Learn about the Institute of Living's previous studies and the results that were obtained as a result of the studies.
GROUP COGNITIVE-BEHAVIORAL THERAPY REDUCES THE SYMPTOMS OF HOARDING DISORDER
Hoarding disorder (HD) is common and can be severe. Cognitive-behavioral therapy can improve hoarding symptoms to some extent, but this treatment is usually given one-on-one with a therapist, which is time-consuming and costly. The aim of this study was to find out if treatment in a group setting would be helpful and whether specific changes in beliefs are associated with symptom improvement. Eighty-seven adults who were diagnosed with HD were assigned at random to either start group CBT right away or to wait for 16 weeks before starting treatment. CBT consisted of 16 weekly, 90-min group sessions. In the group participants practiced discarding personal items and practiced resisting acquiring new items. Participants also learned and practiced new decision-making, problem-solving, and distress tolerance skills. Therapists used motivational strategies and a reward system to help participants meet their treatment goals. We found that HD symptoms improved more for those participants in CBT than for those on the wait list. Changes in beliefs about saving things were related to changes in HD symptoms. These results suggest that brief group CBT is a helpful and feasible treatment for adults with HD, and that reductions in possession-related beliefs are partially responsible for symptom reduction.
Reference: Tolin DF, Wootton BM, Levy HC, et al. Efficacy and mediators of a group cognitive-behavioral therapy for hoarding disorder: A randomized trial. J Consult Clin Psychol. Jul 2019;87(7):590-602.
COGNITIVE-BEHAVIORAL THERAPY CHANGES BRAIN FUNCTION IN HOARDING DISORDER
The aim of this study was to determine whether the benefits of cognitive-behavioral therapy (CBT) for hoarding disorder (HD) are associated with changes in brain activity. Sixty-four individuals with HD received group CBT or wait list. Functional magnetic resonance imaging (fMRI) was used to examine brain activity during simulated decisions about whether to acquire and discard objects. During acquiring decisions, activity decreased from pre- to post-CBT in several brain regions (including dorsolateral prefrontal cortex, anterior intraparietal area, medial intraparietal areas, amygdala, and nucleus accumbens). During discarding decisions, activity decreased from pre- to post-CBT in several brain regions (including dorsolateral prefrontal cortex, rostral cingulate cortex, anterior ventral insular cortex, and medial intraparietal areas). We also found that pre-treatment activity in several areas (including rostral cingulate, caudal cingulate cortex, and medial intraparietal parcels) was associated with changes in hoarding symptoms. Thus, CBT changes brain function in HD, and brain function prior to treatment can help predict response to treatment.
Reference: Tolin DF, Levy HC, Hallion LS, et al. Changes in neural activity following a randomized trial of cognitive behavioral therapy for hoarding disorder. J Consult Clin Psychol. Mar 6 2023.
CHRONIC HYPERVENTILATION IS ASSOCIATED WITH GREATER RESPIRATORY DISTRESS AND ANXIETY
The aim of this study was to examine self-report, body, and brain correlates of naturally-occurring, chronic hyperventilation (HV), and to examine the additional effect of acute, experimentally-induced HV in anxious and healthy participants. We measured brain activity and physical responses during a paced breathing task in 70 individuals with anxiety disorders and 34 healthy control participants without psychiatric disorders. Anxious patients who were also chronic hyperventilators exhibited greater skin conductance response (sweat activity on the skin) than did anxious patients who were not chronic hyperventilators, and anxious participants reported greater HV-related symptoms and anxiety sensitivity than did the control group. No brain abnormalities were noted as a function of anxiety group or baseline HV status. Following paced HV, anxious patients (but not controls) showed an increase in left-frontal alpha 1 power in the brain. Participants who were chronic hyperventilators exhibited an increase in skin conductance. Anxious patients reported an increase in negative beliefs about HV symptoms, and anxious patients who were also chronic hyperventilators reported an increase in emotional responses to HV. Thus, chronic HV is associated with greater arousal, and increased self-reported and physiological sensitivity to paced HV.
Reference: Tolin DF, O'Bryan EM, Davies CD, Diefenbach GJ, Johannesen J. Central and peripheral nervous system responses to chronic and paced hyperventilation in anxious and healthy subjects. Biol Psychol. Jan 2023;176:108472.
THE DIAMOND-KID IS A RELIABLE AND VALID DIAGNOSTIC TOOL FOR YOUTH WITH ANXIETY, MOOD, AND OCD-RELATED DISORDERS
The objective of this study was to examine the reliability and validity of a new semi-structured interview for pediatric psychiatric disorders. Three hundred forty-four child and adolescent patients were administered the Diagnostic Interview for Anxiety, Mood, and OCD and Related Neuropsychiatric Disorders-Child and Adolescent Version (DIAMOND-KID). Of these, 67 provided inter-rater reliability data, and 61 provided test-retest reliability data. Participants also completed a battery of self-report measures that assessed symptoms of anxiety, mood, and obsessive-compulsive and related disorders. Test-retest reliability (the extent to which the same diagnoses were reached 1 week apart) of DIAMOND-KID diagnoses ranged from very good to excellent. Inter-rater reliability (the extent to which two interviewers reached the same diagnostic conclusions) of DIAMOND-KID anxiety, mood, and obsessive-compulsive and related diagnoses was more variable, with estimates for generalized anxiety disorder and major depressive disorder in the questionable range; the other inter-rater reliability estimates ranged from good to very good. Convergent validity (the extent to which DIAMOND-KID diagnoses relate to symptom severity on self-report measures) was established by significant between-group comparisons on applicable self-report measures for all diagnoses. The results of the present study indicate that the DIAMOND-KID is a promising semi-structured diagnostic interview for DSM-5 psychiatric disorders in pediatric populations.
Reference: Tolin DF, Sain KS, Davis E, et al. The DIAMOND-KID: Psychometric properties of a structured diagnostic interview for DSM-5 anxiety, mood, and obsessive-compulsive and related disorders in children and adolescents. Assessment. in press.
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