DSM-5 in Action by Dziegielewski Sophia F

Author:Dziegielewski, Sophia F. [Dziegielewski, Sophia F.]
Language: eng
Format: epub, pdf
Published: 0101-01-01T00:00:00+00:00

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D I A G N O S T I C A N D T R E A T M E N T A P P L I C A T I O N S

perceived defects or flaws in physical appearance

Hoarding Disorder (HD)

that are not observable or appear slight to others”

(APA, 2013, p. 243). In criterion B, these per-

Hoarding disorder (HD) has six specific criteria

ceived defects or flaws that may not be as visible

(ranging from A to F) that must be met. In

to others become the focus of great attention and

criterion A, individuals with HD suffer from

this preoccupation results in repetitive behaviors

an inability to discard and/or a desire to save

such as mirror checking or seeking reassurance of

possessions that others might perceive as value-

others when the cause of concern is simply not

less. Hoarded possessions can range from having

visible or concerning to others. Because of the

significant financial value, emotional value, to no

individual’s preoccupation, he or she may con-

value at all. In criterion B, the primary problem is

tinue to perform repetitive behaviors. The indi-

the extreme desire to save these items as a way of

vidual may have also participated in mental acts,

avoiding the distress that it creates. In criterion C,

such as comparing self with others. In criterion

the accumulation of possessions reduces the

C, this preoccupation must be so excessive that

quality of the individual’s living environment

the individual experiences clinically significant

as they encroach upon available living space and

distress or impairment in social, occupational, or

in extreme cases can directly cause a health

other important areas of functioning. Lastly, in

hazard. The clinically significant distress resulting

criterion D, an individual who suffers from BDD

from hoarding impacts the individual’s social and

remains primarily preoccupied with appearance

occupational level of functioning (criterion D).

and does not meet the criteria for an eating

In criteria E and F, the diagnosis of HD is not

disorder (APA, 2013).

attributed to symptoms of another mental dis-

Two types of specifiers are outlined; one

order or medical condition.

relates to muscle dysmorphia and the other is

There are two specifiers to be used with

related to insight. When diagnosing an individ-

HD; one involves acquisition and the other

ual with this disorder, the practitioner must

OCD spectrum disorder involves insight. The

specify whether the individual also has muscle

practitioner must use the specifier with exces-

dysmorphia. Individuals who present with

sive acquisition when hoarded items are not

muscle dysmorphia perceive their body build

needed or there is no space to maintain the

as distorted (e.g., “body build is too small or

hoarded items. The insight specifier is also used

insufficiently muscular”) (APA, 2013, p. 243).

when diagnosing HD. Identify is whether the

The practitioner must use this specifier even if

individual with HD has good or fair insight

the client’s perception of his or her body build is

regarding hoarding, poor insight, or “absent

distorted in only one part of the body. The

insight/delusional beliefs” (APA, 2013, p.

second specifier for BDD that constitutes Specify

247). Individuals with HD who possess good

if, relates to insight. The practitioner must specify

or fair insight recognize the problematic fea-

if the individual presents with good or fair

tures of maintaining the hoarded items. Indi-

insight, poor insight, or if the individual does

viduals with poor insight don’t see the hoarding

not understand that the delusions are not true

as a problem.

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