2 - (SYM 115) the Critical Role of Loneliness in Hoarding Disorder: Targeting Unmet Interpersonal Needs to Reduce Pathological Object Attachment

A prominent characteristic of hoarding is the presence of strong emotional attachments to objects. This pathological attachment to possessions is understood to drive both difficulties discarding and excessive acquiring tendencies, which jointly reflect two of the core hoarding features. Increasingly research has investigated risk and vulnerability factors that may contribute to the development of strong object attachment. Attachment theory suggests that object attachment is an attempt at compensating for unmet relatedness needs. Rather than seeking out or receiving social support to alleviate distress, hoarding patients may seek comfort and security from other sources including objects. Consistent with this perspective, research shows that hoarding is associated with insecure attachment styles, interpersonal or childhood trauma, greater interpersonal difficulties, and more constricted social networks. It therefore stands to reason that if object attachment originates from attempts at compensating for unmet relatedness needs, then hoarding should be associated with greater loneliness. Furthermore, increasing a sense of belonging and relatedness should subsequently be a key mechanism by which to reduce object attachment. Across two studies we sought to first examine levels of loneliness in relation to hoarding, and second examine whether reducing loneliness would result in lower object attachment.

Study 1 compared individuals with clinical levels of hoarding to those with low hoarding symptoms in a community sample (N=1,080). Results showed high loneliness levels in 77.7% of participants in the hoarding group compared to 36.8% in the non-hoarding group. The positive association between loneliness and hoarding remained significant after controlling for age, gender, marital status, and depression. Study 2 included individuals with clinically elevated hoarding symptoms (N=298) who were randomized to a online, single-session loneliness intervention (n = 142) or an active control condition (n = 156). Results showed small but significant improvements in loneliness (F = 6.5, p < .01) and object attachment (F = 4.4, p < .05) for participants who received the loneliness intervention relative to control participants. Mediational analyses revealed that changes in loneliness mediated the effect of the intervention on object attachment. Our results underscore the importance of assessing and addressing loneliness in hoarding disorder patients, and further suggest that reducing loneliness might lead to lower object attachment.