title: Parental bonding and hoarding in obsessive-compulsive disorder.
abstract: Hoarding behavior may indicate a clinically and possibly etiologically distinct subtype of obsessive-compulsive disorder (OCD). Empirical evidence supports a relationship between hoarding and emotional over-attachment to objects. However, little is known about the relationship between hoarding and parental attachment in OCD.
  
  
  
  The study sample included 894 adults diagnosed with DSM-IV OCD who had participated in family and genetic studies of OCD. Participants were assessed for Axis I disorders, personality disorders, and general personality dimensions. The Parental Bonding Instrument (PBI) was used to assess dimensions of perceived parental rearing (care, overprotection, and control). We compared parental PBI scores in the 334 hoarding and 560 non-hoarding participants, separately in men and women. We used logistic regression to evaluate the relationship between parenting scores and hoarding in women, adjusting for other clinical features associated with hoarding.
  
  
  
  In men, there were no significant differences between hoarding and non-hoarding groups in maternal or paternal parenting scores. In women, the hoarding group had a lower mean score on maternal care (23.4 vs. 25.7, p<0.01); a higher mean score on maternal protection (9.4 vs. 7.7, p<0.001); and a higher mean score on maternal control (7.0 vs. 6.2, p<0.05), compared to the non-hoarding group. The magnitude of the relationships between maternal bonding dimensions and hoarding in women did not change after adjustment for other clinical features. Women who reported low maternal care/high maternal protection had significantly greater odds of hoarding compared to women with high maternal care/low maternal protection (OR=2.54, 95% CI=1.60-4.02, p<0.001).
  
  
  
  Perceived poor maternal care, maternal overprotection, and maternal overcontrol are associated with hoarding in women with OCD. Parenting dimensions are not related to hoarding in men. These findings provide further support for a hoarding subtype of OCD and for sex-specific differences in etiologic pathways for hoarding in OCD.
authors.affiliation: Department of Psychology, Loyola University, Baltimore, MD.
authors.forename: David
authors.initials: D
authors.lastname: Chen
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: O Joseph
authors.initials: OJ
authors.lastname: Bienvenu
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Janice
authors.initials: J
authors.lastname: Krasnow
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Ying
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Marco A
authors.initials: MA
authors.lastname: Grados
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Bernadette
authors.initials: B
authors.lastname: Cullen
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Fernando S
authors.initials: FS
authors.lastname: Goes
authors.affiliation: Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
authors.forename: Brion
authors.initials: B
authors.lastname: Maher
authors.affiliation: Department of Psychiatry and Human Behavior, Brown Medical School, Butler Hospital, Providence, Rhode Island.
authors.forename: Benjamin D
authors.initials: BD
authors.lastname: Greenberg
authors.affiliation: Department of Psychiatry and Human Behavior, Brown Medical School, Butler Hospital, Providence, Rhode Island.
authors.forename: Nicole C
authors.initials: NC
authors.lastname: McLaughlin
authors.affiliation: Department of Psychiatry and Human Behavior, Brown Medical School, Butler Hospital, Providence, Rhode Island.
authors.forename: Steven A
authors.initials: SA
authors.lastname: Rasmussen
authors.affiliation: Department of Psychiatry, College of Physicians and Surgeons at Columbia University and the New York State Psychiatric Institute, New York City, NY.
authors.forename: Abby J
authors.initials: AJ
authors.lastname: Fyer
authors.affiliation: Department of Psychiatry, University of Southern California School of Medicine, Los Angeles, CA.
authors.forename: James A
authors.initials: JA
authors.lastname: Knowles
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, School of Medicine, Los Angeles, CA.
authors.forename: James T
authors.initials: JT
authors.lastname: McCracken
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, School of Medicine, Los Angeles, CA.
authors.forename: John
authors.initials: J
authors.lastname: Piacentini
authors.affiliation: Department of Psychiatry, Harvard Medical School, Boston, MA.
authors.forename: Dan
authors.initials: D
authors.lastname: Geller
authors.affiliation: Department of Psychiatry and Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA.
authors.forename: David L
authors.initials: DL
authors.lastname: Pauls
authors.affiliation: Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver.
authors.forename: S Evelyn
authors.initials: SE
authors.lastname: Stewart
authors.affiliation: Laboratory of Clinical Science, National Institute of Mental Health, National Institute of Health, Bethesda, MD.
authors.forename: Dennis L
authors.initials: DL
authors.lastname: Murphy
authors.affiliation: Unit of Statistical Genomics, Division of Intramural Research, National Institute of Mental Health, Bethesda, MD.
authors.forename: Yin-Yao
authors.initials: YY
authors.lastname: Shugart
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Riddle
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Gerald
authors.initials: G
authors.lastname: Nestadt
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD. Electronic address: jacks@jhmi.edu.
authors.forename: Jack
authors.initials: J
authors.lastname: Samuels
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D060845:Hoarding / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009769:Object Attachment; D009771:Obsessive-Compulsive Disorder / Q000523:psychology*; D016487:Parenting / Q000523:psychology*; D012727:Sex Characteristics; D055815:Young Adult