El desarrollo de la técnica del bordado con mostacillas 66

As summarised in Table 4, two key findings were discovered when reviewing the data regarding checking and affective phenomena. First, that elevated guilt may contribute to the affective profile of individuals with checking or certainty OCE. Second, that reduced fear may also differentiate “checkers” from “washers”, but that the role of disgusting stimuli may be crucial in this interaction. Third, that anxiety and depression may underlie the majority of obsessive-compulsive presentations and thus be inherent in all such affective profiles. 3.3. Hoarding

Thirteen studies considered hoarding. Table C1 reports how hoarding presentations were measured, while Table 5 highlights which affective phenomena were measured alongside hoarding.

3 _{Seyfollahi and Gupta (2014) also found the “checker” group to score significantly lower than the}

“washer” group on the moral standard subscale of the GI (d = 0.10). However, this finding appears statistically inaccurate and therefore has been discounted from the findings of the review.

--- Insert Table 5 here --- 3.3.1. Depression

Ten studies considered “hoarding” alongside depression or sadness, five of which reported reduced depression in hoarding. Calamari et al. (2004) found that the hoarding subgroup reported significantly lower levels of depression (d = 0.43) than all other groups. This is in line with findings from Grisham, Brown, Liverant, and Campbell-Sills (2005) and Neziroglu, Weissman, Allen, and McKay (2012), who found people with hoarding

presentations to report significantly less depression than other obsessive-compulsive groups (for example, individuals with other OCE with and without hoarding compulsions). In two studies, which used correlation analyses (Olatunji et al., 2010; Olatunji et al., 2011), hoarding was not significantly correlated with depression (r = .17 and r = .10, respectively); however, other compulsion-types were (see Table C1). This could be interpreted to suggest that “hoarders” are less likely to experience depression than some other compulsion-types.

In contrast, two studies suggested that “hoarders” may experience increased

depression. Frost, Steketee, Williams, and Warren (2000) found “hoarders” to report higher depression than people with any other OCE, but this finding became non-significant when anxiety was controlled; this suggests the reported relationship between hoarding OCE and low mood may not be straightforward. Similarly, Torres et al. (2016) found scores of the hoarding dimension of the DY-BOCS to be independently associated with having a diagnosis of major depressive disorder (d = 0.28). However, this finding has a relatively small effect, perhaps only made statistically significant by the large sample size (N = 1001).

Three of the ten studies investigating hoarding behaviours and depression or sadness found no evidence to suggest a significant relationship or association between these

3.3.2. Anxiety and anxiety sensitivity

Eight studies from the review considered either anxiety or anxiety-sensitivity

alongside hoarding, seven of which found evidence to suggest that people with hoarding-only presentations may experience less anxiety than other compulsion groups. Grisham et al. (2005) found individuals with hoarding-only OCE to report significantly less anxiety than either individuals with mixed obsessive-compulsive presentations (including hoarding; d = 0.75) or individuals with mixed OCE (not including hoarding; d = 0.86); they also found these patterns regarding worry and stress. Similarly, Neziroglu et al. (2012) found individuals with hoarding-only difficulties to report significantly lower anxiety than

individuals with wider obsessive-compulsive presentations (both with, d = 0.70, and without, d = 0.93, hoarding aspects).

In addition, Calamari et al. (2008) found that the mixed contamination/harming subgroup had significantly higher ASI total scores than the hoarding subgroup (d = 1.01) and Calamari et al (1999) found that their certainty subgroup had higher trait anxiety scores than their hoarding subgroup (d = 1.29). Furthermore, Olatunji et al (2011) found no significant relationship between hoarding and anxiety (r = .09), despite observing relationships between anxiety and multiple other compulsions. Torres et al. (2016) found no significant association between hoarding presentations, or indeed any other compulsion-types, and diagnoses of generalized anxiety disorder. Finally, although Calamari et al. (2004) found no significant difference between hoarding and all other groups on the ASI-III, they reported a medium effect size for lower anxiety sensitivity in the hoarding group (d = 0.54).

Only one study (Frost et al., 2000) evidenced individuals with obsessive-compulsive hoarding difficulties to report higher anxiety levels than individuals with non-hoarding compulsions (d = 0.71). However, this finding became non-significant when depression was controlled, suggesting the reported relationship between hoarding OCE and anxiety may be influenced by low mood.

3.3.3. Positive affect, negative affect, and stress

Grisham et al. (2005) were the only researchers to consider measures of positive and negative affect, and stress. They found individuals with hoarding-only OCE to report

significantly less negative affect and stress than either individuals with mixed OCE including hoarding (d = 1.01; d = 1.42, respectively) or individuals with non-hoarding OCE (d = 1.21; d = 1.14, respectively). Similarly, they found the hoarding-only group to report significantly more positive affect than the mixed-presentation group (d = 0.81), and the mixed-presentation group to report significantly more positive affect than the non-hoarding group (d = 0.62). 3.3.4. Affective profile for hoarding

As summarised in Table 5, two key findings were discovered when reviewing the data regarding hoarding and affective phenomena. First, that hoarding presentations alone may be characterised by fewer undesirable affective phenomena (including anxiety, fear, negative affect, stress and depression) than individuals with other obsessive-compulsive presentations. This is somewhat contradictory to previous suggestions that depression and anxiety may be consistently present in all obsessive-compulsive presentations. Second, data from the reviewed articles suggests that the presence of multiple compulsions may be associated with increased experiences of undesirable affective phenomena.