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Exploring emotions and cognitions in hoarding: a Q-methodology analysis

Published online by Cambridge University Press:  07 May 2020

Adam Postlethwaite ,
Stephen Kellett  and
Nathan Simmonds-Buckley
Adam Postlethwaite
Affiliation:
Sheffield Health and Social Care NHS Foundation Trust, Sheffield, UK
Stephen Kellett*
Affiliation:
University of Sheffield and Sheffield Health and Social Care NHS Foundation Trust, Sheffield, UK
Nathan Simmonds-Buckley
Affiliation:
Barnet, Enfield and Haringey Mental Health Foundation NHS Trust, UK
*
*Corresponding author. Email: [email protected]
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Abstract

Background:

The cognitions and emotions of people prone to hoarding are key components of the dominant cognitive behavioural model of hoarding disorder.

Aims:

This study sought to use Q-methodology to explore the thoughts and feelings of people that are prone to hoarding, to identify whether distinct clusters of participants could be found.

Method:

A 49-statement Q-set was generated following thematic analysis of initial interviews (n = 2) and a review of relevant measures and literature. Forty-one participants with problematic hoarding met various study inclusion criteria and completed the Q-sort (either online or offline). A by-person factor analysis was conducted and subsequent participant clusters compared on psychometric measures of mood, anxiety, hoarding and time taken on the online task as proxy for impulsivity.

Results:

Four distinct participant clusters were found constituting 34/41 (82.92%) of the participants, as the Q-sorts of n = 7 participants failed to cluster. The four clusters found were ‘overwhelmed’ (n = 11 participants); ‘aware of consequences’ (n = 13 participants); ‘object complexity’ (n = 6 participants) and ‘object–affect fusion’ (n = 4 participants). The clusters did not markedly differ with regard to hoarding severity, anxiety, depression or impulsivity.

Conclusions:

Whilst the participant clusters reflect extant research evidence, they also reveal significant heterogeneity and so prompt the need for further research investigating emotional and cognitive differences between people prone to hoarding.

Keywords

cognitionsemotionshoardingQ-methodology
Type
Main
Information
Behavioural and Cognitive Psychotherapy , Volume 48 , Issue 6 , November 2020 , pp. 672 - 687
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2020

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References

Bjelland, I., Dahl, A. A., Haug, T. T., & Neckelmann, D. (2002). The validity of the Hospital Anxiety and Depression Scale. An updated literature review. Journal of Psychosomatic Research, 52, 69–77. doi: 10.1016/S0022-3999(01)00296-3CrossRefGoogle ScholarPubMed
Brouwer, M. (1999). Q is accounting for tastes. Journal of Advertising Research, 39, 35–40.Google Scholar
Brown, S. R. (1993). A primer on Q methodology. Operant Subjectivity, 16, 91–138. doi: 10.15133/j.os.1993.002Google Scholar
Brown, S. R. (1996). Q methodology and qualitative research. Qualitative Health Research, 6, 561–567. doi: 10.1177/104973239600600408CrossRefGoogle Scholar
Cairns, R. C. (2012). Understanding science in conservation: a Q method approach on the Galápagos Islands. Conservation and Society, 10, 217–231.CrossRefGoogle Scholar
Cherrier, H., & Ponnor, T. (2010). A study of hoarding behavior and attachment to material possessions. Qualitative Market Research, 13, 8–23. doi: 10.1108/13522751011013945CrossRefGoogle Scholar
Coles, M. E., Frost, R. O., Heimberg, R. G., & Steketee, G. (2003). Hoarding behaviors in a large college sample. Behaviour Research and Therapy, 41, 179–194. doi: 10.1016/S0005-7967(01)00136-XCrossRefGoogle Scholar
Coogan, J. & Herrington, N. (2011). Q methodology: an overview. Research in Secondary Teacher Education, 1, 24–28.Google Scholar
Davis, L. L. (1992). Instrument review: getting the most from a panel of experts. Applied Nursing Research, 5, 104–107 doi: 10.1016/S0897-1897(05)80008-4CrossRefGoogle Scholar
Dennis, K. E. (1988). Q-methodology: new perspectives on estimating reliability and validity. In Strickland, O. L & Waltz, C. F (eds), Measurement of Nursing Outcomes (pp. 409–419). New York, USA: Springer.Google Scholar
Dozier, M. E., Taylor, C. T., Castriotta, N., Mayes, T. L., & Ayers, C. R. (2017). A preliminary investigation of the measurement of object interconnectedness in hoarding disorder. Cognitive Therapy and Research, 41, 799–805. doi: 10.1007/s10608-017-9845-xCrossRefGoogle ScholarPubMed
Faraci, P., Perdighe, C., Del Monte, C., & Saliani, A. M. (2018). Reliability, validity and factor structure of the Compulsive Acquisition Scale (CAS). Clinical Neuropsychiatry: Journal of Treatment Evaluation, 15, 42–49. doi: 10.1037/t19526-000Google Scholar
Fernandez de la Cruz, L., Landau, D., Iervolino, A.C., Santo, S., Pertusa, A., Singh, S., & Mataix-Cols, D. (2013). Experiential avoidance and emotion regulation difficulties in hoarding disorder. Journal of Anxiety Disorders, 27, 204–209. doi: 10.1016/j.janxdis.2013.01.004CrossRefGoogle ScholarPubMed
Frost, R. O., Gabrielson, I., Deady, S., Dernbach, K. B., Guevara, G., Peebles-Dorin, M., Yap, K., & Grisham, J. R. (2018). Scrupulosity and hoarding. Comprehensive Psychiatry, 86, 19–24. doi: 10.1016/j.comppsych.2018.06.011CrossRefGoogle ScholarPubMed
Frost, R. O., & Gross, R. C. (1993). The hoarding of possessions. Behaviour Research and Therapy, 31, 367–381. doi: 10.1016/0005-7967(93)90094-BCrossRefGoogle ScholarPubMed
Frost, R. O., & Hartl, T. L. (1996). A cognitive-behavioral model of compulsive hoarding. Behaviour Research and Therapy, 34, 341–350. doi: 10.1016/0005-7967(95)00071-2CrossRefGoogle ScholarPubMed
Frost, R. O., Steketee, G., & Grisham, J. (2004). Measurement of compulsive hoarding: Saving Inventory-Revised. Behaviour Research and Therapy, 42, 1163–1182. doi: 10.1016/j.brat.2003.07.006CrossRefGoogle ScholarPubMed
Frost, R. O., Steketee, G., & Tolin, D. F. (2011). Comorbidity in hoarding disorder. Depression and Anxiety, 28, 876–884. doi: 10.1002/da.20861CrossRefGoogle ScholarPubMed
Frost, R. O., Steketee, G., Tolin, D. F., & Renaud, S. (2008). Development and validation of the Clutter Image Rating. Journal of Psychopathology and Behavioral Assessment, 30, 193–203. doi: 10.1007/s10862-007-9068-7.CrossRefGoogle Scholar
Frost, R. O., Steketee, G., Tolin, D. F., Sinopoli, N., & Ruby, D. (2015). Motives for acquiring and saving in hoarding disorder, OCD, and community controls. Journal of Obsessive-Compulsive and Related Disorders, 4, 54–59. doi: 10.1016/j.jocrd.2014.12.006CrossRefGoogle ScholarPubMed
Furby, L. (1978). Possession in humans: an exploratory study of its meaning and motivation. Social Behavior and Personality: An International Journal, 6, 49–65. doi: 10.2224/sbp.1978.6.1.49CrossRefGoogle Scholar
García-Pérez, M. A., & Vicente, N.A. (2003). Cellwise residual analysis in two-way contingency tables. Educational and Psychological Measurement, 63, 825–839. doi: 10.1177/0013164403251280CrossRefGoogle Scholar
Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: development, factor structure, and initial validation of the Difficulties in Emotion Regulation Scale. Journal of Psychopathology and Behavioral Assessment, 26, 41–54. doi: 10.1023/B:JOBA.0000007455.08539.94.CrossRefGoogle Scholar
Grisham, J. R., Brown, T. A., Savage, C. R. Steketee, G. & Barlow, D. H. (2007). Neuropsychological impairment associated with compulsive hoarding. Behaviour Research and Therapy, 45, 1471–1483. doi: 10.1016/j.brat.2006.12.008CrossRefGoogle ScholarPubMed
Grisham, J. R., Norberg, M. M., Williams, A. D., Certoma, S. P., & Kadib, R. (2010). Categorization and cognitive deficits in compulsive hoarding. Behaviour Research and Therapy, 48, 866–872. doi: 10.1016/j.brat.2010.05.011CrossRefGoogle ScholarPubMed
Kellett, S., & Holden, K. (2014). Emotional attachment to objects in hoarding: a critical review of the evidence. In Frost, R. O & Steketee, G (eds), The Oxford Handbook of Hoarding and Acquiring. New York, NY, USA: Oxford University Press.Google Scholar
Kellett, S., & Knight, K. (2003). Does the concept of object-affect fusion refine cognitive-behavioural theories of hoarding? Behavioural and Cognitive Psychotherapy, 31, 457–461. doi: 10.1017/S1352465803004077CrossRefGoogle Scholar
Kim, H.-J., Steketee, G., & Frost, R. O. (2001). Hoarding by elderly people. Health & Social Work, 26, 176–184. doi: 10.1093/hsw/26.3.176CrossRefGoogle ScholarPubMed
Koenig, T. L., Leiste, M. R., Holmes, R., & Macmillan, K. R. (2014). Multidisciplinary teams’ practice strategies with older adult clients who hoard. Social Work in Mental Health, 12, 81–97.CrossRefGoogle Scholar
Kyrios, M., Mogan, C., Moulding, R., Frost, R. O., Yap, K., & Fassnacht, D. B. (2018). The cognitive–behavioural model of hoarding disorder: Evidence from clinical and non-clinical cohorts. Clinical Psychology & Psychotherapy, 25, 311–321. doi: 10.1002/cpp.2164CrossRefGoogle ScholarPubMed
Lynn, M. (1986). Determination and quantification of content validity. Nursing Research, 35, 382–386.10.1097/00006199-198611000-00017CrossRefGoogle ScholarPubMed
Mataix-Cols, D., Frost, R. O., Pertusa, A., Clark, L. A., Saxena, S., Leckman, J. F., Stein, D.J., Matsunaga, H., & Wilhelm, S. (2010). Hoarding disorder: a new diagnosis for DSM-V? Depression and Anxiety, 27, 556–572. doi: 10.1002/da.20693CrossRefGoogle ScholarPubMed
McKeown, B., & Thomas, D. B. (2013). Person samples and the single case. In Quantitative Applications in the Social Sciences: Q Methodology. Thousand Oaks, CA, USA: SAGE Publications. doi: 10.4135/9781483384412.n3Google Scholar
Mogan, C., Kyrios, M., Schweitzer, I., Yap, K., & Moulding, R. (2012). Phenomenology of hoarding – what is hoarded by individuals with hoarding disorder? Journal of Obsessive-Compulsive and Related Disorders, 1, 306–311. doi: 10.1016/j.jocrd.2012.08.002CrossRefGoogle Scholar
Muroff, J., Underwood, P., & Steketee, G. (2014). Group Treatment for Hoarding Disorder: Therapist Guide. London, UK: Oxford University Press.CrossRefGoogle Scholar
Mykletun, A., Stordal, E., & Dahl, A. A. (2001). Hospital Anxiety and Depression (HAD) scale: factor structure, item analyses and internal consistency in a large population. British Journal of Psychiatry, 179, 540–544. doi: 10.1192/bjp.179.6.540CrossRefGoogle ScholarPubMed
Nazariadli, S., Morais, D. B., Supak, S., Baran, P. K., & Bunds, K. S. (2019). Assessing the visual Q method online research tool: a usability, reliability, and methods agreement analysis. Methodological Innovations. doi: 10.1177/2059799119832194CrossRefGoogle Scholar
Polit, D. F., & Beck, C. T. (2006). The content validity index: are you sure you know whatʼs being reported? Critique and recommendations. Research in Nursing & Health, 29, 489–497. doi: 10.1002/nur.20147CrossRefGoogle ScholarPubMed
Preacher, K. J., Zhang, G., Kim, C., & Mels, G. (2013). Choosing the optimal number of factors in exploratory factor analysis: a model selection perspective. Multivariate Behavioral Research, 48, 28–56. doi: 10.1080/00273171.2012.710386CrossRefGoogle ScholarPubMed
Przeworski, A., Cain, N., & Dunbeck, K. (2014). Traumatic life events in individuals with hoarding symptoms, obsessive-compulsive symptoms, and comorbid obsessive-compulsive and hoarding symptoms. Journal of Obsessive-Compulsive and Related Disorders, 3, 52–59. doi: 10.1016/j.jocrd.2013.12.002CrossRefGoogle Scholar
Schmalisch, C. S., Bratiotis, C., & Muroff, J. (2010). Processes in group cognitive and behavioral treatment for hoarding. Cognitive and Behavioral Practice, 17, 414–425. doi: 10.1016/j.cbpra.2009.08.005CrossRefGoogle Scholar
Selby-Harrington, M. L., Mehta, S. M., Jutsum, V., Riportella-Muller, R., & Quade, D. (1994). Reporting of instrument validity and reliability in selected clinical nursing journals, 1989. Journal of Professional Nursing, 10, 47–56.CrossRefGoogle ScholarPubMed
Stainton-Rogers, R. (1995). Q-methodology. In Smith, J. A., Harre, R. & Van Langenhove, L. (eds), Rethinking Methods in Psychology (pp. 178–192). London, UK: Sage Publications.CrossRefGoogle Scholar
Steketee, G., & Frost, R. (2003). Compulsive hoarding: current status of the research. Clinical Psychology Review, 23, 905–927. doi: 10.1016/j.cpr.2003.08.002CrossRefGoogle Scholar
Steketee, G., Frost, R. O., & Kyrios, M. (2003). Cognitive aspects of compulsive hoarding. Cognitive Therapy and Research, 27, 463–479. doi: 10.1023/A:1025428631552CrossRefGoogle Scholar
Stenner, P., & Stainton-Rogers, R. (2004). Q methodology and qualiquantology: the example of discriminating between emotions. In Tod, Z., Nerlich, B., McKeown, S. & Clark, D. (eds), Mixing Methods in Psychology. London, UK: Routledge.Google Scholar
Stephenson, W. (1935). Correlating persons instead of tests. Journal of Personality, 4, 17–24. doi: 10.1111/j.1467-6494.1935.tb02022.xCrossRefGoogle Scholar
Taylor, J. K., Theiler, S., Nedeljkovic, M., & Moulding, R. (2019). A qualitative analysis of emotion and emotion regulation in hoarding disorder. Journal of Clinical Psychology, 75, 520–545. doi: 10.1002/jclp.22715CrossRefGoogle ScholarPubMed
Tolin, D. F., Fitch, K. E., Frost, R. O., & Steketee, G. (2010). Family informants’ perceptions of insight in compulsive hoarding. Cognitive Therapy and Research, 34, 69–81. doi: 10.1007/s10608-008-9217-7CrossRefGoogle Scholar
Tolin, D. F., Kiehl, K. A., Worhunsky, P., Book, G. A., & Maltby, N. (2009). An exploratory study of the neural mechanisms of decision making in compulsive hoarding. Psychological Medicine, 39, 325–336. doi: 10.1017/S0033291708003371CrossRefGoogle ScholarPubMed
Tolin, D. F., Levy, H. C., Wootton, B. M., Hallion, L. S., & Stevens, M. C. (2018). Hoarding disorder and difficulties in emotion regulation. Journal of Obsessive-Compulsive and Related Disorders, 16, 98–103. doi: 10.1016/j.jocrd.2018.01.006CrossRefGoogle ScholarPubMed
Timpano, K. R., & Shaw, A. M. (2013). Conferring humanness: the role of anthropomorphism in hoarding. Personality and Individual Differences, 54, 383–388. doi: 10.1016/j.paid.2012.10.007CrossRefGoogle Scholar
Valenta, A. L., & Wigger, U. (1997). Q-methodology: definition and application in health care informatics. Journal of the American Medical Informatics Association, 4, 501–510.CrossRefGoogle ScholarPubMed
Warren, L. W., & Ostrom, J. C. (1988). Pack rats: world class savers. Psychology Today, 22, 58–62.Google Scholar
Watts, S., & Stenner, P. (2005). Doing Q methodology: theory, method and interpretation. Qualitative Research in Psychology, 2, 67–91. doi: 10.1191/1478088705qp022oaCrossRefGoogle Scholar
Watts, S., & Stenner, P. (2012). Doing Q Methodological Research: Theory, Method and Interpretation. London, UK: Sage Publications.Google Scholar
Webler, T., Danielson, S., & Tuler, S. (2009). Using Q method to Reveal Social Perspectives in Environmental Research. Greenfield, MA, USA: Social and Environmental Research Institute.Google Scholar
Weingarden, H., & Renshaw, K. D. (2015). Shame in the obsessive compulsive related disorders: a conceptual review. Journal of Affective Disorders, 171, 74–84. doi: 10.1016/j.jad.2014.09.010CrossRefGoogle ScholarPubMed
Wilbram, M. Kellett, S., & Beail, N. (2008). Compulsive hoarding: a qualitative investigation of partner and carer perspectives. British Journal of Clinical Psychology, 47, 59–73. doi: 10.1348/014466507X240740CrossRefGoogle ScholarPubMed
Yap, K., & Grisham, J.R. (2019). Unpacking the construct of emotional attachment to objects and its association with hoarding symptoms. Journal of Behavioral Addictions, 8, 249–258. doi: 10.1556/2006.8.2019.15CrossRefGoogle ScholarPubMed
Zabala, A., & Pascual, U. (2016). Bootstrapping Q methodology to improve the understanding of human perspectives. PLoS ONE, 11, e0148087. doi: 10.1371/journal.pone.0148087CrossRefGoogle ScholarPubMed
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