Jessica R Grisham

UNSW Sydney | UNSW · School of Psychology

Mental images appear to be important mental events in hoarding that may maintain the disorder by interfering with discarding. We tested whether a novel written imagery rescripting task, focused on modifying a negative imagined outcome of discarding a hoarded object into a positive alternative, could be used to promote discarding in individuals with...

The factors driving excessive reassurance seeking in obsessive–compulsive disorder are incompletely understood. We investigated whether low memory confidence, which drives compulsive checking, may also lead to excessive reassurance seeking during a novel in vivo contamination-based task. Undergraduates ( N = 91) completed a memory test and received...

Imagery rescripting commonly seeks to target memories by imagining the intervention of a caregiver. In some cases, such as obsessive-compulsive disorder (OCD), the target imagery may also be episodic future imagery, and a sense of mastery may be more salient than an intervening caregiver. We aimed to compare how varying the target image and rescrip...

Individuals with hoarding disorder (HD) report increased loneliness and isolation, reduced social support, and greater insecure attachment styles. Preliminary findings of elevated anger and hostility, and emotion dysregulation difficulties, in individuals with HD may partially explain these social difficulties and insecure attachment styles. To-dat...

Attachment theory suggests that strong object attachment in hoarding disorder (HD) may be due to an attempt at compensating for unmet relatedness needs. We tested this compensatory process with an online experiment and hypothesized that reducing loneliness among participants with high hoarding symptoms would result in lower object attachment, and t...

A feared possible self refers to the unwanted characteristics that a person may possess or develop. We tested an experimental paradigm to target fear of possible self using imagery rescripting. A student sample ( n = 91), with moderate obsessive–compulsive disorder symptoms, engaged in written and audio-guided exercises to evoke episodic future men...

Background Mental images of feared events are overactive and intrusive in generalized anxiety disorder (GAD). Imagery rescripting involves integration of positive or neutral imagery and corrective information into images to facilitate emotional processing, reduce imagery intrusions, and re‐structure underlying schema. Yet only one known study has a...

Obsessive-compulsive and related disorders include obsessive-compulsive disorder, hoarding disorder, body dysmorphic disorder, trichotillomania (hair-pulling disorder), and excoriation (skin-picking) disorder. This volume reviews the phenomenology and epidemiology of each of the disorders. Next, it reviews how the disorders are maintained, from bio...

Obsessive-compulsive and related disorders include obsessive-compulsive disorder, hoarding disorder, body dysmorphic disorder, trichotillomania (hair-pulling disorder), and excoriation (skin-picking) disorder. This volume reviews the phenomenology and epidemiology of each of the disorders. Next, it reviews how the disorders are maintained, from bio...

Childhood obsessive–compulsive disorder (OCD) is among the most prevalent and disabling mental health conditions affecting children and adolescents. Although the distress and burden associated with childhood OCD are well documented and empirically supported treatments are available, there remains an unacceptable “treatment gap” and “quality gap” in...

Objective People tend to live with obsessive-compulsive disorder (OCD) for many years before receiving evidence-based treatment. This delay is partly due to a lack of access to information about which healthcare providers offer evidence-based treatment for OCD. This information was not easily accessible online for people in Australia. Methods In t...

Emerging evidence suggests that rescripting intrusive mental imagery may reduce OCD symptoms. We tested whether a similar process could be adapted to an online experimental format. Amazon mTurk workers high in OCD traits (n = 198) were asked to identify OCD-related imagery of the future. They were then randomised to one of three audio-guided imager...

Background Cognitive-behavioral group therapy for hoarding disorder (HD) is efficacious, but outcomes are modest and dropout rates are generally high. Clinical challenges in this population include high rates of comorbidity and difficulty regulating and tolerating negative emotions, which may reduce engagement with discarding exposures and lead to...

Background Emerging research has suggested that hoarding may be associated with reduced social cognition, specifically reduced theory of mind and hostility biases, which may contribute to the social difficulties observed in this population. The primary aim of this study was to evaluate the feasibility and acceptability of Social Cognition and Inter...

Cognitive-behavioural models of obsessive–compulsive disorder (OCD) propose that a tendency to negatively interpret ambiguous thoughts and situations plays a key role in maintaining the disorder. Moreover, some researchers have proposed that negative interpretive biases may share a common processing mechanism with attentional biases, with changes i...

Excessively reassuring loved ones with OCD may prevent them from learning to tolerate uncertainty with negative consequences during psychotherapy. Researchers have yet to isolate the characteristics that predict OCD caregiver over-reassurance in real-life scenarios. The current study sought to identify the role of caregiver characteristics of empat...

An experiment examined decision-making processes among nonclinical participants with low or high levels of OCD symptomatology (N = 303). To better simulate the decision environments that are most likely to be problematic for clients with OCD, we employed decision tasks that incorporated “black swan” options that have a very low probability but invo...

Social anxiety disorder (SAD) is associated with marked physiological reactivity in social-evaluative situations. However, objective measurement of biomarkers is rarely evaluated in treatment trials, despite potential utility in clarifying disorder-specific physiological correlates. This randomized controlled trial sought to examine the differentia...

The COVID-19 pandemic has necessitated the use of video-teleconferencing (VTC) for psychological treatments but VTC effectiveness studies are sparse. We examined treatment outcomes for a modified Buried in Treasures (BIT) group program for hoarding disorder (HD) delivered via VTC. Participants were 10 individuals with HD. Hoarding severity was eval...

Background One of the key areas of functional impairment in hoarding is interpersonal difficulties, with burgeoning evidence suggesting that these social difficulties are a component of the psychopathology observed in hoarding. The specific nature of these interpersonal difficulties, however, has yet to be fully elucidated. The aim of the current s...

Background and objectives Cognitive-behavioural models of obsessive-compulsive disorder (OCD) suggest that maladaptive beliefs about perfectionism play a key role in the development and maintenance of OCD. Cognitive-bias modification for interpretation bias (CBM-I) is an experimental procedure that can test this proposed causal relation. Methods A...

Background and objectives Excessive reassurance seeking (ERS) in OCD increases following scenarios with high threat and personal responsibility, but the mechanism via which ERS addresses these concerns is unclear. We investigated whether reassurance following OCD-related threats facilitated temporary threat re-appraisal and/or transferred responsib...

Regular weighing is a routine component of public health interventions but concerns have been raised about possible negative psychological consequences. Blind weighing is an alternative form of weighing that is commonly used in clinical contexts, and that is thought to decrease weighing anxiety and engagement with disordered eating behaviours. In t...

The formation of intense emotional attachments to objects, difficulty parting with possessions, and the extreme accumulation of clutter are key features of Hoarding Disorder (HD). Although substantial literature implicates processes such as dysfunctional beliefs and maladaptive emotional cycles in HD, little is known about the vulnerability factors...

Researchers have proposed that the excessive acquisition of objects is a more malleable symptom of hoarding disorder (HD) than the symptoms of difficulty discarding and clutter. Thus, early intervention to reduce acquiring among higher-risk individuals may be a key pathway to reduce subsequent hoarding symptoms. Despite emerging research on motivat...

Aim To compare the efficacy and acceptability of internet-delivered exposure therapy for panic disorder, to multi-component internet-delivered cognitive behavioral therapy (iCBT) that included controlled breathing, cognitive restructuring and exposure. Methods Participants with panic disorder, with or without agoraphobia, were randomized to intern...

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...

Objectives: Researchers are increasingly investigating how technology could be used to improve the efficacy of treatment for anxiety and obsessive-compulsive (OC) spectrum disorders. A broad range of technologies, disorders and therapeutic processes have been examined in the literature. This review summarizes the evidence for using technology in c...

Previous research has linked certain psychological disorders, including obsessive-compulsive disorder (OCD), to the experience of disgust and how it is interpreted/appraised. Therefore, the present study examined whether targeting primary and secondary disgust appraisals (i.e., cognitive reappraisal) in individuals with moderate to high OCD-relevan...

Background: Cognitive behavior therapy (CBT) is effective for most patients with a social anxiety disorder (SAD) but a substantial proportion fails to remit. Experimental and clinical research suggests that enhancing CBT using imagery-based techniques could improve outcomes. It was hypothesized that imagery-enhanced CBT (IE-CBT) would be superior...

Hoarding disorder (HD) is characterised by compulsive acquisition and extreme difficulty discarding possessions, resulting in clutter that substantially impacts upon functioning. Heightened object attachment is a central feature of HD according to prominent theoretical models. We review current research on the nature and function of object attachme...

Objective Maladaptive behaviours involving consumer goods underlie compulsive buying disorder and hoarding disorder, but only hoarding disorder involves a long-term maladaptive emotional attachment to possessions. Excessive object attachment may result from using possessions to manage interpersonal conflict and buffer its corresponding loneliness....

Background and aims Object attachment is a core feature of hoarding disorder (HD), but it also occurs in people without HD. It is therefore critical to clarify differences between normal and abnormal object attachment. Although previous studies show that HD is associated with high emotional reactivity, no study to date has examined the nature and i...

Visual perspective may have an important role in the phenomenology of intrusive images relevant to psychological disorders such as obsessive-compulsive disorder (OCD). The aim of the current study was to examine the subjective and behavioural effects of manipulating visual perspective, to either field or observer, on intrusive images related to dou...

Background and aims: Individuals who meet criteria for compulsive buying-shopping disorder (i.e., acquiring problems only) or hoarding disorder (i.e., acquiring and discarding problems) may acquire possessions to compensate for unmet belonging needs, but may do so in different ways. Those with compulsive buying-shopping disorder may acquire object...

Emerging research suggests that hoarding individuals display atypical activation in their anterior cingulate cortex (ACC). Hemodynamic studies have found a biphasic pattern of ACC activity in hoarding individuals that appears sensitive to possession-related decision-making. Electrophysiological studies suggest that hoarding individuals display a bl...

Problems with emotional attachment to objects (i.e., object attachment) are a key component of hoarding disorder (HD) in the cognitive-behavioral model of HD. We hypothesized that excessive object attachment is an attempt to compensate for unmet relatedness needs. We tested this hypothesis in two studies by examining whether object attachment media...

Mental images may be experienced in field (first-person) or observer (third-person) perspective. Compared to field, observer perspective has been shown to be less sensorially and emotionally evocative. Previous research suggested that images in obsessive–compulsive disorder (OCD) are predominately experienced in field perspective. We examined the i...

The cognitive-behavioural model of hoarding posits that maladaptive beliefs play a causal role in saving behaviours. These beliefs may operate as interpretive biases to save in ambiguous situations in which hoarding individuals must decide whether to discard an item. We used a novel interpretative cognitive bias modification paradigm (CBM-I) to mod...

Background and aims: The appetitive aspects of hoarding disorder, such as the compulsive acquisition and saving of objects, are akin to other behavioral addictions. Underpinning these appetitive features is the strong emotional and sentimental attachments that hoarding sufferers have for their possessions. Different facets of object attachment hav...

The ability to regulate anger facilitates harmonious interactions with strangers, colleagues, friends, and romantic partners. We review the influence of four emotion regulation strategies (i.e., cognitive reappraisal, suppression, angry rumination, and mindfulness) on subjective anger experience, cardiovascular reactivity, and aggressive behavior....

Evidence from analogue samples suggests that deficits in emotional functioning, namely elevated emotional reactivity and distress intolerance, are implicated in the development and maintenance of hoarding disorder. We aimed to extend previous research in this area by investigating emotional reactivity and distress intolerance in a sample of individ...

Background and objectives: Intolerance of uncertainty (IU) is a transdiagnostic process contributing to the maintenance of anxiety disorders, and is a potential target for treatment. Recent literature has investigated IU as a cognitive process underpinning pathological fear and anxiety in Anorexia Nervosa (AN). The current study was designed to ex...

Background: The Saving Inventory - Revised (SI-R) is the most widely used self-report measure of hoarding symptom severity. The goal of this study is to establish a firm empirical basis for a cutoff score on the SI-R and to examine the functioning of the SI-R as a screening tool and indicator of hoarding symptom severity across the lifespan. Meth...

The inference-based approach (IBA) is one cognitive model that aims to explain the aetiology and maintenance of obsessive-compulsive disorder (OCD). IBA theory suggests that certain reasoning processes lead an individual with OCD to confuse imagined possibilities with actual probabilities, a process termed inferential confusion. One such reasoning...

Assessing obsessive compulsive disorder (OCD) in paediatric populations is complex, and a number of scales have been developed or validated for this purpose. As is the case with instruments measuring other mental health disorders, it is often assumed that youth OCD scales assess the same construct and can be used interchangeably. However, the exten...

Individuals with elevated hoarding symptoms report elevated symptoms of ADHD and these symptoms are related to impaired daily functioning. Neuropsychological studies have found specific deficits in attention, and a recent review of attentional data from numerous hoarding studies concluded that inattention likely represents an etiological factor in...

This poster was presented at the 39th AACBT National Conference in October 2018. and describes the development of the The Possessions as Memories and Self-Extensions Scale (PAMSS). The PAMSS taps into two facets of object attachment: the use of possessions as an extension of personal identity (Possessions as Identity subscale) and the use of posses...

Background and aims: People who hoard form intense attachments to their possessions and save items for sentimental and instrumental reasons. Feeling socially excluded may encourage these individuals to anthropomorphize objects (i.e., perceive them as human-like) to fulfill unmet belonging needs, which may increase the sentimental and instrumental...

The Macbeth effect is a proposed phenomenon, whereby feelings of immorality activate a desire to cleanse. Extensions of this theory suggest that cleansing alleviates immoral feelings, thus reducing the urge to engage in compensatory behaviors, such as volunteering. We examined the Macbeth effect and volunteerism in undergraduate students with high...

Objective: Recent evidence suggests that avoiding waste may be a prominent motive to save in hoarding disorder. Such beliefs are reminiscent of scrupulosity obsessions in OCD. This paper reports on three studies examining scrupulosity-like beliefs in hoarding and the development and validation of a measure of material scrupulosity. Methods: Stud...

Women are particularly vulnerable to anxiety and depressive disorders. This greater vulnerability has been partly attributed to post-pubertal sex hormone fluctuations, estradiol and progesterone, as well as gender-specific tendencies to engage in maladaptive forms of emotion regulation, particularly rumination. To date, no research has investigated...

Raw data for each participant.

The inference-based approach (IBA) is a cognitive account of the etiology and maintenance of obsessive-compulsive disorder (OCD). According to the IBA, individuals with OCD confuse an imagined possibility with an actual probability, which leads them to become immersed in their obsessions. To investigate the relationship between OCD and the cognitiv...

Patients with Anorexia Nervosa (AN) and patients with Body Dysmorphic Disorder (BDD) are both characterized by body image disturbance and dissatisfaction; furthermore, these disorders share clinical features and frequently co-occur. However, few studies have explored the relation between AN and BDD. Therefore, the first aim of the study was assessi...

Previous research suggests that individuals with OCD lack confidence in their memories and experience intolerance of uncertainty regarding the completion of tasks, which fuels compulsive rituals. The current pilot study aimed to test a novel interpretive cognitive bias modification training (CBM-I) to attenuate maladaptive thinking styles related t...

Background: Comorbidity of obsessive-compulsive disorder (OCD) with other mental disorders has been demonstrated repeatedly. Few longitudinal studies, however, have evaluated the temporal association of prior OCD and subsequent mental disorders across the age period of highest risk for first onset of mental disorders. We examined associations betw...

Background and aims Most individuals with hoarding disorder (HD) are prone to excessively acquiring new possessions. Understanding the factors that contribute to this collecting behavior will allow us to develop better treatment approaches for HD. The aim of this study was to test our assumption that an anxious attachment style is associated with a...

Background and objectives: This study examined the hypothesis that participants diagnosed with obsessive-compulsive disorder (OCD) show a selective deficit in inductive reasoning but are equivalent to controls in deductive reasoning. Methods: Twenty-five participants with OCD and 25 non-clinical controls made inductive and deductive judgments ab...

Hoarding disorder (HD) is characterised by strong emotional attachment to possessions, which may be a way in which HD sufferers compensate for problematic interpersonal relationships. Attachment difficulties and intense, dysregulated emotions have been associated with hoarding in nonclinical and clinical samples. The specificity of these problems t...

Objective: Body Dysmorphic Disorder (BDD) is a psychiatric condition characterized by preoccupation with perceived defects in physical appearance that are not observable or appear slight to others, along with low self-esteem, high perfectionism, and high comorbidity. Little is known about BDD prevalence and phenomenology in the Italian context, and...

Cognitive models of obsessive-compulsive disorder propose that beliefs about the importance of and need to control thoughts (ICT) are central to the maintenance of the disorder. Cognitive Bias Modification for Interpretation (CBM-I) can be used to experimentally test this theory and may also have clinical utility as an adjunct therapeutic tool. The...

Previous research has documented that patients referred for problems related to alcohol use rely primary on maladaptive coping and are deficient in adaptive coping skills. However, the relation between dispositional and situational coping in these patients is not yet fully understood. Therefore, the first aim of the present study was to assess disp...

Individuals who hoard report poor tolerance for uncertainty. They also exhibit error-monitoring abnormalities and increased activation of the anterior cingulate during possession-relevant decision-making, potentially reflecting a context-dependent error sensitivity. Together, these underlying vulnerabilities may lead individuals who hoard to avoid...

Background and objectives: The inference-based approach (IBA) is a cognitive account of the genesis and maintenance of obsessive-compulsive disorder (OCD). According to the IBA, individuals with OCD are prone to using inverse reasoning, in which hypothetical causes form the basis of conclusions about reality. Several studies have provided prelimin...

Background and objectives: Leading cognitive theories of OCD suggests that despite prevalent and persistent doubt, individuals with OCD do not have perceptual deficits. An alternate cognitive theory, the Seeking Proxies for Internal States hypothesis (SPIS), proposes that sensory distrust in OCD stems from actual deficits in accessing internal sta...

Cognitive behavior group therapy (CBGT) is effective for social anxiety disorder (SAD), but a substantial proportion of patients do not typically achieve normative functioning. Cognitive behavioral models of SAD emphasize negative self-imagery as an important maintaining factor, and evidence suggests that imagery is a powerful cognitive mode for fa...

The inference-based approach (IBA) is one cognitive model that aims to explain the aetiology and maintenance of obsessive-compulsive disorder (OCD). The model proposes that certain reasoning processes lead an individual with OCD to confuse an imagined possibility with an actual probability, a state termed inferential confusion. One such reasoning p...

Objectives: Unfulfilled basic psychological needs have been associated with disordered eating behaviours, but the mechanisms underlying that associations are not well understood. This study examined a two-stage path model linking basic psychological need satisfaction to disordered eating behaviours via issues of control. Methods: Female universi...

Aims Cognitive models of Obsessive-Compulsive Disorder propose that beliefs about the importance of and need to control thoughts, memory confidence, perfectionism, and intolerance of uncertainty are important in the etiology and maintenance of the disorder. Cognitive Bias Modification for Interpretation (CBM-I) has been used as an experimental man...

Abstract: Body Dysmorphic Disorder (BDD) is a distressing condition characterized by preoccupation with defects in physical appearance that are not observable to others (APA, 2013). Skin, hair and nose are the most common areas of concern (Phillips, 2006). BDD is related to low self-esteem and high levels of perfectionism, as well as to depressive,...

Pathological doubting and checking is a common symptom presentation in obsessive-compulsive disorder (OCD). Previous research has established that compulsive checkers do not display an actual memory deficit, but lack confidence in their memories and experience intolerance of uncertainty regarding the completion of tasks. We investigated whether int...

Background: Issues of personal control have been proposed to play a central role in the aetiology and maintenance of eating disorders. Empirical evidence supporting this relationship is inconsistent, partly due to the multiplicity of constructs used to define "control". This study compares six commonly used measures of control with the aim of dete...

With a prevalence of 2 to 6%, hoarding disorder is common and causes significant impairment to patients and their families. Evidence-based tools are available for diagnosing and assessing the severity of hoarding disorder. Cognitive behavioural therapy is the primary evidence-based treatment.

Pathological doubting and checking is a common symptom presentation in obsessive-compulsive disorder (OCD). Previous research suggests that compulsive checkers do not display an actual memory deficit, but lack confidence in their memories and experience intolerance of uncertainty regarding the completion of tasks. The focus of this study is on exam...

Pathological doubting and checking is a common symptom presentation in obsessive-compulsive disorder (OCD). Previous research has established that compulsive checkers do not display an actual memory deficit, but lack confidence in their memories and experience intolerance of uncertainty regarding the completion of tasks. The focus of this study is...

Studies investigating cognitive bias modification (CBM) procedures or computerized treatment techniques have traditionally included self-report measures of outcomes. However,it is vital for these studies to include multi-method assessments including behavioural tasks and physiological measures in order to examine links between cognition, behaviour,...

The cognitive-behavioural model of hoarding disorder proposes that individuals may hoard to avoid negative emotions. Distress intolerance may contribute to avoidance of negative emotions. The aim of this study was to examine the influence of sadness and other psychiatric distress on the relationship between distress intolerance and discarding in a...