Hostname: page-component-8448b6f56d-jr42d Total loading time: 0 Render date: 2024-04-23T13:37:01.544Z Has data issue: false hasContentIssue false

Compulsive Hoarding: An Interpretative Phenomenological Analysis

Published online by Cambridge University Press:  12 January 2010

Stephen Kellett*
Affiliation:
Centre for Psychological Services Research, University of Sheffield, UK
Rebecca Greenhalgh
Affiliation:
University of Sheffield, UK
Nigel Beail
Affiliation:
University of Sheffield, UK
Nicola Ridgway
Affiliation:
University of Glasgow, UK
*
Reprint requests to Stephen Kellett, Clinical Psychology Unit, University of Sheffield, S10 2TN, UK. E-mail: s.kellett@sheffield.ac.uk

Abstract

Background: This project aimed to explore the experiences of people who compulsively hoard and how they make sense of their own hoarding behaviours. Method: A total of 11 compulsive hoarders were recruited and interviewed using a simple semi-structured interview format, designed for the purposes of the study. The resulting transcribed interviews were analyzed using interpretive-phenomenological analysis. Results: Four super-ordinate discrete, but interacting, themes were found: (1) childhood factors; (2) the participants' relationship to their hoarded items; (3) cognitive and behavioural avoidance of discard; and (4) the impact of hoarding on self, others and the home environment. The themes as a whole described people entrapped in massively cluttered physical environments of their own making. Efforts at discard appeared consistently sabotaged by cognitive/behavioural avoidance, thereby creating maintaining factors of associated personal distress and environmental decline. Conclusions: The results are discussed in the context of the extant evidence concerning hoarding, the distinct contribution made by the current results and the identified methodological shortcomings of the research approach.

Type
Research Article
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abramowitz, J. S., Wheaton, M. G. and Storch, E. A. (2008). The status of hoarding as a symptom of obsessive-compulsive disorder. Behaviour Research and Therapy, 46, 10261033.CrossRefGoogle ScholarPubMed
Allchin, D. (2001). Error types. Perspectives on Science, 9, 3858.CrossRefGoogle Scholar
Anderson, S. W., Damasio, H. and Damascio, A. R. (2005). A neural basis for collecting behaviour in humans. Brain, 128, 201212.CrossRefGoogle ScholarPubMed
American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders – IV. Washington, DC: American Psychiatric Association.Google Scholar
Black, D. W., Monahan, P., Gable, J., Blum, N., Clancy, G. and Baker, P. (1998). Hoarding and treatment response in 38 non-depressed subjects with obsessive compulsive disorder. Journal of Clinical Psychiatry, 59, 420425.CrossRefGoogle Scholar
Bley, N. F. (1984). Denial in fantasy and hypomania: an exploration. Journal of the American Psychoanalytic Society, 32, 865879.Google ScholarPubMed
Bystritsky, A. (2006). Treatment resistant anxiety disorders. Molecular Psychiatry, 11, 805811.CrossRefGoogle ScholarPubMed
Calvocoressi, L., Lewis, B., Harris, M., Trufan, S. J., Goodman, W. K., McDougle, C. J. and Price, L. H. (1995). Family accommodation in obsessive-compulsive disorder. American Journal of Psychiatry, 152, 441443.Google ScholarPubMed
Cromer, K. R., Schmidt, N. B. and Murphy, D. L. (2007). Do traumatic events influence the clinical expression of compulsive hoarding? Behaviour Research and Therapy, 45, 25812592.CrossRefGoogle ScholarPubMed
Flowers, P., Duncan, B. and Knussen, C. (2003). Re-appraising HIV testing: an exploration of the psychosocial costs and benefits associated with learning one's HIV status in a purposive sample of Scottish gay men. British Journal of Health Psychology, 8, 179194.CrossRefGoogle Scholar
Fraley, R. C., Waller, N. G. and Brennan, K. A. (2000). An item response theory analysis of self report measures of attachment. Journal of Personality and Social Psychology, 78, 350365.CrossRefGoogle ScholarPubMed
Frost, R. O. and Hartl, T. L. (1996). A cognitive-behavioural model of compulsive hoarding. Behaviour Research and Therapy, 36, 657664.CrossRefGoogle Scholar
Frost, R. O., Novaro, C. and Rheume, J. (2002). Perfectionism in obsessive compulsive disorder. In Frost, R. O. and Steketee, G. (Eds.), Cognitive Approaches to Obsessions and Compulsions: theory, assessment and treatment (pp. 91107). Amsterdam: Elsevier.CrossRefGoogle Scholar
Frost, R. O. and Shows, D. L. (1993). The nature and measurement of compulsive indecisiveness. Behaviour Research and Therapy, 31, 683692.CrossRefGoogle ScholarPubMed
Frost, R. O., Steketee, G. and Grisham, J. (2004). Measurement of compulsive hoarding: the saving inventory revised. Behaviour Research and Therapy, 42, 11631182.CrossRefGoogle ScholarPubMed
Frost, R. O., Steketee, G., Williams, L. F. and Warren, R. (2000). Mood, personality disorder symptoms and disability in obsessive-compulsive hoarders: a comparison with clinical and non-clinical controls. Behaviour Research and Therapy, 38, 10711081.CrossRefGoogle Scholar
Furby, L. (1978). Possessions: toward a theory of their meaning and function throughout the life cycle. In Yates, P. B. (Ed.), Life-Span Development and Behaviour (Vol. 1, pp. 297336). New York: Academic Press.Google Scholar
Gilbert, P., Gilbert, J. and Irons, C. (2004). Life events, entrapments and arrested anger in depression. Journal of Affective Disorders, 79, 149160.CrossRefGoogle ScholarPubMed
Grisham, J. R., Frost, R. O., Steketee, G., Kim, H. J. and Hood, S. (2000). Age of onset of compulsive hoarding. Journal of Anxiety Disorders, 20, 675686.CrossRefGoogle Scholar
Grisham, J. R., Brown, T. A., Liverant, G. I. and Campbell-Sills, L. (2005). The distinctiveness of compulsive hoarding from obsessive-compulsive disorder. Journal of Anxiety Disorders, 19, 767779.CrossRefGoogle ScholarPubMed
Grisham, J. R., Steketee, G. and Frost, R. O. (2007). Interpersonal problems and emotional intelligence in compulsive hoarding. Depression and Anxiety, 25, 6371CrossRefGoogle Scholar
Hartl, T. L., Duffany, S. R., Allen, G. J., Steketee, G. and Frost, R. O. (2005). Relationships among compulsive hoarding, trauma and attention deficit/hyperactivity disorder. Behaviour Research and Therapy, 43, 269276.CrossRefGoogle ScholarPubMed
Hartl, T. L., Frost, R. O., Allen, G. J., Deckersbach, T., Steketee, G., Duffany, S. R. and Savage, C. R. (2004). Actual and perceived memory deficits in individuals with compulsive hoarding. Depression and Anxiety, 20, 5969.CrossRefGoogle ScholarPubMed
Kellett, S. (2006). The treatment compulsive hoarding with object-affect informed CBT: initial experimental case evidence. Behavioural and Cognitive Psychotherapy, 34, 481485.CrossRefGoogle Scholar
Kellett, S. (2007). Compulsive hoarding: a site security model and associated psychological treatment strategies. Clinical Psychology and Psychotherapy, 14, 413427.CrossRefGoogle Scholar
Kellett, S. and Knight, K. (2003). Does the concept of object-affect fusion refine cognitive-behavioural theories of hoarding? Behavioural and Cognitive Psychotherapy, 31, 457461.CrossRefGoogle Scholar
Keski-Rahkonen, A. and Tozzi, F. (2005). The process of recovery in eating disorder sufferers’ own worlds: an internet based study. International Journal of Eating Disorders, 37, 773782.CrossRefGoogle Scholar
Kyrios, M., Steketee, G., Frost, R. O. and Oh, S. (2002). Cognitions in compulsive hoarding. In Frost, R. O. and Steketee, G. (Eds.), Cognitive Approaches to Obsessions and Compulsions: theory, assessment and treatment. Amsterdam: Elsevier Science Ltd.Google Scholar
Lawrence, N. S., Wooderson, S., Mataix-Cols, D., David, R., Speckens, A. and Phillips, M. L. (2006). Decision making and set shifting impairments are associated with distinct symptom dimensions in obsessive-compulsive disorder. Neuropsychology, 20, 409419.CrossRefGoogle ScholarPubMed
Maier, S. F. (1976). Learned helplessness: theory and evidence. Journal of Experimental Psychology, 105, 346.CrossRefGoogle Scholar
Maier, T. (2004). On the phenomenology and classification of hoarding: a review. Acta Psychiatrica Scandinavica, 110, 323337.CrossRefGoogle ScholarPubMed
Main, M. and Goldwyn, R. (1994). Adult Attachment Interview Classification System: Version 6.0. Unpublished manuscript, University of California, Berkeley.Google Scholar
Marchesi, C., Ampollini, P., DePanfilis, C. and Maggini, C. (2008). Temperament features in adolescents with ego-syntonic and ego-dystonic obsessive-compulsive features. European Child and Adolescent Psychiatry, 17, 392396.CrossRefGoogle Scholar
Mataix-Cols, D., Rauch, S. L., Baer, L., Eisen, J. L., Shera, D. M. and Goodman, W. K. (2002). Symptom stability in adult obsessive-compulsive disorder: data from a naturalistic two-year follow-up study. American Journal of Psychiatry, 159, 263268.CrossRefGoogle ScholarPubMed
Mataix-Cols, D., Rosario-Campos, M. C. and Leckman, J. F. (2005). A multidimensional model of obsessive-compulsive disorder. American Journal of Psychiatry, 162, 228238.CrossRefGoogle ScholarPubMed
Mathews, C. A., Nievergelt, C. M., Azzam, A., Garrido, H., Chavira, D. A., Wessel, J., Bagnarello, M., Reus, V. I. and Schork, N. J. (2007). Heritability and clinical features of multigenerational families with obsessive-compulsive disorder and hoarding. American Journal of Medical Genetics, 144, 174182.Google Scholar
Merckelbach, H. and Wessel, I. (2000). Memory for actions and dissociation in OCD. Journal of Nervous and Mental Disease, 12, 846848.CrossRefGoogle Scholar
Millar, G. M. and Stermac, L. (2000). Substance misuse and childhood maltreatment: conceptualising the recovery process. Journal of Substance Misuse Treatment, 19, 175182.CrossRefGoogle Scholar
Mueller, A., Mueller, U., Albert, P., Mertens, C., Silbermann, A., Mitchell, J. E. and de Zwaan, M. (2007). Hoarding in a compulsive buying sample. Behaviour Research and Therapy, 45, 27542763.CrossRefGoogle Scholar
Neziroglu, F., Bubrick, J. and Yaryura-Tobias, J. A. (2004). Overcoming Compulsive Hoarding. Oakland, CA: New Harbinger Publications.Google Scholar
Pertusa, A., Fullana, M. A., Singh, S., Alonso, P., Menchón, J. M. and Mataix-Cols, D. (2008). Compulsive hoarding: OCD symptom, distinct clinical syndrome or both? American Journal of Psychiatry, 165, 12891298.CrossRefGoogle ScholarPubMed
Rufer, M., Fricke, S., Moritz, S., Kloss, M. and Hand, I. (2006). Symptom dimensions in obsessive compulsive disorder: prediction of cognitive-behaviour therapy outcome. Acta Psychiatrica Scandinavica, 113, 440446.CrossRefGoogle Scholar
Samuels, J., Shugart, Y. Y., Grados, M. A., Willour, V. L., Bienvenu, O. J., Greenberg, B. D., Knowles, J. A., McCracken, J. T., Rauch, S. L., Murphy, D. L., Wang, Y., Pinto, A., Fyer, A. J., Piacentini, J., Pauls, D. L., Cullen, B., Rasmussen, S. A., Hoehn-Saric, R., Valle, D., Liang, K. Y., Riddle, M. A. and Nestadt, G. (2007). Significant linkage to compulsive hoarding on chromosome 14 in families with obsessive-compulsive disorder: results from the OCD collaborative genetics study. American Journal of Psychiatry, 164, 493499.CrossRefGoogle ScholarPubMed
Saxena, S. (2007). Is compulsive hoarding a genetically and neurobiologically discrete syndrome? Implications for diagnostic classification. American Journal of Psychiatry, 164, 380384.CrossRefGoogle ScholarPubMed
Saxena, S. and Maidment, K. M. (2004). Treatment of compulsive hoarding. Journal of Clinical Psychology, 60, 11431154.CrossRefGoogle ScholarPubMed
Saxena, S., Brody, A. L., Maidment, K. M., Smith, E. C., Zohrabi, N., Katz, E., Baker, S. K. and Baxter, L. R. (2004). Cerebral glucose metabolism on obsessive-compulsive hoarding. American Journal of Psychiatry, 161, 10381048.CrossRefGoogle ScholarPubMed
Saxena, S., Maidment, K. M., Vapnik, T., Golden, G., Rishwain, T. and Rosen, R. M. (2002). Obsessive-compulsive hoarding: symptom severity and response to multimodal treatment. Journal of Clinical Psychiatry, 63, 2127.CrossRefGoogle ScholarPubMed
Shafron, R. and Tallis, F. (1996). Obsessive-compulsive hoarding: a cognitive-behavioural approach. Behavioural and Cognitive Psychotherapy, 24, 209221.CrossRefGoogle Scholar
Smith, J. A. (1996). Beyond the divide between cognition and discourse: using interpretative phenomenological analysis in health psychology. Psychology and Health, 11, 261271.CrossRefGoogle Scholar
Smith, J. A. (1997). Developing theory from case studies: self reconstruction and the transition from motherhood. In Hayes, N. (Ed.), Doing Qualitative Analysis in Psychology (pp. 187199). Hove: Psychology Press.Google Scholar
Smith, J. A. (2004). Reflecting on the development of interpretative phenomenological analysis and its contribution to qualitative research in psychology. Qualitative Research in Psychology, 1, 3954.Google Scholar
Smith, J. A., Jarman, M. and Osborn, M. (1999). Doing interpretative phenomenological analysis. In Murray, M. and Chamberlain, K. (Eds.), Qualitative Health Psychology; theories and methods (pp. 218240). London: Sage.CrossRefGoogle Scholar
Smith, J. A. and Osborn, M. (2003). Interpretative phenomenological analysis. In Smith, J. A. (Ed.), Qualitative Psychology: a practical guide to research methods (pp. 5181). London: Sage.Google Scholar
Steketee, G. and Frost, R. O. (2003). Compulsive hoarding: current status of the research. Clinical Psychology Review, 23, 905927.CrossRefGoogle ScholarPubMed
Steketee, G., Frost, R. O. and Kyrios, M. (2003). Cognitive aspects of compulsive hoarding. Cognitive Therapy and Research, 27, 463479.CrossRefGoogle Scholar
Steketee, G., Frost, R. O. and Kim, H. J. (2001). Hoarding by elderly people. Health and Social Care, 26, 176184.Google Scholar
Stiles, W. B. (2003). Qualitative research: evaluating the process and the product. In Llewelyn, S. and Kennedy, P. (Eds.), Handbook of Clinical Health Psychology (pp. 477499). New York: Wiley.CrossRefGoogle Scholar
Tolin, D. F., Frost, R. O. and Steketee, G. (2007). An open trial of cognitive behaviour therapy for compulsive hoarding. Behaviour Research and Therapy, 45, 14611470.CrossRefGoogle ScholarPubMed
Tolin, D. F., Frost, R. O., Steketee, G. and Fitch, K. E. (2008). Family burden of compulsive hoarding: results of an internet survey. Behaviour Research and Therapy, 46, 334344.CrossRefGoogle ScholarPubMed
Turpin, G., Barley, V., Beail, N., Scaife, J., Slade, P. and Smith, J. A. (1997). Standards for research projects and theses involving qualitative methods; suggested guidelines for trainees and courses. Clinical Psychology Forum, 108, 37.CrossRefGoogle Scholar
Warren, L. W. and Ostrom, J. C. (1988). Pack rats: world-class savers. Psychology Today, 22, 5862.Google Scholar
Wilbram, M., Kellett, S. and Beail, N. (2008). Compulsive hoarding: a qualitative investigation of partner and carer perspectives. British Journal of Clinical Psychology, 47, 5973.CrossRefGoogle ScholarPubMed
Windell, D. L., Norman, R. M. and Malla, A. K. (2006). Treatment and recovery in first-episode psychosis: a qualitative analysis of client experiences. Schizophrenia Research, 86, 141147.CrossRefGoogle Scholar
Winsberg, M. E., Cassic, K. S. and Koran, L. M. (1999). Hoarding in obsessive-compulsive disorder: a report of 20 cases. Journal of Clinical Psychiatry, 60, 591597.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.