Hoarding Disorder

Question 1

What is the diagnostic criteria for hoarding disorder?

Answer 1

A. Persistent difficulty discarding or parting with possessions, regardless of their actual value.
B. This difficulty is due to a perceived need to save the items and to distress associated with discarding them.
C. The difficulty discarding possessions results in the accumulations of possessions that congest and clutter active living areas and substantially compromises their intended use. If living areas are uncluttered, it is only because of the interventions of third parties (e.g., family members, cleaners, authorities)
D. The hoarding causes clinically significant distress or impairment in social, occupational or other important areas of functioning (including maintaining a safe environment for self and others)
E. the hoarding is not attributable to another medical condition
F. The hoarding is not better explained by the symptoms of another mental disorder

Question 2

What are the Hoarding disorder specifiers?

Answer 2

Specify if:
- 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
Specify if:
- With good or fair insight: the individual recognizes that hoarding-related beliefs and behaviours (pertaining to difficulty discarding items, clutter or excessive acquisition) are problematic
- with poor insight: the individual is mostly convinced that hoarding related beliefs and behaviours are not problematic despite evidence to the contrary
- With Absent insight/delusional beliefs: the individual is completely convinced that hoarding-related beliefs and behaviours are not problematic despite evidence to the contrary

Question 3

How did Frost and Gross (1993) define hoarding?

Answer 3

defined hoarding as “the acquisition of and the failure to discard”.

Question 4

Is hoarding a western problem?

Answer 4

• Hoarding is a world-wide phenomenon.

Question 5

What age range is hoarding typically associated with?

Answer 5

Hoarding disorder is associated with old age.

Question 6

What is the prevalence of hoarding disorder?

Answer 6

Prevalence is estimated at 2%- 5%, twice as prevalent as OCD

Question 7

What is the etiology of hoarding disorder from a cognitive perspective?

Answer 7

• faulty information processing (i.e., distractibility and difficulty thinking about categories),
• erroneous cognitions about the importance and meaning of possessions,
• and misguided attachments with objects to seemingly compensate for emotional deficits in attachment to people.

Question 8

What is cognitive behavioural therapy for hoarding disorder?

Answer 8

• Previous studies of CBT for OCD found that those who also had hoarding symptoms showed poorer responses.
• Uses exposure aimed at not acquiring items as well as discarding items
• Cognitive restructuring targets beliefs that are problematic for hoarding.
• Skills training which focuses on organizing, problem solving, and making decisions.
• Motivational interviewing techniques for ambivalence
• Finally, the therapist makes home visit for more intensive exposure, lasting hours for some clients with severe hoarding

Question 9

Is hoarding genetic?

Answer 9

• Genetic and moderate non-environmental correlations have been associated with difficulty parting with items and excessive acquisition of items.