Hoarding disorder is a behavioral pattern characterized by the unwillingness or inability to discard items that others may view as worthless or the excessive acquisition of possessions, leading to clutter that disrupts their ability to use workspaces or home in general. This disorder is not the same as collecting as they often save the same random things and store them haphazardly in most cases.
Hoarding disorder and ADHD
Traditionally, hoarding symptoms are conceptualized as part of obsessive-compulsive disorder or OCD but a recent study shows that they may be linked to attention deficit hyperactivity (ADHD) symptoms. The National Institute of Mental Health (NIMH) has defined ADHD as a disorder marked by an ongoing pattern of hyperactivity-impulsivity or inattention that interferes with development or functioning.
A team of researchers from the Anglia Ruskin University (ARU) in England discovered the link between hoarding disorder (HD) and ADHD. Their study, which appeared in Medical Xpress, was funded by the British Academy and the UK grant-making organization Leverhulme Trust.
Study leader Dr. Sharon Morein and colleagues compared adults diagnosed with ADHD. These subjects were recruited through the National Health Service trust in England. It was found that about 20% of people with ADHD also have clinically significant levels of hoarding.
Dr. Morein said that those with HD have difficulties with executive functioning and information processing in the same way as people diagnosed with ADHD. Hence, they wanted to focus on the aspects of hoarding symptoms among people attending an adult ADHD clinic in their country.
Using the Clutter Image Rating Scale
Several assessments were conducted, such as the Clutter Image Rating Scale. In this test, participants were given various photographs of a living room, bedroom, and kitchen. They were asked to choose the photo that most closely represents their living conditions. The result shows that age and sex are less of a factor among individuals with ADHD regarding concerning clinically significant levels of HD.
Dr. Morein went on to say that based on their study results, up to one in five adults seeking help for ADHD may likewise have issues with hoarding that impair their daily life. On average, those who hoarded are in their late 30s and no relation was found on gender. The study results are likewise consistent with the possibility that much of the older hoarders may have undiagnosed ADHD.
In a book titled Group Treatment for Hoarding Disorder: Therapist Guide, authors Gail Steketee and Randy O. Frost, who were not involved in the recent study, said that the average scores for people with HD are 3.7 in the living room, 3.4 in kitchen, and 4.1 in bedroom images. On the other hand, the average scores for people without HD are 1.3 in the living room, 1.2 in the kitchen, and 1.3 in bedroom images.
ADHD symptoms in childhood and lifetime hoarding symptoms
A 2013 epidemiological study by Miquel Angel Fullana from Hospital Clínic de Barcelona and colleagues also showed how hoarding symptoms could be closely related to ADHD symptoms, particularly inattention but not hyperactivity. The study investigated the association between lifetime hoarding symptoms and reported ADHD symptoms in childhood.
Hoarding disorder: statistics and symptoms
The International OCD Foundation shares that around 2% to 6% of the population suffers from HD and it is a disorder that affects men and women at the same rates. Hoarding symptoms may first emerge between ages 11 to 15. The signs of HD are difficulty getting rid of items, a large amount of clutter at home, in the office, in the car, or other spaces that make it difficult to use the appliances or furniture or move easily, feeling overwhelmed by the volume of possessions, losing important items like bills or money in the clutter, being unable to stop taking free items, such as sugar packets from restaurants and advertising flyers, refusing to let people into home to make repairs, and not inviting friends or family into the home due to embarrassment or shame.
Hoarders find it difficult to get rid of the items because they also find it difficult to organize possessions, they have unusually strong positive feelings (delight, joy) when getting new items or they have strong negative feelings (anger, fear, guilt) when considering getting rid of items.
HD can be treated but has not responded well to the usual treatments that work effectively for OCD. The disorder cannot be solved by simply cleaning out the home without treating the underlying problem. Community agencies and families may spend thousands of dollars and hours clearing a home but the problem may recur often within just a few months. Also, hoarders often experience distress when their items are cleared without their consent. As a result, they may refuse future help from other people.
Who struggles with HD?
On average, people who exhibit hoarding behavior live alone, are three times more likely to be obese than the average person, have at least one family member who is also a hoarder, and are a perfectionist, according to the Recovery Village, which offers comprehensive mental health treatments. Although there are many types of hoarding, the most easily recognized form of HD is the hoarding of possessions. These things include paper (magazines, newspapers, mail), books, clothing, photographs, containers, and food. Others compulsively hoard animals, like dogs and cats that usually result in large numbers of animals living in a single place. These animal hoarders may abuse or neglect their pets unintentionally but they have trouble giving the animals up even at the expense of the well-being of these animals. An estimated 78% of animal hoarders' homes are also heavily littered with garbage. In extreme cases, a hoarder may hoard human waste products and garbage.
Prevalence of ADHD
Meanwhile, scientific online publication Our World in Data shares the prevalence of ADHD in males and females in 2017. Countries with the highest prevalence of ADHD in males include Australia (3.36%), Australasia (3.48%), Bermuda (3.24%), United States Virgin Islands (3.24%), and Cuba (3.23%) while those among females are Australia (1.43%), Australasia (1.38%), Uruguay (1.34%), Chile (1.34%), and Southern Latin America (1.33%).
Although previous studies involving HD mainly focused on individuals who consider themselves as hoarders, the Anglia Ruskin University study went further by focusing on aspects of hoarding in people diagnosed with ADHD.