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Compulsive Hoarding or Hoarding Disorder?   arrow

Hoarding appeared in 1980 as one of 9 diagnostic criteria for obsessive compulsive personality disorder in DSM-III and was sometimes referred to as Obsessive Compulsive Disorder.

It could be found as OBSESSIVE COMPULSIVE HOARDING

It went on to be studied under the banner of OCD and some OCD symptoms were seen, especially in studies with children, who would hoard in an obsessional manner.

The very first systematic study and subsequent definition of hoarding was published in 1993 by Frost and Hartl The definition of “the acquisition of, and failure to discard, possessions which appear to be useless or of limited value”

In 1996, Frost and Hartl published the first theoretical account of hoarding . Their model proposed that hoarding resulted from a combination of information-processing deficits, dysfunctional beliefs about and exaggerated emotional attachments to possessions, as well as difficulty with organization. This study marked a change in the direction of research on hoarding. Before 1996, fewer than 10 studies had been published on the topic. By 2009, more than 20 articles per year were being published about hoarding (Mataix-Cols et al., in press).

Also, hoarding resembles OCD in several ways. The avoidance of and difficulties with discarding seem to be driven, at least in part, by fears of losing something significant (either information or emotional attachment) or being responsible for a bad outcome (e.g., behaving wastefully). These could be thought of as obsessional fears.

Hoarding was referred to as COMPULSIVE HOARDING

On the other hand, hoarding appears distinct from OCD in a number of ways. First, few hoarders experience negative, intrusive, or unwanted thoughts about hoarding, whereas this is the defining feature of OCD. Distress in hoarding seems to occur only when the person is forced to discard, and the distress is much more grief-like than the anxiety typically seen in OCD. Also, parts of the hoarding syndrome are experienced as pleasurable (e.g., acquisition), something that almost never happens in people with OCD. Another reason to question the link between hoarding and OCD is that most people who suffer from hoarding (80% or more) do not have any other OCD symptoms, and hoarding shows the smallest correlation with other OCD symptoms of any of the OCD subtypes. Neuroimaging studies, although still preliminary, suggest that different areas of the brain are involved for hoarding than for OCD. Finally, pharmacotherapy and behaviour therapy for OCD do not seem to work as well for hoarding clients as for clients with other forms of OCD.

This is why then they decided on calling it HOARDING DISORDER and it is under this title that it is now found in the new DSM V May 2013 . It is no longer attached to OCD but they can be found together sometimes.