Critical Development in the History of Hoarding

By Zoltana Domotor, from If I was a Hoarder:

On December 1, 2012 the board of trustees of the American Psychiatric Association approved the final diagnostic criteria for the fifth edition of the Diagnostic and Statistical Manual, due to be published in May 2013. Among the diagnoses new to the fifth edition of the manual is Hoarding Disorder, which is defined as:

(A) Persistent difficulty discarding or parting with personal possessions, even those of apparently useless or limited value, due to strong urges to save items, distress, and/or indecision associated with discarding.

Interestingly, the primary behavior to define the disorder is not the act of acquiring—which is included in the diagnostic criteria as a specifier—but a failure to produce (or recognize) waste. Paired with this inadequate waste production is the stipulation that it result in a verifiable reality of clutter:

(B) The symptoms result in the accumulation of a large number of possessions that fill up and clutter the active living areas of the home, workplace, or other personal surroundings (e.g., office, vehicle, yard) and prevent normal use of the space. If all living areas are uncluttered, it is only because of others’ efforts (e.g. family members, authorities) to keep these areas free of possessions.  

Criterion C requires clinically significant distress or impairment; while (D) and (E) stipulate that the hoarding symptoms not result from a general medical condition (brain injury, cerebro-vascular disease) or another mental disorder (Obsessive Compulsive Disorder, Major Depressive Disorder, Prader-Willi Syndrome).

The diagnostic criteria also include two specifiers: whether the symptoms are accompanied by “Excessive Acquisition”: “collecting, buying, or stealing of items that are not needed for which there is no available space”; and whether the hoarding beliefs and behaviors are characterized by good, fair, or poor insight, or are delusional.

See also:

American Psychiatric Association, “News Release: American Psychiatric Association Board of Trustees Approves DSM-5” (Release No. 12-43, 12/1/2012) [ The PDF is available online]

Mataix-Cols, D, A Pertusa, R.O Frost, L.A Clark, S Saxena, J.F Leckman, D.J Stein, H Matsunaga, and S Wilhelm. “Hoarding Disorder: a New Diagnosis for DSM-V?” Depression and Anxiety. 27.6 (2010) [The PDF is available online ]

An earlier post about the DSM-V Hoarding Disorder entry on If I Were a Hoarder: “DSM-V News: Hoarding Disorder

Photo from: Hollywood Autograph News

Photo from: Hollywood Autograph News

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