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Aug 10, 2012 by APRIL McCARTHY
Researchers Discover Brain Activation Areas For Hoarders


It's a serious disorder that has only become more common in recent years. Hoarding (or pathological collecting) is a pattern of behavior that is characterized by the excessive acquisition of and inability or unwillingness to discard large quantities of objects that would seemingly qualify as useless or without value. We all know at least one hoarder. Researchers have now identified parts that the part of a hoarder's brain involved in decision-making is under-activated when dealing with others' possessions, but over-activated when deciding whether to keep or discard their own things, a National Institute of Mental Health (NIMH)-funded study has found.



The show Hoarders has gained a steady stream of viewers as everybody wants to know why people hoard to extremes. Scientists may have found a clue. 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.

NIMH grantee David Tolin, Ph.D., of Hartford Hospital, Hartford, Conn., and colleagues, report on their functional magnetic resonance imaging (fMRI) study in the August 2012 issue of the journal Archives of General Psychiatry.

‘Hoarding’ is just one of the new mental conditions being added to the psychiatrists’ bible, or the Diagnostic And Statistical Manual Of Mental Disorders (DSM), to give it its proper name. It's unfortunately another condition that pharmaceutical companies have another market for.

Many critics are suggesting that the new entries on the DSM such as hoarding are controversial, not least because of fears they will result in many more people being put on drugs that could be ineffective or dangerous.

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 of a salience network that weighs the emotional significance of things and regulates emotional responses and states. Hoarding patients' severity of symptoms, self-ratings of indecisiveness, and feeling of things being "not just right" were correlated with the degree of aberrant activity in these hubs. The results add to evidence of impaired decision-making in hoarding disorder and may help to disentangle its brain workings from those of OCD and depression.

Hopefully, those affected by excessive hoarding patients will first seek therapy before medication as the root of the disorder has an emotional basis strongly related to fear, anxiety, security and loneliness. If the emotions are addressed, most of the symptoms do subside.

April McCarthy is a community journalist playing an active role reporting and analyzing world events to advance our health and eco-friendly initiatives.

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