Inside a Hoarder's Brain

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Whenever I catch an episode of 'Hoarders' on A&E, I'm fascinated- and baffled that people can live that way! But most hoarders can't help themselves without intervention. A study reveals a malfunction in the brain's decision-making network is behind the disorder.

Hoarding is classified as an obsessive compulsive disorder, or OCD, which is an anxiety disorder which drives someone to do something as a result of repeated thoughts or feelings. But the new study offers evidence that hoarding is its own dysfunction. Brain scans of hoarders revealed differences between their brains and those with OCD and healthy adults.

Hoarders were asked to decide whether to keep or toss their junk mail. They also had to decide on someone else's mail. Using functional magnetic resonance imaging or fMRI, the subjects' brains were monitored for changes and activity in the anterior cingulated cortex and insula - the decision-making network.

Faced with whether or not to throw away a piece of their mail, hoarders felt more anxiety compared with the other groups. The scan revealed a massive increase in activity which explains why they feel overwhelmed and unable to throw anything away. In contrast, when deciding on other people's mail, that area of the brain wasn't stimulated, suggesting the malfunction allows them to ignore their own mess.

If hoarding is reclassified as its own disorder, additional treatment methods could be tailored to help sufferers. It'd also benefit those around them who face a well documented health and fire hazard from all that clutter.

More Information

Diagnosis and Assessment of Hoarding Disorder
R.O. Frost, G. Steketee, D.F. Tolin. (2012). Annual Review of Clinical Psychology. Vol. 8, 219-242.

Comprehensive review article that presents the history in this area, the new criteria for diagnosis and a wealth of facts about this disorder.

Why aren't hoarders bothered by all that junk? Scientists find a clue
Nice, layman-friendly review of the recent study by David Tolin, PhD, at Yale University School of Medicine that describes changes in regions of the brain by fMRI leading to the hypothesis that hoarding affects and may be caused by malfunctioning in decision making.