Maximizing decision-making style and hoarding disorder symptoms

Background: Past research links hoarding disorder (HD) to indecisiveness and difficulty with decision-making. However, it remains unclear what contributes to difficulty making decisions in HD. Decision-making research suggests that some individuals have a maximizing decision-making style (seeking the best option through an exhaustive search of all existing alternatives) while others "satisfice" (choosing options that are satisfactory even without seeing all options). Past work has linked the dispositional tendency to maximize in decisions to elevated depression, anxiety and obsessive-compulsive disorder (OCD) symptoms, but no study has investigated whether maximizing may be relevant for hoarding behaviors.

Method: We administered measures of hoarding behaviors, decision-making style (maximizing vs satisficing), generalized difficulty with decision-making (indecisiveness), distress (depression, anxiety and stress symptoms) and OCD symptoms to a sample of community adults (N = 1113) recruited through Amazon Mechanical Turk (MTurk).

Results: The tendency to maximize in decision-making was significantly correlated with hoarding symptoms (including difficulty discarding possessions, excessive acquisition, and clutter). Moreover, regression results showed that maximizing predicted hoarding severity after controlling for indecisiveness, general distress and OCD symptoms.

Limitations: We utilized self-report questionnaires in an unscreened community sample. Replication in a clinical sample is needed.

Conclusions: The dispositional tendency to maximize in decisions may represent a specific aspect of decision-making relevant for hoarding behaviors. Implications for improving cognitive-behavioral models and treatments are discussed.