Neziroglu Hoarding Presentation - Part 1

Jun 10, 2015 | Author: Bio Behavioral Institute

Evidence Based Treatment of Complex Hoarding Disorder
Part 1

Fugen Neziroglu, Ph.D ABBP, ABPP, Leah Frenkiel,B.A., Claudio Clavadetscher,B.A, & Douglas Fabian,B.A
 

1. Hoarding Disorder

         Hoarding is the acquisition of, and failure to discard, large numbers of possessions that have little use or value

         Compulsive Hoarding: A disorder in which a person fails to throw away worn-out or useless items, and may acquire additional items

         Clutter prevents usage of functional space & significant distress or impairment Frost & Hartl (1996)

2. Prevalence

         2-6% in the United States and Europe

         Hoarding disorder affects males & females, but a greater prevalence among males

         More prevalent in older adults (ages 55-94 years) compared with younger adults (ages 34-44 years)

3. Possible Etiology of Hoarding

         Informational-Processing Deficits (e.g. poor decision making, organizing, and memory)

         Emotional attachment to possessions

         Cognitive distortions. For example, “I will never be able to get the info anywhere else”

         Neurobiological

4. Affected Brain Circuits in Hoarding Disorder

         Compared to non-hoarding participants, hoarding participants showed greater activity in left lateral orbitofrontal cortex (OFC) and parahippocampal gyrus (PHG)

         Participants: (n=12) diagnosed with compulsive hoarding, 17% met criteria for OCD and 12 healthy controls

         Tolin, Kiehl et al. (2009)

5. Assessment of Hoarding Disorder

         OCD patients with prominent hoarding symptoms showed greater activation in ventromedial prefrontal cortex (VMPFC) than did patients without hoarding symptoms and healthy controls (An et al., 2009)

         Participants (n=29) OCD patients (13 with and 16 without prominent hoarding symptoms) and 21 healthy controls 

         Yale-Brown Obsessive Compulsive Scale (Y-BOCS; Goodman, et al., 1989)

         The Padua Inventory - Washington State University Revision (PI; Burns, Keortge, Formea, and Sternberger, 1996)

         Multidimensional Perfectionism Scale (MPS; Hewitt, Flett, 1991)

         The Family Emotional Involvement and Criticism Scale (FEIC; Shield et al., 1992)

         Saving Cognition Inventory Revised (SCI-R; Steketee, Frost, & Kyrios, 2003)

         The Family Attitude Scale (FAS; Kavanagh et al., 1997)

         Obsessive Compulsive Inventory (OCI; Clark & Beck, 2002)

         Saving Inventory Revised (SI-R; Frost 2003)

         Attachment to Possessions Questionnaire (Foa and Wilson, 1991)

         Preference for Solitude Scale (PSS; Burger, 1995)

         Hoarding Rating Scale (Tolin, Frost, Steketee, Gray, & Fitch, 2008)

6. Collectors vs. Hoarders

Collectors

·        Feel proud of their possessions

·        Keep possessions organized and well maintained

·        Find joy in their possessions & willingly display them to others

·        Attend meetings or conferences with others who share their interest

·        Enjoy conversations about their possessions

·        Budget their time and money around their possessions

·        Feel satisfaction when making additions to the collection

Hoarders

·        Feel embarrassed by their possessions

·        Have possessions scattered randomly, often without any functional organization

·        Have clutter, often resulting in the loss of functional living space

·        Feel uncomfortable with others seeing their possessions, or outright refuse to let others view their possessions

·        Often have debt, sometimes extreme

·        Feel ashamed, sad, or depressed after acquiring additional items
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