A virtual reality study of experiential avoidance, emotional experiences, and hoarding symptoms

Background and objectives It is posited that the difficulty discarding in hoarding disorder (HD) is maintained by a process of negative reinforcement that occurs through avoidance of difficult emotions. Findings regarding the association between emotional experiences and hoarding symptoms have been inconsistent. This study examined relationships between hoarding severity and emotional components of HD using a virtual reality (VR) paradigm. Methods State and trait experiential avoidance (EA), emotional reactivity, and intensity were measured in an HD group (n = 36) and nonhoarding group (n = 40). Both groups underwent a negative or neutral mood induction, followed by a VR acquisition and discarding task. Results The HD group showed higher overall acquisition and greater increases in negative affect following the imagined discarding task than the nonhoarding group, but no differences in discarding patterns. There were no significant correlations between negative affect and acquiring/discarding patterns; nor were there differences related to emotional intensity during mood inductions. Limitations Specificity is limited due to the lack of a clinical comparison group. Conclusions EA may be more important in predicting symptoms than emotional intensity. Implications for cognitive-behavioral models of HD are discussed.