Conferring humanness: The role of anthropomorphism in hoarding

Hoarding is characterized by a persistent and extreme difficulty with discarding one’s possessions, often resulting in cluttered living spaces and marked distress or impairment. Despite being increasingly recognized as a substantial public health burden, much remains unknown about the etiology. One facet within the cognitive-behavioral model of hoarding that remains poorly understood is the strong emotional attachment to possessions. The tendency to anthropomorphize (i.e., see human-like qualities in non-human entities) may be one possible mechanism contributing to this emotional attachment. The current report is the first empirical study to examine the association between anthropomorphism and hoarding. Non-clinical participants (n = 72) completed a battery of self-report measures focused on hoarding symptoms, saving cognitions, anthropomorphism, and emotional attachments to personal and novel items. Anthropomorphic tendencies were significantly associated with greater saving behaviors and the acquisition of free things. Levels of anthropomorphism moderated the relationship between specific hoarding beliefs and acquiring tendencies, as well as the emotional attachment towards a novel item. Results are discussed with regard to future research directions, and implications for the cognitive-behavioral model of hoarding.     

Compulsive Hoarding: Current Research and Theory

Compulsive hoarding has emerged as a treatment refractory and impairing psychological disorder. Although promising research over the past decade has substantially furthered an understanding of hoarding, the etiology, diagnostic status, and associated features of this phenomenon are not yet completely understood. This article reviews current research on hoarding, including comorbidity and diagnostic issues, theoretical models, and treatment approaches. A cognitive–behavioral model of compulsive hoarding (R. O. Frost and G. Steketee, 1998) is presented, including the proposed information-processing deficits, beliefs and cognitions, and excessive emotional attachment to possessions. In addition, existing treatment approaches that target the cognitive and behavioral components of acquisition, difficulty organizing, and avoidance of discarding are described. Future directions for compulsive hoarding research are suggested to improve diagnostic clarity, refine therapeutic techniques, and enhance treatment response.     

Emotional regulation,attachment to possessions and hoarding symptoms

This study aimed to test which particular facets of emotion regulation (ER) are most linked to symptoms of hoarding disorder, and whether beliefs about emotional attachment to possessions (EA) mediate this relationship. A non‐clinical sample of 150 participants (108 females) completed questionnaires of emotional tolerance (distress tolerance, anxiety sensitivity, negative urgency – impulsivity when experiencing negative emotions), depressed mood, hoarding, and beliefs about emotional attachment to possessions. While all emotional tolerance measures related to hoarding, when considered together and controlling for depression and age, anxiety sensitivity and urgency were the significant predictors. Anxiety sensitivity was fully mediated, and urgency partially mediated, via beliefs regarding emotional attachment to possessions. These findings provide further support for (1) the importance of anxiety sensitivity and negative urgency for hoarding symptoms, and (2) the view that individuals with HD symptoms may rely on items for emotion regulation, leading to stronger beliefs that items are integral to emotional wellbeing.     

The influence of anthropomorphic tendencies on human hoarding behaviours

Hoarding is the excessive acquisition of and failure to discard possessions. Previous research has shown a link between anthropomorphism (the tendency to ascribe human characteristics to non-human objects) and hoarding. Here we assess the psychometric properties of a new Anthropomorphism Questionnaire (AQ) in a nonclinical sample of 264 adults. A further sample of 93 participants was then recruited to assess relationships between hoarding behaviours and cognitions, scores on the AQ, an existing anthropomorphism questionnaire (Individual Differences in Anthropomorphism Questionnaire: IDAQ), and a measure of social anxiety. Regression analyses revealed the AQ but not the IDAQ to be a significant predictor for hoarding behaviours. Women showed stronger childhood anthropomorphising behaviours than men, and younger participants showed stronger anthropomorphising and hoarding cognitions and behaviours. We conclude that the AQ better supports the predicted relationship between anthropomorphism and hoarding than the IDAQ. We also suggest that age and sex need to be more carefully considered in future studies on anthropomorphism and hoarding.     

Measurement of compulsive hoarding: saving inventory-revised

Four studies examined a new measure of compulsive hoarding (Saving Inventory-Revised; SI-R). Factor analysis using 139 hoarding participants identified 3 factors: difficulty discarding, excessive clutter, and excessive acquisition. Additional studies were conducted with hoarding participants, OCD participants without hoarding, community controls and an elderly sample exhibiting a range of hoarding behavior. Internal consistencies and test-retest reliabilities were good. The SI-R distinguished hoarding participants from all other non-hoarding comparison groups. The SI-R showed strong correlations with other indices and methods of measuring hoarding (beliefs, activity dysfunction from clutter, observer ratings of clutter in the home) and relatively weaker correlations with non-hoarding measures (positive and negative affect and OCD symptoms). The SI-R appears to be an appropriate instrument for assessing symptoms of compulsive hoarding in clinical and non-clinical samples.     

Inattention, but not OCD, predicts the core features of hoarding disorder

Hoarding Disorder (HD), defined as the acquisition of and failure to discard large volumes of possessions, resulting in clutter that precludes normal use of living spaces, is a common and debilitating condition. Although hoarding has historically been conceptualized as a variant of obsessive-compulsive disorder (OCD), increasing evidence suggests that hoarding might be more closely associated with the symptoms of attention deficit-hyperactivity disorder (ADHD). The aim of the present study was to clarify the relationship between the core features of hoarding (clutter, difficulty discarding, acquiring), OCD symptoms, and ADHD symptoms. HD (N = 39), non-hoarding OCD (N = 26), and healthy control (N = 36) participants underwent careful diagnostic interviewing and completed standardized self-report measures of the core features of hoarding (clutter, difficulty discarding, acquiring), OCD symptoms, negative affect, and the inattentive and hyperactive/impulsive symptoms of ADHD. Multiple linear regressions demonstrated that after controlling for global negative affect, OCD symptoms did not significantly predict any of the core features of HD. Conversely, the inattentive (but not hyperactive/impulsive) symptoms of ADHD significantly predicted severity of clutter, difficulty discarding, and acquiring. These results challenge current conceptualizations of hoarding as a subtype of OCD, and suggest an association with neurocognitive impairment.     

The value of possessions in compulsive hoarding: Patterns of use and attachment

Hoarding behavior, patterns of use of possessions, and emotional attachment to possessions were examined among a sample of female undergraduates and a sample of community volunteers. Hoarding behavior was associated with a decreased frequency of use of possessions and excessive concern about maintaining control over possessions. Furthermore, high scores on the hoarding scale were associated with higher levels of perceived responsibility for: (1) being prepared; and (2) the well-being of the possession. Hoarding was also associated with greater emotional attachment to possessions and to the reliance on possessions for emotional comfort. The implications of these findings for the definition of hoarding are discussed.     

Excessive Object Attachment in Hoarding Disorder: Examining the Role of Interpersonal Functioning

Excessive attachment towards possessions can be maladaptive because it can lead individuals to excessively acquire and save objects. Little is known about how attachment to objects develops and changes over time; however, interpersonal factors have been theorized to play a role. The current study examined whether interpersonal factors, specifically interpersonal attachment style and empathy, moderate changes in object attachment over time. A total of 145 participants with excessive acquiring and discarding difficulties rated their level of attachment to a novel object just after receiving it, and 1 week later. Participants also completed measures of interpersonal anxious attachment and interpersonal functioning. We found that changes in object attachment over time were moderated by interpersonal anxious attachment. Also, our findings suggested that individuals with hoarding problems are likely not impaired in their ability to empathize with others, but rather have difficulty displaying empathy in tense social situations and also have more empathy for fictional characters. Further, greater discomfort in tense social situations and greater empathy for fictional characters interacted to predict greater object attachment. Taken together, these findings indicate that individuals with an interpersonal anxious attachment style may be those at risk of forming greater attachments to objects over time. A learning history that includes inconsistent support from caregivers may result in individuals experiencing more empathy for fictional characters and discomfort in tense social situations, which may produce a vulnerability for becoming excessively attached to objects. Our results are in line with theories of hoarding which propose that individuals use objects to compensate for unmet interpersonal needs and suggest that treatment may need to target interpersonal functioning to reduce hoarding symptoms.     

The effectiveness of a biblio-based support group for hoarding disorder

Compulsive hoarding is characterized by the acquisition of, and failure to discard, a large number of possessions and clutter that prevents the use of living spaces as intended. Current successful treatments such as individual and group cognitive-behavioral therapy are lengthy and costly, requiring a time commitment ranging from four to twelve months, trained clinicians to administer treatment, and multiple home visits. Nonprofessional interventions may provide a cost-effective pre-treatment, adjunct, or alternative for individuals who want to work on hoarding problems but are unable or unwilling to engage in treatment. The purpose of the present study was to investigate the effectiveness of an innovative program consisting of a 13-session non-professionally facilitated biblio-based, action-oriented support group using Tolin, Frost, and Steketee’s (2007b) self-help book. In study 1, seventeen self-identified hoarding participants experienced significant decreases in clutter, difficulty discarding, and excessive acquisition from pre-treatment to post-treatment, with reductions evident at mid-treatment. Study 2 replicated the findings of study 1 using interview and observational measures taken in participants’ homes. These findings suggest that a facilitated biblio-based group may be a promising intervention for hoarding disorder.     

Examining the Link Between Hoarding Symptoms and Cognitive Flexibility Deficits

Executive functioning deficits have been found to underlie primary symptoms of hoarding, such as difficulty discarding belongings and significant clutter. Cognitive flexibility—the ability to inhibit irrelevant material and attend flexibly between different mental sets—may be impaired as well, as individuals experience difficulty staying on task and are often distracted by specific possessions that tend to evoke an exaggerated emotional response. The present study investigated cognitive flexibility deficits via eye-tracking technology as a novel approach. Participants (N = 69) with high and low self-reported hoarding symptoms were asked to respond to a series of auditory cues requiring them to categorize a small target number superimposed on one of three distractor image types: hoarding, nature, or a blank control. Across a range of behavioral and eye-tracking outcomes (including reaction time, accuracy rate, initial orientation to distractors, and viewing time for distractors), high hoarding participants consistently demonstrated greater cognitive inflexibility compared to the low hoarding group. However, high hoarding participants did not evidence context-dependent deficits based on preceding distractor types, as performance did not significantly differ as a function of hoarding versus nature distractors. Current findings indicate a pervasive, more global deficit in cognitive flexibility. Those with hoarding may encounter greater difficulty disengaging from previous stimuli and attending to a given task at hand, regardless of whether the context of the distractor is specifically related to hoarding. Implications and future directions for clarifying the nature of cognitive inflexibility are discussed.     

A Multifaceted Assessment of Emotional Tolerance and Intensity in Hoarding

Hoarding is characterized by emotionally reinforced saving behaviors, which often combine with excessive acquisition to give rise to clutter, distress, and impairment. Despite the central role emotional processes are thought to play in hoarding, very little research has directly examined this topic. There is suggestive evidence linking hoarding with several facets of emotional intolerance and avoidance, though one key limitation of this past research has been the exclusive reliance on self-report questionnaires. The aim of the current study was to conduct a multimethod investigation of the relationship between hoarding and perceptions of, and cognitions about, negative emotional states. A large unselected sample of nonclinical young adults (N = 213) completed questionnaires, behavioral tasks, and a series of negative mood inductions to assess distress tolerance (DT), appraisals of negative emotions, and emotional intensity and tolerance. Hoarding symptoms were associated with lowered tolerance of negative emotions, as well as perceiving negative emotions as more threatening. Individuals high in hoarding symptoms also experienced more intense emotions during the mood inductions than individuals low in hoarding symptoms, though there was no association with poorer performance on a behavioral index of DT. Across measures, hoarding was consistently associated with experiencing negative emotions more intensely and reporting lower tolerance of them. This relationship was particularly pronounced for the difficulty discarding and acquiring facets of hoarding. Our results offer initial support for the important role of emotional processes in the cognitive-behavioral model of hoarding. A better understanding of emotional dysfunction may play a crucial role in developing more effective treatments for hoarding.     

Processes in Group Cognitive and Behavioral Treatment for Hoarding

Processes that emerge in the course of group treatment, such as universality and mutual aid, have been posited to promote therapeutic change (e.g., Yalom, 1995); however, they have received relatively little attention in the group cognitive behavioral treatment (CBT) literature (Rose, 2004). Group CBT interventions have been successful in alleviating symptoms of mood and anxiety disorders, such as major depression and obsessive-compulsive spectrum disorder (e.g., Anderson & Rees, 2007; Himle et al., 2001). A specialized group CBT protocol has been developed to treat hoarding (Muroff et al., 2009; Steketee & Frost, 2007), characterized by excessive clutter in the home, difficulty discarding objects that appear of little value, and often excessive acquisition, resulting in significant distress and/or impairment (Frost & Hartl, 1996). Individual (Tolin, Frost, & Steketee, 2007) and group (Muroff et al.) CBT for hoarding have shown promising effects. An examination of group process factors relevant to hoarding, however, is critical in order to further understand and tailor group interventions for this complex problem. The current paper characterizes four group processes specific to group CBT for hoarding: (a) universality or inclusion may reduce stigma and shame about having hoarding; (b) cohesion seems to support attendance and to provide positive peer pressure to motivate change; (c) the opportunity to give mutual aid seems to instill hope and motivate change; (d) social contact and socializing may reduce social isolation, a characteristic of this population. Discussion includes specific case examples illustrating these group processes and their potential complexity, within the context of group CBT for hoarding. Recommendations are advanced for future directions in evaluating group CBT for hoarding, particularly the formal study of group process variables with this population.     

Body ownership and beyond: Connections between cognitive neuroscience and linguistic typology

During the past few decades, two disciplines that rarely come together—namely, cognitive neuroscience and linguistic typology—have been generating remarkably similar results regarding the representational domain of personal possessions. Research in cognitive neuroscience indicates that although the core self is grounded in body ownership, the extended self encompasses a variety of noncorporeal possessions, especially those that play a key role in defining one’s identity. And research in linguistic typology indicates that many languages around the world contain a distinct grammatical construction for encoding what is commonly called “inalienable” possession—a category of owned objects that almost always includes body parts, but that also tends to include several other kinds of personally relevant entities. Both of these independent lines of investigation are summarized, and a number of interdisciplinary connections between them are discussed.     

The Relationship between Traumatic Life Events and Hoarding Symptoms: A Multi-Method Approach

Hoarding Disorder is characterized by difficulties with discarding and frequently excessively acquiring possessions, resulting in substantial clutter. Previous research has implicated trauma in the development of hoarding, but no study to date has examined the relationship between trauma and hoarding using hypothetical hoarding paradigms. This study investigated the association between traumatic events and both self-report and hypothetical indices of hoarding symptoms. We predicted that frequency of trauma would be associated with greater hoarding symptoms (across self-report and hypothetical indices). Undergraduate students (N = 80) completed self-report measures of hoarding symptoms and trauma, and hypothetical measures of acquiring and saving tendencies. As expected, more frequent trauma, and physical/sexual trauma in particular, was associated with greater acquiring tendencies. However, frequency of trauma was not significantly correlated with saving tendencies or self-reported hoarding symptoms. Future research should replicate these findings using longitudinal designs to confirm whether trauma actually serves as a risk factor for hoarding. Replication in a clinical sample is needed to better understand the implications of these results for intervention.     

Yours or mine? Ownership and memory

An important function of the self is to identify external objects that are potentially personally relevant. We suggest that such objects may be identified through mere ownership. Extant research suggests that encoding information in a self-relevant context enhances memory (the so-called 'self-reference effect'), thus an experiment was designed to test the impact of ownership on memory performance. Participants either moved or observed the movement of picture cards into two baskets; one of which belonged to self and one which belonged to another participant. A subsequent recognition test revealed that there was a significant memory advantage for objects that were owned by self. Acting on items (i.e., moving them) had no impact on memory. Results are discussed with reference to the importance of self-object associations in cognition.     

信息时代的“数字占有”——数字囤积及其相关研究

数字囤积是指数字文件的积累致使个体降低目标检索能力,最终导致个体的压力和混乱,与实物囤积有联系但有所不同。数字囤积者的认知表现、情感特点、行为动机可分别从自我损耗、禀赋效应、进化的视角进行理解。未来研究应完善测量工具,并考虑文化背景,针对不同数字囤积人群,考察其行为的潜在动机和前因后果,同时应采用不同的研究方法,加强该领域的量化研究。     

Procrastinators and Clutter: An Ecological View of Living with Excessive “Stuff”

In the present study, young adults (n = 346; M age = 21.5 years old) completed self-reported measures of procrastination, self-identity with possessions, clutter, place attachment, and psychological home to provide an ecological understanding of the context in which chronic procrastinators live. Results found behavioral procrastination tendencies related only to clutter (a belief that living spaces have too much “stuff,” feeling overwhelmed with excessive possessions, and that one’s personal life is negatively impacted by many possessions). Clutter in one’s living space, negative emotions, and impaired social ability all predicted high procrastination scores. Clutter was the best predictor of procrastination as determined by multiple regression. Taken together, chronic procrastinators reported too much clutter (possessions, or stuff), and that clutter interferes with a strong quality of their lives.     

Do traumatic events influence the clinical expression of compulsive hoarding?

Traumatic experiences have been posited as one potential catalyst for the abrupt onset of obsessive-compulsive symptoms including compulsive hoarding. To determine whether traumatic life events (TLEs) might influence the expression of compulsive hoarding in obsessive-compulsive disorder (OCD), interview responses to the Posttraumatic Stress Disorder module of the Structured Clinical Interview for DSM-IV (SCID) were examined in 180 individuals with OCD. Compared to individuals with OCD who did not meet criteria for hoarding, participants classified as hoarders (24% of the sample) were significantly more likely to have reported at least one TLE in their lifetime. Patients who met criteria for hoarding and who had also experienced TLEs had significantly greater hoarding symptom severity than those hoarders not exposed to trauma. This association was found to be robust. That is, the relationship between TLEs and hoarding symptom severity was not better accounted for by age, age of OCD onset, depressive symptoms, general OCD symptomatology, or mood and anxiety comorbidity. Closer examination revealed that the clutter factor of compulsive hoarding (and not difficulty discarding or acquisitioning) was most strongly associated with having experienced a traumatic event.     

Treating Elders With Compulsive Hoarding: A Pilot Program

Hoarding among elderly clients can have serious health and safety consequences, including death. Because medications and standard behavioral treatments have yielded limited benefits for people with serious hoarding problems, we employed a specialized cognitive behavioral treatment (CBT) based on Frost and colleagues' model of hoarding problems. Of 11 elderly clients who met screening criteria for hoarding at a community mental health center, 6 completed an average of 35 sessions of therapy administered by a B.A.-level therapist trained and supervised in CBT methods. Treatment consisted of weekly home visits that included motivational interviewing, organizing and decision-making skills, cognitive therapy regarding hoarding and related beliefs, and practice sorting, discarding, and not acquiring. Modest improvement was evident in ratings of clutter, risky situations in the home, and functioning. Clients were generally satisfied with treatment. Challenges in treating hoarding in elderly clients include health and safety risks as well as reduced physical capacity that required problem-solving strategies.     

When hoarding is a symptom of OCD: A case series and implications for DSM-V

Hoarding, the excessive collection and failure to discard objects of apparently little value, can represent a serious psychiatric problem and pose a threat to public health. Hoarding has traditionally been considered a symptom (or symptom dimension) of Obsessive-Compulsive Disorder (OCD), but its nosological status has recently been debated. Mounting evidence suggests that, once other primary causes are ruled out, hoarding may be a discrete diagnostic entity, recently named Hoarding Disorder. However, hoarding can sometimes be a genuine OCD symptom. This can be confusing and clinicians may sometimes struggle making the differential diagnosis. To illustrate this, we describe 10 OCD patients with severe hoarding behavior that is better conceptualized as a symptom of OCD. We focus on the motivations for hoarding and the overlapping of hoarding with other obsessive-compulsive symptom dimensions. We estimate that this clinical presentation is relatively rare and accounts for a minority of severe hoarding cases. We discuss the unique characteristics of hoarding as a symptom of OCD and the implications for DSM-V.