Example Paper Note to learners: This paper (a previously submitted paper which earned a grade of A) is provided to act as an example of one way which this final research paper might be approached



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Final Project

12/04/2011

Example Paper

Note to learners:

This paper (a previously submitted paper which earned a grade of A) is provided to act as an example of one way which this final research paper might be approached. It is not intended to be an example of the only way to approach this paper. Much of how this paper is constructed depends upon the topic selected. Make sure to reference the requirements of the paper, found in the guidance document and also feel free to contact the professor if you have any questions.

Introduction

Two brothers, Homer and Langley Collyer, lived in a highly reclusive residence in Harlem, New York in the early 20th century. In 1947, the brothers made headlines when an anonymous caller reported and insisted to the police that there was a dead body in the Collyer residence. Authorities came to investigate and found the entrance of the home blocked by clutter. They tried to remove tons of garbage to gain entrance, but were unsuccessful. They finally entered the home through a second-floor window after which they found the body of the older brother, Homer, among boxes and trash. Because of the huge amount of garbage in the house, it took about three weeks to find the body of the younger brother, Langley, who had died from suffocation after being crushed by a tower of bundles of newspapers. The brothers’ bodies were found several feet from each other.

Langley had been crawling through a newspaper tunnel in their home to bring food to his older brother, who was blind, when one of his many traps fell down and crushed him. He planted the traps to prevent intruders from entering their home, and to protect the “wealth” of items they had collected throughout their lifetime. After Langley’s death, Homer died of starvation. Authorities eventually removed more than 100 tons of materials from the Collyer’s house, which included thousands of books and newspapers, several grand pianos, the chassis of a Model T Ford, an X-ray machine, rusted bicycles, and mounds of trash (Steinfatt, 2010; Koretz and Gutheil, 2009). Homer and Langley Collyer’s story illustrates the extent that people go to hold on to things they believe are important to them. This bizarre behavior is called hoarding.

Hoarding is a clinical syndrome that affects millions of people across the United States. This disorder can have devastating consequences not only for the individual struggling with this condition, but also to those close to them and the community. Clutter in the homes of people with hoarding problems is extremely disorganized resulting in unhealthy and hazardous living conditions. Individuals with compulsive hoarding problems show lack of awareness of the severity of their behavior. They deny the problem, resist help that is offered to them, and fail to follow through with treatments.



Brief History

Contemporary definitions of hoarding differ from earlier definitions. Prior to the Collyer brothers’ case becoming international news, the term “hoarding” referred primarily to the accumulation of wealth or money – not trash. Hence, the Oxford English Dictionary defined hoarding as “the accumulation and hiding of money”. While earlier centuries regarded hoarding as a sign of financial greed, it is now being viewed as a psychopathological disorder (Herring, 2011).



Definition

According to Frost and Hart, hoarding is a syndrome characterized by excessive acquisition of, and failure to discard, possessions which appear to be useless or of limited value. It results in a cluttered living space and significant distress or impairment in functioning caused by the hoarding behavior. Inability to return borrowed items may also be present. The impulse to obtain more things could lead to kleptomania or stealing (cited in Koretz and Gutheil, 2009). However, it is not a diagnosis. The diagnosis which often goes with this condition is obsessive compulsive disorder.


Cause

Generally, the cause of hoarding is difficult to understand. However, its underlying causes appear to include family history, genetic tendency, and environmental factors such as traumatic life events. Reports indicate that hoarders are more likely to have first-degree relatives with hoarding symptoms (Walter and Zsuzsa, 2007). A study on a sample of a large number of twins (N=5,022) showed that hoarding is highly prevalent and heritable (Iervolino et al., 2009). From these findings, it is reasonable to believe that children inherit, along with their parents’ genes, their parents, and the places they live in. Not surprisingly, family upbringing greatly affects an individual’s personality. Children who are living with a parent or parents with hoarding behaviors are more likely to become hoarders themselves. Yes.

Freud’s psychosexual developmental theory states that the core of personality is formed before age 6, and that erotic urges in childhood have lasting effects on development. Harsh or lenient toilet training may lock into personality. Freud described the anal-retentive (holding-on) personality as obstinate, orderly, and compulsively clean. On the other hand, the anal-expulsive (letting-go) personality is disorderly, destructive, or messy. Although Freud said little about the hoarding of things, he did suggest that hoarding money may have resulted from fixations at the anal stage (International OCD Foundation).

Moreover, an individual who experienced any traumatic or stressful life events may develop hoarding syndrome (Iervolino et al., 2009). Death or loss of a loved one is a devastating experience, which may trigger fears of losing “anything” regardless of whether it is important or not. In sum, heredity, along with environmental influences thus play an important role in shaping the person that you are today. Good point.



Onset

The onset of hoarding appears to manifest in the teenage years or late adulthood. In the case of onset in youth, hoarding is often associated with Obsessive Compulsive Disorder (OCD). As the hoarder ages, the clutter worsens, and it progressively creates unhealthy and hazardous living conditions. Studies indicated high rates of mood disorders (e.g. depression), anxiety disorders (e.g. social phobia), and impulsive behaviors (e.g. compulsive shopping) in this group of hoarders. On the contrary, OCD is usually not present in cases of onset in the elderly. There is limited empirical data for this group; however; psychiatric characteristics including lifetime alcohol dependence and personality disorders such as paranoia were found to be present in this group. Difficulties in childhood due to lack of physical security, excessive physical discipline, and having a parent with psychiatric symptoms were also noted in this study (Sansone and Sansone, 2010).

It is important to mention that in another study, sudden onset in adulthood, such as after a traumatic life event or brain injury, were also reported (Grisham and Norberg, 2010).

Prevalence

Although little is known about the prevalence of hoarding behavior, epidemiological reports suggest that hoarding may be highly prevalent in the community. In one study, data from the Hopkins Epidemiology of Personality Disorder Study (N=742) were investigated; results showed an estimated prevalence of 4%. These findings also suggest that hoarding behavior is greater in older than younger age groups; it also appears to be greater in men than women (Samuels et al, 2008).

In addition to the above, one survey on public health departments conducted by Frost and associates found that over a 5-year period 26 cases of hoarding per 100,000 persons were reported. However, Frost believed that these findings underestimate the prevalence of hoarding (Walter and Zsuzsa, 2007).

Overall, it is believed that hoarding statistics are inadequately represented due to the difficulty of those affected by this disorder to ask for help. Some hoarders may not acknowledge that this is a problem while others are fearful that they may be removed from their homes because of health and safety violations (The Compulsive Hoarding Center).



Effects

As mentioned earlier, hoarding has debilitating effects not only on the individuals struggling with this disorder, but also on their families and the community. Individuals inflicted with this disorder isolate themselves and rarely seek treatment because of embarrassment. Additionally, hoarders and their families are confronted by continued threats of eviction because of unhealthy and hazardous living conditions. Some hoarders reported that they have been evicted from their homes because of hoarding; some have had a child or elder removed from the home. Further, a survey showed that family members living with a hoarder reported high levels of distress in children and problems in the family. Frustration, rejection, and hostility among family members were also indicated (Tolin et al., 2008).

Evidence also suggests that hoarding creates a number of public health concerns. Steketee et al. (2001) reported increased risk of fire, falling, poor sanitation and health risks resulting from clutter in the homes of hoarders. Like the Collyer brothers’ case, excessive hoarding behaviors create physical dangers that can result to death. Also, Frost et al. (1999) contend that housing officials struggle with hoarding cases (cited in Tolin et al., 2008).

Treatment

Hoarding has been known to be difficult to treat as its causes are difficult to understand. However, two treatment studies have been published; pharmacotherapy and cognitive-behavioral therapy (CBT). Reports show that hoarders do not respond well to serotonin reuptake inhibitors. As a result, researchers have developed psychological treatments such as cognitive-behavioral therapy (CBT) as mentioned above, which show promising results. However, improvements are slow and multiple sessions are needed to produce change (Grisham and Norberg, 2010).



Opinion

Prior to my writing this paper, I had little knowledge about hoarding syndrome. My perception of the people who are affected by it was that they were selfish and greedy, and that they had no purpose in life. I felt sorry for their loved ones, especially the children, as I thought they were “victims” of their parent’s horrible choices in life. Although my perceptions might not be totally wrong, I failed to look into the deeper prospective of things – what might be causing this disorder? As I did my research, I found myself in awe and disbelief of how bad this can affect a person, and equally important, those who are close to them – parents, spouses, children, and friends.

In my opinion, one of the biggest problems surrounding this syndrome is the lack of awareness or insight from the hoarder’s end – they do not recognize, or they deny, that they have a problem. As a result, they show lack of distress about their condition. I believe that there is a need for awareness/insight-building strategies to help hoarders understand the severity of their condition. Likewise, friends and families should educate themselves about hoarding; the more informed they are, the better they can understand and help the hoarder. I believe that early intervention could make a difference and treat the problem before it gets worse! Or what? Keep going a bit further with this critical thought regarding the topic.

This research has been a real eye opener for me. I believe that hoarders are “victims” of a very serious disorder, rather than just lazy people who dislike cleaning and enjoy collecting things. I recognize the complicated nature of this disorder as well as the difficulty of treatment, and I do agree that there is a need for effective screening to help identify this disorder.



Benefits or Detriments to Society and Individually

I have left this area blank for this example paper. Although you are expected to discuss this issue in your paper, I do not want you influenced or biased by someone else’s perspectives or opinions. The discussion of this topic should be at least a page in length.

Conclusion

Hoarding has been recognized and documented for a long time; yet, it has received little systematic study. Its origins have been difficult to understand, which leads to difficulties in diagnosis and treatment. One thing is clear though, hoarding syndrome can take over the lives of those affected by it. In severe cases, like the Collyer brothers’ case, the fear of losing “anything” results in losing the most important “thing” there is – their lives!

Much more needs to be known about this syndrome. Unless researchers and clinicians know how to accurately screen hoarding behaviors, effective treatment won’t be developed.

References

Herring, S.. (2011). Collyer Curiosa: A Brief History Of Hoarding. Criticism, 53(2), 159-188.  Retrieved December 4, 2011, from Research Library. (Document ID: 2495293191)

Iervolino, A.C.; Perroud, N; Fullana, M.A.; Guipponi, M.; Cherkas, L.; Collier, D; Mataix-Cols, D. (2009). Prevalence and Heritability of Compulsive Hoarding: A Twin Study. Retrieved November 30, 2011 from http://ajp.psychiatryonline.org/article.aspx?articleid=101221

International OCD Foundation: From Dante to DSM-V: A Short History of Hoarding. Retrieved on November 30, 2011 from http://www.ocfoundation.org/hoarding/dante_to_dsm-v.aspx
Jesicca R. Grisham, PhD and Melissa M. Norberg, PhD, Compulsive hoarding: current controversies and new directions. (2010). Retrieved November 29, 2011 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181962/?tool=pubmed
Koretz, J., & Gutheil, T.. (2009). "I Can't Let Anything Go:" A Case Study with Psychological Testing of a Patient with Pathologic Hoarding. American Journal of Psychotherapy, 63(3), 257-66.  Retrieved November 30, 2011, from Research Library. (Document ID: 1980029851).
Randy A. Sansone, MD and Lori A. Sansone, MD, Hoarding: Obsessive Symptom or syndrome (2010). Retrieved on November 30, 2011 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2848465/?tool=pubmed
Samuels JF, Bienvenu OJ, Grados MA, Cullen B, Riddle MA, Liang KY, Eaton WW, Nestadt G. Prevalence and correlates of hoarding behavior in a community-based sample. Retrieved on November 29, 2011 from http://www.ncbi.nlm.nih.gov/pubmed/18495084

Steinfatt, T. (2010, June 7). Compulsive Hoarding Case of 1947: The Collyer Brothers. Retrieved on November 30, 2010 from http://www.homeinsteadrva.com/2010/06/07/compulsive-hoarding-case-of-1947-the-collyer-brothers/



The Compulsive Hoarding Center. Offering Hope and Inspiration for Change. Retrieved on November 28, 2011 from http://www.compulsivehoardingcenter.com/Compulsive_Hoarding.html
Tolin, D., Fitch, K., Frost, R. Steketee, G. (2008). Family Informants’ Perceptions of Insight in Compulsive Hoarding. Retrieved November 27, 2011 from http://drtolin.com/wp-content/uploads/2009/11/Family-Informants%E2%80%99-Perceptions-of-Insight-in-Compulsive-Hoarding-Tolin-et-al.1.pdf
Walter A. Brown, MD and Zsuzsa Meszaros, MD, PhD.  (2007, November). Hoarding. Psychiatric Times, 24(13), 50.  Retrieved November 28, 2011, from ProQuest Nursing & Allied Health Source. (Document ID: 1375824271).


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