Interpersonal functioning in Hoarding Disorder: An examination of attachment styles and emotion regulation in response to interpersonal stress

Hoarding disorder (HD) is characterised by strong emotional attachment to possessions, which may be a way in which HD sufferers compensate for problematic interpersonal relationships. Attachment difficulties and intense, dysregulated emotions have been associated with hoarding in nonclinical and clinical samples. The specificity of these problems to HD, however, is unclear. We contrasted self-reported attachment style and emotion dysregulation in a HD group (n = 24) to healthy (n = 26) and clinical (n = 22) control groups. We also compared in vivo emotional and physiological responses of the three groups to an interpersonally-based recall stressor task. Our findings indicated that individuals with HD reported greater attachment-related anxiety and avoidance and more emotion regulation difficulties than healthy, but not clinical, controls. For the stressor task, the hoarding group reported more intense negative emotions than the healthy group and a slower rate of emotional recovery than the clinical control group. No differences were observed among groups in physiological response to the stressor task. Our results support proposed interpersonal and emotion regulation difficulties in HD, but provide very limited evidence of increased difficulties relative to other emotional disorders.