Hoarding (Messie-Syndrom)

Cognitive Deficits in Compulsive Hoarding

Compulsive hoarding is characterized by accumulation of an excessive number of objects due to an inability to discard things of little value.
Researchers have only recently begun to study hoarding, and it was first defined as a mental disorder in 2013.It was not clear whether compulsive hoarding is a separate disorder, or rather a symptom of obsessive-compulsive disorder. The prevalence of compulsive hoarding in the population has been estimated at between 2% and 5%, significantly higher than the rates of other disorders. (Wikipedia)
Hoarders hold onto a large number of items:
– Junk mail, old catalogues, photos and newspapers
– Worn out, broken cooking and handcraft equipment
– Clothes that might be worn one day
– Broken things or trash
– Advertising and promotional products
– Books and CDs (Bibliomania)
– Larger than usual numbers of animals as pets (Animal hoarding)

The cognitive characteristics of individuals with hoarding disorder are not well understood. Existing studies are relatively few and somewhat inconsistent but suggest that individuals with HD may have specific dysfunction in the cognitive domains of categorization, speed of information processing, and decision making. Compulsive hoarding patients exhibit problems grouping their possessions into categories, which contributes to the disorganization and clutter. They treat each object as unique, which leads them to feel more anxious, sort more slowly, and create numerous categories when a few may suffice.
The categorization problems demonstrated by hoarding patients may be linked to information-processing difficulties proposed to underline hoarding behaviour. Hoarding patients report increased symptoms of attention deficit hyperactivity disorder and have been found to perform worse on certain psychological tasks, including measures of attention and nonverbal intelligence,
memory and decision-making. According to the cognitive-behavioral model, the combination of these information-processing deficits contributes to organizational problems. For example, efficient
categorization involves planning, developing strategies for how to best group objects, sustained attention, sufficient impulse control, and decision-making abilities. With respect to
planning, the individual must identify and organize the steps needed to carry out the goal of creating distinct categories. He or she needs to consider alternatives, weigh these alternatives,
and make choices. Furthermore, the individual must be able to stick to the task at hand. All of these skills are needed in order to make a decision about where an object belongs. Along
these lines, researchers found that self-reported indecisiveness related positively with the number of categories created and pre-task anxiety levels.
Results from several recent studies indicate that hoarding individuals perform more poorly on cognitive tests assessing organization, visual and verbal recall, attention, implicit learning, planning and problem solving.
A group of patients with compulsive hoarding was compared to a mixed clinical group and a nonclinical community group on laboratory tests of information-processing features. Hoarding patients demonstrated slower and more variable reaction time, increased impulsivity, greater difficulty distinguishing targets and non-targets, and worse spatial attention relative to comparison groups.
Department of Psychiatry, University of California
Im Sammeln steckt ein Dominanzbedürfnis (besitzen wollen, beherrschen wollen), aber auch ein Ausweichverhalten mit Rückzug und Beschäftigung mit Gegenständen. Sammeln kann eine Kompensation unerfüllter sozialer Wünsche nach Anerkennung oder Bewunderung sein. Auch als Ersatzbefriedigung zur Kompensation unerfüllter sexueller Wünsche kann es dienen. Sammeln kann helfen, Ängste und depressive Stimmung abzubauen.
Epidemiologische Daten zum Messie-Syndrom liegen derzeit nicht vor – nicht zuletzt aufgrund des Mangels an einer verbindlichen Definition des Begriffes. Pritz spricht von geschätzten 30.000 Betroffenen in Österreich.
Für Horten und Sammelzwänge sind kognitive Faktoren bekannt. Die Wissenschaftler fassen an psychologischen Befunden zusammen: Störungen der Exekutivfunktionen und der Informationsverarbeitung, Entscheidungsschwierigkeiten (diese spielen beim Klassifizierungsverhalten eine besondere Rolle) und Gedächtnisprobleme.