Applying attachment theory to indecisiveness in hoarding disorder

Abstract Research shows that individuals who experience distress when discarding their possessions are more indecisive than individuals who do not experience such difficulty. These individuals report more intense emotional responses and greater intolerance to distress when faced with a discarding task. The aim of this study was to determine whether an insecure attachment style contributes to indecisiveness among individuals with discarding difficulties and whether this association is mediated by emotional reactivity and distress intolerance. This study used a within-group cross-sectional design. One hundred fifty-six participants with clinically significant discarding problems (82.7% female; Mean age  = 21.96, SD  = 7.38) from a population of university students and community members completed self-report questionnaires that assessed severity of hoarding behaviours, insecure attachment styles, emotional reactivity, distress intolerance, and indecisiveness. Analyses revealed that an anxious attachment style was associated with greater indecisiveness, and this relationship was mediated by emotional reactivity, but not distress intolerance. Furthermore, avoidant attachment was not related to indecisiveness. Clinical interventions should consider the role of attachment styles in hoarding disorder and address emotional reactivity difficulties in treatment through the use of discarding exposures, as emotion plays an important role in these decision-making processes.