What is Hoarding Disorder?

The information included in this section is drawn from research and is included in the HoardingUK presentation materials.  In an effort to have it be readable, detail is not provided.  If you have any questions, please get in touch.

The DSM-V current diagnostic criteria

The British Psychological Society A Pscyhological Perspective on Hoarding

NHS Guidance

The American Psychological Association Guidance

 

Who?

  • Some research finds that hoarding disorder is more common in males but more females present for support (this has also been found to be equal in terms of how many of each gender hoard)
  • No distinction between age, gender, ethnic group, socio-economic status, educational, occupational tenure
  • Often family history of OCD and or hoarding (50% in three studies identified parent, sibling or offspring)
  • Potentially only 5% of hoarders come to the attention of professionals.

Source: Singh, 2012

In short, Hoarding Disorder is found across all ages, ethnicities, genders, religions, education levels, sexualities, etc.

It is a stereotype to associate hoarding tendencies with older people.

 

What?

Old ClothesMagazinesCD/Video/DVD
Post
Pens
Old notes
Bills
Newspapers
Receipts
Cardboard boxes
Beads
Fabric
Pins
Rags
Old Medication
Canned Food
OCD related:
body products
(nail, hair, excrement);
rotten food; animals

Source: Pertusa et al, 2008

 

When?

  • Hoarding often begins in adolescence
  • Hoarding becomes significant problem for most people in their 30′s
  • However, the average age of people seeking treatment is about 50, ranging mainly from early 40s’ to elderly adults.

Source: Steketee, 2010

 

Where…else?

Other than their own environment, the person who deals with hoarding behaviours:

  • May have storage spaces (or several)
  • May be using space of other family, friends, etc.
  • May be using external areas of private or other property including hallways, yards, vehicles, etc.

 

Why?

Behaviours include: Excessive acquisition
Saving behaviours and inability to discard
Difficulty organising
Complexity in decision making
Attachment to itemsPerfectionism (including over attentionto detail)Avoidance (anxiety)Trust issues
Lack of insight doesn’t see the problem
Absence of distress (until asked to discard)
Justification e.g. the place is too small, I don’t have time to organiseSource: Boodman, 2000; Claiborn, 2009
Psychological Reasons include:  Eating Disorders (Mainly Food)
Obsessive Compulsive Personality Disorder (OCPD)Traumatic life events linked
to onset, severity of trauma correlates to the severity of the hoarding behavioursComorbid with many other physical and psychological disordersMaterial deprivation not found to be a driverSource: Singh (2012), Mataix-Cols (2012)

 

How?

Compulsive Acquisition

  • Compulsive buying (usually considered an impulse control disorder)
  • Acquiring free things, such as extra newspapers, advertisements, promotional give-aways, and discarded items from street trash or dumpsters
  • Less frequently, acquisition includes stealing and kleptomania (about 10%)
  • Often associated with positive feelings and even euphoria, which reinforce the behaviour and make it difficult to curtail
  • Sometimes associated with dissociated states and may be used to soothe negative moods

Source: Frost, Steketee, 2007

Failure to Discard

  • Sentimental (emotional), instrumental (useful), or intrinsic (aesthetic) value in excess of their worth in most people’s eyes:
    • If I discard this, I will lose the memory
    • This may come in handy later
    • This may gain in value
    • Rescuing
    • This object is a part of me
    • Family ties
    • Safety (feeling of safety as a result of clutter)
    • Process time-consuming and complicated and the number of newly acquired items exceeds removed ones, so the home gradually fills with things.

Source: Frost, Steketee, 2007/Mataix-Cols, 2012

 

What is Hoarding Disorder?

This text is taken directly from research undertaken by Megan Karnes and cannot be used without consent.  Citation information is available upon request.

Approximately seventy species of animals hoard food in order to ensure survival. Studies show that humans and animals share same the subcortial region in the brain that drives this instinct. Although the ancient Greeks recognised compulsive collecting the word hoarding was not used to describe human behaviour until the 1960’s by Bolman and Katz. Frost and Steketee define a person who hoards as a person who collects but fails to discard possessions that appear to have little or no value, whose living space becomes unfit for purpose and who experiences ‘distress or impairment’ in functioning as a result of the clutter.

In the context of hoarding even clinical evidence does not allow for a simple discussion. While now considered more than a personal eccentricity, it only became recognised as a disorder in its own right with the publication of DSM V in 2013. Instead it was previously listed in the DSM IV TR as one of the diagnostic criteria for Obsessive-Compulsive Personality Disorder (OCPD). This criterion was based on Freud’s theory of anal fixation, although that rationale is no longer considered valid. The OCPD criterion is often disputed. More commonly hoarding is discussed as a manifestation of Obsessive Compulsive Disorder (OCD), but recent research reveals that hoarding is often, but not always, found with OCD. Comorbidity has been found with schizophrenia, eating disorders, brain injury, dementia, social phobia, depression, psychosis, Pica, Prader-Willi syndrome, and Alzheimer’s, etc.  In fact 92% of people who hoard have at least one other mental health disorder. ‘Diogenes Syndrome’ also involves hoarding but includes self-neglect and squalor. Chromosomal links, frontal lobe damage and brain dysfunction have been cited as potential biological causes.

While these facts pointedly expose the lack of clarity amongst researchers about what causes and how to classify hoarding, Professor Paul Salkovskis succinctly states “Knowing which area of the brain is affected does not help you in treatment one little bit.”

Most people collect something at various points in their lives clinical evidence shows we still know very little about the behaviour.

Problematic hoarders can be of any age, sex or socio-economic group. They often, but not always, live alone, and lead isolated lives, although some have partners and/or children, who can also be adversely affected.

Collected items include papers, packaging, films, clothing, furniture and crockery, electrical items, tools, new items, animals, human waste and anything else.

‘An Introduction to Hoarding’ a man discusses the impact of his wife’s hoarding on his life. “I buried my wife yesterday… After fifty years of marriage, her dying words to me were not ‘I love you.’ They were ‘Don’t touch my stuff…What could I have done that might have made things different?’”

Hoarding UK is determined to become a proactive part of finding that answer.

We are able to write letters, make calls and work to bring professionals and people who
deal with hoarding behaviours to find a way forward.  Please get in touch by letter, phone or email.

HoardingUK
Davina House
137-149 Goswell Road
London EC1V 7ET

T: 020 3239 1600

Office hours:  10:00-17:00 Monday-Friday