Is it Hoarding, Clutter, Collecting, or Squalor?

What are the differences between hoarding disorder (HD) and clutter, collecting, and squalor?  Simply collecting or owning lots of things does not mean someone has HD.  A major feature of HD is the disorganized nature of the clutter — in most cases, the living spaces can no longer be used for everyday living as they were intended. Moving through the home is challenging, exits are blocked, and normal routines within the home are difficult.

Thus, while it’s common for our homes to get messy and/or cluttered at times, this is not the same as having HD.  Similarly, being a collector of items does not mean a person has HD.  Some of the key differences between these terms are defined below:

Clutter

Clutter is defined in the [1] DSM-5 as “a large group of usually unrelated or marginally related objects piled together in a disorganized fashion in spaces designed for other purposes (e.g. tabletops, floor, hallway).”  While clutter is the most easily visible marker of HD, a home can be cluttered for a wide variety of reasons.  HD is only considered when the clutter results from excessive acquisition and difficulty getting rid of things.

The location of the clutter is also an important factor — it is common for most people to have cluttered storage areas, such as basements and attics. Instead, HD involves clutter that takes over the living spaces of the home (kitchens, living rooms, bedrooms, hallways, etc.) and keeps them from being usable for everyday living – cooking, eating, relaxing, sleeping, moving freely through the house, etc.

Collecting

In contrast to people with hoarding problems, collectors typically keep their possessions well-organized, and each item differs from other items to form interesting and often valuable groupings. Further, an important purpose of collecting is to display the items to others who appreciate them.  People with HD are seldom able to accomplish such goals.

HD is different from collecting in that collecting is organized and systematic, even though some collectors may have a similar amount of possessions as someone with HD.  Collecting does not produce the clutter, distress, or impairment that HD does.

Squalor

Squalor (or “severe domestic squalor”) refers to unsanitary conditions in the home. Squalor is most often found in elderly persons who have additional mental challenges, such as dementia. Squalor can sometimes occur as the result of HD, and sometimes occurs without HD. In HD, squalor occurs when the items saved include spoiled food and/or when animals are present.  In many cases, squalor results from the neglect of normal cleaning activities.

Types of Items

Method of Acquiring

Appearance of Home

Life Impact

Hoarding

Items do not have a specific theme, usually many different types of items. Items are not acquired in a planned fashion.  Acquisition is often excessive. Items may be free (e.g., from the side of the road, giveaways, etc.) and/or purchased. Disorganized clutter, taking over living spaces (bedroom, living room, kitchen, etc.) and preventing them from being used as intended.

Efforts to get rid of the items and not acquire items causes distress.

Spending may be excessive, causing financial distress.

Can cause conflict in social/family relationships, in addition to general withdrawal from society.

State of home may have a broader impact on surrounding homes (e.g. sanitation concerns, structural issues, etc.).

Normal Clutter

Items may or may not have a specific theme. Items are not acquired in a planned fashion; acquisition is not excessive. Disorganized clutter, generally located in storage spaces (e.g. attic, basement, etc.). May also occur in living spaces, but does not prevent them from being used as intended.

Items may cause mild distress, but generally do not have broad or lasting impact on finances, work, social life, etc.

The thought of getting rid of items or not acquiring any more does not cause distress.

Collecting

Items center around a specific theme, e.g. stamps, models, figurines, etc. Items are acquired through planned searches. Items are mainly purchased and are limited in number. Items are arranged, stored, and/or displayed in an organized fashion. Items do not take over living spaces.

Items usually have a positive or pleasurable impact.

Collecting usually does not cause financial distress, nor impairment in work, social life, etc.

Squalor

No intentional saving of items. No intentional saving or acquiring of items. Build-up is instead due to neglect or inability to remove them. Home is generally in a state of disrepair, may look unclean or unkempt.

State of home may or may not cause distress, depending on the individual’s mental status.

State of home has a negative impact on the health and wellbeing of all inhabitants, and may have a broader impact on surrounding homes.

 


Sources:

  • [1] 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (APA, 2014)