Investigating associations between hoarding symptoms and affective and cognitive empathy.

Objectives: Hoarding is associated with poor interpersonal functioning, such as social isolation and difficulties in forming relationships, but the reasons for these social problems are not well understood. Previous studies have identified empathy as an important precursor to social functioning, particularly for clinical disorders characterized by social deficits. The aim of the current study was therefore to investigate associations between measures of cognitive and emotional empathy and hoarding symptoms.

Method: A total of 278 participants recruited via MTurk completed online self-report questionnaires on hoarding, empathy (including cognitive and affective components), and depression. All participants subsequently completed The Awareness of Social Inference Test-Short version (TASIT-S), a behavioural measure of theory of mind, a concept used interchangeably with cognitive empathy.

Results: Hoarding symptoms were associated with greater self-reported emotional empathy, specifically emotional contagion, and less self-reported cognitive empathy. Emotional empathy predicted hoarding even after controlling for depression symptoms. Hoarding symptoms were also associated with poorer performance on the TASIT-S with respect to both emotion recognition and theory of mind, with theory of mind remaining a unique predictor of hoarding symptoms after controlling for depression. Participants who reported clinically significant hoarding symptoms were impaired in emotion recognition and theory of mind according to TASIT-S norms.

Conclusions: Hoarding symptoms are associated with increased emotional contagion and decreased cognitive empathy. Empathy may be an avenue for understanding and treating interpersonal difficulties in hoarding disorder.

Practitioner Points: As hoarding increased, self-reported emotional contagion increased As hoarding increased, self-reported and behavioural cognitive empathy decreased Self-reported emotional empathy and behavioural cognitive empathy predicted hoarding even after controlling for depression Empathy may be an avenue for understanding social difficulties in hoarding disorder.