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Hoarding

Patel and Hughes (2019) reported on hoarding in an article in the Journal of Heath Service Psychology . I thought  that their reportage was interesting and worth sharing. After all, most of us like getting and keeping our stuff. However, like with many good things, going too far can bring trouble. About 5% of the population do go too far and show some level of hoarding, and 20% have undue problems with discarding possessions. Hoarding includes both excessive acquisition and reluctance to discard possessions.

These problems tend to worsen over time, therefore, with greater prevalence in older adults. Although the data is somewhat unclear, the prevalence also looks likely to be higher in men. The American Psychiatric Association (2013) has delineated certain diagnostic criteria, such as persistent reluctance or refusal to discard items, no matter their value, which is often objectively minimal. Another criterion is the need to save items to avoid the distress in parting from them. In addition, the accumulation has to compromise the living space.

Patel and Hughes (2019) report that the growing body of evidence supports the conclusion that the diagnosis of Hoarding Disorder is a distinct diagnosis. They propose that it arises from four psychological factors: organization problems, an unusually strong emotional attachment to objects, the avoidance of of the distress anticipated in getting rid of them, and some maladaptive beliefs about possessions. These beliefs, for example, may be that the objects may be needed in some undetermined future, fear of losing memories associated with them, and the exaggerated fear of wasting the objects if they are discarded. They mention other etiological  factors, such as genetics, executive dysfunction, and trauma.

Hoarding can bring intense anxiety about being overwhelmed. It also is likely to cause significant distress to family members, especially spouses. Important relationships can suffer. Psychotherapy can help, but more needs to be discovered to make treatment more immediately effective.and longer lasting.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th Ed.). Washington, DC: Author.

Patel, K. S., & Hughes, A. J. (2019). Assessment and treatment of hoarding behavior. Journal of Health Service Psychology, 45(1), 11-16.

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