The Hoarding HUB 2013
Understanding Hoarding in Vancouver’s downtown eastside
"A separate arm of the project is to get a sense of the prevalence of
the Downtown Eastside neighbourhood, which has many
supportive housing buildings.
A previous study by a community group in the neighbourhood involved a survey
landlords and building managers and suggested a very high prevalence
rate - up to
four times as high as estimates for the general population"
Science Alert, January 8, 2013
Hoarders struggle to make decisions
"Compulsive hoarders struggle to throw out their many possessions because
their brains lack flexibility,
new research suggests.But psychologists at Curtin University now think the
problem may be down to a
chronic case of putting things in the
UCSF Carol Mathews, MD
May 31, 2012
OCD linkage study published in Biological Psychiatry
Journal of Aging Research
By Kyle Y. Whitfield, Jason S. Daniels, Keri
Flesaker, and Doneka Simmons
Older Adults with Hoarding Behaviour Aging in Place:
to a Collaborative Community-Based Planning Approach for Solutions
"Results demonstrated that when a highly collaborative approach to
planning is used, there
were quite direct benefits for older adults with
hoarding behavior and, at the same time, there
were benefits for the
members of the community collaborative. This approach to planning for
the health and social needs of this population resulted in people with
hoarding behavior being
able to remain in their own homes when eviction
was a potential, enhancing their safety, helping to
isolation, and creating opportunities to increase control in their own
of Cognitive Therapy:
Vol. 4, Special Section: Hoarding, pp. 225-238.2011
By M. Wheaton, J
Abramowitz, L. Fabricant, N. Berman, J. Franklin,UNC
Is Hoarding a Symptom of Obsessive-Compulsive
"The presence of
hoarding symptoms in patients with obsessive-compulsive disorder (OCD)
is a commonly reported phenomenon. How these symptoms are to be understood
is less clear.
The extent to which hoarding fits with other symptoms of
OCD by considering its diagnostic
utility and underlying cognitive
processes is evaluated. In the first study, hoarding symptoms
differentiate OCD patients from individuals with other anxiety disorders or
students, indicating that hoarding does not inform diagnostic
decision making. In the second study,
using an independent nonclinical
sample, cognitive variables related to OCD were distinct from
hoarding-specific cognitions, and not predictive of hoarding symptoms. These
results add to a
growing body of evidence suggesting that hoarding is
not a symptom or manifestation of OCD.
The need for careful assessment
of the function of hoarding symptoms is discussed"
University of St. Thomas, Minnesota, November
By Ryan J. Sorensen
Hoarding Disorder (Compulsive Hoarding): A
Comprehensive Literature Review and Professional
Training to Prepare Clinicians to Treat Problematic Hoarding
Psychiatric Times, August 19, 2011
By Suzanne Otte and Gail Steketee
Psychiatric Issues in Hoarding - Strategies for Diagnosing and
Treating Symptoms of Hoarding
"Historically, hoarding has been deemed a subtype of OCD, although
suggests there are more differences than
similarities. Hoarding is under consideration for
inclusion in DSM-5 as
a stand-alone disorder. A set of provisional criteria for hoarding disorder
has been proposed and will require further study in the future. A recent
study conducted by
Frost and colleagues that examined the largest sample
of participants to date confirmed that
major depressive disorder was the
most frequently occurring comorbid condition (more than 50%)
kleptomania was a factor in 10% of the sample. This article highlights
for hoarding that are available to practitioners,
including alternative approaches focusing on
self-help, support group,
and Web-based delivery models."..........
Social Work Today, May/June 2011, Vol.11, No.3, P.14
Who Hoard — What Works for Clients and Families
shows can help and hurt people who hoard. Find out why and know what really
best for clients and the families who care about them."
Depress Anxiety. 2010 Jul;27(7):667-74.
UCSF Psychiatry Resident
By Sheppard, Azzam, Grados, Umana, Garrido, & Mathews
ADHD prevalence and association with hoarding behaviors in childhood-onset
CONCLUSION: ADHD rates were elevated in this sample of individuals with
compared to the general population rate of ADHD, and there was a strong
ADHD and clinically significant hoarding behavior. This association is
consistent with recent studies
suggesting that individuals with hoarding may exhibit substantial executive
and/or abnormalities, including attentional problems.
Depression and Anxiety:
Volume 27, Issue 6, pp 556–572 June (2010)
Mataix-Cols, Ph.D.,Randy O. Frost, Ph.D.,Alberto Pertusa, M.D.,
Clark, Ph.D.,Sanjaya Saxena, M.D., James F. Leckman, M.D.,
Dan J. Stein,
M.D.,Hisato Matsunaga, M.D.,and Sabine Wilhelm, Ph.D.
REVIEW: HOARDING DISORDER: A NEW DIAGNOSIS FOR DSM-V?
See the full article and research at the link
One of the conclusions and preliminary recommendations:
1. Clinically significant
hoarding is prevalent and can
vary from mild to life threatening. The
public health consequences of hoarding are substantial and
it is generally considered difficult to
treat. These direct and indirect
hoarding are serious enough to warrant its consideration
as a mental disorder
10. If it becomes a separate
diagnostic category, the most appropriate ‘‘neighborhood’’ for hoarding
disorder is unclear as it has ties with several groupings of disorders,
particularly OCD and
impulse control disorders. Until we learn moreabout
its etiology, the decision will necessarily
require expert consensus. For
the time being, giventhe historical link between hoarding and OCD/
the fact that some hoarders are seen in OCD clinics, and the conservative
by DSM-V, it would be reasonable to acknowledge hoarding
disorder as an OCSD, if such a group is
included in DSM-V. An alternative
to our recommendation would be to include it in an Appendix of
Sets Provided for Further Study.
Anxiety Discrd. 2011
Mar;25(2):192-202. Epub 2010 Sep 15.
By Landau, Lervolino, Pertusa, Santo, Singh, & Mataix
Stressful life events and material deprivation in
Results support a link between trauma, life stress and hoarding, which may
inform the conceptualization and treatment of hoarding disorder, but await
in a representative epidemiological sample and using a longitudinal design.
2011, Part 5, 687-701, DOI: 10.1007/978-1-4419-0338-9_34
by J. Grisham, A.D.Williams, R. Kadib
Hoarding as a Behavioral Addiction
"Compulsive hoarding is a psychiatric syndrome with serious personal and
public health consequences.
Although the diagnostic status of hoarding is uncertain, it appears to be
associated with a number of
other psychiatric disorders, including obsessive-compulsive disorder.
Several important features of
hoarding, however, differentiate it from obsessive-compulsive disorder and
other anxiety disorders.
Moreover, there are important phenomenological similarities between hoarding
and behavioral addictions,
such as the pleasurable feelings that may be associated with collecting and
saving. In this chapter, we
review diagnostic and comorbidity issues regarding hoarding, while
highlighting the relationship between
hoarding and impulse control disorders. In addition, we discuss ways in
which a behavioral addiction model
may be consistent with compulsive hoarding. We also outline a prominent
model of hoarding that emphasizes the role of both information-processing
deficits and excessive emotional
attachment to possessions. Finally, we describe various self-report and
interview measures used to assess
hoarding, as well as current biological and psychological approaches to
Clinical Social Work Journal,
2010, DOI: 10.1007/s10615-010-0311-4
by J. Muroff, C. Bratiotis and G Steketee
Treatment of Hoarding Behaviors: A Review of the Evidence
"Overall, evidence supports the use of specialized CBT methods to
improve hoarding symptoms.
Future testing may include controlled trials with more diverse samples."
A study of hoarding behavior
and attachment to
Psychiatry.com, CNS Spectr. 2010;15(4):258-265. CNS Spectr.
Clinical Features and Treatment Characteristics of Compulsive Hoarding in
with Obsessive-Compulsive Disorder
Hisato Matsunaga, MD, PhD, Kazuhisa Hayashida, MD, Nobuo Kiriike, MD, PhD,
Toshihiko Nagata, MD, PhD, and Dan J. Stein, MD, PhD
"Conclusion: The prevalence and clinical characteristics of compulsive
hoarding in OCD subjects
was similar to those reported in Western countries, supporting its
The distinction between primary and secondary hoarding in OCD is clinically
useful, and may
contribute to the debate about whether hoarding should be a separate
BehaV. Res Ther.,2010
Oct;48(10):1012-20. Epub 2010 Jul 29.
When hoarding is a symptom of OCD: a case series and
implications for DSM-V.
Journal of Anxiety Disorders, 2010
Stressful life events and material deprivation in
Int Psychogeriatr.,2010 Sep 14:1-3.
to consider mood disorders,
and especially chronic mania,
in cases of Diogenes syndrome (squalor syndrome)
JPsychiatry Res., 2010 Sep 3.
Quality of life and functional impairment in compulsive
Published Online: March 24, 2010
Waitlist-controlled trial of
cognitive behavior therapy
Gail Steketee, Ph.D.
, Randy O. Frost, Ph.D.
, David F. Tolin, Ph.D.
, Jessica Rasmussen, M.A.
, Timothy A. Brown, Psy.D
61:205, February 2010 doi: 10.1176/appi.ps.61.2.205
Personalized Intervention for
Those At Risk of Eviction
by Carolyn Rodriguez, M.D., Ph.D.,
Lisa Panero, M.S.W. and Audrey Tannen
Clin Psychol Rev.
2010 Jun;30(4):371-86. Epub 2010 Feb 4.
Refining the diagnostic boundaries of compulsive
hoarding: a critical review
Behaviour Research and Therapy
Volume 48, Issue 1,
January 2010, Pages 79-85
Delivery of internet treatment for
by Jordana Muroff, Gail Steketee, Joe Himle
and Randy Frost
From abstract: "Online CBT-based self-help for
hoarding appears to be a promising intervention
enter the following into the text box provided
strategy that may extend access to treatment. Evaluating the
benefits of internet self-help groups
is critical given growing popularity of and demand for web-based
Behavioural and Cognitive Psychotherapy
Published online by
Cambridge University Press January 12, 2010
: an interpretive phenomenological analysis
Background: This project aimed to explore the
experiences of people who compulsively hoard
and how they make sense of
their own hoarding behaviours.
Method: A total of 11
compulsive hoarders were recruited and interviewed using a simple
interview format, designed for the purposes of the study. The resulting transcribed
interviews were analyzed using
Results: Four super-ordinate discrete, but
interacting, themes were found: (1) childhood factors; (2) the
relationship to their hoarded items; (3) cognitive and behavioural avoidance of discard; and (4) the impact
hoarding on self, others and the home environment. The themes as a
whole described people entrapped in
massively cluttered physical environments of their own making. Efforts at discard appeared consistently
sabotaged by cognitive/behavioural avoidance, thereby creating maintaining
factors of associated personal
distress and environmental decline.
Conclusions: The results are discussed in the context of
the extant evidence concerning hoarding, the distinct
by the current results and the identified methodological shortcomings of the
Molecular Psychiatry (2009) 14, 318–331; doi:10.1038/sj.mp.4002129;
published online January 8, 2008
by S K An, D Mataix-Cols, N S Lawrence, S Wooderson, V Giampietro,
A Speckens, M J Brammer, and M L Phillips
To discard or not to discard: the neural basis of hoarding symptoms
in obsessive-compulsive disorder.
First go to
then copy and paste in : doi:10.1038/sj.mp.4002129
Cognitive Therapy Research,
2008, Volume 34, Number1 69-81, DOI: 1007/s10608-008-9217-7
by Tolin Frost, Steketee
Family Informants' Perceptions of Insight in Compulsive Hoarding
"Family/friend informants’ ratings of hoarding severity were significantly
greater than were their estimates
of the hoarder’s ratings. Hoarders described as showing less distress about
the hoarding were described
as showing poorer insight. These results suggest that compulsive hoarding is
characterized by poor insight
into the severity of the problem. Treatment development might need to
emphasize strategies to bolster
awareness, insight, and motivation."
Journal of Psychopathology and Behavioral Assessment,
2008, Vol31, Number 3220-227, DOI: 10.1007/s10862-008-9106-0
by L Hayward, M.E.Coles
Elucidating the Relationship of Hoarding to Obsessive Compulsive Disorder
and Impulse Control Disorders
"Therefore, the current study tested the hypothesis that hoarding would be
as strongly related to symptoms
of ICDs as it is to OCD and that these relationships would be medium to
strong in magnitude. Results from
an undergraduate sample showed hoarding behaviors were strongly related to
symptoms of OCD, moderately
related to symptoms of compulsive buying, and more modestly related to
symptoms of pathological gambling,
trichotillomania, and kleptomania. Finally, findings suggest indecisiveness
may be a particularly important
underlying feature in hoarding behaviors. These results support the
consideration of hoarding outside the confines
American J. Psychiatry 165:129-1233 Oct. 2008
A Developmental and Evolutionary Perspective on
Whence and Whither Compulsive Hoarding?
James F. Leckman, M.D., and Michael H. Bloch, M.D.
Genes Brain Behav- 01-OCT-2008 7(7): 778-85
Genetic Susceptibility to Obsessive Compulsive Hoarding
"Among other clinical dimensions, the presence of
hoarding obsessions and compulsions
has been shown to be correlated with a number of
clinical and neuroimaging findings,
as well as with a different pattern of genetic
Despression and Anxiety, vol 25,
issue 9, Sept.2008
Wiley InterScience, February 20, 2007
Interpersonal problems and
emotional intelligence in
by Jessica R. Grisham, Ph.D. , Gail Steketee,
Ph.D., Randy O. Frost, Ph.D.
Behavior Research and Therapy, 2008 September
Sex-Specific Clinical Correlates of Hoarding in
Current Psychiatrity Reports, Volume
10, Number 4, August 20, 2008
by Sanjaya Saxena
Recent Advances in Compulsive
"Compulsive hoarding is
a common and often disabling neuropsychiatric disorder.
This article reviews the
conceptualization, phenomenology, diagnosis, etiology,
neurobiology, and treatment of compulsive hoarding.
Compulsive hoarding is part of a discrete clinical
syndrome that includes difficulty discarding, urges to
excessive acquisition, indecisiveness, perfectionism,
procrastination, disorganization, and avoidance. It was
thought to be part of obsessive-compulsive disorder or
obsessive-compulsive personality disorder, but recent
evidence indicates that it should be classified as a
separate disorder with its own diagnostic criteria.
hoarding is a genetically discrete, strongly heritable
phenotype. Neuroimaging and neuropsychological studies
are elucidating its neurobiology, implicating
dysfunction of ventral and medial prefrontal cortical
mediate decision-making, attention, and emotional
regulation. Effective treatments include pharmacotherapy
and cognitive-behavioral therapy. More research will be
required to determine the prevalence, etiology, and
pathophysiology of compulsive hoarding and to develop
Br J Clin Psychol. 2008 Mar;47(Pt 1):59-73.
Compulsive hoarding: a qualitative investigation of
partner and carer perspectives.
Behav Res Ther.
2008 Mar;46(3):334-44. Epub 2008 Jan 3.
Family burden of compulsive hoarding: results of an
Journal of Psychopathology and Behavioral Assessment,
2007, Vol 30, Number 3,193-203, DOI: 10.1007/s10862-007-9068-7
by Frost, Steketee, Tolin, S Renaud
Development and Validation of Clutter Image Rating
"Few instruments are available to assess compulsive hoarding and severity of
clutter. Accuracy of assessment
is important to understanding the clinical significance of the problem. To
overcome problems associated with
over- and under-reporting of hoarding symptoms, the clutter image rating
(CIR) was developed. This pictorial
scale contains nine equidistant photographs of severity of clutter
representing each of three main rooms of
most people’s homes: living room, kitchen, and bedroom. The psychometric
properties of this measure were
examined in two studies. Internal consistency, test–retest, and
interobserver reliabilities were good and
convergent validity with other questionnaire and interview measures was also
good. The CIR correlated more
strongly with measures of clutter than with other hoarding and
psychopathology scales. The CIR’s very brief
pictorial assessment method makes it useful in clinical and treatment
contexts for measuring the clutter
dimension of compulsive hoarding. Development and Validation of the Clutter
Behaviour Research and Therapy 45 (2007) 1657–1662
Cognitive aspects of nonclinical obsessive compulsive hoarding
by Luchian, McNally, and Hooley
See this article for information on a very small study delineating problems
of categorization, under inclusiveness, and indecisiveness in non clinical
Behavior Research Therapy 2007 Nov;
45(11):2754-63. Epub 2007 Aug 8
HOARDING AND COMPULSIVE BUYING
Hoarding in a compulsive buying sample
Literature Review April 2007
Comparison of Medication Treatment versus Cognitive Behavior
Therapy of Hoarding Behaviors
in Obsessive-Compulsive Behavior.
Extensive evidence-based medicine literature review
by C. Powers, T.Quigley,MPH, College of Health Professions,
Wichita State University
Am J Psychiatry 164:3, March 2007
By Sanjaya Saxena
Editorial: Is Compulsive Hoarding a Genetically and
Neurobiologically Discrete Syndrome?
Implications for Diagnostic Classification
Behavior Research Therapy 2007 Apr;
45(4):673-86. Epub 2006 Jul 5.
Hoarding in obsessive-compulsive
disorder: results from the OCD Collaborative Genetics Study.
Department of Psychiatry and Behavioral
Sciences, Johns Hopkins University School of Medicine