An online experimental test of the compensatory process in hoarding disorder: reducing loneliness and its effects on object attachment

Abstract

AbstractAttachment theory suggests that strong object attachment in hoarding disorder (HD) may be due to an attempt at compensating for unmet relatedness needs. We tested this compensatory process with an online experiment and hypothesized that reducing loneliness among participants with high hoarding symptoms would result in lower object attachment, and that change in loneliness would mediate the impact of an online loneliness intervention on object attachment. A pretest-posttest control group design was used. Participants were 298 MTurk workers pre-screened for high hoarding symptoms recruited via cloudresearch.com. At Time 1, participants completed measures of hoarding severity, loneliness, and four aspects of object attachment: overall object attachment to possessions, insecure object attachment, attachment to an old cherished item, and attachment to a novel item. We randomly assigned participants to either a loneliness intervention (n = 142) or an active control (a health education program; n = 156). All participants completed follow-up questionnaires after two weeks. We conducted ANCOVAs to assess for group differences at Time 2 whilst controlling for Time 1 variables. Results showed small but significant improvements in loneliness, thwarted belongingness, and object attachment for the novel item for participants who received the loneliness intervention relative to control participants. Mediational analyses revealed that the change in loneliness mediated the effect of the intervention on insecure object attachment. Consistent with attachment theory, these results indicate that reducing loneliness might lead to lower object attachment in hoarding disorder. Trials with clinical participants using more intensive loneliness interventions are warranted.