Hoarding: What Everyone Needs to Know®

Cover
Hoarding
Copyright
Contents
List of Tables
List of Figures
Acknowledgments
Introduction
1 What is hoarding and hoarding disorder?
	How is hoarding defined?
		Excessive acquisition
		Excessive saving
		Excessive clutter
		Disorganization
	What are the criteria for diagnosing hoarding disorder?
	What distinguishes hoarding from other psychiatric and  medical problems?
		Obsessive-​compulsive disorder
		Depression
		Eating disorders
		Psychosis
		Dementia
		Brain injury
	Is hoarding of animals part of hoarding disorder?
	What’s the difference between hoarding and collecting?
	Do people who hoard also have a compulsive buying problem?
	Does a messy or disorganized home mean there is a  hoarding problem?
	Does a dirty home mean there is a hoarding problem?
	Is saving electronic information part of hoarding disorder?
	Why are some people unable to admit they have a hoarding problem?
	What does hoarding look like in children?
	Focus on: definition of hoarding and HD
2 What are the common features of hoarding?
	How prevalent is hoarding?
	Is this a new problem?
	Who is most at risk for HD?
		Age
		Gender
		Education and economic status
		Family and culture
		Genetics and family history
		Life experiences
	Why do people save stuff?
		Sentimental attachment
		Utility
		Aesthetics
	What emotions are associated with hoarding?
	What other problems commonly co-​occur with hoarding?
	Focus on: common features of hoarding
3 What are the neurocognitive features  of hoarding?
	What do we know about brain patterns in hoarding?
	What do brain scans show?
	How does the brain process information?
		Attention
		Organizing and categorizing
		Memory
		Decision making
		Avoiding risk
		Impulsivity
		Problem solving
	Do people who hoard have special thoughts and beliefs?
		Usefulness, waste, and responsibility
		Sentimental beliefs and emotional attachment to possessions
		Confidence in memory
		Creative thinking
		Perfectionism
	Is hoarding associated with emotion regulation?
	Focus on: neurocognitive features of hoarding
4 What is the impact of hoarding on sufferers, families, and communities?
	What kinds of problems does hoarding cause?
		Household maintenance and tenancy preservation
		Employment and finances
		Physical health
		Mental health
	Does hoarding cause family and social problems?
		Family problems
		Social problems
	Does hoarding cause problems for neighbors and communities?
	Focus on: the impact of hoarding
5 How serious is the hoarding problem?
	How do I know when my saving is really a problem?
		Hoarding Rating Scale
		Saving Inventory-​Revised
		Clutter Image Rating
		Activities of Daily Living for Hoarding
	Is my thinking problematic?
	How do communities decide when hoarding is a problem?
		Hoarding Interview
		HOMES multidisciplinary risk assessment
		Home Environment Index
		Community use of the Clutter Image Rating
	What other assessments can help determine the severity of hoarding?
	Focus on: measuring the severity of hoarding
6 Why do people hoard?
	What features might help us understand how hoarding develops  and persists?
		Genetics
		Mood
		Trauma
	Can animal models help us understand human hoarding?
	Is attachment to possessions related to problems with attachment to people?
		Site security model
		Identity and attachment model
	Is there a comprehensive psychological model that explains hoarding symptoms?
		Vulnerability factors
		Information-​processing problems
		Beliefs
		Positive and negative emotional reactions
		Avoidance behaviors and hoarding symptoms
		Secondary consequences and the vicious cycle
	How does this model guide treatment?
	Focus on: conceptual models for hoarding
7 What treatments work best for hoarding  and acquiring?
	Do medications work for hoarding?
		SRIs used for OCD
		Paroxetine
		Venlafaxine
		Other medications
	How helpful is CBT?
		Exposure and response prevention for OCD
		Components of CBT for hoarding
		Individual CBT with a mental health clinician
		Group CBT
		Comparisons of group and individual treatments
	What about treatments for special populations?
		Treating older adults with hoarding
		Treating children with hoarding
		Treating people who hoard animals
		Other therapy methods
	Focus on: treatment for hoarding
8 How can family members and other methods help with hoarding?
	How do you know when a family member has hoarding problems?
	How can family members help?
		Harm reduction
		Making a harm-​reduction plan
	Should family members get professional help?
	Can I get help from the internet?
	Are there self-​help books I can read?
	Will joining a support group help?
	Will hiring a professional organizer help?
	Focus on: families and other sources of help for hoarding
9 How can communities help with hoarding?
	Isn’t my home my castle?
	Who is responsible for health and safety risks due to hoarding?
		Housing
		Public or environmental health
		Protective services
		Coordinated community services
	What community-​based supports are available to help with hoarding?
		Task forces
		Peer-​led and community-​based support groups
		Case management models
		In-​home decluttering
		Cleanouts
	Focus on: community responses to hoarding
10 What are the next steps to understand and treat hoarding?
	What don’t we understand about hoarding disorder?
		Diagnostic criteria for HD
		Acquiring behavior
		Digital hoarding
		Insight and motivation
		Use of language about hoarding
		Causes of hoarding behavior
		Symptoms in diverse populations
		Hoarding in children
		Animal hoarding
		Clinic and community partnerships
	What’s missing from the CBT model of HD?
		Addictions models
		Human attachment models
		Consumer behavior models
	How can we improve interventions for HD?
		Prevention and early intervention
		Medications
		Enhancing motivation
		Access to services
		Alternative delivery strategies for CBT
		Alternative methods of treatment
		Stepped-​care methods for delivering hoarding intervention
		Focus on: next steps in understanding and treating HD
Bibliography and resources
Index