A Higher Endowment Effect in Children and Adolescents with OCD and Hoarding Symptoms

Abstract

Hoarding is characterized by (a) the persistent difficulty discarding personal items; (b) clutter that interferes with living areas; and (c) significant distress or functional impairment. Hoarding symptoms often emerge in childhood and adolescence, yet very few studies on hoarding in this age group exist. Current models of hoarding emphasize impairments in decision-making, yet the literature on decision-making processes in hoarding presents inconsistent findings. Preliminary cognitive studies in adults suggest that hoarding may be associated with deficits in value attribution (the tendency to assign value to personal items). Thus, we propose that the Endowment Effect (EE), in which ownership of an item increases its perceived value, may be informative for the study of hoarding symptoms. This study investigated the EE in youth (children and adolescents) with Obsessive-Compulsive Disorder (OCD) and hoarding symptoms. Given that hoarding involves significant difficulty discarding personal items, we hypothesized that hoarding in youth is associated with a higher EE. Thirty youth participants with a confirmed DSM-5 diagnosis of OCD completed the Endowment Task, a game script of the EE; the Wisconsin Card Sorting Test (WCST), a test of cognitive flexibility; and the Balloon-Analogue Risk Task (BART), a test of risky decision-making. The Children’s Saving Inventory-Parent Version (CSI) was used to measure severity of hoarding symptoms. We divided our sample into thirds based on CSI scores to create a ‘High Hoarding’ group (HH; n=12; mean CSI (S.D.)=30.83 (5.47446)) and a ‘Low Hoarding’ group (LH; n=10; mean CSI (S.D.)=5.00 (3.16228)). The HH group demonstrated a higher average EE than the LH group (average EE, 3.22 and 1.59, respectively). In contrast, no significant between-group differences were found on the WCST and the BART (t=0.901, p=0.378 and t=0.338, p=0.739, respectively). The results of this thesis suggest that psychological ownership plays an important role in the manifestation of hoarding symptoms. Thus, we propose that hoarding might be associated with a specific decision-making deficit related to personal possessions.