A Multi-Method Investigation of Mechanisms of Attachment in Hoarding Disorder

项目摘要。囤积症（HD）是一种严重的精神疾病， 约占人口的3 - 6% 8，27.房屋署对市民构成沉重的负担， 与高失业率和利用公共援助计划有关， 卫生保健服务，和极端混乱往往导致火灾的危险，更高的驱逐率， 在某些情况下，死亡9，10。尽管有这种影响，但HD的治疗效果有限， 这表明有必要确定现有政策中可能没有充分针对性的因素， 治疗11. HD的核心特征之一是对财产的适应不良依恋12，13， 理论家认为，个人可能会试图弥补人际关系不好的影响， through通过connections连接to objects对象21，22.虽然依恋常常被概念化， 人际关系框架，人际依恋的核心过程可能提供重要的 关于对非人类实体（诸如物体）的附着的信息。根据 根据美国国家心理健康研究所提出的研究领域标准，依恋是 衡量为倾向于表现出对一个特定的人舒适的偏好，以及 与那个人分离后的痛苦增加1。从生物学的角度来看，催产素 交感神经兴奋可能是催产素减少时依恋困难的基础， 当个体与依恋分离时，交感神经的唤起增加图2，3，5。 综上所述，HD患者可能表现出不同的生物行为模式， 对人和财产的反应表明依恋系统功能失调， 这可能有助于解释他们对财产的依赖和极端困难。 重要的是，必须阐明这种关系的性质和机制， 提高我们对HD的认识和治疗。拟议的研究将描述 囤积和依恋之间关系的生物行为机制。 具体而言，本研究将：a）调查自我报告的财产依恋的差异 以及患有和不患有HD的人，B）比较生物和情感反应 与依恋的行为表现相关联（即，偏爱和苦恼于 分离）与HD患者和无HD患者的财产关系，以及c）比较 对财产和人的依恋在患有和不患有HD的个体中通过两个 表达性写作任务。通过这项研究所获得的经验将准备 申请人的独立研究生涯调查transdiagnosis风险因素 焦虑相关的精神病理学。

Project Summary. Hoarding disorder (HD) is a severe psychiatric disorder that affects approximately 3-6% of the population8,27. HD poses an enormous public burden, as it is associated with high rates of unemployment and utilization of public aid programs and healthcare services, and extreme clutter often results in fire hazards, higher rates of evictions, and in some cases, death9,10. Despite this impact, treatment for HD is only moderately effective, which points to a need to identify factors that may not be sufficiently targeted in existing treatments11. One of the core features of HD is a maladaptive attachment to possessions12,13, and theorists suggest individuals may attempt to compensate for poor interpersonal connections through connections to objects21,22. Though attachment has often been conceptualized within an interpersonal framework, the core processes of interpersonal attachment may provide important information regarding attachment to non-human entities, such as objects. According to the Research Domain Criteria put forth by the National Institute of Mental Health, attachment is measured as the tendency to show preference for a particular person for comfort, as well as increased distress upon separation from that person1. From a biological perspective, oxytocin and sympathetic arousal may underlie attachment difficulties as oxytocin decreases and sympathetic arousal increases when individuals are separated from attachment figures2,3,5. Taken together, it may be that individuals with HD exhibit differential patterns of biobehavioral responses to people and possessions that would indicate dysfunction of the attachment system, which may help to explain their reliance on and extreme difficulty parting with possessions. Importantly, elucidating the nature and mechanisms of this relationship is imperative in order to advance our understanding of and treatment for HD. The proposed study will delineate biobehavioral mechanisms underlying the relationship between hoarding and attachment. Specifically, this study will: a) investigate differences in self-report attachment to possessions and people in individuals with and without HD, b) compare biological and emotional responses associated with behavioral manifestations of attachment (i.e., preference and distress upon separation) to possessions in individuals with and without HD, and c) compare indicators of attachment to both possessions and people in individuals with and without HD through two expressive writing tasks. The experience gained through this fellowship will prepare the applicant for an independent research career investigating transdiagnostic risk factors of anxiety-related psychopathology using a translational approach.