Cognitive remediation for neuropsychological impairment in hoarding disorder: A pilot study

• We describe a controlled trial of cognitive remediation for hoarding disorder (HD).
• Seventeen patients were randomly assigned to CR or relaxation (REL) for 24 sessions.
• CR produced greater improvements in attention than did REL.
• The two groups did not differentially impact memory or executive function.
• CR appears promising as an adjunct to cognitive-behavioral therapy for HD.

The aim of this pilot randomized controlled trial was to investigate whether an extended, standardized program of computer-assisted cognitive remediation (CR; a behavioral intervention designed to improve cognitive function through repeated task practice and strategy acquisition) improves disordered attention and related cognitive functions in patients with hoarding disorder (HD) as compared to patients with HD assigned to a relaxation control condition. Seventeen participants with primary HD were randomized to receive 8 weeks and 24 sessions of either CR or relaxation control treatment, and blinded assessments of cognitive functioning and hoarding severity were conducted before and after treatment. Results revealed that cognitive remediation produced improvements in attention relative to the relaxation control condition; the two conditions did not differentially influence memory or executive functioning, or hoarding severity. Future research should confirm these findings in larger sample studies and investigate the utility of cognitive remediation for attentional impairment as an adjunct to cognitive-behavioral therapy for hoarding disorder.