Hoarding Disorder And Theoretical Orientation


Hoarding disorder is a psychopathological symptom complex manifested by an extreme disregard for her appearance and health, social isolation, apathy, a tendency to accumulate junk, and a lack of shame. The patient’s first symptoms began to manifest in kindergarten when her teacher began to notice that the girl left a large mess on her desk. Jenny would forget that she needed to put away her toys. Later in the initial stages of schooling, the girl showed symptoms of attention deficit disorder.


Hoarding manifested itself mostly at home. Among the qualities accompanying manifestations of pathological hoarding, the girl had attention deficit disorders and indecisiveness. The patient experienced difficulty in parting with her toys from an early age. As heredity is an important factor in diagnosing this disorder, it is important to pay attention to the presence in Jenny’s family of relatives with manifestations of similar diagnoses. After her son’s death, the girl’s aunt Olivia maniacally gathered in one room all things that reminded her of the deceased child. For a long time, Jenny did not see a problem in her hoarding, explaining it by her unwillingness to part with her favorite things. Later, she referred to the fact that she managed to find a large number of things at a bargain price. This behavior caused puzzlement on the part of those closest to her. Soon her husband and children left Jenny, and the girl’s mother insisted on starting a full course of treatment.

During the interview with the therapist, it was decided to pursue a behaviorist orientation to explore the various motives that prompted the girl to engage in this behavior as part of her disorder. In this approach, the main tool for gathering information about the patient is observation. It is possible to understand the initial stimulus that causes the reaction, in Jenny’s case – hoarding. In working with the patient, the principles of theoretical behaviorism were applied, which implies taking into account not only the behavioral appearances of patients but also their feelings and sensations.

The accompanying diagnosis was attention deficit disorder, which manifested in the early school years. In this disorder, the functioning of the central nervous system is impaired, resulting in difficulty concentrating and maintaining attention, ability, and problem-processing information (Goodman & Livingston, 2013). The disorder manifested itself in Jenny’s inability to maintain order at her desk and complete many tasks requiring concentration. After the birth of her child, the patient experienced depressive manifestations. This was mainly because the girl had to be alone for a long time in her husband’s absence.

Against the background of all these disorders, the girl had for many years maniacally accumulated things, both in her parents and her own home. Neither external nor internal motives were enough to stop this behavior. Moreover, before her husband left, the girl did not notice any problems with it for a long time. She usually reacted with aggression to complaints from people close to her. Based on this information, a diagnosis of pathological hoarding can be made as part of obsessive-compulsive disorder, the typical symptoms of which are obsessive compulsions, usually of irresistible nature. In addition to obsessions, there are also compulsions through which patients attempt to reduce anxiety and distract themselves from intrusive thoughts.


In some episodes, patients carry out compulsive actions surreptitiously or mentally. In Jenny’s case, the compulsions are overt. Often the manic actions of patients with this diagnosis are accompanied by some absent-mindedness and slowness in the performance of work or household duties (Herstowska, M., & Cubala, 2013). This explains the girl’s inability to keep her house clean and tidy and her husband’s numerous comments.


Goodman, D. M., & Livingston, E. H. (2013). Attention-deficit/hyperactivity disorder. JAMA, 309(17), 1843.

Herstowska, M., & Cubala, W. J. (2013). Efficacy in obsessive-compulsive disorder comorbid with bipolar disorder. Dusunen Adam: The Journal of Psychiatry and Neurological Sciences.