Hoarding (HD) is a relatively recently recognized condition that has been added to the DSM-V. Its inclusion has raised concern, and debate still exists as some are suggesting that it be placed on the spectrum of obsessive compulsion (OCD), while others oppose that classification. Another question that has arisen with the inclusion of HD is the validity of measures used to diagnose it. The first ever field test was recently conducted by David Mataix-Cols of the Institute of Psychiatry at King’s College London, to determine if the criteria for HD are valid, effective, and clinically accurate for identifying people with HD and, more importantly, recognizing individuals who do not have HD but exhibit characteristics similar to those with HD.
In the study, Mataix-Cols interviewed 20 self-described collectors and 50 participants with hoarding tendencies. The participants were evaluated in their homes several times and independent raters assessed the results. According to the results, 58% of the hoarding participants met diagnostic criteria for HD. The raters reported excellent specificity and sensitivity of symptoms as well as reliability and validity. The specifiers, which included acquisition of items and clutter, were defined as acceptable tools, but Mataix-Cols believes that the wording of some of the specifiers might need some modification. The most promising finding was that none of the participants who called themselves collectors met the criteria for HD. This is a key finding and suggests that the design of the diagnostic measures used to classify someone with HD are extremely complex in nature and can adequately distinguish collecting behavior from hoarding behavior.
Mataix-Cols also discovered what could be some predictive factors. In this study, the hoarding participants were more likely to be single, have less education, and live in smaller homes than the collectors. This could indicate that higher levels of education and cohabitation or marriage may act as buffers against the onset of hoarding and could potentially keep collecting from escalating into hoarding. In sum, Mataix-Cols believes that these results provide evidence of the efficacy of the proposed diagnostic criteria for HD. He added, “Crucially, they seem to be sufficiently conservative and unlikely to over pathologize normative behavior.”
Mataix-Cols, D., et al. (2013). The London field trial for hoarding disorder. Psychological Medicine 43.4 (2013): 837-47. ProQuest.Web.
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