Brain Hubs Boil When Hoarders Have to Organize

Hoarding has been a hidden disorder for many years, but with recent media coverage interest has increased dramatically among research scientists and clinicians.  A recent study by the National Institute of Mental Health (NIMH) found that certain areas of the brain responsible for decision-making were under-activated when dealing with others’ possessions, but over-activated when deciding whether to keep or discard their own things.

Brain scans revealed the abnormal activation in areas of the anterior cingulate cortex and insula known to process error monitoring, weighing the value of things, assessing risks, unpleasant feelings, and emotional decisions.

Hoarding disorder, a proposed category in psychiatry’s new diagnostic manual, is basically made up of three connected problems:   collecting too many items, difficulty getting rid of items, and problems with organization.

The new findings pinpoint brain circuit activity suspected of underlying the lack of self-insight, indecisiveness, sense that the wrong decision is being made, inflated estimates of the desirability of objects, and exaggerated perception of risk that are often experienced with the disorder.

In the study, brain activity of 43 hoarding disorder patients was compared to that of 31 obsessive compulsive disorder (OCD) patients and 33 healthy controls while they had to decide whether to keep or discard their own or others’ junk mail and newspapers.  Notably, such ownership did not appear to differentially affect brain activity in the OCD patients.  Hoarding disorder patients, as expected, decided to keep many more items than the other groups.

“The results of this study reflect an accelerating trend toward finding disturbed regulation of brain systems responsible for various dimensions of behavior that may cut across mental disorders as traditionally defined,” said Bruce Cuthbert, Ph.D., director of NIMH’s Division of Adult Translational Research.

In this case, the implicated brain areas are hubs that weigh the emotional significance of things and regulate emotional responses and states.  Hoarding patients experience symptoms of indecisiveness, and feeling of things being “not just right.  The more abnormal the activity in these control centers, the more severe the symptoms.

The results add to evidence of impaired decision-making in hoarding disorders and may help to separate its brain workings from those of OCD and depression.


41 thoughts on “Brain Hubs Boil When Hoarders Have to Organize”

  1. Ellen McDade says:

    What does Dr. Amen recommend to help reverse this disorder?

  2. Harriet says:

    After reading the article on hoarding disorder, I have a question on how to keep this from happening to my own brain? My aunt was a hoarder as she aged. She died last year at 85, but had been severely disabled by the condition for about 15 years. I’m so afraid of it happening to me! What can I do to prevent it? She also had Alzheimer’s, so I am taking lecithin, coQ 10, most all vitamins, exercising physically and brainwise, to try to prevent that too.

  3. v.marion says:

    Treatment options?

  4. Donna Aanerud says:

    Is there any help for people that are Hoarders? I am in my fifties and was diagnosed with ADD when I was in kindergarten, and placed on Ritalin. I took it for several years. As an adult, I have had problems with concentration, brain fog, etc. I am trying to de-clutter my home and am totally overwelmed. What suggestions might you have for me. I also suffer with migraine and cluster headaches.

    Thank you! Sincerely,

  5. v.marion says:

    I did some web research: NIMH Hoarding Disorders, then to Much good info.

  6. Shira Nahari says:

    This article was extremely helpful in explaining to me the possible reasons behind an indecisiveness I perceive in one or two of my grown daughters. Both have Mom’s habit of keeping too many possessions and finding it difficult to get rid of them.
    What so often infuriates me is when I am dependent on a decision on their part in order that I can move forward on something, and I am left with an incompletion in my space for a long, long time while they make up their mind. Now at least I know where the solution lies: get rid of more stuff!

  7. susan says:

    there are 12 step programs clutters anonymous etc

  8. Trope Sandoval says:

    Please change the name of the disorder from “Hoarding” to something else. The word “hoard” has terrible meanings even before it was assigned to a disorder. People feel it is bad before they even know what it is. Call it “joy” disorder instead. Or, use your imaginations! You want to HELP us, don’t you?

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