Abnormal ca report lucy and aoife

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Compulsive Hoarding Introduction Frost and Hartl (1996) defined hoarding disorder as a pattern of behaviour that is characterised by the extreme attainment of and inability or reluctance to discard large amounts of objects that cover the living areas of a home and cause impairment and/or distress. Compulsive hoarding affects approximately 700,000 to 1.4 million people in the US Hoarding (Saxena, 2007).often starts during childhood or the teen years, but generally doesn’t become a major problem or issue until adulthood. Hoarding commonly runs in families and can accompany other mental health issues such as depression and anxiety. People with hoarding difficulties may suffer from obsessive compulsive disorder (OCD) . Some estimate that as many as 1 in 4 people with OCD also have compulsive hoarding ( Borchard, 2011). Having stated that, compulsive hoarding can affect people who don’t have OCD. In the fifth DSM, Hoarding disorder went from being listed as a symptom of obsessive-compulsive personality disorder to its own diagnostic category (Grohol, 2013). Four blogs composed by family members of hoarders were used for this research. Thematic analysis was the method used to analyse the dataset. Thematic analysis is the most common form of analysis in qualitative research. This type of analysis focuses on identifying patterned meaning across a dataset and the results can be seen below.

Transcript of Abnormal ca report lucy and aoife

Page 1: Abnormal ca report lucy and aoife

Compulsive Hoarding

Introduction

Frost and Hartl (1996) defined hoarding disorder as a pattern of behaviour that is

characterised by the extreme attainment of and inability or reluctance to discard large

amounts of objects that cover the living areas of a home and cause impairment and/or

distress.

Compulsive hoarding affects approximately 700,000 to 1.4 million people in the US Hoarding

(Saxena, 2007).often starts during childhood or the teen years, but generally doesn’t

become a major problem or issue until adulthood. Hoarding commonly runs in families and

can accompany other mental health issues such as depression and anxiety. People with

hoarding difficulties may suffer from obsessive compulsive disorder (OCD). Some estimate

that as many as 1 in 4 people with OCD also have compulsive hoarding (Borchard, 2011).

Having stated that, compulsive hoarding can affect people who don’t have OCD. In the fifth

DSM, Hoarding disorder went from being listed as a symptom of obsessive-compulsive

personality disorder to its own diagnostic category (Grohol, 2013).

Four blogs composed by family members of hoarders were used for this research. Thematic

analysis was the method used to analyse the dataset. Thematic analysis is the most common

form of analysis in qualitative research. This type of analysis focuses on identifying

patterned meaning across a dataset and the results can be seen below.

Results

Qualitative

Three blogs on the topic of hoarding were chosen. They were all composed by family

members of hoarders. We decided to analyse these particular blogs as they accurately

depict the lived experience of the disorder. According to Frost and Hartl (1996) Hoarding

disorder can be described as a pattern of behaviour that is characterised by the excessive

attainment of and inability or unwillingness to discard large quantities of objects that cover

the living areas of the home and cause distress or impairment. The First task of the

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researchers was to identify a number of themes that occur in the text. Three themes

emerged from the data: (i) Relationships; (ii) Emotion, including the sub themes of Positive

Emotion and Negative Emotion; (iii) Organisation Abilities. Table 1 provides a breakdown of

the themes. The themes were coded by the researchers who developed a definition of each

theme. Both researchers coded the text separately using the definitions they had

developed. The researchers then came together and found that they had more than 70%

inter-rater reliability (see appendix A). Table 1 provides a breakdown of the themes, their

definition, code and samples

Table 1: Breakdown of Themes

Themes Codes Definition Sample

Relationships R Defined as the way in

which bloggers say

their relationships

have been affected

by hoarding

“I've realized more

and more that

creating a healthy

relationship with my

mother may not

actually be an

achievable goal”

Negative emotion NE Defined as the

negative feelings

expressed by the

bloggers in relation

to hoarding

“I was so

embarrassed, I am

still so

embarrassed.”

Positive emotion PE Defined as the

positive feelings

expressed by the

bloggers in relation

to hoarding

“I really do love my

wife, and I'm sure

that she loves the

kids.”

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Organisation Abilities OA Defined as the way

bloggers say

organisation has

been affected by

hoarding

“Forget about being

organized, punctual

or keeping your

house in order to be

able to achieve any

sort of organization

or punctuality.”

Quantitative

Of the data coded, 28.13% was categorised under the theme of “Relationships”, 45.31%

was categorised as “Emotion” and 26.56 % as “Organisation Abilities”. This is represented in

the pie chart below.

RelationshipsEmotionOrganisational Abilities

Fig1: Visual Representation of percentage of theme occurrence

Within the theme of emotion there were two sub-themes; Positive Emotion and Negative

Emotion. Of the text that was coded there were a total of 32 instances in which any of the

three themes were mentioned. The theme of Emotion occurred an average number of 14.5

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times, with Positive Emotion occurring twice (6.25% of the overall 32) and negative emotion

occurring an average of 12.5 times(39.06% of the overall 32).

Positive Emotion

Negative Emotion

0 2 4 6 8 10 12 14

Column1

Fig 2: Visual Representation of Positive and Negative emotion as sub-themes of Emotion

Discussion

The aim of the research was to analyse the lived experience of those affected by hoarding.

This was achieved by identifying common themes which are discussed in the blogs. The

theme of Emotion was the most recurrent as it was mentioned an average of 14.5 times.

Within this, Negative Emotion occurred 12.5 times, compared to Positive Emotion which

only occurred twice. From this data, it is evident that Hoarding can have devastating effects

on both the hoarder themselves and their loved ones, as the blogs were written by family

members of hoarders. This research is useful as it is clear that hoarding negatively affects

the loved ones of hoarders, which could suggest that more support should be put in place

for family members.

Of the blogs that spoke about the theme of Organisation Abilities, 64.7% spoke of their own

organisational abilities, rather than that of the hoarder. It is clear to see living with a

hoarder has a detrimental effect on the organisational skills of their loved ones as most

showed a complete inability to plan or organise anything, “I never learned about putting

things in their places, grocery shopping, cooking and never mind cleaning.” As previously

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mentioned, hoarding often runs in families, although perhaps this is merely a result of never

having been talk to organise one’s home, rather than suffering from the disorder itself.

Originally, the researchers included Stigma as a separate theme. However, it was found that

stigma was not directly mentioned in any of the blogs. Some expressed feelings of

embarrassment and shame when having guests over (“I was so embarrassed, I am still so

embarrassed.”) which was linked to the theme of Relationships. This could be interpreted as

self-stigma. This could also suggest a lack of understanding from those who are not directly

affected by Compulsive Hoarding.

Further research is still required to fully understand hoarding disorder and how it affects

both the hoarder themselves and their loved ones. However, the content analysed in the

current research provides a thorough insight into the lived experience of those affected by

Hoarding Disorder.

References

Borchard, T. (2011). 10 Things You Should Know About Compulsive Hoarding. Psych Central.

Retrieved on March 11, 2014, from http://psychcentral.com/lib/10-things-you-

should-know-about-compulsive-hoarding/0006787

Frost, R. O., & Hartl, T. L. (1996). A cognitive-behavioral model of compulsive

hoarding.Behaviour Research and Therapy, 34, 341–350.

Grohol, J. (2013, May 28). Dsm-5 changes: Obsessive-compulsive and related disorders.

Retrieved from http://pro.psychcentral.com/2013/dsm-5-changes-obsessive-

compulsive-and-related-disorders/004404.html

Saxena, S.(2007). Is compulsive hoarding a genetically and neurobiologically discrete

syndrome? Implications for diagnostic classification. American Journal of Psychiatry,

164(30),380-384.

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Appendices

Appendix A:

The data which was coded:

A Family Intervention?

September 10 2012

I've managed to keep the downstairs of our house pretty decent (OA)...Not great, but

liveable. The upstairs, where the bedrooms are, is a no man's land, though. (OA) The beds

are accessible, but you are basically walking on clothes for the rest. (OA) We rarely have

guests, because we are embarrassed by the mess. (NE) I'm afraid (NE) that this is stunting

the kids socially. Is that what others experienced, or did they manage to come through?

My oldest kids (almost teenagers) are both struggling in school with things like finishing

assignments and organization (OA). I think it is related.

I really do love my wife, and I'm sure that she loves the kids. (PE) I'm just not sure

whether she loves us enough to give up the stuff.

http://www.hoardersson.com/2012/09/a-family-intervention.html

Waiting for the Apology You Will Never Get

Stevi January 7, 2013 at 6:46 AM

“My parents are both convinced that the hoard is something that happened to them, rather

than something they've done. So no apology there. (NE) I've also come to realize that my

dad is never going to apologize for the damage his work addiction did (and still does) to the

family. Apparently my parents are the victims and I should just feel sorry for them,

regardless of how their dysfunction screwed up my own view of myself (NE) and my

relationships...” (R)

Escaped the Hoard January 7, 2013 at 7:18 AM

“That's a great point, Stevi. The victimization is absolutely mind boggling, isn't it?

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I've always wondered if somewhere deep within my HP, there's a realization of the impact

of her actions, but is just too uncomfortable to accept the fault.” (NE)

Hate the Sin, Love the Sinner?

Saturday, August 10, 2013

It's difficult for me, even as an adult, to separate my mother as a person from her hoarding

and her behavioural oddities. I've worked through and let go of a lot of the childhood

resentment and recrimination. (NE) I have changed quite a bit, but the fact remains that

she, well, hasn't.

I've realized more and more that creating a healthy relationship with my mother may not

actually be an achievable goal. (R) I realized this afresh recently after she stopped speaking

to me. (R) Over the course of the last decade, she has repeatedly requested that we talk

about my childhood. I'd refused every time, because that was clearly not going to end well.

She was looking for validation as a mother and a person, and I have none to give. It's not

really my job, anyway. But this time I decided that maybe it would be good for me to say my

piece, and so I did. There's really no gentle way to explain how being raised by a clinically

depressed hoarder feels to a child. (NE) I tried. She didn't like it. And now she isn't speaking

to me. (R)

http://hoarderschild.blogspot.ie/

Chances

Tuesday, February 5, 2013

I never learned about putting things in their places, grocery shopping, cooking and never

mind cleaning. (OA) Forget about being organized, punctual or keeping your house in order

to be able to achieve any sort of organization or punctuality. (OA) I never learned about

planning for long-term goals, or even what it meant to achieve any sort of sense of pride in

the short term goals I actually saw through to the end. (OA) I never got a chance at normal

relationships. (R) They were built on secrets and shame. (NE) I kept my house a secret, I kept

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my relationships at a distance, I never had anyone over. (R) That's not entirely true, I had

two sleepovers that I can remember, each one never happened again after the first time. I

was so embarrassed, I am still so embarrassed. (NE) My relationships of any kind always

deteriorated or just plain burst in flames, (R) given that I spent most of my time alone, in my

room, I am holding you accountable. You socially handicapped me. (R) An introvert by

nature who got to see how cruel the world really can be. (NE)

I took a chance. I moved away. I moved further away. And then I moved 3,000 miles away.

This has helped in many, many ways. I still can't keep a house clean despite all of my efforts.

(OA) I still can't manage to buy enough food to get me through a week because goodness

knows, I can't plan that far ahead. (OA) I started seeing Therapist and this has helped,

tremendously. I started taking medication, which has also helped, (PE) but I always wonder

if you hadn't been such a clutter monkey, would I be therapy and drug free? Would I be able

to go a night without having a drink (or five). (NE) Would I be better equipped to

concentrate and not blow up in frustration or anger? (NE)

http://dirtdoeshurt.blogspot.ie/

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Appendix B:

The wordles from which the themes were chosen:

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Appendix C:

Inter-rater Reliability Tests:

Aoife’s Table

Relationships (R)

Positive Emotion (PE)

Negative Emotion (NE)

OrganisationalSkills (OA)

20, 31, 35, 36, 37, 42, 52, 53, 54, 57,

10, 63 6, 7, 16, 19, 25, 32, 41, 55, 58, 65, 66

3, 4, 5, 9, 48, 49, 51, 61, 62,

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Number of times observed10

Number of times observed2

Number of times observed11

Number of times observed9

Total number of observations

32

Percentages (column total / overall total x 100

Lucy’s Table

Relationships (R)

Positive Emotion (PE)

Negative Emotion (NE)

OrganisationalAbilities (OA)

31, 35, 37, 42, 52, 53, 54, 57

10, 63 6, 7, 16, 19, 20, 25, 32, 36, 41, 55, 58, 59, 65, 66

4, 5, 9, 48, 49, 51, 61, 62,

Number of times observed8

Number of times observed2

Number of times observed14

Number of times observed8

Total number of observations

32

Percentages (column total divided by overall total and multiplied by 100

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Means Table

Relationships (R)

Positive Emotions (PE)

Negative Emotions (NE)

Organisational Abilities (OA)

Mean number of times observed

9

Mean number of times observed 2

Mean number of times observed

12.5

Mean number of times observed

8.5

Total number of observations

32

28% 6% 39% 26.5%Percentages (column total divided by overall total and multiplied by 100