Cluttered spaces, strained bonds: Examining the correlation between hoarding symptoms and social functioning among long-term care facilities older adult residents.

BACKGROUND: Symptoms of hoarding, such as the inability to part with possessions, leading to significant clutter, are commonly observed among residents in long-term care facilities in Egypt. This behavior significantly impacts their social interactions and functioning. Therefore, this study examined the relationship between hoarding symptoms and social functioning among older adult residents in long-term care facilities. METHODS: The study employed a cross-sectional survey on a purposive sample of 300 older adults. TOOLS: Saving Inventory-Revised and Functional Idiographic Assessment Template-Questionnaire-Short Form were used. RESULTS: The findings revealed a significant positive correlation between hoarding symptoms and social functioning (r = 0.682, p < 0.000). A linear regression analysis supported this correlation, establishing hoarding symptoms as a significant predictor of social functioning (adjusted R2 = 0.32). CONCLUSION: The current study highlighted that a significant proportion of long-term care older adult residents displayed moderate hoarding symptoms and compromised social functioning. A noticeable positive association was observed between hoarding symptoms and social functioning. These results underscore the potential impact of hoarding symptoms on various aspects of social functioning. Given these findings, long-term care nurses should comprehend the various facets of compulsive hoarding behavior and devise effective strategies for assessment and intervention. Establishing support groups within these facilities could provide a platform for these residents to share their experiences and coping strategies. This could reduce interpersonal conflicts and argumentativeness and foster emotional expression and intimacy.

Childhood environmental unpredictability and hoarding: Mediating roles of attachment and security.

Life history theory provides a unified perspective for understanding human behaviors as adaptive strategies to specific environmental conditions. Within this theoretical framework, hoarding emerges as a behavior reflecting an evolved strategy in response to unpredictable environmental challenges, serving as a buffer against resource scarcity and enhancing survival prospects. This study aimed to explore the key roles of childhood environmental unpredictability, attachment, and sense of security in the development of hoarding. 662 participants completed scales on childhood environmental unpredictability, Revised Experiences in Close Relationships (ECR-R), sense of insecurity, and Savings Inventory-Revised (SI-R). The results showed that childhood environmental unpredictability was significantly positively correlated with hoarding. Attachment anxiety and sense of security individually mediate the effect of childhood environmental unpredictability on hoarding. Additionally, 'attachment anxiety--sense of security' and 'attachment avoidance--sense of security' serve as chain mediators in this relationship separately. This study offers insights into the cognitive-behavioral model of hoarding, highlighting the importance of life history theory in examining childhood environmental unpredictability's relationship with hoarding. It also integrates insights from the psychosocial acceleration theory into our comprehension of hoarding's development. Future research directions are also discussed.

Situational, emotional, and individual dispositions to weight gain in people with hoarding problems.

OBJECTIVES: Individuals with hoarding disorder are more likely to be overweight or obese than the general population for unknown reasons. METHODS: One hundred and twenty-nine individuals (Hoarding Group: n = 63; Control Group: n = 66) completed self-report measures and were offered snacks in a tidy and a cluttered environment in a counterbalanced order. Groups were based on the self-reporting of high or low hoarding symptoms. RESULTS: The hoarding group reported being less able to use their kitchen and prepare food at home and experiencing more impulsivity, distress intolerance and problematic eating beliefs than did the control group. The hoarding group consumed more cookies in the tidy room, whereas the control group consumed more cookies in the cluttered room. Greater impulsivity, distress intolerance and problematic body and eating beliefs were related to greater cookie consumption for the hoarding group. CONCLUSIONS: Early interventions that help individuals to tolerate distress and to engage in goal-directed behaviour regardless of their emotional state may have benefits for both hoarding and eating behaviour. We encourage future researchers to examine this hypothesis.

The experience of leaving a valuable object: An investigation of emotional processes related to Hoarding disorder features.

One of the core features of hoarding is a significant resistance to discarding objects, which is fueled by dysfunctional beliefs and unwarranted negative emotions that hoarders tend to feel when disposing of their possessions. To our knowledge, longitudinal studies investigating the psychological effects that people who hoard experience after separating from their valuable possessions have yet to be conducted. Our study's principal aim was to explore psychological processes that individuals with high hoarding features (n = 53; 49.1%) and individuals with low hoarding features (n = 55; 50.9%) experienced when they had to separate from a valuable possession. To do this, we evaluated participants' thoughts and feelings at several time points after they had to leave a valuable object at the University laboratory (evaluations were specifically conducted at baseline, during the week, and at the end of the week). To investigate hoarding and anxiety, as well as depressive, obsessive-compulsive, and emotional processes-related features, a mixed-method approach was employed involving self-report questionnaires, ad hoc surveys, and a daily self-monitoring schedule. Our findings showed that compared to participants with low hoarding features, participants with high hoarding traits: 1) scored higher for anxiety sensitivity, distress tolerance, and emotional dysregulation; 2) reported having more negative emotions when leaving their object; 3) had more intrusive object-related beliefs; and 4) experienced a higher frequency of negative emotions as well as a higher level of distress during the week. Both groups experienced more negative emotions in the first part of the week, which decreased as the time at which participants could receive their object back drew closer. Finally, dysfunctional beliefs about leaving a personal object (Saving Cognitions Inventory), sensitivity to anxiety (Anxiety Sensitivity Index-3), and distress tolerance (Distress Tolerance Scale) contributed to the level of discomfort that participants with higher hoarding scores reported when they had to leave their possession. These results highlight the relevance of emotional processes in the hoarding disorder framework as well as underscore the importance of assessing and treating them in clinical settings.

Association between attachment and hoarding behavior: Mediation of anthropomorphism and moderation of hoarding beliefs among Chinese adolescents.

The impact of insecure attachment on hoarding behavior (HB) has been supported by empirical evidence. However, scant literature has focused on how anthropomorphism (attributing human-like traits, characteristics, or emotions to nonhuman objects) and hoarding beliefs (motivations for ownership) affect the relationship between insecure attachment and HB, especially among Chinese adolescents. Using a cross-sectional study, we reserved 903 participants (561 males, 342 females, M = 20.20, SD = 1.85, age range = 18-24 years) to complete self-report questionnaires about close relationships, anthropomorphism, saving beliefs, and saving inventory to investigate the mediating role of anthropomorphism and the moderating role of hoarding beliefs in the relationship between insecure attachment and HB. Attachment anxiety and avoidance had a positive relationship with HB, and anthropomorphism is a mediating factor in the association between attachment anxiety and HB. In addition, hoarding beliefs moderated the relationship between attachment anxiety and HB. This study further elaborated on the relationships between insecure attachment, anthropomorphism, hoarding beliefs, and HB, which might shed some light on adolescent clinical interventions.

Redefining object attachment: Development and validation of a new scale.

Background and aims: Object attachment is the emotional bond or connection that we have with possessions. Although thought to be ubiquitous, when excessive, object attachment is presumed to contribute to compulsive buying and hoarding problems. Unfortunately, our understanding of this relationship has been limited by the constraints of existing object attachment measures. In this paper, we developed and validated a new self-report questionnaire, called the Object Attachment Security Measure (OASM). Methods: We developed an item pool based on previous measures and consultation with 24 experts in the field. After piloting, we administered this measure to a large sample (Final N = 365), along with self-report measures of hoarding, compulsive buying, and previous object attachment measures. Results: We found that the OASM distinguished between secure and insecure object attachment. Both subscales showed excellent internal consistency and test-retest reliability over a two-week period. Additionally, they demonstrated excellent convergent and divergent validity, and criterion validity with measures of hoarding and compulsive buying symptoms. We also found that insecure, but not secure object attachment, was uniquely related to hoarding and compulsive buying symptomology. Discussion and conclusion: Our findings extend theoretical models, highlighting the role of insecure object attachment. Future research in both clinical and consumer behaviour fields should utilise the OASM, as reducing insecure object attachment and potentially encouraging secure object attachment could decrease maladaptive possession use and increase sustainable consumption.

Health-related quality of life in hoarding: A comparison to chronic conditions with high disease burden.

Hoarding disorder often results in debilitating functional impairment and may also compromise health-related quality of life (QoL). This study investigated the association between hoarding behavior and QoL relative to six highly impairing medical and psychiatric disorders in a sample of 20,722 participants enrolled in the internet-based Brain Health Registry. Nearly 1 in 8 participants (12.2%) endorsed clinically relevant hoarding symptoms (CHS). In separate multivariable linear regression models, hoarding was more strongly associated with mental QoL than diabetes (Standardizedß = -0.21, 95% CI: [-0.22, -0.20] vs. -0.01 [-0.02, 0.0]), heart disease (-0.22 [-0.23, -0.20] vs. 0.00 [-0.02, 0.01]), chronic pain (-0.18 [-0.19, -0.16] vs. -0.12 [-0.13, -0.10]), post-traumatic stress disorder (PTSD; -0.20 [-0.22, -0.19] vs. -0.07 [-0.09, -0.06]), and substance use disorder (SUD; -0.21 [-0.23, -0.20] vs. -0.04 [-0.05, -0.03]). Similarly, CHS was more strongly negatively associated with physical QoL than diabetes (-0.11 [-0.10, -0.12] vs. -0.08 [-0.06, -0.09]), major depressive disorder (-0.09 [-0.10, -0.08] vs. -0.05 [-0.06, 0.03]), PTSD (-0.11 [-0.12, -0.10] vs. -0.08 [-0.09, -0.07]), and SUD (-0.12 [-0.13, -0.09] vs. -0.01 [-0.02, 0.00]). Higher hoarding severity was associated with reductions in both mental (Standardizedß = -0.28, ΔR2 = 0.08, p < 0.0001) and physical (ß = -0.12, ΔR2 = 0.02, p < 0.0001) QoL, though the strength of the relationship between hoarding symptoms and QoL varied with depression severity. Efforts to improve the overall QoL and well-being of those with CHS are needed.

Is it really "panic buying"? Public perceptions and experiences of extra buying at the onset of the COVID-19 pandemic.

Shopping behaviour in response to extreme events is often characterized as "panic buying" which connotes irrationality and loss of control. However, "panic buying" has been criticized for attributing shopping behaviour to people's alleged psychological frailty while ignoring other psychological and structural factors that might be at play. We report a qualitative exploration of the experiences and understandings of shopping behaviour of members of the public at the onset of the COVID-19 pandemic. Through a thematic analysis of semi-structured interviews with 23 participants, we developed three themes. The first theme addresses people's understandings of "panic buying". When participants referred to "panic buying" they meant observed product shortages (rather than the underlying psychological processes that can lead to such behaviours), preparedness behaviours, or emotions such as fear and worry. The second theme focuses on the influence of the media and other people's behaviour in shaping subsequent shopping behaviours. The third theme addresses the meaningful motivations behind increased shopping, which participants described in terms of preparedness; some participants reported increased shopping behaviours as a response to other people stockpiling, to reduce their trips to supermarkets, or to prepare for product shortages and longer stays at home. Overall, despite frequently using the term 'panic', the irrationalist connotations of "panic buying" were largely absent from participants' accounts. Thus, "panic buying" is not a useful concept and should not be used as it constructs expected responses to threat as irrational or pathological. It can also facilitate such behaviours, creating a self-fulfilling prophecy.

Emotion dysregulation and hoarding symptoms: A systematic review and meta-analysis.

OBJECTIVES: Much of the research on hoarding is focused on cognition and behavior, with less focus on emotion and its regulation. METHOD: A comprehensive search yielded nine studies (out of 5581) from which to draw data for the current study. Across the eight studies (nine independent effect sizes) which provided data for 1595 total participants (Meanage = 34.46, SD = 8.78; 64.26% females). RESULTS: Emotion dysregulation had a medium association with hoarding symptoms (r = 0.43). The effect was strong (r = 0.61) in some populations and weaker (r = 0.19) in others. However, it was higher in nonclinical samples than in clinical samples. Also, the strength of the association between hoarding and emotion regulation differed by the type of hoarding measures adopted in the individual studies. Moreover, there were no statistically significant differences between emotion dysregulation facets and hoarding. CONCLUSION: The findings highlight the importance of studying emotions and emotion regulation in hoarding.

Prevalence and correlates of hoarding behavior and hoarding disorder in children and adolescents.

Although hoarding symptoms are reported to begin in childhood and adolescence, the true prevalence of the disorder in this age group is unknown. This study aims to estimate the prevalence of hoarding disorder (HD) in children and adolescents. The present study was planned as a two-stage epidemiological research. In the first stage, the Children's Saving Inventory (CSI) and informed consent forms were delivered to a group of students' parents. In the second stage, one-on-one psychiatric interviews with a physician were planned with the families and children who had hoarding behavior (HB), as described by their parents. The DSM-5-based HD interview and the Development and Well-Being Assessment (DAWBA) diagnostic tool were used to detect prevalence of HD and comorbid psychiatric disorders. A total of 3249 children were included in the study, and 318 children and their parents were evaluated in the second stage. As a result of the second assessment, 32 out of 318 children met the HD diagnostic criteria. The estimated prevalence of HD was 0.98% (95% CI 0.7-1.4). Hoarding disorder was found more frequently in females (F/M = 3/1). After a logistic regression analysis, variables such as female sex and the presence of any psychopathology were identified as independent correlates of HD. More than half (56.2%) of the children diagnosed as having HD also had a comorbid psychiatric disorder. In the present study, the two-stage evaluation method was used in a large pediatric sample to determine the estimated prevalence of HD, as well as the factors associated with the disorder and comorbid psychiatric disorders.

Traumatic and stressful life events in hoarding: the role of loss and deprivation.

Background: Although past research shows hoarding to be associated with stressful life events involving loss and/or deprivation, the temporal relationship between the onset of symptoms and these events is not completely clear. Objectives: In a cross-sectional online study, we examined the relationship between the number of events involving loss or deprivation before/simultaneously vs. after the onset of hoarding and various hoarding-related beliefs, such as emotional attachment to possessions, and symptom severity. Further, we examined whether perceived social support moderated the influence of these events on emotional attachment to objects. Methods: One hundred seventeen subjects with hoarding problems responded to a series of instruments to assess the history and timing of traumatic and stressful loss and/or deprivation in relation to the onset of hoarding, and self-report tools evaluating the severity of hoarding, beliefs/motivations, depression, anxiety, general distress, and perceived social support. Results: The number of events involving loss or deprivation occurring before hoarding was related to increased emotional attachment to possessions, whereas events happening after the onset of hoarding were related to increased concerns about memory as drivers of hoarding symptoms. Events happening before hoarding did not interact with perceived social support to influence emotional attachment to objects. Conclusions: The timing of traumatic and stressful life events related to loss and deprivation is associated with different hoarding phenotypes, including beliefs/motivations for hoarding. If confirmed by longitudinal studies, these findings may be relevant for therapeutic and preventive measures.

Antecedentes: Aunque investigaciones pasadas han mostrado que la acumulación se asocia con eventos vitales estresantes que incluyen pérdidas y/o deprivación, la relación temporal entre el inicio de los síntomas y estos eventos no están completamente claras.Objetivo: En un estudio transversal realizado online, examinamos la relación entre el número de eventos que incluían perdida o deprivación en forma previa/simultánea versus posterior al inicio de la acumulación y variadas creencias relacionadas con la acumulación, tales como el apego emocional a las posesiones y la severidad sintomática. Además, examinamos si es que el apoyo social percibido moderaba la influencia de estos eventos en el apego emocional a los objetos.Métodos: Ciento diecisiete sujetos con problemas de acumulación respondieron a una serie de instrumentos para evaluar la historia y temporalidad de eventos traumáticos y estresantes de pérdida y/o deprivación en relación al inicio de la acumulación, y herramientas de auto-reporte que evaluaban la severidad de la acumulación, motivaciones/creencias, depresión, ansiedad, malestar general, y apoyo social percibido.Resultados: El número de eventos que incluían pérdida o deprivación que ocurrieron antes de la acumulación fueron relacionados con un aumento del apego emocional a las posesiones, mientras que los eventos que ocurrieron posteriores al inicio de la acumulación se relacionaron con una mayor preocupación sobre la memoria como potenciador de los síntomas de acumulación. Los eventos que ocurrieron antes de la acumulación no interactuaron con el apoyo social percibido para influir en el apego emocional a los objetos.Conclusiones: La temporalidad de los eventos vitales traumáticos y estresantes relacionados con la pérdida y la deprivación está asociada con diferentes fenotipos de acumulación, incluyendo las motivaciones/creencias por las cuales se acumula. Si estos hallazgos son confirmados por estudios longitudinales, pueden ser relevantes para medidas terapéuticas y de prevención.

Exposure to stressful and traumatic life events in hoarding: Comparison to clinical controls.

BACKGROUND: Individuals with hoarding report stressful and traumatic life events at an elevated rate compared with those with obsessive-compulsive disorder and healthy controls, but have not been compared with other clinical groups. This study compared rates of traumatic life events between those with clinically significant hoarding, anxiety disorders, or posttraumatic stress disorder (PTSD), hypothesizing that rates would be higher in the hoarding and PTSD groups than the anxiety group. METHODS: Rates of traumatic and stressful events were compared across groups. RESULTS: All comparisons across groups on types of events were significant (partial-eta squared 0.051-0.162). The hoarding group endorsed significantly more crime-related events but similar rates of other events as compared to the PTSD and anxiety disorder groups. CONCLUSION: These findings suggest that many stressful and traumatic life events are not uniquely elevated in hoarding when compared with other clinical populations.

Pandemic buying: Testing a psychological model of over-purchasing and panic buying using data from the United Kingdom and the Republic of Ireland during the early phase of the COVID-19 pandemic.

The over-purchasing and hoarding of necessities is a common response to crises, especially in developed economies where there is normally an expectation of plentiful supply. This behaviour was observed internationally during the early stages of the Covid-19 pandemic. In the absence of actual scarcity, this behaviour can be described as 'panic buying' and can lead to temporary shortages. However, there have been few psychological studies of this phenomenon. Here we propose a psychological model of over-purchasing informed by animal foraging theory and make predictions about variables that predict over-purchasing by either exacerbating or mitigating the anticipation of future scarcity. These variables include additional scarcity cues (e.g. loss of income), distress (e.g. depression), psychological factors that draw attention to these cues (e.g. neuroticism) or to reassuring messages (eg. analytical reasoning) or which facilitate over-purchasing (e.g. income). We tested our model in parallel nationally representative internet surveys of the adult general population conducted in the United Kingdom (UK: N = 2025) and the Republic of Ireland (RoI: N = 1041) 52 and 31 days after the first confirmed cases of COVID-19 were detected in the UK and RoI, respectively. About three quarters of participants reported minimal over-purchasing. There was more over-purchasing in RoI vs UK and in urban vs rural areas. When over-purchasing occurred, in both countries it was observed across a wide range of product categories and was accounted for by a single latent factor. It was positively predicted by household income, the presence of children at home, psychological distress (depression, death anxiety), threat sensitivity (right wing authoritarianism) and mistrust of others (paranoia). Analytic reasoning ability had an inhibitory effect. Predictor variables accounted for 36% and 34% of the variance in over-purchasing in the UK and RoI respectively. With some caveats, the data supported our model and points to strategies to mitigate over-purchasing in future crises.

Report practices in the field of animal hoarding: a scoping study of the literature.

BACKGROUND: Animal hoarding has been portrayed as a manifestation of hoarding behaviour that is escalating worldwide. Professionals trying to support or help animal hoarders face several challenges due to the lack of systematized information on intervention strategies. AIMS: To comprehensively review and systematize the information available on intervention practices with this population. METHOD: A scoping study was performed using five databases (B-ON, EBSCO, SCOPUS, Web of SCIENCE, PubMed), searching for papers published until March 2020. Fifteen papers were selected and submitted to thematic analysis. RESULTS: The main findings point to two main themes: (i) what is done-responding to animal hoarding as an emergency; and (ii) what should be done-responding animal hoarding in a long-term, integrated manner. CONCLUSIONS: To have a consistent strategy that assures better results, it seems relevant to prepare community interventions based on collaborative and solution-focused approaches. In addition, there is a strong need to have more research on animal hoarding and on successful intervention strategies.

The Impact of Compulsivity and Impulsivity in Cerebellar Ataxia: A Case Series.

Background: The cerebellum has recently been identified to have a key role in reward processing, and individuals with ataxia have been found to be more impulsive and compulsive as part of cerebellum-related cognitive and behavioral disturbances. Case Report: We reported five individuals with cerebellar ataxia who demonstrate impulsive and compulsive behaviors, including hobbyism, gambling, and compulsive medication use, to illustrate that these symptoms can be highly disabling. Discussion: These five cases provide examples of behavioral symptoms in cerebellar ataxia. Further investigations of the pathomechanism of these symptoms will advance our understanding of the cerebellum in cognition and behavior.

Perceptions of public on the COVID-19 outbreak in Singapore: a qualitative content analysis.

BACKGROUND: Singapore is among the several countries affected by the COVID-19 outbreak. The outbreak has elicited panic and unease among Singapore's public. This study aimed to analyze the comments left on local media news outlets to find common concerns and discuss potential new measures that can be developed to reduce panic and support for Singapore's public during and beyond COVID-19. METHODS: A qualitative content analysis on the comments on relevant news articles from the Facebook pages of six online local news publications dated from 23 January 2020 to the 3 April 2020 was carried out. RESULTS: Five common themes were derived 1: fear and concern (35.42%), 2 panic buying and hoarding (21.21%), 3 reality and expectations about the situation (20.24%), 4 staying positive amid the 'storm' (10.07%) and 5 worries about the future (5.01%). The analysis revealed that fear and concern were the main reasons behind the public's responses. CONCLUSION: Clear communication between the government and the public is one of the best ways to maintain calm among the public and to contribute to greater social cooperation. Timely updates and support measures from the government further help to maintain social peace and cohesion.

Object attachment and emotions in hoarding disorder.

BACKGROUND AND AIMS: Object attachment is a core feature of hoarding disorder (HD), but it also occurs in people without HD. It is therefore critical to clarify differences between normal and abnormal object attachment. Although previous studies show that HD is associated with high emotional reactivity, no study to date has examined the nature and intensity of discrete emotions in people with and without HD in relation to object attachment. METHOD: Individuals with HD (n = 93) and matched controls (n = 93) were recruited via MTurk. They identified and described a possession of low monetary value that they were emotionally attached to and found difficult to discard. Participants rated their object attachment and the intensity of emotions when imagining being with the object (Scenario A) and irretrievably losing the same object (Scenario B). RESULTS: Unexpectedly, there were no significant between-group differences on object attachment; however, the HD group experienced more incongruent emotions about their possessions; they reported significantly higher disgust, anxiety and anger than controls when they imagined being with their chosen object (Scenario A) and were more relaxed compared to controls when the object was lost (Scenario B). There were no significant differences between groups on congruent emotions (i.e., positive emotions in Scenario A or negative emotions in Scenario B). CONCLUSION: People with and without HD experience similar emotional attachment for sentimental items but people with HD experience more mixed emotions, consistent with an insecure object attachment.

How well do hoarding research samples represent cases that rise to community attention?

This study used archival data from three different research groups and case file data from three independent community organizations to explore how well research samples reflect cases of hoarding that come to community attention. Using data from 824 individuals with hoarding, we found that research volunteers differ from community clients in several ways: community clients are older, more likely to be male and less likely to be partnered; they have lower socio-economic status and are less likely to demonstrate good or fair insight regarding hoarding severity and consequences. The homes of community clients had greater clutter volume and were more likely to have problematic conditions in the home, including squalor and fire hazards or fire safety concerns. Clutter volume was a strong predictor of these conditions in the home, but demographic variables were not. Even after accounting for the influence of clutter volume, the homes of community-based clients were more likely to have squalor. These findings suggest limitations on the generalizability of research samples to hoarding as it is encountered by community agencies.

Mental health of animal hoarders: a study of consecutive cases in New South Wales.

Objective The aim of this study was to review animal hoarding cases referred to the Royal Society for the Prevention of Cruelty to Animals (RSPCA) in New South Wales (NSW) to examine mental health factors that influence the development of animal hoarding and to consider strategies for dealing with such cases. Methods Data were gathered by RSPCA inspectors regarding consecutive cases referred to the agency over 2 years. Result Details were provided about animals and 50 identified hoarders (11 male, 39 female; mean age 57 years) on 48 properties. The mean number of animals per case was 53 (range 6-300). Fifteen participants (30%) were known to have had involvement with mental health or social services. Mental health factors appeared to contribute to animal hoarding in well over 50% of cases. Severe and moderate squalor were observed in 52% and 21% of dwellings assessed respectively, many with accumulated rubbish. Conclusions Animal hoarding is largely attributable to psychological and psychiatric problems. It is recommended that clinical services work alongside animal welfare inspectorates, assessing (and, where appropriate, treating) such problems. What is known about the topic? Animal hoarding is believed to be partly attributable to the hoarders having psychiatric or psychological problems, but relevant mental health assessment of hoarders is not usually arranged. Recidivism after removal of animals is nearly 100%. What does this paper add? The study confirms that animal hoarders commonly have mental health issues. However, RSPCA inspectors are not expected to screen for such issues or refer cases to mental health clinicians. What are the implications for practitioners? There is good reason to develop clinical services to help animal hoarders deal with their psychological or psychiatric problems.

Recent Advances in Research on Hoarding.

PURPOSE OF REVIEW: The purpose of the following paper is to review recent literature trends and findings in hoarding disorder (HD). Our goal is to highlight recent research on etiology, associated features, and empirically based treatments. RECENT FINDINGS: Recent literature has added support for cognitive differences as a risk factor for HD; however, there is evidence that individuals with HD may overestimate their level of cognitive impairment. Several associated features have been highlighted in recent studies, including emotion regulation, intolerance of uncertainty and distress intolerance, and attachment. Finally, several psychotherapeutic treatments for hoarding have been recently validated, including group-based therapy and treatments using the cognitive-behavioral model. Although recent research demonstrates that hoarding can be effectively treated with available psychotherapeutic modalities, the effectiveness of current treatments is not as robust as that for other psychiatric disorders and more work is needed in treatment precision.