disposophobia

20 Dec

the scenario

i always do this in class. give a word to my students and ask them to guess what it means where their answers are opened for discussion and justification. later, my students would come up with various illogical nor fascinating ideas of what the words mean especially if the words given were rather alien to them šŸ˜›

the word above is alien indeed. it’s a scientific term to represent a disease quite unknown in malaysia or probably gone unnoticed. thus, it’s not common for us here to face such disaster and state. why dont i relate it to a picture where it might give us the hint about the meaning of the word.

the answer

yes, it is a term use to define compulsive hoarding in science. in wikipedia,it is stated that Compulsive hoarding (or pathological hoarding or disposophobia) is the excessive acquisition of possessions (and failure to use or discard them), even if the items are worthless, hazardous, or unsanitary. Compulsive hoarding impairs mobility and interferes with basic activities, including cooking, cleaning, showering, and sleeping. A person who engages in compulsive hoarding is commonly said to be a “pack rat“, in reference to that animal’s characteristic hoarding.

It is not clear whether compulsive hoarding is an isolated disorder, or rather a symptom of another condition, such as obsessive-compulsive disorder.

the Characteristics

While there is no clear definition of compulsive hoarding in accepted diagnostic criteria (such as the current DSM), Frost and Hartl (1996) provide the following defining features:[3]

  • The acquisition of and failure to discard a large number of possessions that appear to be useless or of limited value
  • Living spaces sufficiently cluttered so as to preclude activities for which those spaces were designed
  • Significant distress or impairment in functioning caused by the hoarding
  • Reluctance or inability to return borrowed items; as boundaries blur, impulsive acquisitiveness could sometimes lead to kleptomania or stealing

According to Sanjaya Saxena, MD, director of the Obsessive-Compulsive Disorders Program at the University of California, San Diego, compulsive hoarding in its worst forms can cause fires, unclean conditions (e.g. rat and roach infestations),[4] injuries from tripping on clutter and other health and safety hazards.[5] The hoarder may mistakenly believe that the hoarded items are very valuable, or the hoarder may know that the accumulated items are useless, or may attach a strong personal value to items which they recognize would have little or no value to others. A hoarder of the first kind may show off a cutlery set claiming it to be made of silver and mother-of-pearl, disregarding the fact that the packaging clearly states the cutlery is made of steel and plastic. A hoarder of the second type may have a refrigerator filled with uneaten food items months past their expiration dates, but in some cases would vehemently resist any attempts from relatives to dispose of the unusable food. In other cases the hoarder will recognize the need to clean the refrigerator, but due (in part) to feelings that doing so would be an exercise in futility, and overwhelmed by the similar condition of the rest of their living space, fails to do so.

the Levels of hoarding

Although not commonly used by clinical psychologists, criteria for five levels of hoarding have been set forth by the National Study Group on Chronic Disorganization (NSGCD) entitled the NSGCD Clutter Hoarding Scale.[6] Using the perspective of a professional organizer, this scale distinguishes five levels of hoarding with Level I being the least severe and Level V being the worst. Within each level there are four specific categories which define the severity of clutter and hoarding potential:

  • Structure and zoning
  • Pets and rodents
  • Household functions
  • Sanitation and cleanliness

Level I hoarder

Household is considered standard. No special knowledge in working with the Chronically Disorganized is necessary. Level 1 hoarding can be seen as someone overlooking a pile of newspapers or pizza boxes gathering in the corner.

Level II hoarder

Household requires professional organizers or related professionals to have additional knowledge and understanding of Chronic Disorganization.

Level III hoarder

Household may require services in addition to those a professional organizer and related professional can provide. Professional organizers and related professionals working with Level III households should have significant training in Chronic Disorganization and have developed a helpful community network of resources, especially mental health providers.

Level IV hoarder

Household needs the help of a professional organizer and a coordinated team of service providers. Psychological, medical issues or financial hardships are generally involved. Resources will be necessary to bring a household to a functional level. These services may include pest control services, “crime scene cleaners”, financial counseling and licensed contractors and handy persons.

Level V hoarder

Professional organizers should not venture directly into working solo with this type of household. The Level V household may be under the care of a conservator or be an inherited estate of a mentally ill individual. Assistance is needed through the use of a multi-task team. These members may include social services and psychological/mental health representative (not applicable if inherited estate), conservator/trustee, building and zoning, fire and safety, landlord, legal aid and/or legal representatives. A written strategy needs to be outlined and contractual agreements made before proceeding.

The following case study is taken from a published account of compulsive hoarding:[5]

A 79-year-old woman recently died in a fire at her Washington, D.C., row house when ‘pack rat conditions’ held back firefighters from reaching her in time. A couple of days later, 47 firefighters from 4 cities spent 2 hours fighting a fire in a Southern California home before they were able to bring it under control. There was floor-to-ceiling clutter that had made it almost impossible for them to come in the house.

the Subtypes and related conditions

Obsessiveā€“compulsive disorder

It is not clear whether compulsive hoarding is a condition in itself, or rather a symptom of other related conditions.[2] Several studies[specify] have reported a correlation between hoarding and the presence and / or severity of obsessiveā€“compulsive disorder (OCD). Compulsive hoarding does not seem to involve the same neurological mechanisms as more familiar forms of obsessiveā€“compulsive disorder and does not respond to the same drugs (which target serotonin).[2][8][9] Hoarding behavior is also related to obsessiveā€“compulsive personality disorder (OCPD). There may be an overlap with a condition known as impulse control disorder (ICD), particularly when compulsive hoarding is linked to compulsive buying or acquisition behavior. However, some people displaying compulsive hoarding behaviour show no other signs of what is usually considered to be OCD, OCPD or ICD. Those diagnosed with attention-deficit hyperactivity disorder (ADHD) often have hoarding tendencies.[10]

Book hoarding

Bibliomania is an obsessiveā€“compulsive disorder involving the collecting or hoarding of books to the point where social relations or health are damaged. One of several psychological disorders associated with books, bibliomania is characterized by the collecting of books which have no use to the collector nor any great intrinsic value to a more conventional book collector. The purchase of multiple copies of the same book and edition and the accumulation of books beyond possible capacity of use or enjoyment are frequent symptoms of bibliomania.

This definition may also be applied to those who collect such things as vinyl records (vinylmania) or other forms of recorded music (cassettes, CDRs, MP3s) and/or published items such as VHS cassettes, DVDs, magazines, newspapers, fliers as well as souvenir items and articles of clothing (sneakers are amongst the most common) which due to their limited production runs are considered unique.

Animal hoarding

Animal hoarding involves keeping larger than usual numbers of animals as pets without having the ability to properly house or care for them, while at the same time denying this inability. Compulsive animal hoarding can be characterized as a symptom of obsessiveā€“compulsive disorder rather than deliberate cruelty towards animals. Hoarders are deeply attached to their pets and find it extremely difficult to let the pets go. They typically cannot comprehend that they are harming their pets by failing to provide them with proper care. Hoarders tend to believe that they provide the right amount of care for their pets. The American Society for the Prevention of Cruelty to Animals provides a “Hoarding Prevention Team”, which works with hoarders to help them attain a manageable and healthy number of pets.[11] Along with other compulsive hoarding behaviours, it is linked in the DSM-IV to obsessiveā€“compulsive disorder and obsessiveā€“compulsive personality disorder.[12] Alternatively, animal hoarding could be related to addiction, dementia, or even focal delusion.[13]

Animal hoarders display symptoms of delusional disorder in that they have a “belief system out of touch with reality”.[14] Virtually all hoarders lack insight into the extent of deterioration in their habitations and the health of their animals, refusing to acknowledge that anything is wrong.[15] Delusional disorder is an effective model in that it offers an explanation of hoarder’s apparent blindness to the realities of their situations. Another model that has been suggested to explain animal hoarding is attachment disorder, which is primarily caused by poor parent-child relationships during childhood.[16] As a result, those suffering from attachment disorder may turn to possessions, such as animals, to fill their need for a loving relationship. Interviews with animal hoarders have revealed that often hoarders experienced domestic trauma in childhood, providing evidence for this model.[16] Perhaps the strongest psychological model put forward to explain animal hoarding is obsessiveā€“compulsive disorder (OCD).

the Physiology and treatment

Brain imaging studies using positron emission tomography (PET) scans that detect the effectiveness of long-term treatment have shown that the cerebral glucose metabolism patterns seen in OCD hoarders were distinct from the patterns in non-hoarding OCD. The most notable difference in these patterns was the decreased activity of the dorsal anterior cingulated gyrus, a part of the brain that is responsible for focus, attention and decision making.[9] A 2004 University of Iowa study found that damage to the frontal lobes of the brain can lead to poor judgment and emotional disturbances, while damage to the right medial prefrontal cortex of the brain tends to cause compulsive hoarding.[17]

Obsessive compulsive disorders are treated with various antidepressants: from the Tricyclic antidepressant family clomipramine (brand name Anafranil); and from the SSRI families paroxetine (Paxil), fluoxetine (Prozac), fluvoxamine (Luvox), sertraline (Zoloft) and citalopram (Celexa). With existing drug therapy OCD symptoms can be controlled, but not cured. Several of these compounds (including paroxetine, which has an FDA indication[18]) have been tested successfully in conjunction with OCD hoarding. A 2006 study of this usage of the drug to treat compulsive hoarding was conducted by the University of California, San Diego. Compulsive hoarding is also treated with psychotherapy which allows patients to deal with their emotions and behaviors. This method is vital to the successful treatment of hoarding[citation needed]. Most symptoms of OCD, such as contamination fears, checking and morbid/ritualistic thinking, are effectively treated with “Exposure and Response Prevention” (ERP). ERP consists of two parts: Behavior Therapy (BT) and Cognitive Behavioral Therapy (CBT)[citation needed].

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