The cognitive-behavioural model of hoarding disorder
Standard therapy for compulsive hoarding needs to unpack many factors that contribute to the problem.
This includes examining each person's upbringing, early family history and understanding the way they think, according to Australian and US researchers.
Led by Flinders University Professor Mike Kyrios, who has been conducting this research over many years while previously working at the University of Melbourne, Swinburne University and the Australian National University, the paper on Hoarding Disorder assigns great significance to the emotional attachment that individuals place on possessions as a way of compensating for a lack of emotional warmth experienced in their early years.
"While different forces are at play in each individual case, recollections about the lack of emotional warmth experienced by participants with Hoarding Disorder distinguished them from those with anxiety, obsessive-compulsive disorder and healthy participants," says Professor Kyrios, Executive Dean of the College of Education, Psychology and Social Work at Flinders University.
"As a consequence, by not having a strong sense of emotional belonging, the people who hoard cling to personal belongings, to mimic a heightened sense of security and control.
"The strong attachment to possessions compensates for their feelings of uncertainty or being threatened.
"In addition, a need to keep possessions in view compensates for poor confidence in their memory. They deal with fears about decision making by holding on to possessions even when the resulting clutter is detrimental to their quality of life.
"Therefore, beliefs about possessions and attachment to possessions was the strongest predictor of hoarding severity and needs to be targeted in psychological treatments."
The study – 'The cognitive-behavioural model of hoarding disorder: Evidence from clinical and non-clinical cohorts,' by M Kyrios, C Mogan, R Moulding, RO Frost, K Yap and DB Fassnacht DOI 10:1002/cpp.2164 – has been published online in Clinical Psychology and Psychotherapy March 2018 (Wiley).
Professor Kyrios says these findings extend an understanding of the behavioural model of hoarding to include early developmental factors.
"It seem crucial to understand the range of factors that are associated with the development of hoarding problems," Professor Kyrios says.
"From a clinical perspective, this knowledge could help us better understand who might be at risk for the development of the disorder and how to fine-tune treatments."
Key messages for practitioners from the paper:
- The cognitive-behavioural model of hoarding disorder was examined
- The hoarding cohort exhibited poor confidence in memory
- The cohort showed greatest concerns about the consequences of forgetting
- They reported the lowest recollections of warmth in their family
- Lack of warmth in one's family was a significant predictor predictor of hoarding severity.