Galveston County Daily News January 22, 2013
Medical Discovery News
By Drs. David Niesel and Norbert Herzog
Most people who watch an episode of the TV show “Hoarders” can’t tear their eyes away from the screen. Oftentimes what’s shown is too hard to believe – tall stacks of old newspapers, broken light bulbs, empty water bottles, bag after bag of unopened inexpensive household items, and all kinds of objects the owner can’t imagine throwing away. One episode of the show featured a man who had to crawl on his stomach to dodge the piles of junk paper he had accumulated over years.
Hoarding was thought to be an obsessive compulsive disorder (OCD), which drives someone to do something as a result of repeated thoughts, feelings, or ideas. But recent studies, especially a new finding published in the “Journal of the American Medical Association,” shows hoarding is not a form of OCD, but rather its own dysfunction.
The new study led by David Tolin, director of the Anxiety Disorders Center at the Institute of Living, shows hoarders have unusual brain activity in areas responsible for decision making. Tolin’s team recruited 40 hoarders, 33 healthy adults, and 31 with OCD. Each was asked to bring 50 ordinary objects from home and their brains were scanned while they decided whether to keep or destroy the items one by one. They also had to decide to keep or destroy 50 similar items that did not belong to them.
Functional magnetic resonance imaging (fMRI) monitored subjects’ brains for changes in blood flow and activity in key regions of the brain, the anterior cingulated cortex and insula – a decision-making network that helps a person determine whether something should be kept or tossed.
When faced with deciding whether to throw away one of their own items, hoarders felt more anxiety and indecisiveness compared to the others. The fMRI revealed a massive increase in activity in these two decision-making regions of the brain.
In contrast, when making decisions about items that were not theirs, the brain scans of hoarders showed no activity in these regions compared to the other two groups, showing an extreme lack of engagement with things that do not belong to them. Yet, the overstimulation of these regions leads to overwhelming angst and the inability to discard anything. Thus, the malfunction of this brain decision-making network may explain hoarders' behaviors, including how they can ignore the massive amounts of clutter in their own homes.
Should the upcoming authoritative “Diagnostic and Statistical Manual of Mental Disorders” recognize hoarding as its own disorder, drug companies may be more incentivized to develop medication to treat the symptoms. Combined with cognitive therapy, doctors believe people can overcome hoarding. Two to five percent of the population suffers from hoarding, twice the number of people who live with OCD.
Hoarding can also become a health and fire hazard for others. Recent studies show homes of hoarders caused one-fourth of fire-related fatalities, and having damages that are eight times more than non-hoarding homes. Addressing the hoarding problem and helping hoarders overcome their disorder can have a ripple effect that benefits others.
Medical Discovery News is a weekly radio and print broadcast highlighting medical and scientific breakthroughs hosted by professor emeritus, Norbert Herzog, and professor, David Niesel, biomedical scientists at the University of Texas Medical Branch at Galveston. Learn more at www.medicaldiscoverynews.com.