Hoarding disorder (HD) is a condition characterized by an attachment to possessions and poor decision-making skills. A study in the Archives of General Psychiatry looked to examine the neural mechanisms that hindered decision-making via fMRI scans in 43 patients undergoing treatment for HD compared to patients with obsessive compulsive disorder and healthy subjects. Results showed that “participants with HD exhibited abnormal activity in the anterior cingulate cortex and insula that was stimulus dependent.” When faced with discarding items that belonged to them, HD patients tended to exhibit excessive functional signals in these neural areas in comparison to the other two groups, as well as relatively low activity when the items did not belong to them. These signaling abnormalities may correlate with “problems in identifying the emotional significance of a stimulus, generating appropriate emotional response”. The study helps validate the current proposal to categorize HD as a separate condition from OCD in the upcoming DSM-5.