Transcript Compulsive Hoarding

Compulsive Hoarding
Barbara J. Chromy
Definition of Hoarding
• No consistent definition of hoarding
• The term is used in different clinical and
non-clinical contexts to describe a broad
spectrum of behavioral abnormities
(Maier, 2004)
Commonly Accepted Definition
1. The acquisition
of, and failure to
discard, a large
number of
possessions
that appear to
be of useless or
limited value
Definition (continued)
2. Living spaces
sufficiently cluttered
so as to preclude
activities for which
those spaces were
designed
Definition (continued)
3. Significant distress
or impairment in
functioning cause
by the hoarding
(Frost, Hartl, & Gross)
Types of Hoarding
• Scarcity Mentality Hoarder
– “What if the depression returns?”
• Frugality Mentality Hoarder
– Nothing should be wasted
• Frozen Indecision Hoarder
– Finds no decision easy
(NSGCD, 2003)
Types of Hoarding (continued)
• Ordinary Hoarders
– Primarily objects
• Animal Hoarders
– Can have in excess of 300 animals in a
home
• Trash Hoarders
– Syllogomania
Types of Hoarding (continued)
• Animal Hoarding
Animal Hoarding Defined
• HSUS defines an animal hoarder as a
person who has more animals than he or
she can properly care for
• A defining characteristic of animal
hoarders is their refusal to acknowledge
their inability to care for the number of
animals they have accumulated
(Simmons, 2006)
Causes
• Little is known
about onset
and course of
compulsive
hoarding
Grisham, Frost, Steketee,
Kim and Hood (2006)
Prevalence
• 1.4 to 2 million people in the United States have
compulsive hoarding syndrome
(Maidment, 2005; Collingwood, 2006).
• Hoarding accompanies OCD in 25% to 40% of
individuals diagnosed
(Understanding Hoarding, 2005; Seedat and Stein, 2002).
• 2-3% of the general population has OCD and up
to one-third of those diagnosed with OCD exhibit
hoarding behavior
(Cohen, 2004; Haggerty, 2006).
Co-morbidity
•
•
•
•
•
Anorexia nervosa
Bipolar disorder
Dementia
Depression
Impulse control
disorders
– Such as compulsive
buying or gambling
• Social phobia
• Obsessivecompulsive disorder
• Personality disorders
• Schizophrenia
• Diogenes syndrome
• Prader-Willi syndrome
• Head injury
• Autism
Hoarding Dangers
• Health hazards
• Injury
• Isolation
Impact on Elderly
• Compulsive hoarding is known to co-exist
with both dementia and Diogenes
syndrome; two conditions that are
correlated with age
• Compulsive hoarders are more likely to be
socially isolated, live alone, and to be
female
Impact on Elderly (continued)
• Hoarding medications is not uncommon
among the elderly who have many ways to
obtain drugs
(MacIsaac & Bartus Adamson, 1989)
Treatment
• No known ‘cure’ for compulsive hoarding
(Understanding Hoarding, 2005)
• Traditional treatments for OCD have not
proven to be effective with compulsive
hoarders
(Saxena and Maidment, 2004)
Treatment (continued)
• Intensive multimodal treatment found
effective in pilot studies following a course
of up to one year
• This treatment focused on the following
areas 1) discarding; 2) organizing; 3)
preventing incoming clutter; and 4)
introducing alternative behaviors
•
(Saxena & Maidment, 2004)
Applications
• Educators need to bring educational programs
about hoarding to their communities
• Need to spearhead or gain access to community
hoarding task forces to protect the interest of
older adults
• Research how hoarding manifest itself in the
elderly, the special concerns of elderly hoarders,
and effective treatment protocols for older
hoarders
Conclusion
• Compulsive hoarding is a devastating
disorder that is not well understood and is
difficult to treat
• Prevalence rates are unclear and the
causes have not been identified
• Early intervention is essential
References
• Maier, T. (2004). On phenomenology and classification of hoarding:
A review. Acta Psychiatr Scand, 110, 323-337.
• Frost, R.O., & Gross, R.C. (1993). The hoarding of possessions.
Behavioral Research and Therapy, 31, 367-381.
• Frost, R.O., & Hartl, T. (1996). A cognitive-behavioral model of
compulsive hoarding.
• Behavioral Research and Therapy, 34(4), 341-350.
• National Study Group on Chronic Disorganizations (NSGCD).
(2003). Types of hoarding: Different perspective [fact Sheet 02 3-03],
1-2. Retrieved from www.nsgcd.org.
• Simmons, R. (2006). Behind closed doors: The horrors of animal
hoarding. The Humane Society of the United States. Retrieved
11.27/06 from
http://www.hsus.org/pets/issues_affecting_our_pets/behind_closed_
doors_the_horrors_of_animal_hoarding.html.
References (continued)
• Grisham, J.R., Frost, R.O., Steketee, G., Kim, H. & Hood, S.
(2006). Age of onset of compulsive hoarding. Journal of
Anxiety Disorders, 20, 675-686.
• Cohen, J. (2004). The danger of hoarding. USA Today;
2/19/04 [Electronic version].
• Haggerty, J. (2006). The impact of obsessive-compulsive
disorder. Psychcentral.com, retrieved 11/27/06 from
http://psychcentral.com/lib/2006/02/the-impact-of-obsessivecompulsive-disorder/.
• MacIsaac, A.M., & Bartus Adamson, C. (1989). Multiple
Medications: Is your elderly patient caught in the storm?
Nursing, July, 60-64.
• Saxena, S. & Maidment, M. (2004). Treatment of compulsive
hoarding. JCLP/In Session, 60, 1143-1154.