Excessive acquisition in hoarding

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Abstract

Compulsive hoarding (the acquisition of and failure to discard large numbers of possessions) is associated with substantial health risk, impairment, and economic burden. However, little research has examined separate components of this definition, particularly excessive acquisition. The present study examined acquisition in hoarding. Participants, 878 self-identified with hoarding and 665 family informants (not matched to hoarding participants), completed an Internet survey. Among hoarding participants who met criteria for clinically significant hoarding, 61% met criteria for a diagnosis of compulsive buying and approximately 85% reported excessive acquisition. Family informants indicated that nearly 95% exhibited excessive acquisition. Those who acquired excessively had more severe hoarding; their hoarding had an earlier onset and resulted in more psychiatric work impairment days; and they experienced more symptoms of obsessive-compulsive disorder, depression, and anxiety. Two forms of excessive acquisition (buying and free things) each contributed independent variance in the prediction of hoarding severity and related symptoms.

Section snippets

Excessive acquisition in compulsive hoarding

Compulsive hoarding has come to light as an important yet little-studied psychopathology (Steketee & Frost, 2003). It represents a serious and sometimes life-threatening behavior (Frost, Steketee, & Williams, 2000), particularly for the elderly (Steketee, Frost, & Kim, 2001), and it poses significant economic and family burden (Tolin, Frost, Steketee, & Fitch, 2008; Tolin, Frost, Steketee, Gray, & Fitch, 2008). Historically resistant to treatment (see Steketee & Frost, 2003), development of a

Participants

The present sample was recruited from a database of over 8000 individuals who have contacted the researchers over the past 3 years for information about compulsive hoarding after several national media appearances. Potential participants were sent an e-mail invitation to participate in the study, and were also allowed to forward the invitation to others with similar concerns. Data collection occurred from November 14, 2006 to January 15, 2007. Consistent with current recommendations (Kraut,

Frequency of excessive acquisition in hoarding

Six-hundred and fifty-three participants met criteria for clinically significant hoarding based on their responses to the HRS-SR, though all 878 participants reported hoarding behavior that had a negative impact on their lives. Examination of the HRS-SR acquisition item revealed that 85.5% of clinically significant hoarding participants (558/653) reported at least moderate acquisition problems (a score of 4 or higher). Among informants with a clinically significant hoarding family member, 94.7%

Discussion

The findings of the present study indicate that excessive acquisition occurs with a very high frequency among people with significant hoarding defined as at least moderate difficulty discarding and clutter and moderate distress or interference. Only a small subset of these participants did not acquire excessively. Furthermore, both forms of excessive acquisition were related to hoarding severity and indecisiveness independent of OCD and distress. These findings have implications for the

Acknowledgments

This study was funded by National Institute of Mental Health grants R01 MH068008 and MH068007 (Frost and Steketee), R01 MH074934 (Tolin), and R21 MH068539 (Steketee). Oxford University Press supplied copies of a book used in a raffle for participants. The authors thank Dr. Nicholas Maltby for his technical assistance.

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