A narrative synthesis of possible causes and risk factors of hoarding behaviours

Hombali, Aditi; Sagayadevan, Vathsala; Tan, Weng Mooi; Chong, Rebecca; Yip, Hon Weng; Vaingankar, Janhavi Ajit; Chong, Siow Ann; Subramaniam, Mythily

doi:10.1016/j.ajp.2019.04.001

Cited by 9 publications

(8 citation statements)

References 69 publications

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“…The causes, symptoms and consequences of self‐neglect and/or hoarding were deemed hard to disentangle, and while the consequences, as the tangible or visible side of the disorders were easier to recognise, they could mask underlying causes. With more entrenched behaviour, these causes may be particularly difficult to unearth especially if an individual is themself unaware of the triggers (Dozier & Ayers, 2017 ; Hombali et al, 2019 ). In a US study of narratives of self‐neglect (Lien et al, 2016 ), older people revealed isolated traumatic personal experiences—psychologically traumatic loss, separation or abandonment, and violent victimisation, physical trauma or sexual abuse—as possible contributors to self‐neglect.…”

Section: Discussionmentioning

confidence: 99%

“…Genetic models consider hereditary factors in hoarding behaviour (Iervolino et al, 2009 ). Neurological explanations consider neural impairment and neurodegenerative conditions as a cause for self‐neglect and hoarding (Hombali et al, 2019 ; Thew & Salkovskis, 2016 ; Wheaton, 2016 ). A social constructionist view argues that self‐neglect should be understood in relation to cultural and historical norms of hygiene and cleanliness (see also Cox, 2011 ; Lauder, 2001 ).…”

Section: Introductionmentioning

confidence: 99%

“…Life changing experiences and traumatic life events—such as loss of a loved one, illness or abuse and neglect—were considered as causal in hoarding behaviour in several models and evidence of a correlation has been found in some studies but not all (Dozier & Ayers, 2017 ; Hombali et al, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

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Adult safeguarding managers' understandings of self‐neglect and hoarding

Owen

Woolham

Manthorpe

et al. 2022

Health Social Care Comm

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Adult safeguarding managers' understandings of self‐neglect and hoarding

Owen

Woolham

Manthorpe

et al. 2022

Health Social Care Comm

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show abstract

“…However, estimates of hoarding and the subsequent management of people who hoard are limited due to hoarding behaviour being hidden; associated with embarrassment and shame; hoarding being highly stigmatised; the strong emotional attachments people have to possessions and issues around defensiveness and lack of insight (Chasson et al., 2018 ; Frost et al., 2010 ; Kellett & Knight, 2003 ). The risk factors and possible causes of hoarding are not entirely understood; it may well be due to a combination of factors (Dozier & Ayers, 2017 ); one study noted that 76% of their sample ( n = 751 self‐reported people who hoard) had a history of interpersonal violence (Tolin et al., 2010 ) and there is evidence that it may be correlated with previous traumatic and stressful life events (Hombali et al., 2019 ; Tolin et al., 2010 ).…”

Section: Introductionmentioning

confidence: 99%

Council tenancies and hoarding behaviours: A study with a large social landlord in England

Porter

Hanson

2022

Health Social Care Comm

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Hoarding behaviours are highly stigmatised and often hidden. People with problematic hoarding behaviours have a higher rate of mental health and other healthcare and social services utilisation. Hoarding is a community health problem, one factor being housing insecurity. Hoarding behaviours represent significant burden to housing providers, impact the community and dealing with it involves multiple community agencies. This study with a city council in England with a large housing stock (over 14,000 properties) in summer 2021 sought to understand the nature, circumstances and extent that hoarding presents. We developed a reporting system and conducted 11 interviews with housing officers in which they described a case to explain their involvement. Our report details the nature of 38 people who hoard: 47% had a known disability or vulnerability, 34% presented a fire and environmental risk, 87% lived alone and 60% were resident in flats. Our qualitative themes are: Working with others, Balancing an enforcement approach, Feeling conflicted, Complex needs of people who hoard and Staff needs. The cases described by the housing officers are combined into six case studies and illustrate the complex, multi-agency circumstances around decision making and risk stratification. Our findings point to housing officers as frontline professionals dealing with a public health and social care issue which is often the manifestation of complex life histories and mental health conditions. We suggest a greater focus on risk stratification and a more holistic approach to hoarding cases to effectively deal with this most complex of community health and social care issues.

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“…Thought to affect between 2 and 5% of the population (Iervolino et al, 2009;Mueller et al, 2009;Samuels et al, 2008), HD is reportedly three times more prevalent in older adults compared with younger adults (Hombali et al, 2019;Nordsletten et al, 2013), with age appearing to exacerbate severity of behaviours . It must be noted, however, that some research has failed to identify any distinct age or gender differences (Bulli et al, 2014;Fullana et al, 2010;Nordsletten et al, 2013;Timpano et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

A remote cognitive behavioural therapy approach to treating hoarding disorder in an older adult

Malone¹,

McCormack²,

McCullough³

2022

tCBT

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Hoarding disorder (HD) is characterised by excessive acquisition and distress associated with discarding objects, resulting in significant clutter. At present, cognitive behavioural therapy (CBT) represents the strongest evidence base for treating HD, although some limitations exist. Little research has examined the effectiveness of remote-CBT interventions for HD in older adults. This case study focuses on Mary, an older female adult presenting with clinically significant hoarding behaviours which severely impact her daily functioning and quality of life. Assessment and intervention followed a structured CBT approach. Despite the complicating factor of COVID-19, Mary responded well to a remote-CBT intervention, with progress indicators suggesting modest improvements in personal, social and occupational functioning. These findings support the use of remote-CBT for HD in both reducing frequency and intensity of hoarding behaviours and improving wellbeing. Key learning aims (1) Hoarding disorder (HD) is a poorly understood disorder that can significantly impact an individual’s personal, social and occupational functioning. (2) According to a cognitive behavioural model, HD emanates from information-processing deficits, emotional attachment difficulties, behavioural avoidance and maladaptive beliefs about objects and the self (Frost and Hartl, 1996). (3) Observations from this case study suggest the acceptability and effectiveness of a remote cognitive behavioural therapy (CBT) intervention for HD, with outcomes appearing congruous with those produced by face-to-face intervention. (4) While research attests to the effectiveness of a CBT intervention for HD, an augmented account of the mechanisms through which these outcomes are achieved is required.

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A narrative synthesis of possible causes and risk factors of hoarding behaviours

Cited by 9 publications

References 69 publications

Adult safeguarding managers' understandings of self‐neglect and hoarding

Adult safeguarding managers' understandings of self‐neglect and hoarding

Council tenancies and hoarding behaviours: A study with a large social landlord in England

A remote cognitive behavioural therapy approach to treating hoarding disorder in an older adult

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