Transcript The Complexity of a Hoarder - Center for State Policy and

The Complexity of a Hoarder
Wyvonnia W. Walker, MA, GRPA
The Complexity of a Hoarder
▪ What is a Hoarder as defined by the DSM V.
▪ Am I a Hoarder?
▪ What I should know about Hoarding.
▪ How can we help?
▪ Resources
The Complexity of a Hoarder
Hoarding Disorder
Diagnostic Criteria
A.
B.
C.
D.
E.
F.
300.3 (F42)
Persistent difficulty discarding or parting with possessions, regardless of their actual value.
This difficulty is due to a perceived need to save the items and to distress associated with
discarding them.
The difficulty discarding possessions results in the accumulation 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)
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 other).
The hoarding is not attributable to another medical condition (e.g., brain injury, cerebrovascular
disease, Prader-Willi syndrome).
The hoarding is not better explained by the symptoms of another mental disorder (e.g.,
obsessions in obsessive-compulsive disorder, decreased energy in major depressive disorder,
delusions in schizophrenia or another psychotic disorder, cognitive deficits in major
neurocognitive disorder, restricted interests in autism spectrum disorder).
The Complexity of a Hoarder
Collector or Hoarder?
Take our quiz and find out if your possessions are in control?
Take this quick quiz and find out if you are at risk for compulsive hoarding—the tendency to over-collect, along with an inability to organize and/or
get rid of items.
Print this page, circle the answers you most agree with, and score your quiz below.
1. I have difficulty using spaces in my home for their intended purpose (for example, eating at my kitchen table, sitting on my sofa to watch TV, or sleeping in my bed).
a. Never
b. Sometimes
c. Often/Always
2. Getting rid of my possessions—whether I'm throwing them out, donating them, or selling them—causes me distress and anxiety.
a. Never
b. Sometimes
c. Often/Always
3. I never pass up a freebie, even if I don't need it or have space for it.
a. Never
b. Sometimes
c. Often/Always
The Complexity of a Hoarder
Collector or Hoarder? Continue
4. I have duplicates of many things (for example, Italian cookbooks, scarves of the same color, similar toiletry items).
a. Never
b. Sometimes
c. Often/Always
5. I buy things I want, even if I can't afford it or don't have space to put it.
a. Never
b. Sometimes
c. Often/Always
6. My possessions are so disorganized that I often have a hard time finding what I am looking for.
a. Never
b. Sometimes
c. Often/Always
7. I avoid inviting people to my home because of the clutter.
a. Never
b. Sometimes
c. Often/Always
The Complexity of a Hoarder
Collector or Hoarder? Continue
8. I feel like I have no control over the clutter in my home; my possessions own me.
a. Never
b. Sometimes
c. Often/Always
9. My possessions are a source of family conflict.
a. Never
b. Sometimes
c. Often/Always
10. I notice that other people in my family (for example, a sister, mother, or uncle) have a lot of clutter as well.
a. Never
b. Sometimes
c. Often/Always
Score Your Quiz on Hoarding Behaviors
Give yourself 1 point for every A answer, two points for every B, and three points for
every C.
10 to 15 points means you are at low risk for hoarding. Congratulations; your
home is clutter-free. The rest of us envy you.
16 to 21 points puts you at medium risk for compulsive hoarding. Don't let
your possessions get the best of you! Organization may not be your strong suit, so try to
acquire less and recycle or donate items that you don't need or no longer use.
22 points or more means you are at high risk for compulsive hoarding. Your
possessions are very important to you, and though at times you feel like the clutter is
out of control, it's very difficult for you to throw things away. For more assistance on
how to get your collecting habit under control, visit The International OCD Foundation
Hoarding Center.
Source: This quiz was adapted from information from the International OCD
Foundation—Hoarding Center.
Publication Review By: the Editorial Staff at Healthcommunities.com
Published: 01 Nov 2010 Last Modified: 22 Aug 2012
The Complexity of a Hoarder
The Complexity of a Hoarder
Development and Course
▪ Hoarding appears to begin early in life and spans well into the late stages.
Hoarding symptoms may first emerge around ages 11-15 years, start interfering
with the individual’s everyday functioning by the mid -20s, and cause clinically
significant impairment by the mid- 30s. Participants in clinical research studies
are usually in their 50s. Thus, the severity of hoarding increases with each
decade of life. Once symptoms begin, the course of hoarding is often chronic,
with few individuals reporting a waxing and waning course.
▪ Pathological hoarding in children appears to be easily distinguished from
developmentally adaptive saving and collecting behaviors. Because children and
adolescents typically do not control their living environment and discarding
behaviors, the possible intervention of third parties (e.g., parents keeping the
spaces usable and thus reducing interference) should be considered when
making the diagnosis.
The Complexity of a Hoarder
Culture-Related Diagnostic Issues
While most of the research had been done in Western,
industrialized countries and urban communities, the available
data from non-Western and developing countries suggest that
hoarding is a universal phenomenon with consistent clinical
features.
Gender-Related Diagnostic Issues
The key features of hoarding disorder (i.e., difficulties
discarding, excessive amount of clutter) are generally
comparable in males and females, but females tend to display
more excessive acquisition, particularly excessive buying, than
do males.
The Complexity of a Hoarder
What can you do to help?
These are NOT solutions
1. Coercing a person into throwing away all of their possessions.
2.Forcing a person to move.
3. Going into a person home and throwing everything away.
4.Bullying/ intimidation
5. Refusing support
The Complexity of a Hoarder
Communication
▪ You must open as many clear lines of communication as possible.
▪ Both you and the person that you are trying to assist must listen to each other and
have no barriers in communication.
▪ You have to reframe from the following barriers of communication:
▪ Pre-judging
▪ Criticizing
▪ Power Struggles
▪ Minimizing
▪ Arguing
The Complexity of a Hoarder
Actively listening
▪ Giving your physical and mental attention
▪ Eye contact
▪ Paraphrasing
▪ Watching your tone
▪ Watching your body language
(minimizing your fears)
▪ Be in the moment
▪ Taking notes and or pictures (with
permission)
The Complexity of a Hoarder
1. Develop rapport
2. Family education and involvement
3. Multiple visits /Gain trust
The Complexity of a Hoarder
4. Remember that you can only assist
5. Allow the person to feel in control
6. Create a safe and secure place for the person
7. Seek additional help and supports
The Complexity of a Hoarder
8. Start small
The Complexity of a Hoarder
Normative collecting
does not produce
significant clutter,
distress, or impairment
typical of hoarding
disorder
The Complexity of a Hoarder
Common features of hoarding
disorder include
indecisiveness, perfectionism,
avoidance, procrastination,
difficulty planning and
organizing tasks
The Complexity of a Hoarder
Items or object
Hoarding
The Complexity of a Hoarder
What can you do to help?
Develop rapport
Multiple visits /Gain trust
Family education and involvement
Create a safe and secure place for the person
Seek additional help and supports
Allow the person to feel in control
Remember that you can only assist
Start small