Hoarding disorder is estimated to affect 4–14% of the U.S. population. Hoarding is characterized by the accumulation of possessions, the inability to discard items regardless of their value, compromised living space due to possessions and significant impairment and distress in personal, social and professional functioning. Hoarding presents a serious health problem to those who struggle with the disorder, their families and the communities they reside in.
Due to its widespread prevalence, many have wondered if hoarding is genetic or a learned behavior. Research is ongoing on this topic, but there have been substantial discoveries to confirm that compulsive hoarding is largely influenced by family, with both genetic and environmental factors at work.
Compulsive Hoarding and Heredity
Studies have shown that those with compulsive hoarding have at least one first-degree relative with hoarding problems, suggesting that hoarding is hereditary. In one study, over 50% of compulsive hoarders had a first-degree relative with similar hoarding problems. A large study based on twins found that genetic factors accounted for 50% of the variance in hoarding behavior, with environmental factors making up the other 50%.
While these results are interesting, they are not conclusive regarding whether compulsive hoarding is hereditary in the general population. It is important to keep in mind that the symptoms related to hoarding are not always a stand-alone problem, but are often associated with other health and psychiatric problems. For instance, rates of comorbidity with other mental health conditions are high with compulsive hoarding. Hoarding is seen alongside the following conditions:
- Obsessive-compulsive disorder (20%)
- Depression and anxiety (24.4%)
- Social phobia (23.5%)
- Acquisition-related impulse control problems (78.3%)
- Obsessive-compulsive personality disorder (29.5%)
- Attention deficit-hyperactivity disorder (30%)
The link between compulsive hoarding and hereditary factors is high, though researchers agree that more studies need to be conducted in regard to the general population in determining the underlying factors in hoarding and whether genetic or other traits are responsible for this behavior.
Link to Chromosome 14 in Families With OCD
A team from Johns Hopkins University School of Medicine led a study analyzing samples from nearly 1,000 patients from 219 different families with obsessive-compulsive disorder (OCD). Hoarding, often seen in those with OCD, received special attention in this study. Researchers were able to identify a unique region on chromosome 14 in families where two or more members shared hoarding behavior. What that pattern means and how exactly it relates to hoarding behavior is yet to be seen, but it certainly is significant in understanding hoarding and research.
The study of genetics and health disorders is not new. With psychiatric disorders being the leading cause of disability worldwide, the impact on individuals and society in general is high. The goal of understanding the origins of such disorders is at the top of the list for geneticists and researchers alike. The brain, however, is not so easily understood. This limits what researchers are able to do. Genetics provides the basis for understanding the possible hereditary links to mental health disorders and developing related treatments. The link found between chromosome 14 and hoarding is exciting news for researchers, clinicians and those with the disorder. It could help in the future development of treatment specific to hoarding.
Trauma & Other Risk Factors
In addition to genetic heritability, hoarding risk factors include significant environmental causes. Leading research indicates that one such environmental factor contributing to hoarding behavior is trauma. A stressful or traumatic event in life such as abuse or bereavement can trigger hoarding behavior as a coping mechanism. Other risk factors can include:
- Age: Hoarding is most common among middle-aged adults, though hoarding behavior usually manifests between the ages of 10 to 20
- Social isolation: Loneliness can lead to the tendency to collect items to fill the empty void in a person’s life
- Personality: Anxiety and indecision are common for those who exhibit hoarding behaviors
Major life changes have also been noted as factors related to hoarding, such as retirement, loss of a job, starting a job change or kids leaving home. While the causes of hoarding can vary, identifying individual risk factors and environmental changes can help during treatment for hoarding.
Treatment for Hoarding Disorder
Compulsive hoarding can be treated, and positive results can be achieved especially when a person cooperates with the outlined treatment plan. Hoarding treatment usually involves medication along with counseling or therapy. With medication alone, hoarding symptoms were reduced by 28–70% in two study groups. Treatment of any co-occurring disorders, such as depression and anxiety, can help to reduce the severity of these conditions and facilitate healthy coping mechanisms.
Different forms of psychotherapy and education can have positive effects on how a person struggling with hoarding views their emotions and environment as it relates to their behavior. Common forms of hoarding disorder treatment may include:
- Cognitive behavioral therapy: Helps an individual change negative emotions and thinking patterns as a way of reducing negative behavior
- Skills therapy: Helps an individual learn vital skills such as decision making and organization to better cope with the demands of daily life
- Motivational interviewing: Provides motivation to encourage changes in hoarding behavior by making clear connections between an individual’s values and goals and how to change behavior that works against those goals
- Support groups: Groups that meet on a regular basis made up of other people struggling with the same disorder; this shame-free environment is conducive to structured learning and is goal-oriented
Whatever method of treatment is advised, it is important to remember that self-motivation is a key aspect of success rates. If well-intentioned family members or friends forcefully clean out a house or get rid of possessions without the person’s permission, these actions almost always backfire. Trust can be lost and hoarding behavior will continue. Remember to respect the person and show a sympathetic attitude that encourages safety and well-being.
If you or someone you know is struggling with compulsive hoarding and self-medicates with drugs or alcohol, contact the Recovery Village. A representative can discuss an appropriate treatment plan with you.
Iervolino, Alessandra C.; et al. “Prevalence and Heritability of Compulsive Hoarding: A Twin Study.” The American Journal of Psychiatry, October 1, 2009. Accessed June 15, 2019. Frost, Randy O.; Steketee, Gail; Tolin, David F. “Comorbidity in Hoarding Disorder.” Depression and Anxiety, July 18, 2011. Accessed June 15, 2019. Samuels, J.; et al. “Significant linkage to compulsive hoarding on chromosome 14 in families with obsessive-compulsive disorder: results from the OCD Collaborative Genetics Study.” The American Journal of Psychiatry, March 2007. Accessed June 15, 2019. Broad Institute. “Why study the genetics of psychiatric disorders?” NA. Accessed June 15, 2019. Dozier, Mary E.; Porter, Ben; Ayers, Catherine R. “Age of onset and progression of hoarding symptoms in older adults with hoarding disorder.” Aging & Mental Health, April 24, 2015. Accessed June 15, 2019. International OCD Foundation. “Treatment of HD – Medication.” 2019. Accessed June 15, 2019. International OCD Foundation. “How is Hoarding Disorder Treated?” 2019. Accessed June 15, 2019.
Iervolino, Alessandra C.; et al. “Prevalence and Heritability of Compulsive Hoarding: A Twin Study.” The American Journal of Psychiatry, October 1, 2009. Accessed June 15, 2019.
Frost, Randy O.; Steketee, Gail; Tolin, David F. “Comorbidity in Hoarding Disorder.” Depression and Anxiety, July 18, 2011. Accessed June 15, 2019.
Samuels, J.; et al. “Significant linkage to compulsive hoarding on chromosome 14 in families with obsessive-compulsive disorder: results from the OCD Collaborative Genetics Study.” The American Journal of Psychiatry, March 2007. Accessed June 15, 2019.
Broad Institute. “Why study the genetics of psychiatric disorders?” NA. Accessed June 15, 2019.
Dozier, Mary E.; Porter, Ben; Ayers, Catherine R. “Age of onset and progression of hoarding symptoms in older adults with hoarding disorder.” Aging & Mental Health, April 24, 2015. Accessed June 15, 2019.
International OCD Foundation. “Treatment of HD – Medication.” 2019. Accessed June 15, 2019.
International OCD Foundation. “How is Hoarding Disorder Treated?” 2019. Accessed June 15, 2019.
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