Brain Oddities: Collector’s Item

In recent months, I have become somewhat of a minimalist. I have come to the belief that less is more simply because, like many New York residents, I live in a shoebox. Due to severely limited space and a desire to see my floor, I’ve had to shed many things I collected in my pre-New York years.

Fortunately, I’ve had an easier time getting rid of belongings than some people might. An estimated 2-5 percent of the U.S. population suffers from compulsive hoarding (CH) [1], which is defined as “an accumulation of an excessive number of objects due to an inability to discard things of little value” [2]. In 2009, A&E began showing a television series called "Hoarders," which profiles people whose lives have been severely and detrimentally affected by CH. Over the course of more than 60 episodes, "Hoarders" has illustrated that what some people consider merely a personality quirk is actually much more serious.

The DSM-V Task Force, the most-superhero-sounding body of scientists responsible for overseeing the development of the fifth edition of the APA’s Diagnostic and Statistical Manual of Mental Disorders, is deciding whether to classify CH as a standalone disorder or as part of a broad definition of obsessive-compulsive disorder (OCD). Between 20 percent and 40 percent of people diagnosed with OCD report hoarding compulsions, meaning it could be a symptom of their disorder; however, hoarding is the major symptom of fewer than 5 percent of those cases. Furthermore, CH is often present alone or with other psychiatric disorders. The lack of CH’s clear placement in the DSM has caused some shortcomings in research on diagnoses and treatments; most studies on the disorder do not differentiate between people with OCD and hoarding tendencies and those whose only symptom is compulsive hoarding.

What is known about CH, however, is that it’s usually chronic and progressive, which means it has a higher prevalence in older people. Furthermore, although it seems to be genetically influenced, it can also be triggered by a stressful life event [3]. Whatever its origin, CH appears to be related to dysfunction in the frontal lobe. One study of patients with focal brain lesions found that 13 participants out of 86 displayed hoarding behavior; all 13 of those participants had lesions in the mesial frontal region of the brain [4]. Some studies have also found that hoarders perform more poorly than controls on tests of memory, attention, planning, and decision-making.

Regardless of how it's classified, finding treatments to ameliorate its symptoms is important. After hours of scientific research—watching "Hoarders" on Netflix streaming— I’ve learned that it’s an illness that needs understanding and visibility. I hope the Task Force will make the right decision to help the millions of Americans who suffer from compulsive hoarding.

In the meantime, enjoy this DSM-V Superhero Task Force logo I drew:

  DSMVcopy

  1. Pertusa, A., Frost, R.O., Fullana, M. A., Samuels, J., Steketee, G., Tolin, D., Saxena, S., Leckman, J.F., Mataix-Cols, D. 2010. Refining the boundaries of compulsive hoarding: A review. Clinical Psychology Review, 30, 371-386.
  2. Blom, R.M., Samuels, J.F., Grados, M.A., Chen, Y., Bienvenu, O.J., Riddle, M.A., Liang, K., Brandt, J., Nestadt, G. 2011. Cognitive functioning in compulsive hoarding. J  Anxiety Dis.
  3. Grisham, J.R., Norberg, M.M. 2010. Compulsive hoarding: current controversies and new directions. Dialogues Clin Neurosci, 12:233-240.
  4. Anderson, S.W., Damasio, H., Damasio, A.R. 2005. A neural basis for collecting behaviouir in humans. Brain, 128:201-212.

— Caitlin Schneider

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