Inside the Hoarder’s Brain: A Unique Problem with Decision-Making

Why do some people find it impossible to get rid of old newspapers and junk mail, and end up hoarding them instead? New research suggests that hoarders have unique patterns of brain activity when faced with making decisions about their possessions, compared with healthy people. And despite the fact that hoarding has traditionally been seen as a symptom or subtype of obsessive compulsive disorder (OCD), brain activity in those who cannot de-clutter is also distinct from that of people with typical OCD, the study shows. “Many things are unique and distinct about hoarding,” says Dr. Eric Hollander, director of the autism and obsessive compulsive spectrum disorder program at Montefiore/Albert Einstein School of Medicine in New York, who was not associated with the new research. He notes that the new study adds to the evidence that hoarding should be recognized as a specific syndrome that falls not under the standard definition of OCD — only about 18% of people with hoarding symptoms meet the full criteria for OCD as it is currently defined — but within a spectrum of related conditions. “[This] is a very interesting and important study,” he says. Indeed, a separate diagnosis of hoarding disorder has been proposed for inclusion in the upcoming revision of psychiatry’s diagnostic manual, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). (MORE: Real-World Hoarders and Obsessive-Compulsives: A Conversation with an OCD Expert) For the new research, published in the Archives of General Psychiatry, David Tolin of the Institute of Living in Hartford, Conn., recruited 107 people for brain scans using functional magnetic resonance imaging (fMRI). Forty-three people had hoarding disorder, 31 people had OCD and 33 participants were normal controls. The participants were asked to bring a sample of their own junk mail or newspapers to the lab and were assured that researchers wouldn’t throw out anything they wanted to keep. The participants were also told that while they were having their brain activity imaged, they would be asked to decide whether to keep or shred these papers. Inside the scanner, the participants were shown images of either their own … Continue reading Inside the Hoarder’s Brain: A Unique Problem with Decision-Making