Hoarding Disorder (HD) was defined by Frost and Hartl (1996) as the excessive acquisition of and difficulty discarding large quantities of possessions of little or no value, leading to restrictive clutter. Although it has been recently defined as a mental health disorder, current understanding of the beliefs, characteristics and behaviours that cause and maintain this condition is unclear. This study attempted to improve current understanding by trying to disentangle the combinations of underlying belief profiles, characteristics and behaviours underpinning and maintaining HD.
The first stage involved using a series of standardised questionnaires to assess people for different beliefs, characteristics, behaviours and symptoms of hoarding. A statistical analysis known as cluster analysis was then undertaken to discover if particular beliefs, characteristics and behaviours as measured by these questionnaires grouped together in certain combinations and with hoarding symptoms. It was hoped this analysis would enable us to identify if a specific combination of beliefs, behaviours and characteristics associated with HD could be discovered. Unfortunately the cluster analysis was unable to identify any specific groupings of symptoms meaning that this section of the study did not discover any particular combination of beliefs, characteristics and behaviours associated with HD.
The second stage used a newly developed measure to explore the importance of specific belief profiles and characteristics and the series of behavioural processes theorised to comprise HD. These behaviours broadly involve the processes of acquisition, difficulty discarding and restrictive clutter outlined in the above HD definition. Analysis of the hypothesised profiles comprising Stage Two suggested Emotional Attachment to possessions, a lack of confidence in ability to remember possessions, and keeping items to extend self-identity were all implicated with hoarding behaviour. A desire to control possessions, a sense that possessions must be kept as the individual is the only person to see the value in them, and a feeling items need to be kept to increase a sense of security also appeared to become more important with hoarding severity.
Whilst all processes were implicated, the maintenance processes involving the storage and organisation of possessions and clutter appeared particularly important. There was also considerable difference between the scores on the profiles and processes between all participants. This individual variability suggests it is important to tailor assessment and treatment to the needs of each individual presenting with hoarding symptoms. The possibility of developing this new measure into a comprehensive assessment of underlying hoarding symptoms was outlined. Overall this second stage was extremely valuable in furthering understanding of the importance of different profiles, characteristics and behavioural processes involved with the development and maintenance of HD.
I would like to thank the members of Voice North for taking part in a time consuming online study into hoarding disorder. Hoarding is a condition with relatively poor treatment outcomes, so the contribution of Voice North members has been vital to furthering our understanding of this condition.