41 Deficits in executive function marked by inhibition, planning, and decision-making difficulties may limit hoarders’ ability to discard and organize their possessions. Although this is an intriguing and rapidly advancing area within hoarding research, there has been some inconsistency with respect to the specific pattern of deficits associated with hoarding. There is some evidence that individuals Inhibitors,research,lifescience,medical who compulsively hoard demonstrate significant difficulty making decisions. They tend to believe

a disproportionate number of their possessions are very important, and feel paralyzed by seemingly commonplace decisions about what items to discard and what items to keep, which items are valuable, and how to

organize the items they decide to keep. These decision-making problems have been associated with hoarding in several LY2157299 solubility dmso studies using self-report measures.42-44 With respect Inhibitors,research,lifescience,medical to laboratory studies, however, research has provided mixed results regarding decision-making deficits. Grisham et al39 found that hoarders displayed relatively intact decision making on the Iowa Gambling Task relative to a clinical and community control groups. A recent study in our laboratory has replicated this finding, showing that individuals with compulsive Inhibitors,research,lifescience,medical hoarding did not demonstrate decision-making problems on the computerized Cambridge Gambling Task.45 However, Lawrence et al41 found that hoarding symptoms were associated with specific decision making impairments on the same gambling task and that these deficits were related to the severity of the hoarding symptoms. Lawrence et al41 suggested that hoarders have difficulty

deciding whether to save Inhibitors,research,lifescience,medical or discard their possession due to general decision-making difficulties. One important difference between the Grisham et al39 and Lawrence et al41 studies was the composition of the hoarding group. In the Grisham et al study, the hoarding group Inhibitors,research,lifescience,medical comprised participants who met criteria for compulsive hoarding, regardless of whether they had OCD, while the hoarding group in the Lawrence et al study consisted of OCD patients who displayed hoarding behaviors. This difference in the samples may explain the discrepancy on the decision-making task in the two studies. Future studies may compare hoarding patients with and without other OCD symptoms to nonhoarding OCD patients and community controls in order to clarify the source of the decision-making Astemizole difficulties. Another area that remains unresolved is the role of proposed categorization problems in hoarding patients.1,46 Compulsive hoarding patients appear to exhibit problems grouping their possessions into categories, which contributes to the disorganization and clutter that are hallmark features of this disorder.1 A few studies have investigated these hypothesized differences in the way hoarding patients categorize.