Elucidating the Relation of Hoarding to Obsessive Compulsive Disorder and Impulse Control Disorders

  • Laura C. Hayward
  • Meredith E. Coles


Hoarding has historically been conceptualized as a symptom of Obsessive Compulsive Disorder (OCD); however, data demonstrate important differences between hoarding and OC symptoms (for discussion, see Grisham et al. Anxiety Disorders, 19, 767‑779. 2005). Hoarding has also been observed in disorders besides OCD, including specific Impulse Control Disorders (ICDs; e.g., kleptomania, trichotillomania, pathological gambling, compulsive buying). Therefore, the current study tested the hypothesis that hoarding would be as strongly related to symptoms of ICDs as it is to OCD and that these relationships would be medium to strong in magnitude. Results from an undergraduate sample showed hoarding behaviors were strongly related to symptoms of OCD, moderately related to symptoms of compulsive buying, and more modestly related to symptoms of pathological gambling, trichotillomania, and kleptomania. Finally, findings suggest indecisiveness may be a particularly important underlying feature in hoarding behaviors. These results support the consideration of hoarding outside the confines of OCD.


Compulsive hoarding Compulsive buying Obsessive compulsive disorder Impulse control disorders Indecisiveness 


  1. Abramowitz, J. S., Franklin, M. E., Schwartz, S. A., & Furr, J. M. (2003). Symptom presentation and outcome of cognitive-behavioral therapy for obsessive-compulsive disorder. Journal of Consulting and Clinical Psychology, 71, 1049–1057.PubMedCrossRefGoogle Scholar
  2. American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders. 3rd ed. Washington, DC: Author.Google Scholar
  3. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders. 4th ed. Washington, DC: Author.Google Scholar
  4. Barkley, R. A., & Murphy, K. R. (1998). Attention-deficit hyperactivity disorder: A clinical workbook (2nd ed). New York: Guilford Press.Google Scholar
  5. Black, D., Monahan, P., & Gabel, J. (1997). Fluvoxamine in the treatment of compulsive buying. Journal of Clinical Psychiatry, 58, 159–163.PubMedGoogle Scholar
  6. Black, D. W., Monahan, P., Gabel, J., Blum, N., Clancy, G., & Baker, P. (1998). Hoarding and treatment response in 38 non-depressed subjects with obsessive-compulsive disorder. Journal of Clinical Psychiatry, 59, 420–425.PubMedGoogle Scholar
  7. Coles, M. E., Frost, R. O., Heimberg, R. G., & Steketee, G. (2003). Hoarding behavior in a large college sample. Behaviour Research and Therapy, 41, 179–192.PubMedCrossRefGoogle Scholar
  8. Faber, R. J., & O’Guinn, T. C. (1992). A clinical screener for compulsive buying. Journal of Consumer Research, 19, 459–469.CrossRefGoogle Scholar
  9. Foa, E. B., Kozak, M. J., Salkovskis, P. M., Coles, M. E., & Amir, N. (1998). The validation of a new obsessive compulsive disorder scale: the obsessive-compulsive inventory. Psychological Assessment, 10, 206–214.CrossRefGoogle Scholar
  10. Fontenelle, L. F., Mendlowicz, M. V., & Versiani, M. (2005). Impulse control disorders in patients with obsessive-compulsive disorder. Psychiatry and Clinical Neurosciences, 59, 30–37.PubMedCrossRefGoogle Scholar
  11. Frost, R. O., & Gross, R. C. (1993). The hoarding of possessions. Behaviour Research and Therapy, 31, 367–381.PubMedCrossRefGoogle Scholar
  12. Frost, R. O., & Hartl, T. L. (1996). A cognitive-behavioral model of compulsive hoarding. Behaviour Research and Therapy, 34, 341–350.PubMedCrossRefGoogle Scholar
  13. Frost, R. O., Kim, H. J., Morris, C., Bloss, C., Murray-Close, M., & Steketee, G. (1998). Hoarding, compulsive buying and reasons for saving. Behaviour Research and Therapy, 36, 657–664.PubMedCrossRefGoogle Scholar
  14. Frost, R. O., Krause, M., & Steketee, G. (1996). Hoarding and obsessive compulsive symptoms. Behavior Modification, 20, 116–132.PubMedCrossRefGoogle Scholar
  15. Frost, R. O., Meagher, B. M., & Riskind, J. H. (2001). Obsessive-compulsive features in pathological lottery and scratch-ticket gamblers. Journal of Gambling Studies, 17, 5–19.PubMedCrossRefGoogle Scholar
  16. Frost, R. O., & Shows, D. L. (1993). The nature and measurement of compulsive indecisiveness. Behaviour Research and Therapy, 31, 683–692.PubMedCrossRefGoogle Scholar
  17. Frost, R. O., Steketee, G., & Grisham, J. (2004). Measurement of compulsive hoarding: saving inventory-revised. Behaviour Research and Therapy, 42, 1163–1182.PubMedCrossRefGoogle Scholar
  18. Grant, J. E., & Kim, S. W. (2002a). Clinical characteristics and associated psychopathology of 22 patients with kleptomania. Comprehensive Psychiatry, 43, 378–384.PubMedCrossRefGoogle Scholar
  19. Grant, J. E., & Kim, S. W. (2002b). An open-label study of naltrexone in the treatment of kleptomania. Journal of Clinical Psychiatry, 63, 349–356.PubMedGoogle Scholar
  20. Grant, J. E., Mancebo, M. C., Pinto, A., Eisen, J. L., & Rasmussen, S. A. (2006). Impulse control disorders in adults with obsessive compulsive disorder. Journal of Psychiatric Research, 40, 494–501.PubMedCrossRefGoogle Scholar
  21. Greenberg, D., Witztum, E., & Levy, A. (1990). Hoarding as a psychiatric symptom. Journal of Clinical Psychiatry, 51, 417–421.PubMedGoogle Scholar
  22. Greve, K. W., Curtis, K. L., Bianchini, K. J., & Collins, B. T. (2004). Personality disorder masquerading as dementia: a case of apparent Diogenes syndrome. International Journal of Geriatric Psychiatry, 19, 703–705.PubMedCrossRefGoogle Scholar
  23. Grisham, J. R., & Barlow, D. H. (2005). Compulsive hoarding: current research and therapy. Journal of Psychopathology and Behavioral Assessment, 27, 45–52.CrossRefGoogle Scholar
  24. Grisham, J. R., Brown, T. A., Liverant, G. I., & Campbell-Sills, L. (2005). The distinctiveness of compulsive hoarding from obsessive-compulsive disorder. Anxiety Disorders, 19, 767–779.CrossRefGoogle Scholar
  25. Grisham, J. R., Frost, R. O., Steketee, G., Kim, H. J., & Hood, S. (2006). The age of onset of compulsive hoarding. Journal of Anxiety Disorders, 20, 675–686.PubMedCrossRefGoogle Scholar
  26. Hajcak, G., Franklin, M. E., Simons, R. F., & Keuthen, N. J. (2006). Hairpulling and skin picking in relation to affective distress and obsessive-compulsive symptoms. Journal of Psychopathology and Behavioral Assessment, 28, 179–187.CrossRefGoogle Scholar
  27. Halmi, K. A., Sunday, S. R., Klump, K. L., Strober, M., Leckman, J. F., Fichter, M., et al. (2003). Obsessions and compulsions in anorexia nervosa subtypes. International Journal of Eating Disorders, 33, 308–319.PubMedCrossRefGoogle Scholar
  28. Hartl, T. L., Duffany, S. R., Allen, G. J., Steketee, G., & Frost, R. O. (2005). Relationships among compulsive hoarding, trauma, and attention-deficit/hyperactivity disorder. Behaviour Research and Therapy, 43, 269–276.PubMedCrossRefGoogle Scholar
  29. Hollander, E. (2005). Obsessive-compulsive disorder and spectrum across the life span. International Journal of Psychiatry in Clinical Practice, 9, 79–86.CrossRefGoogle Scholar
  30. Keuthen, N. J., O’Sullivan, R. L., Ricciardi, J. N., Shera, D., Savage, C. R., Borgmann, A. S., et al. (1995). The Massachusetts General Hospital (MGH) hairpulling scale: 1. development and factor analyses. Psychotherapy and Psychosomatics, 64, 141–145.PubMedCrossRefGoogle Scholar
  31. Lesieur, H. R., & Blume, S. B. (1987). The South Oaks gambling screen (SOGS): a new instrument for the identification of pathological gamblers. American Journal of Psychiatry, 144, 1184–1188.PubMedGoogle Scholar
  32. Little, R. J. A., & Rubin, D. B. (1987). Statistical analysis with missing data. New York: Wiley and Sons.Google Scholar
  33. Lochner, C., Kinnear, C. J., Hemmings, S. M. J., Seller, C., Niehaus, D. J. H., Knowles, J. A., et al. (2005). Hoarding in obsessive compulsive disorder: clinical and genetic correlates. Journal of Clinical Psychiatry, 66, 1155–1160.PubMedCrossRefGoogle Scholar
  34. Luchian, S. A., McNally, R. J., & Hooley, J. M. (2007). Cognitive aspects of nonclinical obsessive-compulsive hoarding. Behaviour Research and Therapy, 45, 1657–1662.PubMedCrossRefGoogle Scholar
  35. Mataix-Cols, D., Marks, I. M., Greist, J. H., Kobak, K. A., & Baer, L. (2002). Obsessive- compulsive symptom dimensions as predictors of compliance with and response to behaviour therapy: results from a controlled trial. Psychotherapy and Psychosomatics, 71, 255–262.PubMedCrossRefGoogle Scholar
  36. McElroy, S., Keck, P., Pope, H., Smith, J., & Strakowski, S. (1994). Compulsive buying: a report of 20 cases. Journal of Clinical Psychiatry, 55, 242–248.PubMedGoogle Scholar
  37. Meng, X. L., Rosenthal, R., & Rubin, D. B. (1992). Comparing correlated correlation coefficients. Psychological Bulletin, 111, 172–175.CrossRefGoogle Scholar
  38. O’Sullivan, R. L., Keuthen, N. J., Hayday, C. F., Ricciardi, J. N., Buttolph, M. L., Jenike, M. A., & Baer, L. (1995). The Massachusetts General Hospital (MGH) hairpulling scale: 2. reliability and validity. Psychotherapy and Psychosomatics, 64, 146–148.PubMedCrossRefGoogle Scholar
  39. Rasmussen, S. A., & Eisen, J. A. (1992). The epidemiology and clinical features of obsessive compulsive disorder. Psychiatric Clinics of North America, 15, 743–758.PubMedGoogle Scholar
  40. Rufer, M., Fricke, S., Moritz, S., Kloss, M., & Hand, I. (2006). Symptom dimensions in obsessive-compulsive disorder: prediction of cognitive-behavior therapy outcome. Acta Psychiatrica Scandinavica, 113, 440–446.PubMedCrossRefGoogle Scholar
  41. Samuels, J., Bienvenu III, O. J., Riddle, M. A., Cullen, B. A. M., Grados, M. A., Liang, K.-Y., et al. (2002). Hoarding in obsessive compulsive disorder: results from a case-control study. Behaviour Research and Therapy, 40, 517–528.PubMedCrossRefGoogle Scholar
  42. Saxena, S., Brody, A. L., Maidment, K. M., Smith, E. C., Zohrabi, N., Katz, E., et al. (2004). Cerebral glucose metabolism in obsessive-compulsive hoarding. American Journal of Psychiatry, 161, 1038–1048.PubMedCrossRefGoogle Scholar
  43. Seedat, S., & Stein, D. J. (2002). Hoarding in obsessive-compulsive disorder and related disorders: a preliminary report of 15 cases. Psychiatry and Clinical Neurosciences, 56, 17–23.PubMedCrossRefGoogle Scholar
  44. Shafer, J. L., & Graham, J. W. (2002). Missing data: our view of the state of the art. Psychological Methods, 7, 147–177.CrossRefGoogle Scholar
  45. Simonds, L. M., Thorpe, S. J., & Elliott, S. A. (2000). The obsessive compulsive inventory: psychometric properties in a nonclinical student sample. Behavioural and Cognitive Psychotherapy, 28, 153–159.Google Scholar
  46. Steketee, G., & Frost, R. O. (2003). Compulsive hoarding: current status of the research. Clinical Psychology Review, 23, 905–927.PubMedCrossRefGoogle Scholar
  47. Tabachnik, B. G., & Fidell, L. S. (2007). Using multivariate statistics (5th ed). Boston: Pearson, Allyn, & Bacon.Google Scholar
  48. Taylor, S., & Cox, B. J. (1998). An expanded anxiety sensitivity index: evidence for a hierarchic structure in a clinical sample. Journal of Anxiety Disorders, 12, 463–483.PubMedCrossRefGoogle Scholar
  49. Wu, K. D., & Watson, D. (2005). Hoarding and its relation to obsessive-compulsive disorder. Behaviour Research and Therapy, 43, 897–921.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  1. 1.Department of PsychologyBinghamton Anxiety Clinic, Binghamton UniversityBinghamtonUSA

Personalised recommendations