2

Accepted Manuscript

Phenomenology of hoarding—What is hoarded by individuals with hoarding disorder?

Christopher Mogan, Michael Kyrios, Isaac Schweitzer, Keong Yap, and Richard Moulding

doi:10.1016/j.jocrd.2012.08.002

To appear in: Journal of Obsessive-Compulsive and Related Disorders

Received 29 March 2012

Received in revised form 22 July 2012

Accepted 7 August 2012

This is an unedited manuscript that has been accepted for publication.

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Running head: PHENOMENOLOGY OF HOARDING

What is hoarded by individuals with hoarding disorder?

Christopher Mogan

University of Melbourne

Michael Kyrios

Swinburne University of Technology

Isaac Schweitzer

University of Melbourne and The Melbourne Clinic

Keong Yap

RMIT University

Richard Moulding

Swinburne University of Technology

Corresponding author: Dr Christopher Mogan, mogan@theanxietyclinic.com.

The Anxiety Clinic

TMC 6, 140 Church Street, Richmond, 3121 Victoria, Australia

Tel. 61-3-9420 1424

Fax 61-3-9421 0077

4

Abstract

Hoarding disorder is an under-recognized yet complex and pervasive psychological

problem that dominates individual’s time, living spaces, relationships and safety. Hoarding

behaviors have been associated with a number of disorders, including Obsessive-Compulsive

Disorder (OCD), but as of yet, there has not been a systematic investigation of the

presentation of hoarding phenomena across disorders. Simply – what do individuals with

hoarding actually hoard, and does that differ from objects kept by people without hoarding?

An understanding of the differential presentation of hoarding phenomena could help clarify

the clinical status of hoarding disorder, which is currently under review. This study examined

hoarding phenomena in 109 participants from five cohorts (individuals who hoard with and

without comorbid OCD, individuals with OCD without hoarding, individuals with other

Anxiety Disorders and non-clinical controls). The results supported the presence of hoarding

symptoms across clinical and non-clinical cohorts, but some differences were apparent. In

particular, individuals with hoarding disorder were far more likely than controls to collect

idiosyncratic objects, some with deeply personal connections. Implications are discussed.

Keywords: Hoarding, Obsessive-Compulsive Disorder, phenomenology, Obsessive-

compulsive spectrum.

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1. Introduction

Hoarding things is a normal human behavior that arises from various symbolic, instrumental

and artistic links which underpin the relationships humans form with objects (Nordsletten &

Mataix-Cols, 2012). There is a growing awareness of a “disordered” type of hoarding, where

the keeping of things is so pervasive that it dominates the person’s life – their space and time,

personal and social functioning. While the early papers on such hoarding were largely

descriptive accounts that linked hoarding with severe and unusual presentations of obsessive

compulsive disorder (OCD) (Greenberg, 1987; Fitzgerald, 1997), more recent research has

examined hoarding as a phenomenon in its own right, as distinct from OCD (e.g., see Mataix-

Cols et al., 2010).

Reflecting this historical emphasis, there is a lack of clarity regarding hoarding in

DSM-IV-TR (American Psychiatric Association, 2000), with hoarding appearing only as a

symptom of Obsessive Compulsive Personality Disorder. This belies the seriousness of

hoarding as a clinical problem, at least as damaging as the other more recognized OCD-

related symptoms (Steketee & Pruyn, 1998), particularly where hoarding and clutter have

been known to lead to severe life-limiting injury from falls and fire-related injury, and even

the death of sufferers (Lucini, Monk, & Szlatenyi, 2009). In an online survey of 864

individuals with compulsive hoarding, Tolin and colleagues (2008) concluded that hoarding

disorder represents a profound public health burden, with work impairment similar to

psychotic disorders, and greater work impairment than individuals with other anxiety, mood

and substance abuse disorders. They also found that participants with hoarding disorder

showed a high degree of a broad range of chronic and severe medical concerns, and had a

five-fold higher rate of mental health service utilization. Eight to 12% had been evicted or

threatened with eviction, while 0.1-3.0% had a child or elder removed from the home (Tolin,

Frost, Steketee, Gray & Fitch. 2008). There is a DSM-5 working party paper reviewing

6

hoarding in order to give clinicians clearer clinical guidelines (Mataix-Cols et al., 2010),

including questions of differential criteria and classification. Answers to these questions

require research into the phenomenon of hoarding and any differences between individuals

who hoard and those with OCD.

Phenomenological differences between hoarding disorder and OCD have traditionally

been considered by examining differences in the clinical presentation or symptom profiles of

individuals. For instance, individuals who hoard frequently do not view their behavior as

unusual and exhibit less insight into their behavior than do those with other OCD symptoms

(Black et al., 1998; Frost & Gross, 1993; Frost, Krause, & Steketee, 1996; Tolin, Fitch, Frost,

& Steketee, 2010). As such, their thoughts regarding their possessions may be better

described as “preoccupations”, in contrast to the inherently distressing obsessive thoughts

that occur in OCD (Rachman, Elliott, Shafran & Radomsky, 2009). Hoarding-related

thoughts have been noted to be “neither intrusive, nor unwanted, and certainly are not

repugnant” (Rachman et al., 2009 p. 521). Furthermore, individuals who do not have to

perform a ritual in response to their thoughts (Mataix-Cols et al., 2010). Adding credence to

such distinctions, individuals with hoarding often do not display any other OCD symptoms

(for review, see Mataix-Cols et al., 2010), and have a lower rate of comorbid OCD (18%)

compared to depression, GAD and social anxiety (Frost, Steketee, & Tolin, 2011).

The present study aimed to explore another potential difference in the phenomenology

of hoarding – specifically by systematically addressing the issue of what do individuals who

hoard actually keep, and is this different from collecting behaviour in people without

hoarding disorder? In addition to etiological and diagnostic implications, a better

understanding of the types of items saved between groups would help guide clinicians in the

assessment and treatment of hoarding disorder with and without OCD. The only previous

study to examine this issue found that individuals with Hoarding with and without OCD

7

collected similar things, with the exception of letters, receipts, bills, old medication, and

bizarre objects (all higher in individuals with OCD; Pertusa et al., 2008). The most kept items

in both groups were old clothes, magazines, CDs, letters, and pens. To extend this analysis,

we examined similarities and differences in hoarding phenomenology across four clinical

groups – individuals with hoarding disorder with and without comorbid OCD; individuals

with OCD without hoarding; individuals with other Anxiety Disorder and a community

control group. This study examined the types of objects individuals saved, and whether

individuals who hoard saved different items from other groups. It was hypothesized that the

range of objects saved by the hoarding groups would differentiate individuals with hoarding

from non-hoarding clinical and community control groups. In addition, consistent with

Pertusa et al. (2008), we wanted to explore if there were any significant difference on items

saved in individuals with and without OCD.

2. Method

2.1 Participants

A total of 89 clinical participants and 20 community controls volunteered for the

study. Clinical participants were patients from University of Melbourne’s Professorial and

Psychology Clinics, members of community-based OCD support groups, or patients who

found out about the study from other clinical referrals and general media publicity. The

Research protocol was approved by the Research and Ethics Committee of the University of

Melbourne. Participants were screened to exclude those with psychosis, dementia and related

disorders. The age range of participants was 18 - 65 years. Five participants were not

included in the study because the questionnaire data was incomplete. The Anxiety Disorders

Interview Schedule for DSM-IV (ADIS-IV; Brown, Di Nardo & Barlow, 1994) administered

by clinical and provisional psychologists under supervision to verify diagnosis. As the ADIS-

IV did not contain items for hoarding disorder, participants were assessed using an expanded

8

version of the Hoarding Rating Scale – Interview (HRS-I; Tolin, Frost, & Steketee, 2010).

Five groups participated: Group 1 consisted of individuals diagnosed with hoarding disorder

with comorbid OCD (HO, n=23); Group 2 consisted individuals with hoarding disorder

without OCD (H, n=26); Group 3 comprised participants diagnosed with OCD but no

hoarding (O, n=20); Group 4 comprised participants who fulfilled the DSM-IV criteria for

Panic or Social Anxiety but not OCD (A, n=20); Group 5 was a community control group,

matched with the hoarding cohort for age, gender and level of education, with no DSM-IV

diagnosis nor a psychiatric history as determined by screening interviews (C, n = 20).

2.2 Procedure

Participants made contact with the research team via the telephone, mail or email to

indicate their interest in participating. They were then contacted by the research team who

arranged an interview. Each participant was provided with an information pack comprising:

(1) a description of the study, a consent form, and detailed explanatory material on the study

written in plain English to ensure adequate comprehension and clarity; and (2) two separate

batches of questionnaires with replied paid envelopes including measures of cognitive,

affective, and developmental factors.

Following informed consent, clinical interviews were conducted by the research team

using the ADIS-IV, whether face-to-face for metropolitan-based enquirers or by telephone for

rural or interstate respondents. Site visits were conducted if possible and photographs and

third party reports obtained to confirm severity of hoarding. Participants were screened to

exclude those with psychosis, dementia and related disorders. Each person was assigned a

number to ensure confidentiality, anonymity and accurate matching of data sets.

Demographic variables including age, gender, marital status, income, and education were

collected across the five groups. Objects that were most saved and the symptomatic features

of the five different groups were measured. With respect to the groups with hoarding

9

behaviour, information about comorbidities and potential hazards noted were also collected.

2.3 Materials

The Anxiety Disorders Interview Schedule for DSM-IV (ADIS-IV; Adult Version:

Brown et al., 1994) is a semi-structured interview screening of DSM-IV criteria for anxiety

and related disorders.

The Saving Inventory – Revised (SIR; Frost, Steketee & Grisham, 2004) is a 23 item

self-report scale designed to measure the major features of hoarding disorder (Frost & Hartl,

1996) Items were scored on a 5-point Likert scale. In this study, excellent internal

consistency was shown with a Cronbach’s α of 0.98.

The Savings List (Kyrios, 2002) is a descriptive list of 82 common objects saved or

hoarded as a systematic guide to the type of things being collected by clinical and non-

clinical groups that has been used in a number of studies (Wincze, 2001; Kyrios et al., 2002;

Novara, unpublished). Participants were asked to indicate the extent they saved each items on

a 7-point Likert scale from 1 (Not at all – I only save what I need or use) to 7 (Very much - I

save an excessive amount. Far more than I will ever use). Space was provided for participants

to include and rate additional items. In this study, two methods of scoring were used: (1) the

sum total of all 82 items, and (2) the number of items saved at the upper end of the Likert

scale (scores 5-7).

The Hoarding Rating Scale – Self Report (HRS-SR; Tolin et al., 2008) consisted of

five self-report diagnostic criteria proposed for compulsive hoarding (Steketee & Frost,

2007). Items were scored on a 9-point Likert scale. In this study, excellent internal

consistency was shown with a Cronbach’s α of 0.96.

3. Results

Table 1 shows the descriptive demographic data across the five groups. The

community control group and individuals who hoard were significantly older than the OCD

10

cohort. As expected, the community control group was significantly higher than the clinical

groups in terms of socioeconomic status as measured by income. There were no significant

differences in gender, marital status, or education between the groups. Within the hoarding

groups, 39 participants had comorbid depression and four had a diagnosis of OCPD.

Table 2 shows differences between groups on measures of hoarding, including HRS-

SR items measuring the five criteria of hoarding suggested by Frost and Hartl (1996). Results

showed that individuals who hoard (with or without comorbid OCD) scored significantly

higher than the clinical and control groups (including OCD) on the five HRS items, SIR, and

SAL, supporting both the validity of groups and the usefulness of the items to discriminate

between them. There were no significant differences between OCD, anxiety and control

groups on these hoarding criteria. Figure 1 shows differences between groups on the mean

number of items saved that were ranked ≥ 5 on the Likert scale. The hoarding groups saved

significantly more types of items than the non-hoarding groups but there was no significant

difference between the two hoarding groups.

In a series of analyses using the Savings List (SAL), all groups were compared on the

items most likely to be saved. A list of the most saved items was constructed for each of the

cohorts (see Table 3). These were items on the SAL endorsed as ≥ 5 on the Likert scale – i.e.,

items that participants indicated that they were highly likely to save even if they did not need

them. Table 4 shows the most saved items amongst individuals with hoarding disorder

(combined groups), while Table 5 shows the list of additional items nominated by this group.

Clothes, books, bills/statements, records/tapes, and sentimental objects were the most

frequently saved items across all the groups. Interestingly, jewellery was one of the top five

items amongst each of the non-hoarding groups; whilst still kept in the groups with hoarding,

the rank order was relatively low (17 and 19th

most saved items in the HO and H groups

respectively). There were relatively few significant differences between the HO and H

11

groups, with the only notable exceptions being keeping school papers, containers, pots, mail

and notes, with the HO group being higher on all of these categories, except for pots. There

were many items added by hoarding participants in the optional additional listing of saved

objects. 65% and 78% of the individuals with hoarding disorder (with and without comorbid

OCD respectively) added extra items, while less than 20% of the other groups did so,

showing the idiosyncratic nature of saving amongst this group. The majority of individuals

who hoarded (69%) acknowledged that their clutter posed at least one safety hazard. Forty-

seven percent of all individuals who hoard noted that fire was the hazard that they were most

concerned about, followed by the risk to falling (38%) and concerns about hygiene standards

(35%).

4. Discussion

The focus of this study was the phenomenology of hoarding disorder – specifically

whether the pattern of objects saved by individuals who hoard differs from those with OCD

and other groups. The validity of the groups was supported, with the hoarding-specific

measures (SIR, SAL, HRS) clearly differentiating the groups who hoarded (with or without

OCD) from the other clinical and community controls. As hypothesised, individuals who

hoard were generally distinctive from the other clinical groups and non-clinical controls in

what they did with objects and possessions, and this did not differ depending on the presence

or absence of comorbid OCD. As expected, the range of objects that were saved excessively

by the hoarding groups was significantly higher than non-hoarding clinical and community

control groups, thus indicating that individuals who hoard did so indiscriminately as opposed

to the excessive saving of items of a specific category. This result is consistent with previous

findings indicating clear differences between individuals who do and do not hoard

(Abramowitz, Franklin, Schwartz & Furr, 2003; Frost & Gross, 1993; Frost & Hartl, 1996;

Leckman et al., 1997; Black et al., 1998; Samuels et al., 2002; Calamari et al., 1999; Samuels

12

et al., 2006).

The Savings List data was consistent with previous reports (Frost & Gross, 1993) that

clothes and books, receipts and bills, and personal and sentimental objects are collected at high

levels across all the groups. Thus, in relationship to general categories, individuals with

hoarding disorder generally collected similar items to non-hoarding groups (i.e. most groups

had similar category items within their top items), but just collected more of them. One notable

difference was that, with the possible exception of the OCD group, greeting cards and letters

tended to be kept more often in the groups with hoarding. This could reflect suggestions that

individuals with hoarding tend to be more likely to “fuse” person and objects (e.g., clients often

report that they may keep anything with people’s handwriting in it, including books with a

parent’s name inside the front cover, or newspapers which have been jotted upon).

Interestingly, jewelry was kept at a lower rank-level within the hoarding groups, despite their

being no differences in rates of being single or being male in this group (if anything, the trends

would suggest that the groups with hoarding were biased towards female married participants).

We could speculate that this may be due to individuals who hoard being less likely to perceive

jewelry as a special class of object (i.e., they may not privilege jewelry over other “sentimental”

or “pretty” objects to the same extent that non-clinical samples do). Anecdotally, many

individuals with hoarding disorder do report that a variety of objects can be considered to be

“pretty things”; for example, one of our recent clients reported difficulties in not collecting

broken glass from a bottle that was outside the therapy room, owing to its lovely colour.

Reflecting such anecdotes, differences were most apparent owing to the idiosyncratic

nature of items collected by those with hoarding disorder. Thus, most individuals with hoarding

disorder added extra items to the Savings List whereas few in the other groups did so. While to

some extent this may reflect known difficulties for individuals with hoarding to classify objects

within existing categories (i.e., “everything is unique”; e.g., Steketee & Frost, 2007), the

13

presence of especially personal items like skin scabs, dental floss, hair, soap and old

medications points to a deep-rooted “self-connectedness” to things, and perhaps a need to

protect the ‘self’ in maintaining ownership of such things. This is also consistent with some

models of hoarding that point to the psychological fusion of “self” with objects (e.g., Steketee

& Frost, 2007; Gwilliam, Wells & Cartwright-Hatton, 2004).

Comparing our results to the study by Pertusa et al. (2008) we found similar results;

with both studies finding very few differences between individuals with hoarding and comorbid

OCD, and those with hoarding without OCD, in terms of number of objects kept. These

findings provide further support to the argument that although related, hoarding disorder can

occur as a separate syndrome from OCD. While the objects collected by individuals varied

somewhat across the studies (although old clothes was the greatest kept item across both

studies), this is likely accounted for in terms of differences in methodology (i.e., questions

asked), as well as possible differences across samples (e.g., cultural differences between

Australian, USA and UK samples; urban or rural location, trauma history). In Pertusa et al.’s

study, they found that letters, receipts, bills, old medication, and bizarre objects were all kept

more frequently by individuals with OCD and hoarding. However, in our study, containers,

school papers, pots, mail and notes significantly differed between the groups, with the co-

morbid group again being higher on all (except for pots). It is unclear why these particular

objects differed between the groups, but it should be noted that in given the list contains 82

items, the relative lack of differences between the hoarding groups is probably more notable

than the few specific differences that were found.

The hoarding group exhibited scores on the hoarding measures that were similar to

those scored by compulsive hoarding samples from the USA and UK. Thus, the hoarding

groups (with or without OCD) were clearly higher on the Saving Inventory-Revised (SIR)

and did not differ from each other, while the group with OCD showed similar levels to

14

control samples. Similarly, groups were clearly distinguished using the Hoarding Rating

Scale-Self Report (HRS-SR) - a new self-report version of an existing interview (Tolin et al.,

2010). This study furthers suggestions that the HRS-SR might prove to be useful as a

standard screening device for this largely under-diagnosed condition, given its brevity in

comparison to the SIR, while the items clearly identify the phenomenology of hoarding. This

scale highlights succinctly the phenomena of hoarding – clutter, inability to stop acquiring

objects, difficulty discarding, the emotional over-attachment to things, and the functional

impairment - that are accentuated in such applied professions. Given the generally ‘hidden’

nature of hoarding, these items could perhaps become part of a standardized assessment

interview for health professionals and community workers.

Whilst the hoarding groups collected significantly more things both in quantity and

type than the other clinical and control groups, future research might consider whether

objects saved are affected by age or gender-related factors across the type or frequency of

collected items. More refined targeting of objects saved could lead to more specific strategies

in training individuals to reduce acquiring behaviour and increase organizational and de-

cluttering skills. The implications of this study are the support for the diagnosis of hoarding-

specific behaviours that manifest in the collection of large quantities of items that become

unmanageable and disruptive in ways that identify a consistent and discrete set of

psychological factors.

A limitation of the current study was the difficulty in differentiating OCD sufferers

who hoarded as part of their OCD from OCD sufferers who had co-morbid hoarding disorder.

Based on clinical interviews and rating scales, we are reasonably confident that all

participants in the HO group had co-morbid hoarding disorder. However, there remains a

possibility that some individuals in the HO group might also have OCD-related hoarding.

Pertusa, Frost, & Mataix-Cols (2010) noted that individuals with OCD-related hoarding were

15

more likely to collect bizarre items such as trash, faeces, urine, and nails. Unfortunately,

another limitation of the current study was the exclusion of indicators of squalor such as

trash, rotten food, faeces, and urine from the Savings List. Hair and nails were items on the

Savings List, but they did not rank highly in all groups. Participants were also invited to add

idiosyncratic items in the savings list but none reported hoarding bizarre items of squalor

with the exception of skin scabs. It is still possible that such items were hoarded but

participants were unwilling or too embarrassed to report them. The question of whether

hoarding as a symptom of OCD differs from hoarding when it is co-morbid with OCD

therefore requires further investigation. Finally, although the control group (C) was matched

to the hoarding groups (HO and H) on age and gender, there was a significant age difference

between the H group and the non-hoarding clinical groups (O and A groups). Age

differences might therefore have had some impact on the ranking of items.

In summary, this study examined hoarding behaviours in individuals with hoarding

both with and without comorbid OCD, and compared the hoarding behaviour to control

groups including individuals with OCD without hoarding. It was found that while commonly

hoarded items were similar across the groups, individuals who hoarded also listed a number

of idiosyncratic items, some which were deeply personal. This examination provides further

impetus to examination of theories that suggests that therapies and models that examine the

role of self and meaning in objects, as well as adding to our characterisation of what it means

to be experiencing hoarding disorder.

16

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Table 1.

Demographics across groups – age, gender, marital status, education and income

Mean (SD)

Hoarding with

OCD (HO)

(n = 23)

Hoarding

without OCD

(H)

(n = 26)

OCD Group (O)

(n = 20)

Anxiety

Group (A)

(n = 20)

Controls (C)

(n = 20)

F Statistic

(partial η2)

Post-hoc test

(Dunnett's T3)

Age (yrs) 47.78 (11.43) 55.04 (10.36) 38.90 (12.29) 43.65 (13.67) 49.50 (9.35) F(4,104)=6.35***

(partial η2=.196)

C > O

H > A, O

Male (%) 30.4 19.2 50.0 50.0 30.0 χ2 (4)=7.24

Married (%) 43.5 57.7 30.0 30.0 50.0 χ2 (4)= 5.45

Tertiary ed (%) 47.8 50.0 60.0 80.0 75.0 χ2 (4)=7.72

Secondary ed

(%)

42.2 50.0 40.0 20.0 25.0

Low Income

(%)

43.5 46.2 30.0 35.0 10.0

Med Income

(%)

43.5 38.5 40.0 30.0 20.0 χ2 (8)=21.65**

High Income

(%)

13.0 15.4 30.0 35.0 70.0

aIncome groups - Low = < AUD$25000; Medium = AUD$25000-$50000; and High = > AUD$50000.

***p < 0.001; **p< 0.005.

20

Table 2

Mean scores (SD) on hoarding scales across group

Mean (SD)

Hoarding with

OCD (HO)

(n = 23)

Hoarding

without OCD (H)

(n = 26)

OCD Group (O)

(n = 20)

Anxiety

Group (A)

(n = 20)

Controls (C)

(n = 20)

F Statistic

(partial η2)

Post-hoc test

(Dunnett's T3)

HRS-SR

Total 24.74 (9.51) 22.77 (7.13) 2.70 (3.79) 3.10 (3.95) 1.25 (2.36) 81.72*** (.759) HO, H > O, A, C

Clutter 4.74 (2.51) 4.58 (2.00) 0.40 (0.75) 0.50 (1.24) 0.30 (0.73) 43.99*** (.629) HO, H > O, A, C

Discarding 5.52 (1.93) 5.27 (1.37) 0.45 (0.76) 0.90 (1.25) 0.50 (0.83) 87.87*** (.772) HO, H > O, A, C

Acquiring 4.22 (2.13) 4.08 (2.08) 0.85 (1.95) 0.70 (0.87) 0.15 (0.49) 30.48*** (.540) HO, H > O, A, C

Distress 5.39 (2.46) 4.23 (2.23) 0.50 (0.83) 0.55 (0.76) 0.15 (0.37) 48.85*** (.653) HO, H > O, A, C

Impairment 4.90 (2.38) 4.62 (2.26) 0.50 (1.05) 0.45 (0.76) 0.15 (0.37) 46.78*** (.643) HO, H > O, A, C

SIR 61.91 (18.81) 57.12 (13.98) 12.85 (11.22) 16.35 (8.90) 12.20 (7.96) 82.66*** (.761) HO, H > O, A, C

SAL 279.61 (81.82) 273.92 (66.88) 136.95 (73.39) 134.35 (41.03) 132.90 (42.06) 33.08*** (.560) HO, H > O, A, C

Note. HRS-SR = Hoarding Rating Scale-Self Report, SIR = Saving Inventory Revised, SAL = total score on the Savings List. *** p < 0.001.

21

21

Table 3

Most saved items in all cohorts

Group Rank Order (% group endorsing item)

Description Hoarding

With OCD (HO)

(n = 23)

Hoarding without

OCD (H)

(n = 26)

OCD Group (O)

(n = 20)

Anxiety

Group (A)

(n = 20)

Controls (C)

(n = 20)

clothes 1 (82.6%) 1 (84.6%) 1 (30%) 6 (20%) 2 (25%)

books 1 (82.6%) 2 (76.9%) 11 (15%) 1 (30%) 1 (50%)

bills, statements 3 (78.2%) 7 (57.6%) 1 (30%) 10 (10%) 5 (15%)

school papers 4 (73.9%) 46 (23.0%) 11 (15%) 10 (10%) 9 (10%)

greeting cards, letters 4 (73.9%) 5 (61.5%) 6 (20%) 16 (5%) 22 (5%)

records, tapes 4 (73.9%) 9 (50%) 4 (25%) 4 (25%) 5 (15%)

sentimental objects 7 (69.5%) 4 (64%) 1 (30%) 1 (30%) 4 (20%)

mementos, souvenirs 8 (65.2%) 3 (73.0%) 11 (15%) 1 (30%) 22 (5%)

jewelry 17 (56.5%) 19 (46.1%) 1 (30%) 4 (25%) 3 (25%)

receipts 20 (52.1%) 9 (50%) 4 (25%) 15 (5.3%) 7 (15%)

stationery 20 (52.1%) 5 (61.5%) 19 (10%) 10 (10%) 9 (10%)

Note: List contains all items that appeared in the “top 5” of a group, which are embolded.

22

Table 4.

Most Saved Items in the Group with Hoarding Disorder

Items Rank Overall % Hoarding with OCD Hoarding without OCD p-value

clothes 1 83.6% 82.61% 84.62% .850

books 2 79.5% 82.61% 76.92% .622

mementos,

souvenirs 3

69.3% 65.22% 73.08% .551

greeting

cards,letters 4

67.3% 73.91% 61.54% .357

bills,statements 4 67.3% 78.26% 57.69% .125

sentimental objects 6 66.6% 69.57% 64.00% .683

records,tapes 7 61.2% 73.91% 50.00% .086

knick knacks 8 59.1% 65.22% 53.85% .419

stationary 9 57.1% 52.17% 61.54% .509

recipes 10 55.1% 60.87% 50.00% .445

old things 10 55.1% 60.87% 50.00% .445

magazines 10 55.1% 60.87% 50.00% .445

clippings 10 55.1% 65.22% 46.15% .181

pictures 14 54.1% 63.64% 46.15% .226

paper 15 53.0% 65.22% 42.31% .109

receipts 16 51.0% 52.17% 50.00% .882

pens 16 51.0% 52.17% 50.00% .879

jewelry 16 51.0% 56.52% 46.15% .469

pencils 19 48.9% 47.83% 50.00% .879

materials 19 48.9% 52.17% 46.15% .674

gifts 19 48.9% 52.17% 46.15% .674

containers 19 48.9% 65.22% 34.62% .032*

wrapping paper 23 46.9% 43.48% 50.00% .648

boxes 23 46.9% 56.52% 38.46% .206

school papers 23 46.9% 73.91% 23.08% .000***

bags 26 45.8% 40.91% 50.00% .529

calendars 26 45.8% 47.83% 44.00% .790

string,yarn,thread 28 40.8% 43.48% 38.46% .721

craft supplies 28 40.8% 43.48% 38.46% .721

picture frames 30 38.8% 30.43% 46.15% .260

dishes 30 38.8% 34.78% 42.31% .590

shoes 30 38.8% 43.48% 34.62% .525

Food 30 38.8% 47.83% 30.77% .221

…

Pots 35 36.7% 21.74% 50.00% .041*

Mail 35 36.7% 56.523% 19.23% .007**

Notes 42 30.6% 47.83% 15.38% .014*

Note: *<.05; **<.01; ***<.001. 82 Items in total list. Top 30 items and items with significant

differences by chi-square test shown.

23

Table 5

Additional Items listed by Individuals with Hoarding Disorder on the SAL

Category Items

Electronic equipment Audiotapes, camera equipment, computers, electrical components, LP records, television sets, VCR’s, video

games, videotapes

Hobby, craft items Art materials, bells, bones, bottles of wine, craft projects, playing cards, post stamps, rocks, sheet music, shells,

timber, loose wool.

Household items Bedding, fabric, garden tools, mugs, padded bags, scissors, spices, tin cups, tins, vases, zippers

Information Advertisements, assignments, business cards, classic novels, old diaries, email, exercise routines, footy records,

holiday pamphlets, information, maps, medications (out of date), notices, sayings/musings from self/others,

school books, university notes.

Personal Coats, dental floss, hair conditioner, jumpers, moisturisers & bubble baths from hotels, perfume bottles, phone

messages, photographs, shampoo bottles, shoes, shower caps, skin scabs, tooth brushes, tooth paste

Sentimental Baby clothes, blankets from grandma, child art, children’s books, children’s school work, collars from deceased

dogs, dead plants, knitting from grandma, letters, little gifts, love letters, own notes on rock or folk music events,

pay slips, theatre or opera programs, toys, broken items I love which I forget to mend.

Useful Broken things, building materials, dried food stuffs (out of date) envelopes, fittings, glad wrap washed and

recycled, industrial waste, kerbside cast-offs with mechanical or Steptoe potential, metal/tin, nuts and bolts,

paper, bits and pieces of paper of all sorts, plastic, plastic bags, plastic containers, product samples, recyclables,

tin, wire, wood.

24

Figure 1. Mean number of items saved that were ranked ≥ 5 on the Savings List. Error bars are

95% confidence intervals.