Psychological models of hoarding

Hoarding disorder (HD) is a common and complex disorder characterized by comorbidity and significant disability, and it constitutes a distinct disorder in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association [APA], 2013). Research has implicated cognitive, behavioral, affective, biological, genetic, and experiential vulnerabilities related to hoarding. A cognitive-behavioral model of hoarding developed by Frost and Hartl (1996) has accrued substantial research support. The model implicates dysfunctional emotional attachments to and erroneous beliefs about possessions, deficits in information processing, and negative mood states in the etiology of hoarding phenomena. More recently, trauma and negative early developmental influences have also been associated with hoarding. The model has demonstrated its heuristic value in forming the basis for effective interventions. Future research will need to incorporate longitudinal and experimental studies and to examine the specificity of etiological factors to hoarding. Moreover, replication of studies is required with cohorts that fulfill DSM-5 diagnostic criteria for HD.