Attachment theory and hoarding disorder: A review and theoretical integration

Area of Science:

• Psychiatry
• Psychology
• Mental Health

Background:

• Hoarding disorder (HD) presents significant public health challenges with limited treatment efficacy.
• Current cognitive behavioral models inadequately address the pathological attachment to possessions seen in HD.
• Individuals with HD often struggle to part with items, leading to cluttered and potentially dangerous living environments.

Purpose of the Study:

• To review existing research on attachment in hoarding disorder.
• To integrate attachment theory into current cognitive behavioral models of HD.
• To propose a theoretical framework for understanding HD, emphasizing the role of dysfunctional attachments.

Main Methods:

• Literature review focusing on attachment theory and hoarding disorder.
• Integration of attachment findings into existing cognitive behavioral frameworks for HD.
• Theoretical analysis to propose new hypotheses regarding HD etiology.

Main Results:

• Pathological attachment to possessions is a critical, under-addressed factor in hoarding disorder.
• Dysfunctional attachments to both people and possessions contribute to hoarding behaviors.
• Attachment theory provides a valuable lens for understanding the relational dynamics in HD.

Conclusions:

• Maladaptive cognitions and dysfunctional attachments are proposed as joint underlying factors in hoarding disorder.
• This theoretical integration may identify new targets for intervention and prevention strategies for HD.
• Future empirical research should explore these proposed hypotheses to advance knowledge of hoarding disorder.