Trait Versus Task-Induced Emotional Reactivity and Distress Intolerance in Hoarding Disorder: Transdiagnostic Implications

• Published in: Behavior therapy 2020-01, Vol.51 (1), p.123-134
• Main Authors: Norberg, Melissa M., Beath, Alissa P., Kerin, Fiona J., Martyn, Chantelle, Baldwin, Peter, Grisham, Jessica R.
• Format: Article
• Language: English
• Subjects: distress tolerance; emotion regulation; emotional reactivity; hoarding; obsessive and compulsive related disorders
• ISSN: 0005-7894; 1878-1888
• DOI: 10.1016/j.beth.2019.05.010

Evidence from analogue samples suggests that deficits in emotional functioning, namely elevated emotional reactivity and distress intolerance, are implicated in the development and maintenance of hoarding disorder. We aimed to extend previous research in this area by investigating emotional reactivity and distress intolerance in a sample of individuals diagnosed with hoarding disorder (n = 24) in comparison to clinical controls (n = 21) and nonclinical community controls (n = 26) using a combination of self-report, physiological, and behavioral measures. We found that trait distress intolerance was significantly and independently associated with greater hoarding severity. The hoarding and clinical control groups reported more trait emotional reactivity and distress intolerance than the community control group, but did not differ from each other on these traits. The hoarding group reported more subjective distress before beginning a frustrating behavioral task, but did not evidence more physiological arousal. Moreover, the hoarding group experienced similar increases in distress during the task and did not differ from either group in regard to time persisting on this task. The clinical control group, however, terminated the frustrating task significantly faster than the community control group, who tended to persist until the task timed out. Lastly, trait distress intolerance evidenced a small-to-moderate but nonstatistically significant independent relationship with task persistence time. Given the desynchrony between subjective distress and physiological arousal, we encourage researchers to utilize multimodal assessment in the future. We also suggest that clinicians start to use behavioral experiments, as has been done with other psychological disorders, to improve distress intolerance among persons who experience hoarding disorder. •Trait distress intolerance independently predicted greater hoarding severity•Trait distress intolerance shared a small-moderate relationship with task persistence•Hoarding and clinical groups self-reported poorer trait emotional functioning•Groups did not differ on task-induced subjective or physiological reactivity•The hoarding group self-reported more distress prior to task initiation