Prior to your paper, had there been research on the prevalence of mental illnesses such as anxiety and depression in the children of people with hoarding behaviors?
That particular question was new to our paper. It was the first time anyone, to my knowledge, had looked at a validated assessment of anxiety and depression in this population.
How did you assess their symptoms and what did you find?
We asked study participants to think back on how they felt throughout their teenage years and gauged their responses with the Patient Health Questionnaire (PHQ), a measure of mental health disorders. I should say up front that we didn’t have a control group. But we found that among our 414 study participants, somewhere between 30% and 50% reported clinically significant anxiety or depressive symptoms, far higher than you’d expect in the normal population. So when looking back on how they were feeling as teenagers in that environment, they were struggling, and they often felt rejected by their parents.
We also found that almost 10% of participants were threatened with eviction at some point in their childhood; 15% had to live outside of their home at some point, because of the clutter; and 2% had involvement from child protective services and were removed from the home.
I know you recruited patients from online forums established by the children of hoarding parents. Presumably, these are the people most affected by this phenomenon. How does this play out in people who simply like to, say, collect something? Is this a continuum of behavior, with a breaking point at which it becomes a pathology?
I think it’s safe to conceptualize collecting and hoarding as a continuum, and you’ve got to draw a line somewhere in terms of clinical significance.
Did you assess whether the children of hoarders were more likely to hoard themselves as adults?
This is our follow-up paper; we haven’t looked at it yet.
But in looking at preliminary data, the prevalence seems pretty low, actually, at least in our sample. And as you mentioned, in our study there were folks who were seeking support specifically because they grew up in a really cluttered home.