Investigating the diagnostic specificity of attachment and relational needs in hoarding disorder

Background: Excessive emotional attachments to objects in hoarding may represent a compensatory strategy for unmet attachment and relational needs. Aims: This study aimed to clarify the extent and specificity of attachment and interpersonal needs in hoarding disorder compared to obsessive compulsive disorder (OCD) and healthy controls (HC). The primary aim of the study was to investigate the specificity of poor bonding with key attachment figures in childhood, and attachment insecurity in current relationships. Secondly, present-day interpersonal interactions, including loneliness and social support, were assessed for diagnostic specificity. Methods: A cross-sectional between-groups design was used to compare scores on measures in those with hoarding (n = 38); OCD (n = 46); and HCs (n = 49). Results: Individuals with hoarding reported diminished parental bonding, greater attachment insecurity and loneliness in current relationships compared to HCs. The clinical groups did not differ from each other. The hoarding group reported the poorest levels of social support. Conclusions: These results suggest interpersonal attachment and relational needs are relevant, but not diagnostically specific, to hoarding. Poor social support is particularly heightened in those with hoarding compared to OCD. Longitudinal and interventional research evaluating the impact of interventions addressing social support on object attachment is needed.