The heterogeneity of hoarding behavior: characterizing disorder diversity to distinguish etiology and longitudinal symptom course

囤积行为的异质性：表征疾病多样性以区分病因和纵向症状过程

• 批准号: 10603152
• 负责人: Sara Nutley
• 金额: $ 3.93万
• 依托单位: UNIVERSITY OF FLORIDA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-21 至 2025-04-20
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10603152
• 关键词: Adult; Affect; Behavior; Brain Health Registry; Classification; Clinical; Clutterings; Communities; Compulsive Hoarding; DSM-V; Data; Data Sources; Detection; Development; Developmental Course; Diagnosis; Diagnostic and Statistical Manual of Mental Disorders; Dimensions; Disease; Elderly; Etiology; Fellowship; General Population; Geography; Goals; Health; Heterogeneity; Impairment; Individual; Individual Differences; Internet; Intervention; Investigation; Knowledge; Measures; Mental disorders; Modeling; Motivation; Occupational; Outcome; Participant; Patient Self-Report; Patients; Pattern; Population; Prevention; Public Health; Questionnaires; Recording of previous events; Registries; Research; Research Personnel; Risk; Risk Factors; Safety; Severities; Subgroup; Symptoms; Time; Variant; Work; active lifestyle; career; clinically significant; common symptom; comorbidity; disability; disorder risk; effective therapy; epidemiologic data; follow-up; functional disability; hazard; health assessment; health related quality of life; improved; individualized medicine; innovation; insight; longitudinal course; neuropsychiatric disorder; neuropsychiatry; novel; patient navigation; personalized medicine; skills; social; symptomatology; treatment program

Project Summary/Abstract Hoarding disorder (HD) is a debilitating neuropsychiatric and public health problem that affects up to 4% of the general population and 6% of older adults. Despite formal recognition as an independent diagnosis in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, HD remains frequently underdiagnosed and effective treatment is limited. To date, multiple challenges have precluded the development of effective HD detection and intervention efforts, including problems arising from wide-ranging heterogeneity in HD symptom presentation. Efforts to better understand this heterogeneity are lacking, though evidence from other psychiatric disorders indicates extensive utility in identifying dimensional symptom subgroups defined by distinct risk factors and requiring unique prevention and intervention needs. The identification of common symptom patterns may improve our ability to detect clinically meaningful hoarding behaviors and quickly navigate patients to personalized treatment. Thus, the overall goal of this project is to distinguish heterogeneity in HD symptomatology, through which I will establish unique profiles of HD symptoms and assess the utility of symptom subgroups for elucidating variability in disorder etiology and longitudinal course. I will achieve this goal through three specific aims. First, I will identify and characterize HD subgroups on the basis of symptom profile and clutter-related functional impairment and safety concerns. In this aim, I will conduct data-driven analyses using self-report symptom data collected from more than 35,500 individuals who have completed assessments of hoarding and clutter in the Brain Health Registry (BHR), an internet-based research registry of adult participants who semi-annually complete comprehensive self-report assessments of health history and behavior. This rich, epidemiologic data source allows for comprehensive and innovative investigation of HD on a population-level. Second, I will investigate variation in HD etiology following classification of subjects into hoarding symptom subgroups. In this aim, I will employ a social-ecological framework for quantifying subgroup diversity in intrapersonal, interpersonal, and community-level risk factors for HD. Finally, I will assess the differential impact of HD subgroups on the longitudinal course of hoarding symptom severity. In this aim, linear mixed-effects models will be used to assess the predictive ability of HD subgroups for distinguishing symptom trajectory. This work will enrich knowledge of symptom presentation in HD and its relationship to disorder etiology and longitudinal symptom course, thus enhancing efforts to effectively identify and treat hoarding behavior, all the while strengthening my technical and professional skills to support my ultimate career goal as an independent investigator.

项目摘要/摘要 囤积障碍(HD)是一种使人衰弱的神经精神和公共健康问题，影响多达4%的 总人口和6%的老年人。尽管在第五个月被正式确认为独立诊断 精神障碍诊断和统计手册版，HD仍然经常被低估和 有效的治疗是有限的。到目前为止，多重挑战阻碍了有效HD的发展 检测和干预工作，包括HD症状的广泛异质性引起的问题 演示文稿。缺乏更好地理解这种异质性的努力，尽管来自其他精神病学的证据 障碍表明在识别由不同风险因素定义的维度症状亚组方面具有广泛的实用价值 并需要独特的预防和干预需求。常见症状模式的识别可以 提高我们检测有临床意义的囤积行为的能力，并快速导航患者到 个性化治疗。因此，该项目的总体目标是区分HD中的异构性 症状学，我将通过它建立HD症状的独特档案，并评估症状的有效性 用于阐明疾病病因和纵向病程的变异性的亚组。我将通过以下方式实现这一目标 三个具体目标。首先，我将根据症状特征和 与杂物相关的功能损害和安全问题。为了达到这个目标，我将使用以下工具进行数据驱动分析 从超过35,500名已完成评估的个人收集的自我报告症状数据 大脑健康注册(BHR)中的囤积和杂乱，这是一个基于互联网的成人参与者研究注册 世卫组织每半年完成一次对健康史和行为的全面自我报告评估。这个富有的， 流行病学数据来源允许在人群水平上对HD进行全面和创新的调查。 其次，我将调查在将受试者归类为囤积症状后HD病因学的变化 子组。在这个目标中，我将使用一个社会-生态框架来量化亚群多样性 HD的个人、人际和社区层面的危险因素。最后，我将评估不同的影响 HD亚组的囤积症状严重程度与纵向病程有关。在这个目标中，线性混合效应 模型将被用来评估HD亚组区分症状轨迹的预测能力。这 这项工作将丰富HD的症状表现及其与疾病病因和 纵向症状疗程，从而加强有效识别和治疗囤积行为的努力，所有 同时加强我的技术和专业技能，以支持我作为独立人士的最终职业目标 调查员。