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  • Cited by 9
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    Ayers, Catherine R. Dozier, Mary E. Wetherell, Julie Loebach Twamley, Elizabeth W. and Schiehser, Dawn M. 2016. Executive Functioning in Participants Over Age of 50 with Hoarding Disorder. The American Journal of Geriatric Psychiatry, Vol. 24, Issue. 5, p. 342.

    Hough, Christina M. Luks, Tracy L. Lai, Karen Vigil, Ofilio Guillory, Sylvia Fekri, Shiva M. Kupferman, Eve Mathalon, Daniel H. and Mathews, Carol A. 2016. Comparison of Brain Activation Patterns during Executive Function Tasks in Hoarding Disorder and Non-Hoarding OCD. Psychiatry Research: Neuroimaging,

    Mackin, R. Scott Vigil, Ofilio Insel, Philip Kivowitz, Alana Kupferman, Eve Hough, Christina M. Fekri, Shiva Crothers, Ross Bickford, David Delucchi, Kevin L. and Mathews, Carol A. 2016. PATTERNS OF CLINICALLY SIGNIFICANT COGNITIVE IMPAIRMENT IN HOARDING DISORDER. Depression and Anxiety, Vol. 33, Issue. 3, p. 211.

    Moshier, Samantha J. Wootton, Bethany M. Bragdon, Laura B. Tolin, David F. Davis, Elizabeth DiMauro, Jennifer and Diefenbach, Gretchen J. 2016. The relationship between self-reported and objective neuropsychological impairments in patients with hoarding disorder. Journal of Obsessive-Compulsive and Related Disorders, Vol. 9, p. 9.

    Park, Jennifer M. Samuels, Jack F. Grados, Marco A. Riddle, Mark A. Bienvenu, O. Joseph Goes, Fernando S. Cullen, Bernadette Wang, Ying Krasnow, Janice Murphy, Dennis L. Rasmussen, Steven A. McLaughlin, Nicole C. Piacentini, John Pauls, David L. Stewart, S. Evelyn Shugart, Yin-Yao Maher, Brion Pulver, Ann E. Knowles, James A. Greenberg, Benjamin D. Fyer, Abby J. McCracken, James T. Nestadt, Gerald and Geller, Daniel A. 2016. ADHD and executive functioning deficits in OCD youths who hoard. Journal of Psychiatric Research, Vol. 82, p. 141.

    Ayers, Catherine R. Najmi, Sadia Mayes, Tina L. and Dozier, Mary E. 2015. Hoarding Disorder in Older Adulthood. The American Journal of Geriatric Psychiatry, Vol. 23, Issue. 4, p. 416.

    Lynch, Fiona A. McGillivray, Jane A. Moulding, Richard and Byrne, Linda K. 2015. Hoarding in attention deficit hyperactivity disorder: Understanding the comorbidity. Journal of Obsessive-Compulsive and Related Disorders, Vol. 4, p. 37.

    Woody, Sheila R. Kellman-McFarlane, Kirstie and Welsted, Alison 2014. Review of cognitive performance in hoarding disorder. Clinical Psychology Review, Vol. 34, Issue. 4, p. 324.

    Ayers, Catherine R. Wetherell, Julie Loebach Schiehser, Dawn Almklov, Erin Golshan, Shahrokh and Saxena, Sanjaya 2013. Executive functioning in older adults with hoarding disorder. International Journal of Geriatric Psychiatry, p. n/a.

  • Behavioural and Cognitive Psychotherapy, Volume 41, Issue 5
  • October 2013, pp. 610-625

An Investigation of Executive Functioning, Attention and Working Memory in Compulsive Hoarding

  • Sandra G. McMillan (a1), Clare S. Rees (a1) and Carmela Pestell (a2)
  • DOI:
  • Published online: 02 November 2012

Background: Compulsive Hoarding involves the acquisition of, and failure to discard, a large number of possessions that appear to be useless or of limited value, cluttered living spaces and significant distress or impairment in functioning (Frost and Hartl, 1996). The problem is multifaceted and appears best explained by a cognitive-behavioural framework. Aims: This study set out to test one aspect of Frost and Hartl's (1996) cognitive-behavioural model of compulsive hoarding by investigating theorized cognitive deficits in executive functioning, such as working memory and attention. Method: 24 participants with compulsive hoarding were tested on the Digit Span, Spatial Span and the Wisconsin Card Sorting Tests (WCST). Results: On the WCST, the hoarding group had a significantly higher number of perseveration errors (t = 1.67, p = .005) and significantly lower numbers of categories completed (t = −2.47, p = .001) than test norms. Only “failure to maintain set” was significantly correlated with hoarding severity (r = .435, p < .05). Conclusions: These findings lend support to the theory that people who compulsively hoard have executive dysfunction, which impacts on their ability to process information. Deficits relate to difficulties in forming effective strategies, inadequate feedback response, problems in concept formation, and impulsivity. Difficulties in sustained attention also appeared to be a factor in hoarding severity. These findings are important in directing more targeted clinical interventions.

Corresponding author
Reprint requests to Sandra McMillan, Psychiatry Department, Royal Perth Hospital, GPO Box X2213, Perth, Western Australia6001. E-mail:
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