Prevalence and correlates of hoarding behavior in a community-based sample

Abstract

Little is known about the prevalence and correlates of hoarding behavior in the community. We estimated the prevalence and evaluated correlates of hoarding in 742 participants in the Hopkins Epidemiology of Personality Disorder Study. The prevalence of hoarding was nearly 4% (5.3%, weighted) and was greater in older than younger age groups, greater in men than women, and inversely related to household income. Hoarding was associated with alcohol dependence; paranoid, schizotypal, avoidant, and obsessive-compulsive personality disorder traits; insecurity from home break-ins and excessive physical discipline before 16 years of age; and parental psychopathology. These findings suggest that hoarding may be relatively prevalent and that alcohol dependence, personality disorder traits, and specific childhood adversities are associated with hoarding in the community. KeywordsHoarding; prevalence; risk factors; personality disorders; comorbidity Hoarding behavior has been called "pathological collecting" and is characterized by the acquisition of, and unwillingness or inability to discard, large quantities of seemingly useless objects (Greenberg, Witztum & Levy, 1990;Frost & Gross, 1993). The behavior can lead to significantly cluttered living space in the home and can cause considerable distress and impairment in functioning for individuals and their family members (Tolin, Frost, Steketee, & Fitch, 2008). The clutter may interfere with the normal use of space for basic household activities and increase the risk of injuries due to fire and falling, and illnesses due to poor sanitation Steketee, Frost, & Kim, 2001). *Corresponding author: Jack Samuels, Ph.D., Department of Psychiatry and Behavioral Sciences, Johns Hopkins, University School of Medicine, 600 N. Wolfe Street, Meyer 109, Baltimore, MD 21287-7228. Phone: 410-614-4942. Fax: 410-614-8137, E-mail address: jacks@jhmi.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. To date, hoarding behavior has been studied primarily in samples of individuals who were not selected from the community, such as respondents to advertisements for hoarding research studies, participants in hoarding self-help groups, individuals referred to clinics specializing in the treatment of obsessive-compulsive disorder, and individuals participating in family studies of obsessive-compulsive disorder. Results from these studies suggest that individuals with hoarding behavior have more symptoms of anxiety and depression, a greater prevalence of anxiety disorders, especially generalized anxiety disorder and social phobia, and poorer functioning...

Predictors of hoarding severity in older adults with hoarding disorder

“…Consistent with HD prevalence reports from across the lifespan, we found that the majority of the participants were unmarried (Timpano et al, 2011) and that married participants were more likely to report lower hoarding severity (Samuels et al, 2008). Similar to prevalence reports of hoarding in community samples, there was no relationship between number of cohabitants and the cognition-related symptoms of HD, such as is measured by the UHSS and the SI-R (Samuels et al, 2008), although increased number of cohabitants led to decreased scores on the CIR, suggesting that as the number of people sharing a home increased, the clutter levels in that home actually decreased.…”

“…Similar to prevalence reports of hoarding in community samples, there was no relationship between number of cohabitants and the cognition-related symptoms of HD, such as is measured by the UHSS and the SI-R (Samuels et al, 2008), although increased number of cohabitants led to decreased scores on the CIR, suggesting that as the number of people sharing a home increased, the clutter levels in that home actually decreased. Thus, being married and having more than one additional person in the home may serve as a buffer to clutter build up over time.…”

“…Although the limited range of years of education in the current sample (all participants were at least high school graduates) might have decreased the likelihood of finding significant results when comparing years of education with hoarding severity, the current findings are congruent with the correlates of hoarding symptoms in the general population (Samuels et al, 2008). There was no significant association between age and hoarding symptom severity, although this may in part be due to the restricted age range (60-85 years).…”

“…Current estimates of the incidence of HD in the general population range from 5.3% (Samuels et al, 2008) to 5.8% (Timpano et al, 2011), depending on the diagnostic criteria used. The incidence of HD has been estimated to be nearly three times higher in older adults than in younger adults (Samuels et al, 2008), and non-clinical community samples suggest that older adults exhibit more severe hoarding symptoms than do their middle-aged counterparts (Reid et al, 2011).…”

Hoarding disorder: a new diagnostic category in ICD-11?

“…For instance, hoarding has been associated with a number of personality disorders other than OCPD, including the paranoid, schizotypal, and avoidant personality disorders. [54][55][56] Also, it has been suggested that deleting hoarding and miserliness items from the set of OCPD criteria may improve the validity of the OCPD diagnosis. 57,58 Similarly, in longitudinal studies, only non-hoarding OCPD criteria, such as preoccupation with details, rigidity and stubbornness, and reluctance to delegate, were predictive of the diagnosis of OCPD two years later.…”