Hoarding 1

Paper 5: Everything you ever wanted to know about compulsive hoarding but were afraid to ask: A psychological perspective

Professor Michael Kyrios, Professor of Psychology, Swinburne University of Technology, VIC

Compulsive hoarding is an under-recognized yet common and pervasive psychological problem that is most closely associated with Obsessive Compulsive Disorder (OCD), but may occur alone or in the context of other disorders such as dementia, schizophrenia, obsessive-compulsive personality disorder, and neurological disorders.

While compulsive hoarding has also been associated with squalor, its diagnostic status remains controversial, and various options for psychiatric classification systems are under consideration. Irrespective of its psychiatric classification, compulsive hoarding dominates sufferers' time, living spaces, relationships and safety, and remains a little understood and complex issue for a range of public agencies including local councils, fire and accident services, age and mental health services, and public housing.

While a number of models of compulsive hoarding have been proposed, research has focused more recently on cognitive-behavioural models that highlight the importance of information processing and decision-making deficits, issues of attachment, erroneous beliefs about the nature of possessions, and their resulting behavioural and functional manifestations (e.g., the acquisition of and failure to discard possessions that are of limited value, the resulting clutter that renders living spaces unusable for their intended purpose, and the significant distress and impairment that results).

With Randy Frost and Gail Steketee from the United States, our site has undertaken a program of research examining the nature of compulsive hoarding in order to develop an evidence-based treatment. While the individualised or group cognitive-behavioural treatment of compulsive hoarding has been found to be effective, its highly specialised and time intensive nature has been a barrier to its widespread dissemination. However, alternative models have emerged recently which can improve access to these treatment strategies.

This workshop will distinguish compulsive hoarding from related problems, going on to describe effective treatment strategies and, finally, describing different models of care that embrace such treatment strategies in the management of those affected by compulsive hoarding problems.