Academic journal article Journal of Cognitive Psychotherapy

The Relationship of Hoarding Symptoms to Schizotypal Personality and Cognitive Schemas in an Obsessive-Compulsive Disorder Sample

Academic journal article Journal of Cognitive Psychotherapy

The Relationship of Hoarding Symptoms to Schizotypal Personality and Cognitive Schemas in an Obsessive-Compulsive Disorder Sample

Article excerpt

This study examined hoarding symptoms and schizotypal personality traits (SPTs) in 38 patients with obsessive-compulsive disorder (OCD) and explored early maladaptive schemas (EMSs) as partial mediators between hoarding symptoms and schizotypal traits in OCD. Hoarding and symmetry/ordering symptoms were correlated with total schizotypal score on the Personality Disorder Questionnaire-4 (PDQ-4). Hoarding predicted the total number of schizotypal traits on the PDQ-4 after adjusting for symmetry/ordering symptoms. Schizotypal traits but not hoarding symptoms were significantly correlated with the social isolation and mistrust/abuse schemas. Schizotypal traits and hoarding were both associated with the emotional inhibition and emotional deprivation schemas, but neither of these mediated the relationship between schizotypal traits and hoarding. Clinical implications for understanding and treating hoarding and schizotypal personality in OCD are discussed.

Keywords: hoarding; schizotypal personality; obsessive-compulsive disorder; schema

Hoarding is a severe and prevalent psychiatric condition characterized by significant difficulties with discarding ordinary possessions, as well as interfering levels of clutter in one's living space (Frost, Steketee, & Tolin, 2012). Traditionally, conceptualized as a symptom subtype of obsessive-compulsive disorder (OCD; Mataix-Cols, Rosario-Campos, & Leckman, 2005), hoarding has been considered treatment refractory to standardized interventions (e.g., psychopharmacology and cognitive behavioral therapy; Rufer, Fricke, Moritz, Kloss, & Hand, 2006). More recently, hoarding has been shown to occur with and without other OCD symptoms (Frost, Steketee, & Tolin, 2011; Pertusa et al., 2008) and has been associated with distinct phenomenological, neurobiological, and genetic substrates (for a review, see Pertusa, Frost, Fullana, et al., 2010). Accordingly, hoarding, considered to be a variant of the obsessive-compulsive compulsive (OC) spectrum, has been classified as its own disorder within the OC-spectrum category of Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association [APA], 2013).

Ongoing characterization of individuals who hoard across multiple phenomenological manifestations (e.g., hoarding without OCD, hoarding with OCD) helps advance understanding and treatment of these symptoms. One area of focus has been the association of hoarding symptoms with Axis II psychopathology. Prior studies of nonclinical and clinical OCD samples (which have included people with hoarding symptoms) have found an association with schizotypal personality traits (SPT) and schizotypal personality disorder (SPD; Aardema & Wu, 2011; Lee, Cougle, & Telch, 2005; Matsunaga, Hayashia, Kiriike, Nagata, & Stein, 2010; Sobin et al., 2000). SPT in OCD has been associated with a unique neurocognitive substrate (e.g., deficits in neuropsychological tasks associated with the orbitofrontal and dorsolateral prefrontal cortex [DLPFC] versus orbitofrontal alone; Harris & Dinn, 2003) and has also been demonstrated to be a predictor of poor treatment outcome (Huang, Hwang, Huang, & Hwu, 2008; Jenike, Baer, Minichiello, Schwartz, & Carey, 1986; Moritz et al., 2004; Poyurovsky et al., 2008).

The OC symptoms more traditionally associated with magical or unrealistic thinking (e.g., aggressive, sexual, and religious obsessions) have been thought to have a particularly strong connection with the presence of SPT, which are also characterized by magical or bizarre thinking ing patterns (Dickey et al., 2005; Kendler, McGuire, Gruenberg, & Walsh, 1995). However, only one study of clinical OCD patients thus far has demonstrated an elevated rate of aggressive obsessions in OCD patients with SPT versus without SPT (Sobin et al., 2000). Another study failed to find differences in the frequency of these obsessions for OCD patients with and without SPD (Poyurovsky et al. …

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.