|It's Time to Move.|
Page 3 of 6Hoarding behaviors affect approximately one to two percent of the U.S. population. This translates into two to four million individuals. Typically the median age is 50, but onset often occurs in adolescence. They are usually unmarried and socially isolated. They are prone to depression, social anxiety, perfectionism, indecisiveness, procrastination, and avoidance (Steketee, 2006). They need to be surrounded by familiar objects to feel safe and secure. Fears of losing important items they might need at some future time, excessive attachment to possessions, and making a wrong decision about what to discard may drive them to save everything. In research by Dr. Randy Frost PhD, emotional deprivation and the level of warmth expressed in the family during adolescence were significant for the development of hoarding behaviors. Hoarding is not linked to income, intelligence, ethniticity, or education. In reviewing the literature, all but one study points to hoarders as females. However, in a study by Samuels, et al., 2002, he reported hoarding as occurring twice as frequently in males than in females.
Hoarding behaviors are often linked with the diagnosis of obsessive-compulsive disorder. Using a positron emission tomography scan or (PET) people diagnosed with OCD with both hoarding and non-hoarding behaviors had their brains scanned. OCD patients with the hoarding component had a very different pattern of cerebral glucose metabolism. They had a significantly lower metabolism in the dorsal anterior cingulated gyrus than non-hoarders. This is the area of the brain that governs decision-making, organization, attention, motivation, and problem solving skills. Usually these people have difficulty with visual, spatial orientation (Saxena et.al, 2004). In a recent study sponsored by NIMH, called “ Neural Mechanisms of Compulsive Hoarding” people with and without compulsive hoarding, regardless of a diagnosis of OCD, were put into an MRI scanner to observe brain activity. While in the scanner, participants were asked to think of making decisions to discard personal possessions. In the brains of people with compulsive hoarding, decisions to discard possessions activated brain regions associated with punishing or unpleasant events. Decisions to discard may be experienced as punishing or uncomfortable and thus to be avoided. Further research is needed to determine if hoarding should be defined as a separate disorder versus a symptom or subset of OCD. Also, people diagnosed with OCD have not responded well to serotonin reuptake inhibitor (SRI) antidepressant medications, whereas compulsive hoarders have had better but limited success. Paroextine (paxil) had the best results, especially if combined with cognitive behavioral therapy. More research is indicated. However, as the hoarder does not recognize he/she have a problem, outcome is guarded even with intervention.
Dr. Randy Frost of Boston University and, as previously mentioned a leading researcher in hoarding found that hoarding runs in families. People who hoard usually have a first-generation relative who is described as a “pack rat” (Frost et al., 2000). Often a person with a diagnosis of Alzheimer’s dementia has hoarding behaviors. However, it is felt that this is due to an inability to differentiate between necessary items and trash. Also, if a person sustains a brain injury to parts of the frontal lobes of the cortex he/she will often develop hoarding behaviors (Anderson, S.W., 2004). In addition, research at Johns Hopkins Medical Center has indicated chromosome 14 is linked with compulsive hoarding behaviors in families with OCD (Samuels, J., Shugart, Y.Y., Grados, M.S. et al.).
Regardless of biology with both hoarding and cluttering the outcomes are similar – piles of stuff. Their houses are full of stuff. Their garages are full of stuff. Their basements are full of stuff. There are narrow pathways surrounded by stuff. With all this stuff it is important to determine if it’s due to disorganization or hoarding behaviors. The National Study Group on Chronic Disorganization (NSGCD) has developed a Clutter-Hoarding Scale as a guideline tool to define the level and clutter in a home. The five levels relate to the health and safety of the individuals living in such an environment. Knowing the level of the clutter help in developing a treatment plan. People at Level I and II are likely to just be disorganized. They are often creative people with numerous interests and projects. People at Level III through Level V need psychological and/or medical intervention. A Level II house may evoke the eyesore of Oscar from the “Odd Couple” whereas a Level V dwelling is a virtual no-man’s land of structural damage, infestation of animals, unusable water and sewer, rotting food, and often no power. It is truly a health hazard. Often the only recourse is to condemn the property.
While hoarding affects a small percentage of the population, and disorganized cluttering probably a much larger percentage, stuff accumulates because it can. If one remains in their home for decades it accumulates. If a corporation moves you even the trash goes along to the next accommodation. If you’re moving yourself you load up the stuff promising to sort it when you have time.
DEALING WITH ALL THAT STUFF