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

项目摘要。囤积障碍(HD)是一种严重的精神障碍， 约占总人口的3-6%8，27。房屋署对市民造成沉重的负担 与高失业率和公共援助方案的使用有关，以及 医疗服务，极端杂乱经常导致火灾危险，更高的驱逐率， 在某些情况下，死亡9，10。尽管有这种影响，治疗HD只有适度的效果， 这表明需要确定现有的可能没有足够针对性的因素 治疗11.HD的核心特征之一是对拥有12、13的不适应依恋， 理论家认为，个人可能会试图弥补不良的人际关系 通过与对象21、22的联系。尽管依恋通常是在 人际框架、人际依恋的核心过程可能为人际依恋提供重要 有关依附于非人类实体(如对象)的信息。根据 由国家心理健康研究所提出的研究领域标准，依恋是 衡量的是在舒适性方面表现出对特定人的偏好的倾向，以及 与那个人分开后增加的痛苦1.从生物学角度来看，催产素 交感兴奋可能是导致依恋困难的原因，因为催产素减少和 当个体脱离依恋图2、3、5时，交感唤醒会增加。 综上所述，患有HD的个体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障碍， 这可能有助于解释他们对财产的依赖和极大的困难。 重要的是，阐明这种关系的性质和机制是必要的，以便 提高对HD的认识和治疗水平。拟议的研究将勾勒出 囤积和依恋之间关系的生物行为机制。 具体地说，本研究将：a)调查对财产依恋的自我报告的差异 在患有和不患有HD的个体中，b)比较生理和情感反应 与依恋的行为表现相关联的(即，偏好和痛苦 分离)与患有和不患有HD的个人的财产，以及c)比较以下指标 对财产和人的依恋在患有和不患有HD的个人中通过两次 表现性写作任务。通过这次奖学金获得的经验将为 申请独立研究职业，调查经诊断的危险因素 使用翻译方法的焦虑相关精神病理学。

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.