, G. (Eds.), Treating Complex Cases: the cognitive behavioural therapy approach. Chichester: Wiley.Google Scholar
Salkovskis, P. M., Wroe, A. L., Gledhill, A., Morrison, N., Forrester, E., Richards, C., Reynolds, M. and Thorpe, S. (2000). Responsibility attitudes and interpretations are characteristic of obsessive compulsive disorder. Behaviour Research and Therapy, 38, 347–372.CrossRefGoogle ScholarPubMed
Samuels, J. F., Joseph Bienvenu, O., Grados, M. A., Cullen, B., Riddle, M. A., Liang, K-Y, Eaton, W. W. and Nestadt, G. (2008). Prevalence and correlates of hoarding behaviour in a community-based sample. Behaviour Research and Therapy, 46, 836–844.CrossRefGoogle Scholar
Steketee, G. and Frost, R. O. (2003). Compulsive hoarding: current status of the research. Clinical Psychology Review, 23, 905–927.CrossRefGoogle ScholarPubMed
Steketee, G. and Frost, R. O. (2007). Compulsive Hoarding and Acquiring: therapist guide. New York: Oxford University Press.Google Scholar
Steketee, G., Frost, R. O. and Kyrios, M. (2003). Cognitive aspects of compulsive hoarding. Cognitive Therapy and Research, 27, 463–479.CrossRefGoogle Scholar
Tolin, D. F., Frost, R. O. and Steketee, G. (2007). An open trial of cognitive-behavioural therapy for compulsive hoarding. Behaviour Research and Therapy, 45, 1461–1470.CrossRefGoogle ScholarPubMed
Watson, J. P. and Marks, I. M. (1971). Relevant and irrelevant fear in flooding: a cross-over study of phobic patients. Behaviour Therapy, 2, 275–295.CrossRefGoogle Scholar
Whittal, M. L., Thordarson, D. S. and McLean, P. D. (2005). Treatment of obsessive-compulsive disorder: cognitive behaviour therapy vs. exposure and response prevention. Behaviour Research and Therapy, 43, 1559–1576.CrossRefGoogle ScholarPubMed
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