King's College London

Hoarding Disorder (HD), conceptualised as difficulties with discarding possessions resulting in distress, the accumulation of items creating a cluttered, unusable environment, and significant impairment in functioning, is reported to affect 1.5% of adults. In addition, evidence suggests that those with HD experience further difficulties in executive functioning, including inhibition, attention, and decision-making. These deficits in executive function and other areas of information processing are thought to play a key role in maintaining HD. This review aimed to systematically review the evidence for executive dysfunction in this population when compared to healthy controls, focussing specifically on studies using clinician-delivered interviews to diagnose HD, and those using primary assessments of executive function. 12 studies were included in this review, and their data extracted. Results suggest consistent evidence for difficulties in sustained attention and inhibitory control, however literature on deficits in other areas of executive function is wide ranging with many contradictory findings. Further research is needed to investigate deficits in other areas of executive function in HD, endeavouring to use consistent methods to diagnose HD and measure executive function, which a lack of has to-date caused some of the problems in interpretation of true deficits.