How Do Hoarding Symptoms Develop in Adolescence?

What you need to know

• Hoarding symptoms can emerge in adolescence, but full-blown hoarding disorder as defined for adults may be rare in youth
• Difficulty discarding possessions is the most prominent hoarding symptom in adolescents
• Adolescents with hoarding symptoms often have other mental health issues like anxiety and depression
• Early hoarding symptoms in youth may be a precursor to developing hoarding disorder later in life

Understanding hoarding in adolescents

Hoarding disorder is a mental health condition where people have extreme difficulty parting with possessions, leading to cluttered living spaces that interfere with daily life. While hoarding disorder is typically diagnosed in adults, the roots of the condition often trace back to childhood or adolescence.

Researchers conducted a study to better understand how hoarding symptoms develop in young people. They followed up with a group of 15-year-old twins who had previously reported significant hoarding symptoms. About 3 years later, the researchers interviewed these teens, their parents, and a comparison group of teens without hoarding symptoms.

Key findings about adolescent hoarding

Hoarding disorder criteria in youth

The study found that none of the teens met the full criteria for hoarding disorder. The main reason was that none had significant clutter in their living spaces - a key diagnostic feature in adults. However, many of the teens who previously reported hoarding symptoms did show some concerning signs:

• About 40% had persistent difficulty discarding or parting with possessions
• Many experienced distress when trying to discard items
• Some reported impairment in their daily lives due to hoarding behaviors

This suggests that while full-blown hoarding disorder may be rare in youth, early signs of problematic hoarding can emerge in adolescence.

Most common hoarding symptoms

The most prominent hoarding symptom in the teens was difficulty discarding possessions. This aligns with previous research on hoarding in young people. Other key features included:

• Saving a wide variety of everyday items like books, tickets, letters, and old clothes
• Reporting multiple reasons for saving items, especially potential future usefulness
• Higher levels of clutter in their rooms compared to teens without hoarding symptoms (though not reaching levels seen in adult hoarding disorder)

Mental health and hoarding

Teens with hoarding symptoms were more likely to have other mental health issues compared to those without hoarding behaviors. Common co-occurring conditions included:

• Anxiety disorders
• Depression
• Symptoms of attention-deficit/hyperactivity disorder (ADHD)
• Traits associated with autism spectrum disorder

This pattern is similar to what’s seen in adults with hoarding disorder, suggesting these mental health connections may start early.

How hoarding develops over time

The study provides some insights into how hoarding behaviors might progress:

1. Difficulty discarding possessions emerges in adolescence
2. Distress related to discarding items increases
3. A wider variety of items are saved for more reasons
4. Clutter slowly accumulates but may not reach problematic levels until adulthood
5. Other mental health issues often develop alongside hoarding symptoms

However, it’s important to note that not all teens with early hoarding symptoms will go on to develop full hoarding disorder as adults. More long-term research is needed to understand the exact progression.

Implications for identifying and helping at-risk youth

The findings suggest that the current diagnostic criteria for hoarding disorder in adults may not capture problematic hoarding behaviors in adolescents well. Young people rarely have control over their entire living space, so the clutter criterion may not apply.

Instead, other warning signs in teens might include:

• Persistent difficulty discarding a variety of items
• Distress when asked to get rid of possessions
• Saving items for multiple reasons, especially “just in case” thinking
• Early signs of clutter accumulation in their personal spaces
• Co-occurring mental health issues, especially anxiety and depression

Identifying these early signs could help get support to at-risk youth before hoarding behaviors become more severe. Treatment approaches for adolescents may need to focus more on addressing difficulties with discarding, challenging hoarding-related thoughts, and building organizational skills rather than dealing with extensive clutter.

Conclusions

• Hoarding symptoms can start to emerge in adolescence, even if teens don’t meet full criteria for hoarding disorder
• Difficulty discarding possessions is the most prominent early sign of problematic hoarding in youth
• Adolescents with hoarding symptoms often struggle with other mental health issues
• Early intervention addressing discarding difficulties and hoarding-related thoughts may help prevent more severe hoarding later in life
• More research is needed to understand how adolescent hoarding symptoms progress over time