'Hoarding Disorder': An "accumulated" problem in society
Blog written by the psychologists at Psinove. We explore topics related to psychology and psychotherapy, daily challenges, and reflections.
Considered an independent diagnosis by the "American Psychiatric Association" in 2013, 'Hoarding Disorder' is a clinical situation that deserves our attention due to the suffering it causes in people who suffer from it (and their respective families).
Because it is a situation that happens "behind closed doors", it ends up being a "hidden" pathology, but one that deserves more and more research to develop forms of intervention, considering that it ends up being a challenge for mental health and public health.
This text seeks to better understand this situation, its possible causes, implications and paths of action/intervention.
'Hoarding Disorder' is characterized by the (excessive) acquisition of unnecessary objects, disorganization and the persistent difficulty (with associated suffering) in getting rid of them (regardless of their real value). It can compromise habitability (obstruction, dumping), professional and social functionality (isolation) of the patient himself (and respective family), due to the suffering associated with discarding things/objects. On the other hand, so much accumulation can also entail other dangers (falls, accidents, fires) particularly in older patients and also problems of insalubrity (accumulated garbage and lack of cleaning).
The most frequently accumulated items are objects and animals. Studies confirm that 'Hoarding Disorder' appears to be a disorder of chronic and progressive course, commonly associated with other clinical situations and in an older population. Of course, it is important to distinguish "accumulation" from "collecting". The latter is orderly and methodical and fulfills a purpose/objective.
As mentioned, 'Hoarding Disorder' is associated with psychiatric comorbidities, including high rates of 'Depression', 'Generalized Anxiety', 'Social Phobia', 'Attention Deficit Hyperactivity Disorder (ADHD)', 'Post-Traumatic Stress Disorder' and 'Obsessive-Compulsive Disorder (OCD)'.
Regarding etiology, it is unknown, but there are some theories that point to genetic factors and/or traumatic life events. In addition, there are also neuroscience studies that have shown dysfunctions in the ability to conceive, plan and execute tasks, which often result in difficulties in attention, organization and decision making.
Individuals with 'Hoarding Disorder' frequently report the existence of traumatic life events and some studies suggest that certain types of (traumatic) events are associated with hoarding disorder. For example, interpersonal traumas (such as domestic violence, accidental or tragic loss of loved ones or childhood neglect) are the most commonly reported types among patients with 'Hoarding Disorder'. The authors also reported that the occurrence of 'Hoarding Disorder' is also related to the intensity of the trauma, particularly physical/sexual abuse.
According to researchers, the experience of an interpersonal trauma can result in a strong emotional attachment to belongings that provide a sense of security/comfort to individuals. Some studies suggest that this may be a reason why patients with 'Hoarding Disorder' have such difficulty separating from their possessions and tend towards excessive acquisition.
Since asking for help can be hampered by suffering, shame, isolation or poor insight or insight, it is usually family members or social entities who ask for help. The evaluation involves interviewing, observing in a home context and collecting information with the collaboration of family members.
Although it is a delicate condition and difficult to detect, when there is a good or reasonable degree of insight, there are psychopharmacological and psychotherapeutic interventions (based on the cognitive-behavioral approach), always in the context of multidisciplinary (and coordinated) intervention, which can generate good results.
In summary, 'Hoarding Disorder' is a severe mental disorder of chronic and progressive course, still little studied, with a prevalence of 2% to 6% in the general population, which may be higher in the elderly population. It was included in the DSM-5 (2013) as an independent nosological entity. It entails significant costs to society due to health (mental and public) and safety risks to individuals, especially the elderly population. Studies indicate the participation of genetic, family, cognitive factors and experiences of traumatic events in the etiology of 'Hoarding Disorder'.
If you know someone who is suffering from this condition, seek professional help.
