Do you have some friends or relatives who messily accumulate lots of objects in the house? You may be wondering if they have a compulsive problem. It is in fact a specific mental disorder, called disposophobia, which is also covered by the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Those affected exhibit many characteristic traits and behaviors that can be monitored and evaluated thanks to the DSM-5 criteria, thus obtaining an informal diagnosis.
Steps
Part 1 of 3: Tracking Characteristic Signs
Step 1. Look for a lot of clutter in the house
The main characteristic of compulsive hoarders is the difficulty in getting rid of or separating from objects; therefore they tend to accumulate them, which often makes the house unlivable. Such items can be anything: newspapers, clothes, flyers, toys, books, trash, or even restaurant napkins.
- Individuals who suffer from it can store items anywhere, from kitchen countertops to tables and sinks, from stoves to stairs and even on beds. As a result, some rooms or areas of the house are no longer habitable - it is not possible to prepare food in the kitchen, for example.
- Once they run out of space inside the house, they can pile things up in the garage, car or yard.
Step 2. Note the poor sanitation conditions
When there is so much material, it is difficult for this person to be able to keep the house clean; however, the situation also tends to get worse, as it continues to accumulate items without throwing any away, creating an unhealthy environment. This is another demonstration that there is something wrong.
- Those affected by this disorder could allow food and garbage to accumulate, causing them to rot and not care about the stench that permeates the house; food stored in the refrigerator may also have expired or deteriorated because the owner does not want to throw it away.
- Some patients may even knowingly pick up trash or other unhealthy items; they can let unnecessary newspapers, magazines and mail form piles on the floor.
Step 3. Observe the lack of organization
This is a common feature in people with disposophobia. Collectors can own a large number of items, but unlike hoarders, they keep them neat and organized without that these prevent the normal use of the environments. While collectors typically look for only one type of item, such as coins or stamps, and scrupulously catalog them, people with compulsive hoarding collect anything - often useless - and don't know how to organize it. This is a problem that interferes with the ability to group similar objects together.
For example, a compulsive hoarder might have great difficulty gathering yarns by color or organizing them into a single whole; its tendency is to create a single group for each element: robin egg color thread, light blue, cyan, dark blue and so on, as each object is considered unique
Step 4. Check the number of animals
Usually, these people tend to have a lot of pets; they need to "collect" and care for other creatures, often cats and dogs, but eventually they are overwhelmed. While they typically have only good intentions, the result is a group of neglected or mistreated animals.
- Patients with disposophobia have dozens of animals living in a single house; they are often worried about finding new animals, frequenting shelters, alleys looking for strays and consulting sites for adoption.
- In addition to the number of creatures, their state of health is also a good indication of mental pathology. The person is not able to take care of them properly and the animals are often malnourished or suffer from severe stress; in some cases, they even die and it is not possible to find them among the mass of objects in disorder.
Part 2 of 3: Observe Psychological Behavior
Step 1. Check if the person is too attached to objects
The hoarder does not just passively accumulate assets over time, but makes a conscious effort to preserve them. He can give many reasons for his behavior, for example he could say that he does not want to waste goods, that they have sentimental value or that objects can be useful sooner or later; all this contributes to excessive attachment to things.
- Individuals with disposophobia may experience some discomfort by allowing someone to touch or borrow their possessions; they also suffer from severe anxiety about throwing them away, related to their perception of having to keep them.
- About 80-90% of patients are also "collectors"; this means that it not only stores items, but actively accumulates them even if they do not need them or have no space to store them.
Step 2. Observe the discomfort at the idea of separating from possessions
Psychologically, the accumulated objects form a kind of "protective shell" for the disposophobic, who does not recognize his behavior as a problem, despite all the evidence pointing to the contrary. The patient lives in a state of denial; the very thought of throwing things away is a source of severe stress.
- Some even go into a state of panic when an object is moved and not thrown away. They can interpret the external pressure to clean as a personal violation and quickly restore the initial conditions, within a few months.
- A "non-hoarder" individual sees objects as trash to be thrown away, rooms as spaces to be lived in, beds as furniture in which to sleep and the kitchen as an environment in which to cook meals; for a disposophobic the house is only a deposit and not a home.
Step 3. Note correlations with other disturbances
Compulsive hoarding does not always manifest itself on its own; often, it develops alongside other mental or behavioral problems. Look for these repetitive patterns in people you fear have disposophobia.
- The disorder may be accompanied by obsessive compulsive, obsessive-compulsive personality, attention deficit hyperactivity disorder, or depression.
- The patient may also have eating problems, Prader-Willi syndrome, dementia, or pica (a tendency to eat inedible foods, such as dust or hair).
Part 3 of 3: Undergo the tests and get a diagnosis
Step 1. Request a psychological assessment
The psychiatrist must perform a thorough examination of the person in order to diagnose compulsive hoarding. He asks the patient questions about his habits of accumulation, disposal of objects and his mental well-being; expect these questions related to the typical behaviors of disposophobia.
- Doctors may ask the person for more information about their psychological state to see if they have symptoms of other disorders, such as depression.
- After obtaining the person's consent, they may also ask family or friends a few questions to get a complete picture of the situation.
Step 2. Make an assessment based on the DSM-5 criteria
It is a manual that lists mental disorders, including compulsive hoarding which is defined according to six specific criteria. You can understand if a person suffers from this mental problem thanks to these parameters. If all or most of the characteristics are met, you are probably dealing with an individual with disposophobia. The first four principles are related to behavior:
- People with disposophobia show persistent difficulties in getting rid of objects, regardless of their real value;
- Their difficulty is due to the perception of the need for such objects and the anxiety they feel when they try to throw them away;
- The result of all this is the accumulation of large quantities of objects that "congest" and occupy the entire living space of the patient's home;
- Disposophobia generates serious discomfort and difficulties in social, work or other aspects of daily life, such as keeping one's home safe.
Step 3. Make sure these behaviors aren't triggered by another problem
The last two criteria of the DSM-5 state that, in order to be able to claim that it is compulsive hoarding, the patient's actions must not be caused by other pathologies or be symptoms that better fit into the picture of another mental disorder. These alternative etiologies include brain injury, Prader-Willi syndrome, or obsessive-compulsive disorder.
- Disposophobia can occur in individuals with neurodegenerative diseases, brain function problems, such as dementia or brain injury; doctors must ensure that there are no such pathologies underlying the abnormal behavior.
- Prader-Willi syndrome is genetic in nature and leads to mild cognitive impairment. The patient may also exhibit obsessive behaviors, such as grabbing food and objects.
- Doctors should also make sure that the buildup is not due to lack of energy, which in turn is induced by depression; disposophobia is an active, not a passive, behavior.
