Investigating the neuropsychological features of hoarding disorder using a novel virtual reality paradigm

Hoarding disorder represents a considerable health concern that warrants further investigation of its associated neuropsychological components. The present study examined a key aspect of the cognitive–behavioural model of hoarding, <i>information processing</i> (memory, attention, decision making, categorisation). Mixed findings in the literature on the presence of cognitive deficits may be attributable to the use of assessment tools with low ecological validity. Thus, novel virtual reality (VR) environments were developed to examine the information-processing components with improved ecological validity. Two groups (i.e., with hoarding disorder, <i>n</i> = 36; without hoarding disorder, <i>n</i> = 40) similar in age and gender were recruited from the community to complete a series of standardised and novel VR memory and decision-making tasks, and to complete a categorisation task for objects in a messy VR home office. Higher attentional difficulties related to ADHD symptoms, poorer category efficiency, and poorer trait, but not state, memory confidence, were reported in the hoarding group. There was no evidence of memory and decision-making impairments specific to the hoarding group. Results from this research advance our understanding of the cognitive–behavioural components of hoarding and offer implications for future treatment and VR research initiatives.