Cognitive/behavioral treatment of compulsive hoarding

What is Compulsive Hoarding?

Compulsive hoarding is a disorder that involves the accumulation of belongings to such an extent that the resulting clutter renders parts of the living space unusable.

What are the signs/symptoms of Compulsive Hoarding?

•The acquisition and failure to discard a large number of items/possession that are considered by most to be of little or no value
•These possessions clutter the living space, rendering the space unable to be used in the manner in which it was intended
•The hoarding behavior causes marked distress or interferes with one’s daily functioning

What maintains Compulsive Hoarding behavior?

•Emotional Attachment - Individuals with compulsive hoarding tend to have strong emotional attachment to objects, finding each unique or meaningful to them and thus have difficulty parting with the items. They often prefer to have control of the items, including who is permitted to touch or sort through them.
•Information Processing - Individuals with compulsive hoarding tend to report difficulties in remembering the location of items and like to have items visible or have visual reminders. They often worry that they might forget something and thus hold on to items as reminders. They have difficulty in utilizing broad categorization skills and find it difficult to make decisions regarding the disposition of possessions.
•Erroneous Beliefs - Individual with compulsive hoarding tend to have erroneous beliefs regarding their possessions related to perfectionism, control, responsibility, value of individual items, and potential utility of items.
•Distress Regarding Discarding/Acquiring - Individuals with compulsive hoarding experience significant distress and anxiety when faced with having to decide whether to discard a possession. They may also experience anxiety when they feel a need to acquire an object they desire and believe that this feeling can only be relieved through acquisition of the item.
•Negative Reinforcement - Compulsive hoarding behavior is maintained through negative reinforcement; in other words, individuals are able to relieve their distress by putting off making decisions about disposition or discarding items, which leads to increased clutter and continued avoidance of sorting and/or discarding.

Is Compulsive Hoarding related to Obsessive-Compulsive Disorder?

Compulsive Hoarding is considered to be related to obsessive-compulsive disorder (OCD), an anxiety disorder characterized by recurrent unwanted thoughts (obsessions) and repetitive behaviors (compulsions); however many consider it to be a distinct disorder in and of itself.

Compulsive hoarding is a complex disorder and may involve co-occurring disorders, trauma history, genetic factors, and/or learned behavior (modeling). Hoarding behavior typically begins in late childhood/early adolescence and progresses throughout the lifespan. Although its exact prevalence is unknown, it is believed that approximately 1% - 5% of the population exhibits compulsive hoarding. Studies suggest that 20% - 30% of individuals with OCD exhibit compulsive hoarding behavior. Insight into the seriousness of the problem may be limited and relatives may be most affected by the behavior.

How is Compulsive Hoarding treated?

Although some individuals with compulsive hoarding respond to antidepressant medication, many individuals do not. Cognitive-Behavioral Therapy has been demonstrated to be helpful in the treatment of compulsive hoarding which involves helping individuals to change they way they think about and make decisions about their possessions in order to control the behavior. This process involves behavioral assessment, psychoeducation, exposure/response prevention, cognitive restructuring, and excavation exposure.

How is The Center for Emotional Health uniquely experienced with Compulsive Hoarding?

Dr. Deibler trained for a full year, 1999, in the treatment of Obsessive-Compulsive Spectrum Disorders, as an apprentice of Dr. Charles Mansueto of the Behavior Therapy Center of Greater Washington, LLC, one of leading experts in the treatment of Obsessive-Compulsive Spectrum Disorders.

Following her apprenticeship, Dr. Deibler was awarded a three-year fellowship to research Trichotillomania and Obsessive-Compulsive Disorder at the National Institute of Mental Health, where she spent three years interviewing, evaluating, and studying hundreds of individuals with these disorders and their families; she also served as an associate investigator in Genetics of Obsessive-Compulsive Disorder: A Collaborative Study. Dr. Deibler produced a 160-page doctoral dissertation as a result of her efforts, “The Five-Factor Model of Personality in Trichotillomania and Obsessive-Compulsive Disorder: Implications for Diagnostic Classification” and was awarded a certificate for “Outstanding Graduate Research” by the National Institutes of Health.

Dr. Deibler has presented her works at regional, national, and international meetings and has published her work in peer-reviewed scientific journals. Dr. Deibler is a member of the International OCD Foundation (formerly the Obsessive Compulsive Foundation) and has been involved in working with the Obsessive-Compulsive Spectrum Disorders community since 1999. She has also appeared on A&E’s

, CBS evening news, It’s Your Call with Lynn Doyle (Comcast Network, Retirement Living TV), and will be appearing on CBS’s Swift Justice with Nancy Grace in the fall of 2010.