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1.
ABCS health sci ; 44(3): 195-202, 20 dez 2019. tab
Artículo en Inglés, Portugués | LILACS | ID: biblio-1047753

RESUMEN

A acumulação de animais é considerada um fenômeno complexo que, apesar de já ser reconhecido no universo acadêmico, ainda é de difícil solução para a gestão da saúde. Os estudos a respeito de acumulação, principalmente de animais, são incipientes no Brasil. Este artigo de revisão da literatura tem por objetivo alertar a respeito desta complexa morbidade, cada vez mais comum às aglomerações urbanas, indicando ações de promoção e de vigilância em saúde que permitam garantir a saúde dos animais, do acumulador e da coletividade a qual ele pertença. Sugere-se que uma nova abordagem em relação ao distúrbio de acumulação de animais possa combater a pouca visibilidade - inclusive acadêmica - demonstrada na revisão da literatura, ampliando o investimento em intervenções específicas que possam explicitar esse importante problema de saúde pública no Brasil.


Animal accumulation is considered a complex phenomenon that, although recognized in the academic universe, is still difficult to solve for health management. Studies on accumulation, mainly of animals, are incipient in Brazil. This literature review article aims to warn about this complex morbidity, which is increasingly common to urban agglomerations, indicating health promotion and surveillance actions to ensure the health of animals, the accumulator and the community to which it belongs. It is suggested that a new approach to animal accumulation disorder may counteract the poor - including academic - visibility demonstrated in the literature review, increasing investment in specific interventions that may explain this important public health problem in Brazil.


Asunto(s)
Humanos , Mascotas , Vigilancia en Salud Pública , Trastorno de Acumulación , Salud Pública
2.
J Behav Addict ; 8(2): 249-258, 2019 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-31112034

RESUMEN

BACKGROUND AND AIMS: The appetitive aspects of hoarding disorder, such as the compulsive acquisition and saving of objects, are akin to other behavioral addictions. Underpinning these appetitive features is the strong emotional and sentimental attachments that hoarding sufferers have for their possessions. Different facets of object attachment have been identified including anthropomorphism, insecure object attachment, possessions as an extension of identity, possessions as a repository of autobiographical memories, and possessions as a source of comfort and safety. The aim of this study was to examine the association between each of these facets and hoarding symptoms independent of non-sentimental hoarding beliefs, depression, and anxiety. METHODS: Participants were 532 individuals recruited via Turkprime who completed online self-report questionnaires on hoarding symptoms, hoarding beliefs, depression, anxiety, and the facets of object attachment. Pearson's correlations and hierarchical multiple regression analyses were conducted. RESULTS: The results showed that all facets of object attachment were positively correlated with hoarding symptoms. After accounting for other non-sentimental hoarding beliefs, depression, and anxiety, three facets made significant unique contributions to hoarding symptoms: insecure object attachment, anthropomorphism, and possessions as a repository of autobiographical memories. DISCUSSION AND CONCLUSIONS: Based on these findings, we propose a compensatory model to explain how the different facets of object attachment may be implicated in hoarding. Further research into ways of reducing anthropomorphism, insecure object attachment, and possessions as memories are warranted.


Asunto(s)
Emociones , Trastorno de Acumulación/diagnóstico , Trastorno de Acumulación/psicología , Apego a Objetos , Encuestas y Cuestionarios , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Trastornos de Ansiedad/complicaciones , Trastornos de Ansiedad/psicología , Trastorno Depresivo/complicaciones , Trastorno Depresivo/psicología , Femenino , Trastorno de Acumulación/complicaciones , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven
3.
Psychoanal Rev ; 106(3): 207-223, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31090506

RESUMEN

This article is an attempt at a psychoanalytic understanding of Diogenes syndrome, or hoarding disorder syndrome, by way of a clinical case. This syndrome is characterized by a failure to attend to proper housing habits, including the hoarding of rubbish that may, in fact, create unsuitable, even dangerous, living conditions. The clinical case used suggests that Diogenes syndrome or hoarding disorder reflects or indicates an extreme form of obsessive neurosis involving libidinal regressions to anal fixations designed, paradoxically, to satisfy both a passion for dirty and for order. However, this pathological hoarding may also function to protect the subject against fears associated with meeting people, thereby avoiding any possible intimacy and promoting self-exclusion in an anti-object aim. Finally, the case under discussion helps us to understand the particular psychological aspects or relevance that the actual items and rubbish accumulated have in this syndrome.


Asunto(s)
Trastorno de Acumulación/terapia , Psicoanálisis/métodos , Anciano , Femenino , Trastorno de Acumulación/diagnóstico , Trastorno de Acumulación/psicología , Humanos , Apego a Objetos , Conducta Obsesiva/psicología , Conducta Obsesiva/terapia , Desarrollo Psicosexual , Síndrome
4.
Psychiatr Pol ; 53(1): 161-166, 2019 Feb 28.
Artículo en Inglés, Polaco | MEDLINE | ID: mdl-31008472

RESUMEN

Hoarding disorder is defined as an extensive collecting and difficulty in discarding objects and items perceived by others as not useful or having low value. As a consequence it leads to numerous problems which impact not only the patient but also his/her family and other people (e.g., residents of the same block of flats). The frequency of hoarding disorder in the United States and Europe is estimated as 2-6%. In the new classifications of psychiatric disorders (DSM-5 and ICD-11), hoarding disorder is classified as a separate disorder. The scientific research shows that hoarding disorder has specific neurobiological determinants affecting mainly the cingulate gyrus, frontal cortex and insula. These regions are connected with the cerebellum with the so-called cortical-limbic loops. This suggests that the cerebellum damage may result in the development of hoarding disorder. The presented case study concerns the patient suffering from hoarding disorder with an atrophy of the cerebellar cortex and cerebellar vermis indicated by brain imaging (computer tomography and magnetic resonance imaging of the head). It was excluded that hoarding disorder may be a symptom of other psychiatric disorders. No abnormalities were found in the somatic and neurological state of the patient. On the basis of the cited research studies it may be assumed that in the case of the discussed patient, the cerebellum damage was a cause of hoarding disorder development.


Asunto(s)
Lóbulo Frontal/patología , Giro del Cíngulo/patología , Trastorno de Acumulación/diagnóstico , Trastorno de Acumulación/patología , Humanos , Masculino , Persona de Mediana Edad , Corteza Prefrontal/patología
5.
J Consult Clin Psychol ; 87(7): 590-602, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31008633

RESUMEN

OBJECTIVE: Hoarding disorder (HD) is a common and potentially debilitating psychiatric disorder. Thus far, psychological treatments have yielded modest effects and/or were time-consuming and costly to deliver. The aim of the present study was to test the efficacy of a brief group cognitive-behavioral therapy (CBT) for adults with HD and to test hypothesized mediators of treatment outcome. METHOD: Eighty-seven adults with a primary diagnosis of HD were randomized to either immediate CBT or wait list. CBT consisted of 16 weekly, 90-min group sessions that emphasized in-session practice of discarding and refraining from acquiring, decision-making and problem-solving training, emotional distress tolerance, motivational interviewing strategies, and contingency management. Participants were assessed at pretreatment, midtreatment, and posttreatment by an independent evaluator unaware of treatment condition. RESULTS: CBT was efficacious for the symptoms of HD compared with wait list. Saving-related cognitions, but not subjective cognitive impairment, partially mediated treatment outcomes. CONCLUSION: Brief Group CBT is an efficacious and feasible treatment for adults with HD, and is partially mediated by reductions in maladaptive beliefs about possessions. Superiority trials comparing CBT to active treatments, and additional research into mechanisms of treatment outcome, are warranted. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Asunto(s)
Terapia Cognitivo-Conductual , Trastorno de Acumulación/terapia , Psicoterapia de Grupo , Adulto , Emociones , Femenino , Trastorno de Acumulación/psicología , Humanos , Masculino , Persona de Mediana Edad , Entrevista Motivacional , Resultado del Tratamiento
6.
Depress Anxiety ; 36(6): 552-564, 2019 06.
Artículo en Inglés | MEDLINE | ID: mdl-30958911

RESUMEN

Hoarding disorder is present in 2-6% of the population and can have an immense impact on the lives of patients and their families. Before its inclusion the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, pathological hoarding was often characterized as a symptom of obsessive-compulsive disorder, and several different diagnostic assessment methods were used to identify and characterize it. Although the age of onset of pathological hoarding is an important epidemiological measure, as clarifying the age of onset of hoarding symptoms may allow for early identification and implementation of evidence-based treatments before symptoms become clinically significant, the typical age of onset of hoarding is still uncertain. To that end, this study is a systematic review and meta-analysis of research published in English between the years 1900 and 2016 containing information on age of onset of hoarding symptoms. Twenty-five studies met inclusion criteria. The mean age of onset of hoarding symptoms across studies was 16.7 years old, with evidence of a bimodal distribution of onset. The authors conclude by discussing practice implications for early identification and treatment.


Asunto(s)
Trastorno de Acumulación/epidemiología , Adolescente , Distribución por Edad , Edad de Inicio , Trastorno de Acumulación/diagnóstico , Trastorno de Acumulación/terapia , Humanos , Incertidumbre
7.
Asian J Psychiatr ; 42: 104-114, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-31003207

RESUMEN

BACKGROUND: Hoarding is a disorder characterized by excessive acquisition and persistent difficulty in discarding possessions. The behaviour has adverse emotional, physical, social, financial, and legal outcomes for the person with the disorder and family members, and might pose a significant public health problem. Hoarding has been included as a distinct disorder in the Diagnostic and Statistical Manual of Mental Disorders Fifth edition (DSM-5). The prevalence of hoarding disorder is approximately 2-6% globally. The current state of the evidence does not offer clear understanding of the causes of hoarding behaviours. A systematic review of the extant literature was carried out to determine the possible causal factors of hoarding behaviours. METHODS: This review is conducted in line with PRISMA guidelines. The following electronic databases: Medline through Ovid, EMBASE and PsycINFO were searched for relevant articles published between January 2000 and November 2018. Only articles published in English language were included. Two reviewers independently scrutinized the studies and included them in this review. RESULTS: Our search strategy returned a total of 396 references. Preliminary findings suggest that individuals with hoarding behaviours may have a genetic susceptibility; abnormal neural activity in the fronto-temporal, para-hippocampal gyrus and insular parts of the brain has also been identified. Traumatic life experiences have also been posited to predispose individuals to hoard. CONCLUSION: Although the understanding of hoarding disorder hasgrown in recent years, greater efforts are still needed to clarify the etiology and mechanisms of hoarding disorder as these may help in planning of more holistic interventions to treat the problem.


Asunto(s)
Trastorno de Acumulación/etiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Femenino , Trastorno de Acumulación/epidemiología , Trastorno de Acumulación/genética , Trastorno de Acumulación/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven
9.
Psychiatry Res ; 272: 499-506, 2019 02.
Artículo en Inglés | MEDLINE | ID: mdl-30616116

RESUMEN

Difficulty discarding is the core behavioral symptom of hoarding disorder (HD). Patients with HD report greater subjective distress when discarding their own possessions as compared to others' possessions. To date, no prior studies have examined psychophysiological activation, an objective measure of anxious arousal, during discarding among individuals with HD. The current study assessed psychophysiological responses during a baseline resting period and two discarding tasks, one involving personal possessions and the other involving matched control ("experimenter-owned") items in 52 patients with a primary diagnosis of HD. Results showed that, compared to discarding control items, discarding personal possessions increased skin conductance and heart rate and decreased end tidal carbon dioxide. There were no differences in heart rate variability, respiratory sinus arrhythmia, and respiration rate between the two discarding tasks. Despite the fact that discarding increased psychophysiological arousal, self-reported HD symptoms (including difficulty discarding) failed to predict psychophysiological responses during the discarding tasks. The findings suggest that there may be discordance between objective and subjective measures of hoarding-related distress, and are discussed in terms of incorporating psychophysiological measures into the assessment and treatment of HD.


Asunto(s)
Respuesta Galvánica de la Piel/fisiología , Frecuencia Cardíaca/fisiología , Trastorno de Acumulación/fisiopatología , Trastorno de Acumulación/psicología , Propiedad , Adulto , Anciano , Ansiedad/diagnóstico , Ansiedad/fisiopatología , Ansiedad/psicología , Nivel de Alerta/fisiología , Femenino , Trastorno de Acumulación/diagnóstico , Humanos , Masculino , Persona de Mediana Edad , Psicofisiología , Autoinforme
10.
Curr Neuropharmacol ; 17(8): 808-815, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30678629

RESUMEN

This brief review deals with the various issues that contributed to the creation of the new Diagnostic and Statistical Manual condition of hoarding disorder (HD) and attempts at reviewing its pharmacotherapy. It appears that after the newly founded diagnosis appeared in the literature as an autonomous entity, distinct from obsessive-compulsive disorder, drug trials are not being conducted and the disorder is left in the hands of psychotherapists, who on their part, report fair results in some core dimensions of HD. The few trials on HD specifically regard the serotonin-noradrenaline reuptake inhibitor venlafaxine, and, possibly due to the suggestion of a common biological background of HD with attention-deficit/hyperactivity disorder, the psychostimulant methylphenidate and the noradrenaline reuptake inhibitor atomoxetine. For all these drugs, positive results have been reported, but the evidence level of these studies is low, due to small samples and non-blind designs. Regretfully, there are currently no future studies aiming at seriously testing drugs in HD.


Asunto(s)
Clorhidrato de Atomoxetina/uso terapéutico , Trastorno de Acumulación/tratamiento farmacológico , Metilfenidato/uso terapéutico , Inhibidores de la Captación de Serotonina/uso terapéutico , Humanos , Trastorno Obsesivo Compulsivo
11.
Psychiatry Res ; 273: 318-324, 2019 03.
Artículo en Inglés | MEDLINE | ID: mdl-30677721

RESUMEN

Research shows that individuals who experience distress when discarding their possessions are more indecisive than individuals who do not experience such difficulty. These individuals report more intense emotional responses and greater intolerance to distress when faced with a discarding task. The aim of this study was to determine whether an insecure attachment style contributes to indecisiveness among individuals with discarding difficulties and whether this association is mediated by emotional reactivity and distress intolerance. This study used a within-group cross-sectional design. One hundred fifty-six participants with clinically significant discarding problems (82.7% female; Mean age = 21.96, SD = 7.38) from a population of university students and community members completed self-report questionnaires that assessed severity of hoarding behaviours, insecure attachment styles, emotional reactivity, distress intolerance, and indecisiveness. Analyses revealed that an anxious attachment style was associated with greater indecisiveness, and this relationship was mediated by emotional reactivity, but not distress intolerance. Furthermore, avoidant attachment was not related to indecisiveness. Clinical interventions should consider the role of attachment styles in hoarding disorder and address emotional reactivity difficulties in treatment through the use of discarding exposures, as emotion plays an important role in these decision-making processes.


Asunto(s)
Toma de Decisiones , Trastorno de Acumulación/psicología , Acaparamiento/psicología , Apego a Objetos , Adulto , Ansiedad/psicología , Estudios Transversales , Emociones/fisiología , Femenino , Humanos , Masculino , Autoinforme , Estrés Psicológico/psicología , Adulto Joven
12.
Psychiatry Res ; 272: 365-368, 2019 02.
Artículo en Inglés | MEDLINE | ID: mdl-30599440

RESUMEN

This study describes 17 publicly available cases of animal hoarding, a special manifestation of hoarding disorder. The cases, which included court documents, animal service documents, photographs, and newspaper clippings, were reviewed by Masters-level clinicians and a veterinarian in private practice. The veterinarian rated the animals in the case files for possible neglect. Over half of the homes had signs of object hoarding. The most commonly hoarded animals were cats, dogs, and rabbits. The majority of animals in the cases reviewed required veterinary care. Individuals with animal hoarding often lack insight about the condition of their animals and require community intervention.


Asunto(s)
Bienestar del Animal , Trastorno de Acumulación/diagnóstico , Trastorno de Acumulación/psicología , Bienestar del Animal/legislación & jurisprudencia , Animales , Gatos , Perros , Femenino , Trastorno de Acumulación/epidemiología , Humanos , Masculino , Conejos
13.
J Affect Disord ; 246: 652-658, 2019 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-30611063

RESUMEN

OBJECTIVE: In recent years there has been some ambiguity about the way hoarding and OCD are related to each other. The present study examines the differences between persons with OCD/hoarding and OCD/non-hoarding and examines which characteristics are associated with the OCD/hoarding group. Information is established about prevalences, socio-demographical characteristics, OCD and related characteristics, OCD subtypes, comorbidity (depression, anxiety disorders and PTSD) and personality traits. METHODS: Data from baseline assessment of The Netherlands Obsessive Compulsive Disorder Association (NOCDA) study are used. The NOCDA sample consists of 419 participants between 18 and 79 years of age, including participants with current or remitted full DSM-IV-TR criteria for OCD. RESULTS: Results show that 58 persons (14.3%) are classified as persons with OCD/hoarding and 349 persons (85,7%) are classified as persons with OCD/non-hoarding. OCD/hoarding is independently associated with severity of autism symptoms (p<.001), living without a partner (p<.05) and being less conscientious (p<.05). Persons with OCD/hoarding are not associated with childhood trauma (p=.31), PTSD (p=.91) and AD(H)D, inattentive type (p=.22) and hyperactive type (p=.57). LIMITATIONS: Causal interferences about associations between the risk indicators and hoarding symptoms were precluded since results were based on cross-sectional data. CONCLUSION: This study confirmed differences between persons with OCD/hoarding and persons with OCD/non-hoarding. The most relevant outcome of this study was the association between persons with OCD/hoarding and the increased severity of autism symptoms. These results provide a better understanding of persons with OCD/hoarding and have the potential to improve treatment.


Asunto(s)
Trastorno de Acumulación/diagnóstico , Trastorno Obsesivo Compulsivo/diagnóstico , Adolescente , Adulto , Anciano , Trastornos de Ansiedad/epidemiología , Niño , Comorbilidad , Estudios Transversales , Trastorno Depresivo/epidemiología , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Femenino , Acaparamiento , Trastorno de Acumulación/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Países Bajos/epidemiología , Trastorno Obsesivo Compulsivo/epidemiología , Prevalencia , Adulto Joven
14.
CuidArte, Enferm ; 13(1): 77-80, jan.2019.
Artículo en Portugués | BDENF - Enfermería | ID: biblio-1015468

RESUMEN

Introdução: A Síndrome de Diógenes - transtorno psicológico e comportamental, caracterizado pelo acúmulo de objetos e lixo em grandes proporções e pelo isolamento social, contraria padrões sociais. Objetivo: Apresentar uma análise crítica e descritiva referente à Síndrome de Diógenes evidenciando o perfil dos pacientes, seus comportamentos e modo de vida...(AU)


Introduction: Diogenes Syndrome - psychological and behavioral disorder, characterized by the accumulation of objects and trash in large proportions and social isolation, contradicts social standards. Objective: To present a critical and descriptive analysis regarding the Diogenes Syndrome showing the patients' profile, their behaviors and lifestyle ... (AU)


Introducción: Síndrome de Diogenes: el trastorno psicológico y del comportamiento, caracterizado por la acumulación de objetos y basura en grandes proporciones y el aislamiento social, contradice los estándares sociales. Objetivo: presentar un análisis crítico y descriptivo sobre el Síndrome de Diógenes mostrando el perfil de los pacientes, sus comportamientos y estilo de vida ... (AU)


Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Factores de Riesgo , Trastorno de Acumulación , Trastornos Mentales
15.
J Ment Health ; 28(1): 97-103, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-27090348

RESUMEN

BACKGROUND: The impact and burden of working with people that hoard is largely unexplored. AIM: To explore professionals' varied experiences of engagement and intervention with this client group. METHOD: Five semi-structured interviews were initially conducted with professionals with detailed experience of working with people that hoard. A thematic analysis then identified key statements for a 49-item Q-set. The Q-sort was subsequently administered to public sector professionals with wide experience of working with people who hoard (N= 36; fire-fighters, environmental health, housing and mental health). Organizational support and job-related wellbeing measures (anxiety/contentment and depression/enthusiasm) were also administered. RESULTS: Factor analysis identified three distinct clusters (a) therapeutic and client focused (N = 15), (b) shocked and frustrated (N = 2) and (c) pragmatic and task focused (N = 5). Therapeutic and client focused professionals were significantly more content and enthusiastic regarding their work with clients with hoarding difficulties. CONCLUSIONS: Professionals experience and approach their work with people that hoard in discrete and dissimilar ways. Service delivery and training implications are considered.


Asunto(s)
Actitud del Personal de Salud , Trastorno de Acumulación/psicología , Relaciones Profesional-Paciente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Psicometría , Q-Sort
17.
Forensic Sci Med Pathol ; 15(1): 114-118, 2019 03.
Artículo en Inglés | MEDLINE | ID: mdl-30535912

RESUMEN

Hoarding is defined as the acquisition of, and failure to discard, possessions of little use or value to others, usually associated with a significant degree of clutter in the individual's home. We describe a case of a woman who died from a combined traumatic and confined space asphyxia, after being trapped under some of the objects amassed in her apartment. The event was considered to be accidental; by taking into account the information gathered during assessment of the scene, we believe that the accident took place while entering or exiting the apartment. It appears that the woman, who was trying to open or close the door, could have been using her leg to keep the objects piled behind the door from falling. Unfortunately the pile of hoarded objects collapsed and the woman was fatally trapped underneath them. The age and strength of the woman played an important role in the fatal incident, she was too old and weak to remove the items that had collapsed over her body. The scarcity of space between the collapsed objects and the woman, as well as the absence of external or internal signs of violent asphyxiation, or other causes of death, allowed us to establish that the death resulted from a combined mechanism of both the traumatic and the confined space asphyxiation.


Asunto(s)
Asfixia/etiología , Espacios Confinados , Trastorno de Acumulación/complicaciones , Anciano , Femenino , Humanos
18.
Arch Gerontol Geriatr ; 80: 95-97, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30391686

RESUMEN

OBJECTIVES: Hoarding disorder (HD) is prevalent in older adults and contributes to morbidity and mortality. We attempted to estimate rates of hoarding amongst the elderly using the international Residential Assessment Instrument - Home Care (interRAI-HC). SETTING: The interRAI is a mandatory prerequisite in New Zealand (NZ) for government-funded community support or for entry into aged residential care. PARTICIPANTS: All 50 years and older people who were assessed using the interRAI in the southern district health board of NZ. MEASUREMENTS: The age, gender, socially inappropriate or disruptive behaviour and squalor interRAI-HC items were analysed. RESULTS: During the 3 years study period (Jan., 2015 to Dec., 2017) 6655 people, mean age 81.4 + 7.6 years, 56% female, were assessed. The interRAI socially inappropriate behaviour (includes hoarding as one of its descriptors) was present in 233 people (3.5%), herein defined as suspected HD. Squalid conditions were present in 98 additional people (1.5%). Mean age for suspected HD group was significantly younger [76.1 + 6.3 years (p < 0.001)] and there were more males [57% (p < 0.05)] compared with the general interRAI group. CONCLUSIONS: Rates of HD estimated by using the interRAI are in line with published international data. As identification of HD with the interRAI is not straightforward it's use as a screening tool for identifying HD should be validated in future studies.


Asunto(s)
Evaluación Geriátrica , Trastorno de Acumulación/epidemiología , Anciano , Anciano de 80 o más Años , Femenino , Servicios de Atención de Salud a Domicilio , Humanos , Masculino
19.
Br J Clin Psychol ; 58(3): 342-356, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-30548281

RESUMEN

OBJECTIVES: A prior study found that over 50% of treatment-seeking individuals who hoard incur at least one psychiatric work impairment day (i.e., they are unable to work or are less effective at work due to poor mental health) each month. The aim of the current study was to assess work-related variables associated with workplace impairment in a non-treatment-seeking sample. DESIGN: Cross-sectional. Self-report questionnaires were administered via Amazon's Mechanical Turk. METHODS: One hundred and eighty-five employed individuals who reported elevated hoarding symptoms completed questionnaires regarding hoarding symptoms, work engagement, psychiatric work impairment, work control, attention and concentration difficulties at work, and quality of workplace relationships. RESULTS: Greater workplace control and higher quality workplace relationships were associated with greater work engagement. Greater hoarding symptoms and attention difficulties at work were associated with more psychiatric work impairment days. Work engagement statistically mediated the association between the quality of workplace relationships and work impairment, though mediation was also significant when reversing the mediating and outcome variables. CONCLUSIONS: Among a community sample of employed individuals, greater hoarding symptoms were associated with greater psychiatric work impairment. Work-related variables, such as co-worker relationships and attention difficulties, contributed additional variance above that accounted for by hoarding symptoms. There were significant associations between co-worker relationships, work engagement, and workplace impairment, though the direction of the mediation model is unclear. Future research should examine factors associated with unemployment in hoarding disorder. PRACTITIONER POINTS: Clinicians should be aware that greater hoarding severity directly contributes to greater workplace impairment. Clinicians should consider prioritizing the reduction in clutter in living areas that impact one's daily activities and subsequent ability to attend work. Clinicians should assess and treat workplace impairment by helping individuals achieve greater control at work, developing higher quality interpersonal relationships, and improving their attentional abilities.


Asunto(s)
Trastorno de Acumulación/psicología , Acaparamiento , Relaciones Interpersonales , Lugar de Trabajo , Adulto , Estudios Transversales , Femenino , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Autoinforme , Encuestas y Cuestionarios
20.
Anthropol Med ; 26(3): 263-279, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-29232962

RESUMEN

Hoarding has become increasingly prominent in clinical practice and popular culture in recent years, giving rise to extensive research and commentary. Critical responses in the social sciences have criticised the cultural assumptions built in to the construct of 'hoarding disorder' and expressed fears that it may generate stigma outweighing its benefits; however, few of these studies have engaged directly with 'hoarders' themselves. This paper reports on in-depth, semi-structured interviews with 10 individuals living in England, who received assessment and intervention for hoarding from Social Services. Their narratives drew on the cultural repertoire of values and discourses around waste and worth, the mediation of sociality and relationships through material objects, physical constraints on keeping order and the role played by mental health. Analysing these perspectives anthropologically shows how dominant models of hoarding, such as the DSM-5 paradigm, potentially lend themselves to reductionist understandings that efface the meaning 'hoarding' may have and thereby deny agency to the person labelled as 'hoarder'. More culturally informed analysis, by contrast, affords insights into the complex landscape of value, waste, social critique, emotion, interpersonal relationships and practical difficulties that may underlie hoarding cases, and points the way to more person-centred practice and analysis.


Asunto(s)
Trastorno de Acumulación/psicología , Acaparamiento/psicología , Anciano , Anciano de 80 o más Años , Antropología Médica , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Femenino , Acaparamiento/diagnóstico , Trastorno de Acumulación/diagnóstico , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad
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