Monday, August 6, 2012

Hoarders' Brain Scans Reveal Why They Never De-Clutter

By Katherine Harmon

Jill, a 60-year-old woman in Milwaukee, has overcome extreme poverty. So, now that she has enough money to put food in the fridge, she fills it. She also fills her freezer, her cupboard and every other corner of her home. “I use duct tape to close the freezer door sometimes when I’ve got too many things in there,” she told A&E’s Hoarders. Film footage of her kitchen shows a cat scrambling over a rotten grapefruit; her counters—and most surfaces in her home—seemed to be covered with several inches of clutter and spoiled food. “I was horrified,” her younger sister said after visiting Jill. And the landlord threatened eviction because the living conditions became unsafe.
Jill joins many others who have been outed on reality TV as a “hoarder.” We might have once called people with these tendencies “collectors” or “eccentrics.” But in recent years, psychiatrists had suggested they have a specific type of obsessive-compulsive disorder (OCD). A movement is underfoot, however, for the new edition of the psychiatric field’s diagnostic bible (the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5), to move hoarding disorder to its own class of illness. And findings from a new brain scan study, published online August 6 in Archives of General Psychiatry, support this new categorization.
Hoarding disorder is categorized as “the excessive acquisition of and inability to discard objects, resulting in debilitating clutter,” wrote the researchers behind the new study, led by Yale University School of Medicine’s David Tolin.
Many of us might feel our homes or workspaces are far more cluttered than we would like—or than might be good for our peace of mind. But those with diagnosed hoarding disorder usually have taken this behavior to a different level. The Mayo Clinic even has a guide for treatment and prevention of hoarding disorder. One recommendation they provide: “Try to keep up personal hygiene and bathing. If you have possessions piled in your tub or shower, resolve to move them so that you can bathe.”
Some people hoard particular types of things, such as newspapers, craft supplies or clothing. Others, with a condition known as Diogenes syndrome, keep trash, including old containers, rotting food or human waste. Finally, as Animal Planet’s Animal Hoarders has shown, many hoarders collect more pets than they can appropriately care for, risking both their own and their animals’ health and safety.
To find out more about how the brains of hoarders might actually differ from those of healthy adults—and potentially even those with OCD—Tolin and his colleagues recruited 43 adults with a diagnosed hoarding disorder, 31 with OCD and 33 healthy adult controls to undergo fMRI brain scans. Each subject was asked to bring in a stack of miscellaneous, unsorted papers from their home, such as newspaper and junk mail. A similar collection of paper items from the experimenters was intermingled. Fifty items belonging to the subject and 50 items belonging to the experimenter were scanned and projected into the subject’s field of view in the fMRI. Subjects were asked to choose whether they wanted to keep a displayed item (either belonging to the subject or to the experimenters) or get rid of it by pressing a button. Afterward (and in a shorter pre-experiment training session), all of the discarded items were shredded right in front of them—ensuring that they knew that their decisions would have a real and immediate consequence..."  More

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