Compulsive Hoarding Barbara J. Chromy. Definition of Hoarding No consistent definition of hoarding...
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![Page 1: Compulsive Hoarding Barbara J. Chromy. Definition of Hoarding No consistent definition of hoarding The term is used in different clinical and non-clinical.](https://reader037.fdocuments.in/reader037/viewer/2022110206/56649ceb5503460f949b61db/html5/thumbnails/1.jpg)
Compulsive Hoarding
Barbara J. Chromy
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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)
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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
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Definition (continued)
2. Living spaces sufficiently cluttered so as to preclude activities for which those spaces were designed
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Definition (continued)
3. Significant distress or impairment in functioning cause by the hoarding
(Frost, Hartl, & Gross)
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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)
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Types of Hoarding (continued)
• Ordinary Hoarders– Primarily objects
• Animal Hoarders– Can have in excess of 300 animals in a
home
• Trash Hoarders– Syllogomania
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Types of Hoarding (continued)
• Animal Hoarding
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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)
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Causes
• Little is known about onset and course of compulsive hoarding
Grisham, Frost, Steketee,
Kim and Hood (2006)
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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).
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Co-morbidity
• Anorexia nervosa• Bipolar disorder• Dementia• Depression• Impulse control
disorders– Such as compulsive
buying or gambling
• Social phobia
• Obsessive-compulsive disorder
• Personality disorders• Schizophrenia• Diogenes syndrome• Prader-Willi syndrome• Head injury• Autism
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Hoarding Dangers
• Health hazards• Injury• Isolation
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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
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Impact on Elderly (continued)
• Hoarding medications is not uncommon among the elderly who have many ways to obtain drugs
(MacIsaac & Bartus Adamson, 1989)
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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)
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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)
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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
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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
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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.
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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-obsessive-compulsive-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.