Wayne State’s Department of Psychiatry and Behavioral Neurosciences has been conducting exploratory hoarding research by 2015 looking at children, adolescents and young adults with compulsive hoarding through neuroscience and genetic analysis since 2015.
“Many people have seen the hoarding shows primarily of adults on TV, but I think that few people know that 80 percent of all cases have their onset in childhood and adolescence,” said Dr. David Rosenburg, chair of the department of psychiatry and behavioral neurosciences at WSU.
Rosenburg and his team are looking in the brain and taking brain images using Magnetic Resonance Imaging.
“We are looking at the brain networks and how those key areas of the brain are working,” he said.
The department is also conducting genetic analysis, looking at the genes in the patients with compulsive hoarding.
“And the goal is to see whether or not [we see] brain abnormalities in children, adolescents and young adults with compulsive hoarding, and whether those brain abnormalities may correct or reverse with effect to treatment,” he said.
Dr. Shibany Taormina, assistant professor in the department of psychiatry and medicine, is involved in the research. Her role is to diagnose and often treat the conditions.
Taormina said she has been doing research concerning obsessive-compulsive disorder for at least 15 years, with several of the cases involving hoarding.
“Well, I think one of the first things that we need to understand is that hoarding for a really long time was considered part of OCD, but in more recent years... it has started to stand out as a separate category,” said Taormina. “Now in the latest edition of the ‘Diagnostic and Statistical Manual,’ it's considered a diagnosis all on it’s own.”
She said one of the most important aspects they need to distinguish when trying to diagnose hoarding in a child or adolescent is determining if the behavior is developmentally appropriate.
“All children pretty much go through a phase of collecting and saving. It's actually a very good phase for them to go through; they learn all types of skills,” said Taormina. “So our first task is to figure out if the symptoms being described to us are actually severe enough to warrant a diagnosis or if they are just typical childhood behaviors.”
Taormina tries to figure out if the behavior is associated with hoarding. She looks to see if the behavior is causing any negative family impact, like child distress, how the child reacts if the child loses the item or if the item was thrown away and if there is an excessive buildup of clutter.
“If they don’t seem to understand how these things are causing a problem, and if they seem to have extremely restrictive interests,” said Taormina. “They only want to do things with these hoarded items or talk about these hoarded items and kind of shun anything else.”
In terms of depression, Rosenburg said one of the hallmarks is ruminating about things over and over again. Coping with depression and anxiety can lead to unnecessary hoarding.
“The fear that I don’t want to throw out something important, or that I can collect and control of what I am collecting. That has a way of in someone who is compulsive or depressed alleviating temporarily the symptoms,” said Rosenburg.
One of the striking finds Rosenburg has noticed is that if a first degree relative, a mother, father, brother or sister, has trouble making decisions can affect the child's decision making skills and the same area of the brain associated with hoarding.
“Perhaps both those areas of the brain that appear to be involved in decision making appear to be the same areas of compulsive hoarding that are working properly,” he said. “So these are some clues to the etiology, cause or causes of compulsive hoarding particularly when it takes over and can no longer be controlled.”
Both Rosenburg and Taormina said WSU’s Hoarding research is still exploratory. The Department of Psychiatry and Behavioral Neurosciences looks to better understand and better treat this disease.