Information processing in hoarding disorder: A systematic review of the evidence

Abstract

Hoarding Disorder (HD), conceptualised as difficulties with discarding possessions resulting in distress, the accumulation of items creating a cluttered, unusable environment, and significant impairment in functioning, is reported to affect 1.5% of adults. In addition, evidence suggests that those with HD experience further difficulties in executive functioning, including inhibition, attention, and decision-making. Deficits in executive function and other areas of information processing are hypothesised to play a key role in maintaining HD. This review aimed to systematically review the evidence for impaired information processing in this population when compared to community controls, focusing specifically on studies using clinician-delivered interviews to diagnose HD, and those using primary assessments of neuropsychological function. 12 studies were included in this review. Results suggest consistent evidence for some difficulties in sustained attention, motor inhibition and organisation, however literature on deficits in other areas of executive function is wide ranging, limiting the extent to which firm conclusions can be drawn. Further research is needed to investigate deficits in other areas of information processing in HD, with a focus on consistent methods to diagnose HD and measure neuropsychological function, as these design issues place restrictions on a full understanding of the true deficits associated with HD. Consideration should be given to whether recorded deficits are ‘true’ or are difficulties associated with the emotional context of hoarding. It is hypothesized that future research will reveal more distinct subgroups of people with hoarding difficulties, only some of whom will show true neuropsychological deficits.

Keywords

• Hoarding disorder
• Executive function
• Neuropsychology
• Deficit