Central and Peripheral Physiological Responses to Decision Making in
Hoarding Disorder
Abstract
Individuals with hoarding disorder (HD) have difficulty parting with
personal possessions, which leads to the accumulation of excessive
clutter. According to a proposed biphasic neurobiological model, HD is
characterized by blunted central and peripheral nervous system activity
at rest and during neutral (non-discarding) decisions, and exaggerated
activity during decision-making about discarding personal possessions.
Here, we compared the error-related negativity (ERN) and
psychophysiological responses (skin conductance, heart rate and heart
rate variability, and end tidal CO2) during neutral and
discarding-related decisions in 26 individuals with HD, 37 control
participants with anxiety disorders, and 28 healthy control participants
without psychiatric diagnoses. We also compared alpha asymmetry between
the HD and control groups during a baseline resting phase. Participants
completed a series of Go/No Go decision-making tasks, one involving
choosing certain shapes (neutral task) and the other involving choosing
images of newspapers to imaginally “discard” (discarding task).
Contrary to hypotheses, there were no group differences in the ERN or
any psychophysiological measures. Alpha asymmetry at rest did not differ
between groups. The findings suggest that the ERN and
psychophysiological responses may not differ in individuals with HD
during simulated discarding decisions relative to control participants,
although the null results may be explained by methodological challenges
in using Go/No Go tasks as discarding tasks. Future replication and
extension of these results will be needed using ecologically valid
discarding tasks.