Invitation to Psychology

Chapter 11 Psychological Disorders 391

The DSM-5 includes hoarding disorder in the

larger category of obsessive-compulsive and related

disorders. Pathological hoarders fill their homes

with newspapers, bags of old clothing, used tissue

boxes—all kinds of junk. They are tormented by

fears of throwing out something they will need

later. A PET-scan study compared obsessive hoard-

ers with other people with obsessive symptoms and

found that hoarders had less activity in parts of the

brain involved in decision making, problem solv-

ing, spatial orientation, and memory (Saxena et al.,

2004). Perhaps these deficits explain why hoarders

keep things and why they often keep decades-old

newspapers and junk in the living room, kitchen,

or even on the bed. Their inability to decide what

to throw away creates a constant worry, and their

difficulty in remembering where things are makes

them feel the need to have them in sight.

or of having unknowingly hurt someone in a traf-
fic accident. Obsessive thoughts take many forms,
but they are alike in reflecting impaired ways of
reasoning and processing information.
As for compulsions, the most common ones
are hand washing, counting, touching, and check-
ing. A woman must check the furnace, lights, locks,
and oven three times before she can sleep; a man
must run up and down the stairs 60 times in 40
minutes or else start over from the beginning. (The
character of Hannah on the TV show Girls, like her
creator Lena Dunham, has OCD; when Hannah is
under particular stress, she starts feeling she must
do everything in multiples of eight.) OCD suffer-
ers usually realize that their behavior is senseless,
and they are often tormented by their rituals. But if
they try to resist the compulsion, they feel mount-
ing anxiety that is relieved only by giving in to it.
In many people with OCD, abnormalities in
an area of the prefrontal cortex create a kind of
cognitive rigidity, an inability to let go of intru-
sive thoughts, and behavioral rigidity, an inability
to alter compulsive behavior after getting nega-
tive feedback (Chamberlain et al., 2008; Clarke
et  al., 2004). Normally, once danger has passed
or a person realizes that there is no cause for fear,
the brain’s alarm signal turns off. In people with
OCD, however, false alarms keep clanging and the
emotional networks keep sending out mistaken
fear messages (Schwartz et al., 1996). The sufferer
feels in a constant state of danger and tries repeat-
edly to reduce the resulting anxiety.

Simulate the Experiment The Obsessive-

Compulsive Test at MyPsychLab

Extreme hoarding can be hazardous to health. The

person who lived here was unable to throw away any

papers or magazines. He was buried under this deluge

of materials for two days.

Recite & Review

Recite: Reciting out loud to yourself should not make you anxious, so recite what you know about

generalized anxiety disorder, panic disorder, phobias, social phobia, agoraphobia, posttraumatic

stress disorder, obsessive-compulsive disorder, and hoarding disorder.

Review: Next, read this section again.

Now take this Quick Quiz:

Match each term on the left with a description on the right.

1. social phobia


2. generalized anxiety disorder


3. posttraumatic stress disorder


4. agoraphobia


5. compulsion


6. obsession

Study and Review at MyPsychLab

a. need to perform a ritual

b. fear of fear; of being trapped with no way of escape

c. continuing sense of dread

d. repeated, unwanted thoughts

e. fear of meeting new people

f. nightmares and flashbacks

Answers: d6. a5. b4. d, f3. c2. e1.