Diagnostic Features
essential feature of hoarding disorder
The essential feature of hoarding disorder is persistent difficulty discarding or parting with possessions, regardless of their actual value
What are the four specifiers for Hoarding Disorder?
with excessive acquisition
with good or fair insight
with poor insight
with absent insight/delusional insight
common associated features of hoarding disorder
indecisiveness, perfectionism, avoidance, procrastination, difficulty planning and organizing tasks, and distractibility.
In cultural contexts in which a high value is placed on thrift and storing of possessions, ____________ should be the basis for the diagnosis.
presence of distress and functional impairment
Sam has been storing newspapers since as long as he can remember. Sam is concerned that he will need information from the newspapers in the future. Sam is not willing to part with the newspapers, however he has disclosed that his hoarding behavior is making it hard for him to cook and restricts him to his bedroom. Sam recognizes that his behaviors are problematic. What is the appropriate specifier for this scenario?
with good or fair insight
main reasons for difficulty in discarding/parting with possessions
- perceived utility or aesthetic value of the items
- strong sentimental attachment to the possessions.
- feeling responsible for the fate of their possessions
- Fear of losing important information are also common.
-Avoid being wasteful
with excessive acquisition
if difficulty discarding possessions is accompanied by excessive acquisition of items that are not needed or for which there is no available space
_________ may be a special manifestation of hoarding disorder. Many individuals who hoard animals also hoard inanimate objects.
animal hoarding
How does hoarding disorder affect basic activities?
accumulation and congestion of possessions inhibits moving through the house, cooking, cleaning, maintaining personal hygiene, and even sleeping.
Sam has been storing newspapers since as long as he can remember. He has accumulated stacks of newspapers that have now spilled over from the garage to the living room and kitchen. Sam is concerned that he will need information from the newspapers in the future. Sam is not willing to part with the newspapers, however he has disclosed that his hoarding behavior is making it hard for him to cook and restricts him to his bedroom. What active and peripheral areas does Sam's hoarding affect?
active - living room, kitchen
peripheral - garage
Individuals with hoarding disorder often accumulate large numbers of items that fill up and clutter active living areas to the point where __________________
their intended use is no longer possible
i.e. not be able to cook in the kitchen or sleep in bed
with good or fair insight
the individual recognizes that hoarding-related beliefs and behaviors are problematic
True or False. Hoarding disorder is more prevalent in women than men.
False.
In a meta-analysis of 12 studies across high-income countries no gender difference was identified. BUT this contrasts clinical samples which are predominantly women.
Quality of life implications for individuals with hoarding disorder
in addition to impaired essential activities in the house, hoarding puts individuals at risk for fire, falling, poor sanitation, and other health risks.
Noel has been diagnosed with hoarding disorder with books. Noel has no space left in any area of his house for more books, but he keeps accumulating books. What specifier best fits Noel's situation?
with excessive acquisition
Clutter
Clutter is defined as a large group of usually unrelated or marginally related objects piled together in a disorganized fashion in spaces designed for other purposes (e.g., tabletops, floor, hallway).
with poor insight
the individual is mostly convinced that hoarding-related beliefs and behaviors are not problematic despite evidence to the contrary
Onset of hoarding disorder
Hoarding appears to begin early in life and spans well into the late stages.
Hoarding symptoms may first emerge around ages 15–19 years with the severity of hoarding increases with age.
Socially, individuals with hoarding disorders __________.
have strained relationships with their family and often have conflicts with their neighbors.
Timothy is 21 years old. He has been diagnosed with hoarding disorder. Despite his family's interventions, Timothy does not think his hoarding is a problem at all. What specifier does Timothy fit?
with absent insight/delusional beliefs
Active vs peripheral areas
Active living space, such as bedroom, living room, kitchen. Peripheral areas, such as garages, attics, or basements, are sometimes cluttered in homes of individuals without hoarding disorder.
However, individuals with hoarding disorder often have possessions that spill beyond the active living areas and can occupy and impair the use of other spaces, such as vehicles, yards, the workplace, and friends’ and relatives’ houses.
with absent insight/delusional beliefs
the individual is completely convinced that hoarding related beliefs and behaviors are not problematic despite evidence to the contrary
environmental risk factors for hoarding disorders
Individuals with hoarding disorder often retrospectively report stressful and traumatic life events preceding the onset of the disorder or causing an exacerbation.
Legal concerns for those with hoarding disorder
a substantial proportion of individuals with severe hoarding disorder have been involved in legal eviction proceedings, and some have a history of eviction.
Lisa loves to shop, especially for handbags. Lisa was 15 when her parents gifted her her first handbag, before they passed away in a tragic car accident. Lisa still has that handbag. She organizes her handbags neatly and stores them in her closet, which has now become full. Lisa periodically discards or donates handbags she doesn't use anymore. Lisa does not find it useful to keep things she does not use and is happy to make space for her new purchases. Based on the information above, does Lisa qualify for hoarding disorder?
Lisa does NOT qualify for hoarding disorder. Lisa may have experienced a stressful life event that coincides with the beginning of her handbag collection. However, she does not have difficulty or experience distress when parting with her handbags. In addition, Lisa keeps her possessions organized and clutter-free. Finally, Lisa's handbags do not compromise active living areas or their intended use.