The Impact of Hoarding on Parent-Child Relationships and Family Functioning
At Hoarding Help Central, we are well aware of the negative impact that compulsive hoarding can have on the hoarding individual but less talked about is the negative impact that the behavior can have on family members. Impairing the day to day lives of the family members of the hoarding individual and proving especially burdensome, hoarding has been consistently linked to disruptions in family functioning. Today, Hoarding Help Central will be exploring the impact of hoarding on, specifically, parent-child relationships and family functioning.
What is Hoarding?
Before we closely examine the findings of the study conducted on the impact of hoarding on parent-child relationships and family functioning, we should talk about what hoarding is. Put simply, hoarding can be described as the act of acquiring a large amount of seemingly useless items while experiencing the inability to discard the acquired items. This behavior results in cluttered living spaces that prevent the use of said spaces for their intended purpose as well as significant distress and/or impairment in functioning due to these behaviors.
Thanks to greater studies completed surrounding compulsive hoarding disorder, researchers have identified more about the disorder in recent years. For one, it has been identified that compulsive hoarding has an estimated prevalence rate of 5.3 percent and typically runs a chronic course when no intervention is put in place to stop the behavior. Demographically, there are some discrepancies in the reports regarding gender distribution in regards to compulsive hoarding disorder. Some reports note higher occurrences of compulsive hoarding disorder in males while others report an equal rate of hoarding amongst males and females.
While compulsive hoarding has been regarded as a distinct symptom cluster encompassed with obsessive compulsive disorder in the past, compulsive hoarding has recently been defined as its own disorder in the DSM-5. The diagnostic criteria for compulsive hoarding disorder is defined as the following by the DSM-5:
- Persistent difficulty discarding or parting with possessions regardless of the value others may attribute to these possessions.
- Difficulty discarding of items is due to strong urges to save items and/or distress associated with the act of discarding.
- The symptoms result in the accumulation of a large number of possessions that fill up and clutter active living areas of the home to the extent that they can no longer be used for their intended purpose.
- The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning in day to day life.
- The hoarding symptoms are not due to a general medical condition such as a brain injury or cerebrovascular disease.
- The hoarding symptoms are not restricted to the symptoms of another underlying mental disorder such as obsessive compulsive disorder, major depressive disorder, schizophrenia, psychotic disorder, dementia, or autism spectrum disorder.
Hoarding’s Effect on Family Functioning
As observed by the study we will be exploring today, in total, there are three main factors that can cause compulsive hoarding to have a negative impact on family functioning: hoarding severity, insight, and family accomodation. In this particular section of the article, we will examine each of these factors to better determine the impact that they have on parent-child relationships and regular family functioning.
Although there has been an increase in the amount of attention paid to compulsive hoarding and the risks associated with the disorder, current understanding of the variables that may have an impact on the relationship between compulsive hoarders and members of their family, specifically children, is very limited. What can be observed, however, is the fact that those with increased hoarding symptoms typically translate to significant functional impairment.
When hoarding is severe within a home, there are a variety of factors that can result in a significant impact on family functioning. For one, hoarding households typically contain dust pollen, bacteria, and rotting food that can accumulate within the clutter and pose significant health hazards not only for the hoarder but other members of the family.
Secondly, clutter can block the use of living areas and walkways and significantly increase the risk of slipping or having items fall on top of residents as they move throughout the home. A total of 1 percent of hoarders have reported having either a child or elder forcibly removed from their home due to the dangerous conditions found in their home. There are additional dangers posed by hoarding for families in the form of community health problems. Community health problems are posed when clutter begins to accumulate outside of the home in the front yard, back yard, or on sidewalks and can even pose as severe fire hazards for the residents of the home and residents of surrounding buildings.
Communities are also burdened by hoarding as city resources have to be utilized in order to resolve hoarding complaints. In a study of code enforcement officials, each individual hoarding case can cost up to an estimated $3,700 in order to resolve. When families are forced to deal with the significant stress and burdens placed upon them when dealing with the legal, community, and social fallouts of having a parent who hoards, families and children especially suffer. As the severity of the hoarding symptoms increase, both tension and conflict tend to surface in the home, causing a significant disruption to the regularity of family life. In addition, the negative impacts on an adult child may also increase and this may result in the breakdown of parent and adult child relationships.
Another factor impacting both the parent-child relationships and family functioning within a hoarding household is insight. Insight consists of three major components: the patient’s awareness and acknowledgement of both the presence and problematic nature of their symptoms, the patient’s ability to recognize unusual mental events as pathological, and the patient’s ability to comply with treatment.
Individuals with obsessive compulsive disorder, for one, have shown a lack of insight that has been linked to increased psychopathology as well as a longer duration of illness and resistance to treatment. When it comes to familial relationships, increased feelings of frustration and hostility towards the hoarder by family members can be attributed to decreased insight. Most often, hoarders with a lack of insight are rejected by their family members and it is these negative feelings that lead to an increase in family conflict and dysfunction within the home.
In addition to causing impairment in the hoarder’s ability to function in their day to day life, a lack of insight also commonly results in impairment in the adult child’s life. This can lead to a breakdown of the parent-child relationship over time.
So what is family accommodation? Family accommodation, put simply, refers to the act of family members providing assistance for individuals in carrying out their compulsions. This is yet another component that can have a negative impact on family functioning and can be attributed to an increase in functional impairment for the adult child. Family accommodation tends to occur commonly in the homes of those with obsessive compulsive disorder (including individuals with compulsive hoarding symptoms) with most studies reporting rates between 62 and 100 percent in terms of accommodation.
Indirect accommodation is also a factor that should be noted in terms of hoarding households. Indirect accommodation occurs when family members may choose to refrain from discarding items within the home in order to avoid direct conflict with the hoarder themself. Indirect accommodation also involves instances of family members modifying their daily routines and decreasing certain responsibilities for the hoarder due to the fact that symptoms may interfere with the hoarder’s ability to meet certain expectations.
There is substantial evidence to suggest that providing accommodation for hoarders can be significantly burdensome for family members. For example, one particular study found that amongst 34 family members of individuals with obsessive compulsive disorder, family accommodation could be directly correlated with an increase in familial stress, increased rejection of the hoarder, and a poorer degree of family functioning. There are a variety of similar studies that reinforce these findings. In yet another study, the family members of those displaying hoarding behavior reported increased feelings of anxiety and depression when they had increased negative feelings towards the patient. This included feelings such as irritability, apathy, and rejection of their hoarding family member.
Results From Study on Hoarding and Parent-Child Relationships and Family Functioning
Now that you have an understanding of the three main factors that influence the impact of hoarding on parent-child relationships and family functioning, it’s time to look at the results provided by one recent study. This study, completed by the University of South Florida, consisted of several questionnaires for adult children of hoarders.
Based on the results of the study, mothers were identified primarily to be the hoarder with both parents being hoarders coming in second and fathers coming in third place. The parents in question ranged in age from 43 years old to 98 years old. 45 percent of the parents reported in the study were married or cohabitating, 3 percent had never been married, and a sizable minority was reported as either divorced/separated (27 percent) or widowed (25 percent). The majority of hoarding parents were reported to be either retired or unemployed (51.8 percent) while an additional 13 percent were reported to be homemakers.
The study also found that 45 percent of the informants lived over 120 miles away from their hoarding parent(s), 31 percent lived within 30 miles, and 8 percent reported living in the same home as their parent. While growing up, 92.4 percent of informants reported living in the same home as the parent who hoards full time. Looking further into this, the majority of informants (approximately 70.9 percent) reported living in the same home as their hoarding parent as they engaged in their behaviors for 10 years or longer.
There were some major patterns observed overall based on the findings of this particular study. For one, it was observed that informants were an average age of 9 years of age when parental hoarding behaviors were first noticed. Further, 76 percent identified their mother as the hoarding parent. This was particularly interesting as previous studies reported either a higher rate of prevalence in males or, at the least, an equivalent rate of hoarding between males and females.
There are a couple of possible reasons for this discrepancy in gender. For one, this may be a reflection of the fact that the informant sample was largely female. In adult children, mother-daughter relationships tend to be closer than most father and adult child relationships. In the case of a mother-daughter relationship, mothers tend to be in more frequent contact with their daughters and may receive more emotional support from their daughters. For this reason, adult daughters may be more likely to seek support when there is a disruption caused within this relationship.
Based on the reporting of the informants, mothers were also observed to have greater hoarding severity as well as a poorer quality of relationship with their adult children in comparison to fathers. It should be noted, however, that the size of the two groups were pretty uneven. For this reason, the results of this study may not be representative of the hoarding population as a whole.
As hypothesized by the researchers involved in this particular study, it was observed that there is a direct correlation between the severity of parental hoarding and the rate of family dysfunction. This finding could then be attributed to the observable decrease in the quality of parent and adult child relationships. These findings are consistent with previous studies that observed family members of hoarders harbored negative attitudes towards hoarders as well as the fact that spouses and children of hoarders experienced regular arguments within the home.
It should also be noted that, as expected by the researchers involved in this study, a lack of insight was indirectly associated with an overall poorer quality relationship between parents and their adult children. These results are well in line with previous research that found that hoarders with a lack of insight were much more likely to be rejected by their family members.
While there were many more findings reported by this particular study, there is much that can be understood about the impact of hoarding on parent-child relationships and family functioning based on the data we have highlighted here. This study highlights the need for future research to more closely examine the psychopathology of adult children of hoarders in order to determine whether parental hoarding is a risk factor for the development of their own psychological disorders.
This study also highlights the need for a further examination of ways that current treatment methods could be enhanced by including family-based interventions. Finally, the findings of this study also highlight the need for effective ways to reach out to the children of hoarders as these children don’t typically present for treatment specifically due to the hoarding behaviors of their parents. At Hoarding Help Central, we believe that these are steps that need to be taken in order to better support hoarders and their families as they deal with hoarding behavior within their homes.