The Structure of Obsessions and Compulsions: Implications for the Classification of Hoarding

摘要

Symptoms of obsessive-compulsive disorder (OCD) are broad in content, reflecting a heterogeneous condition. Substantial consideration has been given to the construct of hoarding and whether it is best considered a symptom of OCD, part of another disorder, or a distinct disorder. Several lines of research target this issue, including epidemiology and estimated comorbidity, cognitive processing, neuroimaging, and treatment response. Structural analyses, such as exploratory and confirmatory factor analysis, also have been used. In this paper, the role of structural analyses for addressing hoarding-OCD relations is considered. Issues include the identification of hoarding factors within OCD symptom measures, the magnitude of association between hoarding and symptoms considered to be "classic" OCD, strength of factor loadings, and between-groups comparisons on factor-analytically derived scales. Collectively, these lines of analysis do not consistently support the inclusion of hoarding as a core OCD symptom, but further work is needed to address key limitations.