The Association between Age and Experienced Emotions in Hoarding Disorder

ABSTRACT

Objectives: Hoarding disorder (HD) is conceptualized as a fear-based disorder and exposure to sorting/discarding possessions is a core part of treatment. However, there has been no investigation of age-related differences in emotional reaction to sorting. The objective of this study was to explore the association between age and affective response during a sorting task.

Methods: Forty-nine adults with HD completed a standardized sorting task. Participants reported their current emotion before and after the sorting task and reported their subjective distress throughout the task.

Results: Older participants reported significantly lower distress ratings. Only 43% of participants reported fear prior to the task and 22% reported fear after the task. The probability of reporting fear before and after the task decreased significantly with age.

Conclusions: Fear may not be the emotion experienced when discarding items, particularly for older adults with HD. Future work should focus on mechanisms of action in HD treatment.

Clinical Implications: Clinicians should not assume fear or anxiety to be the primary emotional response in older adults with HD when engaged in an exposure to sorting/discarding. Older hoarding patients with a more fear-oriented aversion to sorting possessions may require a treatment emphasis on increasing the percentage of items discarded.

KEYWORDS:

• Hoarding disorder
• affective response
• aging
• older adults
• assessment

Disclosure statement

This work was supported by the Clinical Science R and D Program of the Veterans Health Administration under a Merit Award (CLNA-005-14S) awarded to Catherine R. Ayers, Ph.D., ABPP. The contents do not reflect the views of the Department of Veterans Affairs or the United States Government. We have no known conflict of interests to disclose.

Additional information

Funding

This work was supported by the Health Services Research and Development [CLNA-005-14S].