Hoarding 1

Paper 4: The Psychology of Compulsive Hoarding

Dr Christopher Mogan PHD, Clinical Psychologist, The Anxiety Clinic, VIC

Compulsive hoarding is an under-recognized yet complex and pervasive psychological problem that dominates sufferers' time, living spaces, relationships and safety.

Hoarding has been associated with a number of disorders, especially Obsessive-Compulsive Disorder (OCD), but it is not clear whether the presentation of hoarding phenomena differs across disorders.

This paper will present: (1) the phenomenology of compulsive hoarding, including its definition, etiology, age of onset, course, and (2) measures of severity, specific cognitions and behaviours, as well as (3) factors predictive of compulsive hoarding that emerged in recent research.

The DSM-IV-TR (2000) currently fails to clearly distinguish compulsive hoarding with the only reference to hoarding being as one of eight diagnostic criteria for Obsessive Compulsive Personality Disorder, with no mention at all in the descriptions of Obsessive Compulsive Disorder.

Hoarding and related phenomena was studied in 109 participants from 5 cohorts (hoarders with OCD, hoarders without OCD, OCD without hoarding, anxious and healthy controls). Results were consistent with previous findings, supporting the presence of hoarding symptoms across both clinical and non-clinical cohorts, and the clear differentiation of compulsive hoarders from clinical groups (OCD, anxiety) and normal controls. In general, findings supported the CBT model of compulsive hoarding and highlighted the need for ongoing research into this disabling psychological construct.

Finally, the paper will discuss current treatment options, both individual and group-based, the importance of long-term treatment, assessment of individual context, and the therapy-interfering behaviours that impact both on the effectiveness of the interventions and the psychological health of the workers involved in hoarding.