Compulsive hoarding - Wikipedia

Compulsive hoarding, also known as hoarding disorder, is a clinically recognised mental health condition (ICD-11, 2018). The disorder is characterised by ... Compulsivehoarding FromWikipedia,thefreeencyclopedia Jumptonavigation Jumptosearch Behavioralpattern MedicalconditionCompulsivehoardingOthernamesHoardingdisorderCompulsivehoardinginanapartmentSpecialtyPsychiatry,clinicalpsychologyUsualonsetAges11–15[1]DurationChronic[2]CausesNotclear,possiblygenetic,andstressfullifeexperiences[1]RiskfactorsTraumaticevents[3]DiagnosticmethodICD-10-CMCodeF42.3TreatmentPsychotherapy[4]PrognosisProgressive[2]FrequencyUK:2–5%ofpopulationUS:Upto6%[5]GER:c.1.8million[6] Compulsivehoarding,alsoknownashoardingdisorder,isaclinicallyrecognisedmentalhealthcondition(ICD-11,2018).Thedisorderischaracterisedbyaccumulationofpossessionsduetoexcessiveacquisitionofordifficultydiscardingpossessions,regardlessoftheiractualvalue.Excessiveacquisitionischaracterizedbyrepetitiveurgesorbehavioursrelatedtoamassingorbuyingitems.Difficultydiscardingpossessionsischaracterizedbyaperceivedneedtosaveitemsanddistressassociatedwithdiscardingthem.Accumulationofpossessionsresultsinlivingspacesbecomingclutteredtothepointthattheiruseorsafetyiscompromised.Thesymptomsresultinsignificantdistressorsignificantimpairmentinpersonal,family,social,educational,occupationalorotherimportantareasoffunctioning.[7] Prevalenceratesareestimatedat2%to5%inadults,[8]thoughtheconditiontypicallymanifestsinchildhoodwithsymptomsworseninginadvancedage,atwhichpointcollecteditemshavegrownexcessiveandfamilymemberswhowouldotherwisehelptomaintainandcontrolthelevelsofclutterhaveeitherdiedormovedaway.[9] Peoplewithhoardingdisordercommonlylivewithothercomplexand/orpsychologicaldisorderssuchasdepression,anxietyandattentiondeficithyperactivitydisorder(ADHD).[10]Otherfactorsoftenassociatedwithhoardingincludealcoholdependenceandparanoid,schizotypalandavoidancetraits.[11] Contents 1Diagnosis 2ClutterImageRating 3Studies 3.1Differentialdiagnosis 4Treatment 5Inpopularculture 6Seealso 7References 8Furtherreading 9Externallinks Diagnosis[edit] TheDSM-5diagnosticcriteriaforhoardingdisorder[12]are: A.Persistentdifficultydiscardingorpartingwithpossessions,regardlessoftheiractualvalue. B.Thisdifficultyisduetoaperceivedneedtosavetheitemsanddistressassociatedwithdiscardingthem. C.Thedifficultydiscardingpossessionsresultsintheaccumulationofpossessionsthatcongestandclutteractivelivingareasandsubstantiallycompromisestheirintendeduse.Iflivingareasareuncluttered,itisonlybecauseoftheinterventionsofthirdparties(e.g.,familymembers,cleaners,authorities). D.Thehoardingcausesclinicallysignificantdistressorimpairmentinsocial,occupational,orotherimportantareasoffunctioning(includingmaintainingasafeenvironmentforselfandothers). E.Thehoardingisnotattributabletoanothermedicalcondition(e.g.,braininjury,cerebrovasculardisease,Prader-Willisyndrome). F.Thehoardingisnotbetterexplainedbythesymptomsofanothermentaldisorder(e.g.,obsessionsinobsessive-compulsivedisorder,decreasedenergyinmajordepressivedisorder,delusionsinschizophreniaoranotherpsychoticdisorder,cognitivedeficitsinmajorneurocognitivedisorder,restrictedinterestsinautismspectrumdisorder). ClutterImageRating[edit] AUKcharity,HoardingUK,hasfoundthatpeoplehaveverydifferentideasaboutwhatitmeanstohaveaclutteredhome.Forsome,asmallpileofthingsinthecornerofanotherwisewell-orderedroomconstitutesseriousclutter.Forothers,onlywhenthenarrowpathwaysmakeithardtogetthrougharoomdoestheclutterregister.Toensureanaccuratesenseofaclutterproblem,theycreatedtheClutterImageRating,aseriesofpicturesofroomsinvariousstagesofclutter–fromcompletelyclutter-freetoveryseverelycluttereddesignedtoencouragepeopletogetsupport. Studies[edit] 751peoplewerechosenforastudy[13]inwhichpeopleself-reportedtheirhoardingbehavior.Oftheseindividuals,mostreportedtheonsetoftheirhoardingsymptomsbetweentheagesof11and20yearsold,with70%reportingthebehaviorsbeforetheageof21.Fewerthan4%ofpeoplereportedtheonsetoftheirsymptomsaftertheageof40.Thedatashowsthatcompulsivehoardingusuallybeginsearly,butoftendoesnotbecomemoreprominentuntilafterage40.Differentreasonshavebeengivenforthis,suchastheeffectsoffamilypresenceearlierinlifeandlimitsonhoardingimposedbyhousingsituationandlifestyle.Theunderstandingofearlyonsethoardingbehaviormayhelpinthefuturetobetterdistinguishhoardingbehaviorfrom“normal”childhoodcollectingbehaviors. Asecondkeypartofthisstudywastodetermineifstressfullifeeventsarelinkedtotheonsetofhoardingsymptoms.Similartoself-harming,traumatizedpersonsmaycreateaproblemforthemselvesinordertoavoidtheirrealanxietyortrauma.Facingtheirrealissuesmaybetoodifficultforthem,sotheycreateanartificialproblem(intheircase,hoarding)andprefertobattlewithitratherthandetermine,face,ordosomethingabouttheirrealanxieties.Hoardersmaysuppresstheirpsychologicalpainbyhoarding.Thestudyshowsthatadultswhohoardreportagreaterlifetimeincidenceofhavingpossessionstakenbyforce,forcedsexualactivityaseitheranadultorachild,includingforcedsexualintercourse,andbeingphysicallyhandledroughlyduringchildhood,thusprovingtraumaticeventsarepositivelycorrelatedwiththeseverityofhoarding.Foreachfiveyearsoflifetheparticipantwouldratefrom1to4,4beingthemostsevere,theseverityoftheirhoardingsymptoms.Oftheparticipants,548reportedachroniccourse,159anincreasingcourseand39people,adecreasingcourseofillness.Theincidentsofincreasedhoardingbehaviorwereusuallycorrelatedtofivecategoriesofstressfullifeevents.[13] Althoughexcessiveacquiringisnotadiagnosticcriterionofhoarding,atleasttwo-thirdsofindividualswithhoardingdisorderexcessivelyacquirepossessions.[14]Havingamoreanxiouslyattachedinterpersonalstyleisassociatedwithmorecompulsivebuyingandgreateracquisitionoffreeitemsandtheserelationshipsaremediatedbystrongerdistressintoleranceandgreateranthropomorphism.[15]Anthropomorphismhasbeenshowntoincreaseboththesentimentalvalueandperceivedutilityofitems.[16]Thesefindingsindicatethatindividualsmayover-valuetheirpossessionstocompensateforthwartedinterpersonalneeds.Feelingaloneand/ordisconnectedfromothersmayimpairpeople'sabilitytotoleratedistressandincreasepeople'stendenciestoseehuman-likequalitiesinobjects.Thehumannessofitemsmayincreasetheirperceivedvalueandindividualsmayacquirethesevaluedobjectstoalleviatedistress.Individualswithhoardingproblemshavebeenshowntohavegreaterinterpersonalproblemsthanindividualswhoonlyexcessivelyacquirepossessions,[17]whichprovidessomesupportfortheassumptionthatindividualswithhoardingproblemsmayhaveastrongermotivationtohangontopossessionsforsupport.Aspossessionscannotprovidesupportinthewayhumanscanandbecausesavingexcessivelycanfrustrateotherpeopleduetoitsimpactontheirqualityoflife,individualswithhoardingdisordermaybecaughtinafeedbackloop.Theymaysavetoalleviatedistress,butthissavingmaycausedistress,whichmayleadthemtokeepsavingtoalleviatethedistress. Differentialdiagnosis[edit] Collectingandhoardingmayseemsimilar,buttherearedistinctcharacteristicsbetweenhoardersandcollectorsthatsetthemapart.Collectingofteninvolvesthetargetedsearchandacquisitionofspecificitemsthatform—atleastfromtheperspectiveofthecollector—agreaterappreciation,deeperunderstanding,orincreasedsynergisticvaluewhencombinedwithothersimilaritems.Hoarding,bycontrast,appearshaphazardandinvolvestheoverallacquiringofcommonitemsthatshouldnotbeespeciallymeaningfultothepersonwhoisgatheringsuchitemsinlargequantities.[18][19]Peoplewhohoardcommonlykeepitemsthatholdlittletonotruemeaningorvaluetomostothers,unlikesomecollectors,whoseitemsmaybeofgreatvaluetoselectpeople.Mosthoardersaredisorganized,andtheirlivingareasarecrowdedandindisarray.Mostcollectorscanaffordtostoretheiritemssystematicallyorhaveenoughroomtoputtheircollectionsondisplay.[20]Therehavebeenonoccasioncollectorswhobecauseoftheirage,mentalstate,orfinanceshavehadtheircollectionsfallintoahoardingstate.[21] Treatment[edit] Only5%ofpeoplewithhoardingbehavioursreceivehelp(Singh,2012)andtheinterventionstheydoreceivefocusonclearingitems,nottreatingthedisorder. Cognitive-behavioraltherapy(CBT)isacommonlyimplementedtherapeuticinterventionforcompulsivehoarding.Aspartofcognitivebehaviortherapy,thetherapistmayhelpthepatientto: Discoverwhyoneiscompelledtohoard. Learntoorganizepossessionsinordertodecidewhattodiscard. Developdecision-makingskills. Declutterthehomeduringin-homevisitsbyatherapistorprofessionalorganizer. Gainandperformrelaxationskills. Attendfamilyand/orgrouptherapy. Beopentotryingpsychiatrichospitalizationifthehoardingisserious. Haveperiodicvisitsandconsultationstokeepahealthylifestyle.[22] Thismodalityoftreatmentusuallyinvolvesexposureandresponsepreventiontosituationsthatcauseanxietyandcognitiverestructuringofbeliefsrelatedtohoarding.Furthermore,researchhasalsoshownthatcertainCBTprotocolshavebeenmoreeffectiveintreatmentthanothers.CBTprogramsthatspecificallyaddressthemotivationoftheaffectedperson,organization,acquiringnewclutter,andremovingcurrentclutterfromthehomehaveshownpromisingresults.Thistypeoftreatmenttypicallyinvolvesin-homeworkwithatherapistcombinedwithbetween-sessionhomework,thecompletionofwhichisassociatedwithbettertreatmentoutcomes.[23]Researchoninternet-basedCBTtreatmentsforthedisorder(whereparticipantshaveaccesstoeducationalresources,cognitivestrategies,andchatgroups)hasalsoshownpromisingresultsbothintermsofshort-andlong-termrecovery.[24] Othertherapeuticapproachesthathavebeenfoundtobehelpful: Motivationalinterviewingoriginatedinaddictiontherapy.Thismethodissignificantlyhelpfulwhenusedinhoardingcasesinwhichinsightispoorandambivalencetochangeismarked.[25][26] Harmreductionratherthansymptomreduction.Alsoborrowedfromaddictiontherapy.Thegoalistodecreasetheharmfulimplicationsofthebehavior,ratherthanthehoardingbehaviors.[26] Grouppsychotherapyreducessocialisolationandsocialanxietyandiscost-effectivecomparedtoone-on-oneintervention.[27]GroupCBTtendstohavesimilaroutcomestoindividualtherapy.[28]Althoughgrouptreatmentoftendoesnotincludehomesessions,experimentalresearchsuggeststhattreatmentoutcomesmaybeimprovedifhomesessionsareincluded.Individualshavebeenshowntodiscardmorepossessionswheninaclutteredenvironmentcomparedtoatidyenvironment.[29]Indeed,ameta-analysisfoundthatagreaternumberofhomesessionsimprovesCBToutcomes.[30] Individualswithhoardingbehaviorsareoftendescribedashavinglowmotivationandpoorcompliancelevels,andasbeingindecisiveandprocrastinators,whichmayfrequentlyleadtoprematuretermination(i.e.,dropout)orlowresponsetotreatment.[27][31]Therefore,itwassuggestedthatfuturetreatmentapproaches,andpharmacotherapyinparticular,bedirectedtoaddresstheunderlyingmechanismsofcognitiveimpairmentsdemonstratedbyindividualswithhoardingsymptoms.[32] Mentalhealthprofessionalsfrequentlyexpressfrustrationregardinghoardingcases,mostlyduetoprematureterminationandpoorresponsetotreatment.Patientsarefrequentlydescribedasindecisive,procrastinators,recalcitrant,andashavinglowornomotivation,[27][33]whichcanexplainwhymanyinterventionsfailtoaccomplishsignificantresults.Toovercomethisobstacle,somecliniciansrecommendaccompanyingindividualtherapywithhomevisitstohelptheclinician:Getabetterinsightintothehoardingseverityandstyle.Deviseatreatmentplanthatismoresuitabletotheparticularcase.Desensitizeaffectedpatientstovisitors.[34] Likewise,certaincasesareassistedbyprofessionalorganizersaswell. Inpopularculture[edit] Maguire,Emily:LoveObjects(2021),Allen&Unwin,ISBN 9781760878337[35] Seealso[edit] Bibliomania ClutterersAnonymous Compulsivebehavior Compulsivedecluttering Digitalhoarding Diogenessyndrome Dunning–Krugereffect Fear Greed Hoarding Impulsecontroldisorder Obsessive–compulsivespectrum Obsessive–compulsivepersonalitydisorder Simpleliving Survivalism Hoarders AlexanderKennedyMiller,hoardedabout30Stutzautomobiles(1906–1993) Collyerbrothers,HomerCollyer(1881–1947)andLangleyCollyer(1885–1947) EdmundTrebus(1918–2002),participatedinTVdocumentary References[edit] ^ab"Hoardingdisorder–Symptomsandcauses".MayoClinic.Retrieved17March2019. ^abGrisham,JessicaR.;Frost,RandyO.;Steketee,Gail;Kim,Hyo-Jin;Hood,Sarah(2006)."Ageofonsetofcompulsivehoarding".JournalofAnxietyDisorders.20(5):675–686.doi:10.1016/j.janxdis.2005.07.004.PMID 16112837. ^Cromer,KiaraR.;Schmidt,NormanB.;Murphy,DennisL.(1November2007)."Dotraumaticeventsinfluencetheclinicalexpressionofcompulsivehoarding?".BehaviourResearchandTherapy.45(11):2581–2592.doi:10.1016/j.brat.2007.06.005.PMID 17673166. ^"Hoardingdisorder–Diagnosisandtreatment–MayoClinic".www.mayoclinic.org. ^Solovitch,Sara(April11,2016)."Hoardingisaseriousdisorder–andit'sonlygettingworseintheU.S."TheWashingtonPost.Retrieved17March2019. ^"Messie-Syndrom:LöcherinderSeelestopfen".September2002.Retrieved27May2022. ^"ClinicalClassificationofHoardingDisorder|OCD-UK".Retrieved2021-10-01. ^PertusaA.,FrostR.O.,FullanaM.A.,SamuelsJ.,SteketeeG.,TolinD.,SaxenaS.,LeckmanJ.F.,Mataix-ColsD.(2010)."Refiningtheboundariesofcompulsivehoarding:Areview".ClinicalPsychologyReview.30(4):371–386.doi:10.1016/j.cpr.2010.01.007.PMID 20189280.{{citejournal}}:CS1maint:multiplenames:authorslist(link) ^AyersCR,SaxenaS,GolshanS,WetherellJL(2014-01-24)."Ageatonsetandclinicalfeaturesoflatelifecompulsivehoarding".IntJGeriatrPsychiatry.25(2):142–149.doi:10.1002/gps.2310.PMC 4083761.PMID 19548272. ^"HoardingDefinition–DiseasesandConditions".MayoClinic.2011-05-25.Archivedfromtheoriginalon2013-10-24.Retrieved2014-05-01. ^SamuelsJ.F.;BienvenuO.J.;GradosM.A.;CullenB.;RiddleM.A.;LiangK.;EatonW.W.;NestadtG.(2008)."Prevalenceandcorrelatesofhoardingbehaviorinacommunity-basedsample".BehaviourResearchandTherapy.46(7):836–844.doi:10.1016/j.brat.2008.04.004.PMC 2483957.PMID 18495084. ^"F02HoardingDisorder".dsm5.org.AmericanPsychiatricAssociation.Retrieved7May2018. ^abTolinDavidF.;MeunierSuzanneA.;FrostRandyO.;SteketeeGail(2010)."Courseofcompulsivehoardinganditsrelationshiptolifeevents".DepressionandAnxiety.27(9):829–838.doi:10.1002/da.20684.PMID 20336803.S2CID 429636. ^Frost,R.O.;Steketee,G.;Tolin,D.F.(2011)."Comorbidityinhoardingdisorder".DepressionandAnxiety.28(10):876–884.doi:10.1002/da.20861.PMC 3188689.PMID 21770000. ^Norberg,M.M.;Crone,C.;Kwok,C.;Grisham,J.R.(2018)."Anxiousattachmentandexcessiveacquisition:Themediatingrolesofanthropomorphismanddistressintolerance".JournalofBehavioralAddictions.7(1):171–180.doi:10.1556/2006.7.2018.08.PMC 6035017.PMID 29444605. ^Kwok,C.;Grisham,J.R.;Norberg,M.M.(2018)."Objectattachment:Humannessincreasessentimentalandinstrumentalvalues".JournalofBehavioralAddictions.7(4):1132–1142.doi:10.1556/2006.7.2018.98.PMC 6376393.PMID 30311771. ^Norberg,MelissaM.;Kwok,Cathy;Crone,Cassandra;David,Jonathan;Kakar,Vani;Grisham,JessicaR.(2020)."Greaterinterpersonalproblemsdifferentiatethosewhoexcessivelyacquireandsavefromthosewhoonlyexcessivelyacquirepossessions".JournalofObsessive-CompulsiveandRelatedDisorders.27:100571.doi:10.1016/j.jocrd.2020.100571.S2CID 225342060. ^"HoardingDisorder".AmericanPsychiatricAssociation.Archivedfromtheoriginalon2014-10-23.Retrieved2014-10-30. ^Neziroglu,Fugen."Hoarding:TheBasics".ADAA.ArchivedfromtheoriginalonOctober31,2014.RetrievedOctober30,2014. ^"HoardingDisorder".psychiarty.org.AmericanPsychiatricAssociation.Archivedfromtheoriginalon21December2014.Retrieved11December2014. ^"Fabulous60carstashfoundinFrenchbarn".onlymotors.com.2014-12-05.Archivedfromtheoriginalon2015-06-11. ^Roger,HarmsW."Definition".MayoClinic.MayoFoundationforMedicalEducationandResearch,25May2011.Web.21Mar.2012. ^TolinD.F.;FrostR.O.;SteketeeG.(2007)."Anopentrialofcognitive-behavioraltherapyforcompulsivehoarding".BehaviourResearchandTherapy.45(7):1461–1470.doi:10.1016/j.brat.2007.01.001.PMC 1950337.PMID 17306221. ^MuroffJ.;SteketeeG.;HimleJ.;FrostR.(2010)."Deliveryofinternettreatmentforcompulsivehoarding(D.I.T.C.H.)".BehaviourResearchandTherapy.48(1):79–85.doi:10.1016/j.brat.2009.09.006.PMID 19800051. ^Gilliam,C.M.;Tolin(2010)."CompulsiveHoarding".BulletinoftheMenningerClinic.74(2):93–121.doi:10.1521/bumc.2010.74.2.93.PMID 20545491. ^abTolin,D.F.(2011)."Challengesandadvancesintreatinghoarding".JournalofClinicalPsychology:InSession.67(5):451–455.doi:10.1002/jclp.20796.PMID 21374598. ^abcFrost,R.O.(2010)."Treatmentofhoarding".ExpertReviewofNeurotherapeutics.10(2):251–261.doi:10.1586/ern.09.159.PMID 20136381.S2CID 21169686. ^Gilliam,C.M.;Norberg,M.M.;Villavicencio,A.;Morrison,S.;Hannan,S.E.;Tolin,D.F.(2011)."Groupcognitive-behavioraltherapyforhoardingdisorder:Anopentrial".BehaviourResearchandTherapy.49(11):802–807.doi:10.1016/j.brat.2011.08.008.PMID 21925643. ^Crone,C.;Norberg,M.M.(2018)."Scaredandsurroundedbyclutter:Theinfluenceofemotionalreactivity".JournalofAffectiveDisorders.235:285–292.doi:10.1016/j.jad.2018.04.066.PMID 29660644.S2CID 4945691. ^Tolin,D.F.;Frost,R.O.;Steketee,G.;Muroff,J.(2015)."Cognitivebehavioraltherapyforhoardingdisorder:ameta-analysis".DepressionandAnxiety.32(3):158–166.doi:10.1002/da.22327.PMID 25639467.S2CID 205736485. ^Tolin,D.F.(2011)."Understandingandtreatinghoarding:Abiopsychologicalperspective".JournalofClinicalPsychology:InSession.67(5):517–526.doi:10.1002/jclp.20795.PMID 21360705. ^Saxena,S.(2011)."PharmacotherapyofCompulsiveHoarding".JournalofClinicalPsychology:InSession.67(5):477–484.doi:10.1002/jclp.20792.PMID 21404273. ^Tolin,D.F.(2011)."Understandingandtreatinghoarding:Abiopsychosocialperspective".JournalofClinicalPsychology:InSession.67(5):451–455.doi:10.1002/jclp.20795.PMID 21360705. ^Frost,R.O.;Hristova,V.(2011)."Assessmentofhoarding".JournalofClinicalPsychology:InSession.67(5):456–466.doi:10.1002/jclp.20790.PMID 21351103. ^Baum,Caroline(1April2021)."Aswestockpilewealth,toiletpaper,novelistgivesvoicetoa'hoarder'".TheSydneyMorningHerald.{{citenews}}:CS1maint:url-status(link) Furtherreading[edit] Frost,RandyO.&Steketee,Gail(2011).Stuff:CompulsiveHoardingandtheMeaningofThings.MarinerBooks.{{citebook}}:CS1maint:usesauthorsparameter(link)[ISBN missing] Herring,Scott(2014).TheHoarders:MaterialDevianceinModernAmericanCulture.Chicago,IL:UniversityofChicagoPress.[ISBN missing] Mapes,DianeMapes."Engulfedinclutter,hoarderskeepheapingiton".NBCNews.ArticlediscussingthedisorderanditsrelationshiptoOCD. Sholl,Jessie(2010).DirtySecret:ADaughterComesCleanAboutHerMother'sCompulsiveHoarding.NewYork:Simon&Schuster/GalleryBooks.[ISBN missing] Externallinks[edit] WikimediaCommonshasmediarelatedtoCompulsivehoarding. "Measuring".SqualorSurvivors. 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