Prevalence and description of hoarding behavior
Of 735 participants with information on the hoarding trait, 27 (3.7%) were rated as having “pathological” hoarding. The weighted prevalence of hoarding was 5.3%.
The individuals with hoarding described substantial difficulties due to this behavior. For example, one participant, a 49 year-old man, said that “My room is like a bomb hit it. I’ve got books and papers, stuff in the corner there. I don’t want to throw nothing away. Old suits in my closet, I know I’ll never wear again in my life. Old beat up tennis shoes, think I’ll find a use for them. I never throw a book away. I like to keep articles, the whole paper; it starts building up on me in a hurry. Newspapers knee-high. I keep a whole drawer full of rubber bands; don’t know why, but I do. Lots of junk.” Another participant, a 41 year-old woman, noted that she has saved “old clothes from the 1970’s, piled up clocks, iron, tiny television, picture frame, fans. My house sometimes looks like a junk shop. I argue with my fiancé over throwing things away; he wants to get rid of all my good stuff; to me it’s good stuff, to him it’s junk. Stuff I’ve had for years, reminds me of my mother….you know I’m not going to throw that away.”
As shown in , the prevalence of hoarding increased with age, from 2.3% in the youngest, to 6.2% in the oldest, age groups; the odds of hoarding was nearly three times as great in the oldest compared to the youngest age group. In addition, the prevalence of hoarding was over two times as great in men (5.6%) compared to women (2.6%). The prevalence of hoarding was about two times as great in those who were widowed compared to those who were currently married, and two times as great in the currently unemployed compared to the employed, although the differences were not statistically significant at p<0.05. The prevalence of hoarding was not substantially different by education, living arrangement (i.e., lives alone or with others), or race/ethnicity.
Relationship between hoarding and sociodemographic characteristics Eastern Baltimore, 1997–1999
The prevalence of hoarding was inversely related to household income; the odds of hoarding was over 4 times as great in the poorest, compared to the wealthiest, households (p = 0.052). Household income was strongly related to age, sex, race, marital status, living arrangement, education, and employment status (a greater proportion of participants in lower income households were older, female, nonwhites, not currently married, living alone, unemployed, and of lower educational attainment). However, controlling for these variables, one by one, in logistic regression models did not appreciably change the magnitude of the association between hoarding and household income (results not shown).
Association of hoarding with clinical characteristics
The current total psychosocial stressor score was similar in participants with (M = 13.6, SD = 3.8) and without (M = 13.9, SD = 4.1) hoarding; t(567) = 0.31, p = 0.76. However, the current GAF score was significantly lower in those with hoarding (M = 67.9, SD = 15.3) than in those without (M = 76.1, SD = 10.0); t(700) = 4.2, p < 0.001).
The prevalence of almost all lifetime, as well as current, Axis I disorders was not significantly different in participants with and without hoarding (results not shown). However, the lifetime prevalence of alcohol dependence was significantly greater in individuals with (52.2%), compared to those without (19.5%), hoarding behavior (OR = 4.5, 95% CI = 1.9–10.4, p < 0.001). Current alcohol dependence was more prevalent in individuals with hoarding (11.1%) than in those without hoarding (4.8%), although the difference was not significant (OR = 2.5, 95% CI=0.7–8.7, p = 0.20). None of the individuals with hoarding behavior was diagnosed with OCD; however, some participants with hoarding might have been diagnosed with OCD had the SCAN probe questions included an assessment of compulsive hoarding.
The odds of hoarding increased with the number of personality disorder traits, including paranoid (OR = 1.60, per unit increase in number of paranoid traits), schizotypal (OR = 1.49), antisocial (OR = 1.2), avoidant (OR = 1.66), and obsessive-compulsive traits (excluding the hoarding trait) (OR = 1.76) (). Adjusting for lifetime alcohol dependence substantially reduced the magnitude of the association between hoarding and antisocial personality disorder (OR = 1.07, 95% CI = 0.8–1.4), but not the other personality disorder dimensions.
Relationship between hoarding and number of personality disorder traits Eastern Baltimore, 1997–1999
Association of Hoarding with Childhood Adversities
As shown in , several childhood adversities were reported significantly more often by participants with hoarding. The odds of hoarding were nearly 3 times as great in individuals reporting having a parent with psychiatric symptoms (depression, mania, or heavy drinking). Moreover, the odds of hoarding were nearly 4 times as great in participants reporting lack of security from home break-ins in childhood. In addition, the odds of hoarding were over 4 times as great in individuals who reported receiving excessive physical discipline in childhood.
Relationship between hoarding and childhood adversities Eastern Baltimore, 1997–1999
We evaluated the relationships between these four child adversities and hoarding in a series of logistic regression models, controlling one by one for each of the sociodemographic characteristics (age, sex, household income), personality disorder dimensions (paranoid, schizotypal, avoidant, and obsessive-compulsive), and other clinical features (GAF score, lifetime alcohol dependence) that were associated with hoarding in previous analyses. We found that, in general, the magnitude of the relationships between the four child adversities and hoarding did not substantially change after these adjustments. Moreover, each child adversity remained independently associated with hoarding when each of the other three adversities was included one by one in the models ().
Relationship between hoarding and childhood adversities, controlling individually for sociodemographic and clinical characteristics Eastern Baltimore, 1997–1999
We examined the relationship between childhood adversities, personality disorder dimensions, and other clinical characteristics, on the one hand, and hoarding, on the other, separately in men and women. We found that the magnitude of the association of hoarding with paternal psychiatric symptoms was considerably stronger in women (OR = 6.97, 95% CI = 1.8–26.8, p < 0.001) than in men (OR = 1.23, 95% CI = 0.3–4.7); in a logistic model, the interaction term β = 1.74, SE = 0.97, p = 0.07). Moreover, the magnitude of the association of hoarding with maternal psychiatric symptoms was considerably stronger in women (OR = 4.68, 95% CI = 1.4–15.7, p < 0.01) than in men (OR = 1.91, 95% CI = 0.5–7.4); interaction term β =0.90, SE = 0.93, p = 0.33). In addition, the relationship with avoidant personality disorder score was substantially stronger in women (OR = 2.45, 95% CI = 1.6–3.7; p < 0.001) than in men (OR = 1.09, 95% CI = 0.6–1.9); interaction term β = 0.81, SE = 0.36, p = 0.03). The magnitude of the association between hoarding and lifetime alcohol dependence was similar in women (OR = 3.91, 95% CI = 0.91–16.8) and men (OR = 3.37, 95% CI = 1.2–9.8). The magnitude of associations between hoarding and other correlates also were similar in women and men (results not shown).