Estimating the Heritability of Hoarding Symptoms: Insights from a Classical Twin Study
Abstract
Objectives: Hoarding disorder is a complex condition that significantly impacts individuals' lives, characterized by excessive acquiring, difficulty discarding, clutter, distress, and impairment. This study aimed to examine the extent to which genetics and environment influence difficulty discarding, excessive acquisition, and clutter through the implementation of a classical twin study.
Methods: A total of 194 twins, consisting of 100 monozygotic (MZ) and 94 dizygotic (DZ) twins, participated in this study. Hoarding symptoms was assessed using the saving inventory-revised. To estimate the heritability of hoarding symptoms, the classical univariate twin model was employed.
Results: Based on the univariate analysis, it was found that the heritability estimates for difficulty discarding and excessive acquisition are 0.43 and 0.52, respectively. However, the results did not provide support for the role of genetics in clutter. Instead, it was indicated that the common environment accounts for 0.54 of the variance in clutter, while the specific environment contributes 0.46 to this symptom.
Conclusion: The difficulty discarding and excessive acquisition have been found to be moderately heritable. On the other hand, considering the contribution of genetics and environment to clutter, the results raise doubts about the association of clutter with hoarding. The relatively low genetic influence suggests that this trait may overlap with other behaviors rather than hoarding.
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2. Pertusa A, Fullana MA, Singh S, Alonso P, Menchón JM, Mataix-Cols D. Compulsive hoarding: OCD symptom, distinct clinical syndrome, or both? Am J Psychiatry. 2008;165(10):1289–98.
3. Steketee G, Frost R. Compulsive hoarding: current status of the research. Clin Psychol Rev. 2003;23(7):905–27.
4. Akıncı MA, Turan B, Esin İS, Dursun OB. Prevalence and correlates of hoarding behavior and hoarding disorder in children and adolescents. Eur Child Adolesc Psychiatry. 2022 Oct;31(10):1623–34.
5. Postlethwaite A, Kellett S, Mataix-Cols D. Prevalence of Hoarding Disorder: A systematic review and meta-analysis. J Affect Disord [Internet]. 2019;256:309–16. Available from: https://www.sciencedirect.com/science/article/pii/S0165032719301521
6. Dozier ME, Porter B, Ayers CR. Age of onset and progression of hoarding symptoms in older adults with hoarding disorder. Aging Ment Health [Internet]. 2016 Jul 2;20(7):736–42. Available from: https://doi.org/10.1080/13607863.2015.1033684
7. Williams MT, Brown TL, Sawyer B. Psychiatric Comorbidity and Hoarding Symptoms in African Americans With Obsessive-Compulsive Disorder. J Black Psychol [Internet]. 2016 Mar 22;43(3):259–79. Available from: https://doi.org/10.1177/0095798416639438
8. da Cunha GR, Martins CM, Pellizzaro M, Pettan-Brewer C, Biondo AW. Sociodemographic, income, and environmental characteristics of individuals displaying animal and object hoarding behavior in a major city in South Brazil: A cross-sectional study. Vet world. 2021 Dec;14(12):3111–8.
9. Chia K, Pasalich DS, Fassnacht DB, Ali K, Kyrios M, Maclean B, et al. Interpersonal attachment, early family environment, and trauma in hoarding: A systematic review. Clin Psychol Rev. 2021;90:102096.
10. Mathes BM, Timpano KR, Raines AM, Schmidt NB. Attachment theory and hoarding disorder: A review and theoretical integration. Behav Res Ther [Internet]. 2020;125:103549. Available from: https://www.sciencedirect.com/science/article/pii/S0005796719302359
11. Strom NI, Smit DJA, Silzer T, Iyegbe C, Burton CL, Pool R, et al. Meta-analysis of genome-wide association studies of hoarding symptoms in 27,651 individuals. Transl Psychiatry [Internet]. 2022;12(1):479. Available from: https://doi.org/10.1038/s41398-022-02248-7
12. Burton CL, Park LS, Corfield EC, Forget-Dubois N, Dupuis A, Sinopoli VM, et al. Heritability of obsessive-compulsive trait dimensions in youth from the general population. Transl Psychiatry. 2018 Sep;8(1):191.
13. Iervolino AC, Perroud N, Fullana MA, Guipponi M, Cherkas L, Collier DA, et al. Prevalence and heritability of compulsive hoarding: a twin study. Am J Psychiatry. 2009 Oct;166(10):1156–61.
14. Ivanov VZ, Mataix-Cols D, Serlachius E, Lichtenstein P, Anckarsäter H, Chang Z, et al. Prevalence, Comorbidity and Heritability of Hoarding Symptoms in Adolescence: A Population Based Twin Study in 15-Year Olds. PLoS One [Internet]. 2013;8(7):1–7. Available from: https://doi.org/10.1371/journal.pone.0069140
15. Ivanov VZ, Nordsletten A, Mataix-Cols D, Serlachius E, Lichtenstein P, Lundström S, et al. Heritability of hoarding symptoms across adolescence and young adulthood: A longitudinal twin study. PLoS One [Internet]. 2017 Jun 28;12(6):e0179541. Available from: https://doi.org/10.1371/journal.pone.0179541
16. López-Solà C, Fontenelle LF, Alonso P, Cuadras D, Foley DL, Pantelis C, et al. Prevalence and heritability of obsessive-compulsive spectrum and anxiety disorder symptoms: A survey of the Australian Twin Registry. Am J Med Genet Part B, Neuropsychiatr Genet Off Publ Int Soc Psychiatr Genet. 2014 Jun;165B(4):314–25.
17. Mathews CA, Nievergelt CM, Azzam A, Garrido H, Chavira DA, Wessel J, et al. Heritability and clinical features of multigenerational families with obsessive-compulsive disorder and hoarding. Am J Med Genet Part B Neuropsychiatr Genet. 2007;144(2):174–82.
18. Monzani B, Rijsdijk F, Harris J, Mataix-Cols D. The Structure of Genetic and Environmental Risk Factors for Dimensional Representations of DSM-5 Obsessive-Compulsive Spectrum Disorders. JAMA Psychiatry [Internet]. 2014 Feb 1;71(2):182–9. Available from: https://doi.org/10.1001/jamapsychiatry.2013.3524
19. Zilhão NR, Smit DJ, Boomsma DI, Cath DC. Cross-Disorder Genetic Analysis of Tic Disorders, Obsessive-Compulsive, and Hoarding Symptoms. Front psychiatry. 2016;7:120.
20. Mathews CA, Delucchi K, Cath DC, Willemsen G, Boomsma DI. Partitioning the etiology of hoarding and obsessive–compulsive symptoms. Psychol Med [Internet]. 2014/02/20. 2014;44(13):2867–76. Available from: https://www.cambridge.org/core/article/partitioning-the-etiology-of-hoarding-and-obsessivecompulsive-symptoms/22111C1A149CEA5BBF5619BA7684B90F
21. Nordsletten AE, Monzani B, Fernández de la Cruz L, Iervolino AC, Fullana MA, Harris J, et al. Overlap and specificity of genetic and environmental influences on excessive acquisition and difficulties discarding possessions: Implications for hoarding disorder. Am J Med Genet Part B, Neuropsychiatr Genet Off Publ Int Soc Psychiatr Genet. 2013 Jun;162B(4):380–7.
22. Nordsletten AE, Fernández de la Cruz L, Aluco E, Alonso P, López-Solà C, Menchón JM, et al. A transcultural study of hoarding disorder: Insights from the United Kingdom, Spain, Japan, and Brazil. Transcult Psychiatry [Internet]. 2018 Mar 6;55(2):261–85. Available from: https://doi.org/10.1177/1363461518759203
23. de la Cruz L, E Nordsletten A, Mataix-Cols D. Ethnocultural aspects of hoarding disorder. Curr Psychiatry Rev. 2016;12(2):115–23.
24. Gharipour M, Haghjooy Javanmard S, Mansourian M, Sabri M, Khosravi E, Dianatkhah M, et al. Isfahan Twins Registry (ITR): An Invaluable Platform for Epidemiological and Epigenetic Studies: Design and Methodology of ITR. Twin Res Hum Genet Off J Int Soc Twin Stud. 2019 Dec;22(6):579–82.
25. Frost RO, Steketee G, Grisham J. Measurement of compulsive hoarding: saving inventory-revised. Behav Res Ther. 2004;42(10):1163–82.
26. Kellman-McFarlane K, Stewart B, Woody S, Ayers C, Dozier M, Frost RO, et al. Saving inventory – Revised: Psychometric performance across the lifespan. J Affect Disord [Internet]. 2019;252:358–64. Available from: https://www.sciencedirect.com/science/article/pii/S0165032718316781
27. Mohammadzadeh A. Validation of Saving Inventory-Revised (SI-R): Compulsive Hoarding Measure. ijpcp [Internet]. 2009 May 1;15(1):33–41. Available from: http://ijpcp.iums.ac.ir/article-1-662-fa.html
28. Song Y-M, Lee D, Lee MK, Lee K, Lee HJ, Hong EJ, et al. Validity of the zygosity questionnaire and characteristics of zygosity-misdiagnosed twin pairs in the Healthy Twin Study of Korea. Twin Res Hum Genet Off J Int Soc Twin Stud. 2010 Jun;13(3):223–30.
29. Moser JS, Slane JD, Alexandra Burt S, Klump KL. Etiologic relationships between anxiety and dimensions of maladaptive perfectionism in young adult female twins. Depress Anxiety. 2012;29(1):47–53.
30. Coles ME, Frost RO, Heimberg RG, Steketee G. Hoarding behaviors in a large college sample. Behav Res Ther [Internet]. 2003;41(2):179–94. Available from: https://www.sciencedirect.com/science/article/pii/S000579670100136X
31. Ivanov VZ, Mataix-Cols D, Serlachius E, Brander G, Elmquist A, Enander J, et al. The developmental origins of hoarding disorder in adolescence: a longitudinal clinical interview study following an epidemiological survey. Eur Child Adolesc Psychiatry [Internet]. 2021;30(3):415–25. Available from: https://doi.org/10.1007/s00787-020-01527-2
32. Plimpton EH, Frost RO, Abbey BC, Dorer W. Compulsive Hoarding in Children: Six Case Studies. Int J Cogn Ther [Internet]. 2009 Mar 1;2(1):88–104. Available from: https://doi.org/10.1521/ijct.2009.2.1.88
33. Storch EA, Lack CW, Merlo LJ, Geffken GR, Jacob ML, Murphy TK, et al. Clinical features of children and adolescents with obsessive-compulsive disorder and hoarding symptoms. Compr Psychiatry. 2007;48(4):313–8.
34. Turkheimer E. Three laws of behavior genetics and what they mean. Curr Dir Psychol Sci. 2000;9(5):160–4.
35. Everitt BS, Howell DC. Encyclopedia of Statistics in Behavioral Science--Volume 2. John Wiley & Sons, Ltd; 2021.
2. Pertusa A, Fullana MA, Singh S, Alonso P, Menchón JM, Mataix-Cols D. Compulsive hoarding: OCD symptom, distinct clinical syndrome, or both? Am J Psychiatry. 2008;165(10):1289–98.
3. Steketee G, Frost R. Compulsive hoarding: current status of the research. Clin Psychol Rev. 2003;23(7):905–27.
4. Akıncı MA, Turan B, Esin İS, Dursun OB. Prevalence and correlates of hoarding behavior and hoarding disorder in children and adolescents. Eur Child Adolesc Psychiatry. 2022 Oct;31(10):1623–34.
5. Postlethwaite A, Kellett S, Mataix-Cols D. Prevalence of Hoarding Disorder: A systematic review and meta-analysis. J Affect Disord [Internet]. 2019;256:309–16. Available from: https://www.sciencedirect.com/science/article/pii/S0165032719301521
6. Dozier ME, Porter B, Ayers CR. Age of onset and progression of hoarding symptoms in older adults with hoarding disorder. Aging Ment Health [Internet]. 2016 Jul 2;20(7):736–42. Available from: https://doi.org/10.1080/13607863.2015.1033684
7. Williams MT, Brown TL, Sawyer B. Psychiatric Comorbidity and Hoarding Symptoms in African Americans With Obsessive-Compulsive Disorder. J Black Psychol [Internet]. 2016 Mar 22;43(3):259–79. Available from: https://doi.org/10.1177/0095798416639438
8. da Cunha GR, Martins CM, Pellizzaro M, Pettan-Brewer C, Biondo AW. Sociodemographic, income, and environmental characteristics of individuals displaying animal and object hoarding behavior in a major city in South Brazil: A cross-sectional study. Vet world. 2021 Dec;14(12):3111–8.
9. Chia K, Pasalich DS, Fassnacht DB, Ali K, Kyrios M, Maclean B, et al. Interpersonal attachment, early family environment, and trauma in hoarding: A systematic review. Clin Psychol Rev. 2021;90:102096.
10. Mathes BM, Timpano KR, Raines AM, Schmidt NB. Attachment theory and hoarding disorder: A review and theoretical integration. Behav Res Ther [Internet]. 2020;125:103549. Available from: https://www.sciencedirect.com/science/article/pii/S0005796719302359
11. Strom NI, Smit DJA, Silzer T, Iyegbe C, Burton CL, Pool R, et al. Meta-analysis of genome-wide association studies of hoarding symptoms in 27,651 individuals. Transl Psychiatry [Internet]. 2022;12(1):479. Available from: https://doi.org/10.1038/s41398-022-02248-7
12. Burton CL, Park LS, Corfield EC, Forget-Dubois N, Dupuis A, Sinopoli VM, et al. Heritability of obsessive-compulsive trait dimensions in youth from the general population. Transl Psychiatry. 2018 Sep;8(1):191.
13. Iervolino AC, Perroud N, Fullana MA, Guipponi M, Cherkas L, Collier DA, et al. Prevalence and heritability of compulsive hoarding: a twin study. Am J Psychiatry. 2009 Oct;166(10):1156–61.
14. Ivanov VZ, Mataix-Cols D, Serlachius E, Lichtenstein P, Anckarsäter H, Chang Z, et al. Prevalence, Comorbidity and Heritability of Hoarding Symptoms in Adolescence: A Population Based Twin Study in 15-Year Olds. PLoS One [Internet]. 2013;8(7):1–7. Available from: https://doi.org/10.1371/journal.pone.0069140
15. Ivanov VZ, Nordsletten A, Mataix-Cols D, Serlachius E, Lichtenstein P, Lundström S, et al. Heritability of hoarding symptoms across adolescence and young adulthood: A longitudinal twin study. PLoS One [Internet]. 2017 Jun 28;12(6):e0179541. Available from: https://doi.org/10.1371/journal.pone.0179541
16. López-Solà C, Fontenelle LF, Alonso P, Cuadras D, Foley DL, Pantelis C, et al. Prevalence and heritability of obsessive-compulsive spectrum and anxiety disorder symptoms: A survey of the Australian Twin Registry. Am J Med Genet Part B, Neuropsychiatr Genet Off Publ Int Soc Psychiatr Genet. 2014 Jun;165B(4):314–25.
17. Mathews CA, Nievergelt CM, Azzam A, Garrido H, Chavira DA, Wessel J, et al. Heritability and clinical features of multigenerational families with obsessive-compulsive disorder and hoarding. Am J Med Genet Part B Neuropsychiatr Genet. 2007;144(2):174–82.
18. Monzani B, Rijsdijk F, Harris J, Mataix-Cols D. The Structure of Genetic and Environmental Risk Factors for Dimensional Representations of DSM-5 Obsessive-Compulsive Spectrum Disorders. JAMA Psychiatry [Internet]. 2014 Feb 1;71(2):182–9. Available from: https://doi.org/10.1001/jamapsychiatry.2013.3524
19. Zilhão NR, Smit DJ, Boomsma DI, Cath DC. Cross-Disorder Genetic Analysis of Tic Disorders, Obsessive-Compulsive, and Hoarding Symptoms. Front psychiatry. 2016;7:120.
20. Mathews CA, Delucchi K, Cath DC, Willemsen G, Boomsma DI. Partitioning the etiology of hoarding and obsessive–compulsive symptoms. Psychol Med [Internet]. 2014/02/20. 2014;44(13):2867–76. Available from: https://www.cambridge.org/core/article/partitioning-the-etiology-of-hoarding-and-obsessivecompulsive-symptoms/22111C1A149CEA5BBF5619BA7684B90F
21. Nordsletten AE, Monzani B, Fernández de la Cruz L, Iervolino AC, Fullana MA, Harris J, et al. Overlap and specificity of genetic and environmental influences on excessive acquisition and difficulties discarding possessions: Implications for hoarding disorder. Am J Med Genet Part B, Neuropsychiatr Genet Off Publ Int Soc Psychiatr Genet. 2013 Jun;162B(4):380–7.
22. Nordsletten AE, Fernández de la Cruz L, Aluco E, Alonso P, López-Solà C, Menchón JM, et al. A transcultural study of hoarding disorder: Insights from the United Kingdom, Spain, Japan, and Brazil. Transcult Psychiatry [Internet]. 2018 Mar 6;55(2):261–85. Available from: https://doi.org/10.1177/1363461518759203
23. de la Cruz L, E Nordsletten A, Mataix-Cols D. Ethnocultural aspects of hoarding disorder. Curr Psychiatry Rev. 2016;12(2):115–23.
24. Gharipour M, Haghjooy Javanmard S, Mansourian M, Sabri M, Khosravi E, Dianatkhah M, et al. Isfahan Twins Registry (ITR): An Invaluable Platform for Epidemiological and Epigenetic Studies: Design and Methodology of ITR. Twin Res Hum Genet Off J Int Soc Twin Stud. 2019 Dec;22(6):579–82.
25. Frost RO, Steketee G, Grisham J. Measurement of compulsive hoarding: saving inventory-revised. Behav Res Ther. 2004;42(10):1163–82.
26. Kellman-McFarlane K, Stewart B, Woody S, Ayers C, Dozier M, Frost RO, et al. Saving inventory – Revised: Psychometric performance across the lifespan. J Affect Disord [Internet]. 2019;252:358–64. Available from: https://www.sciencedirect.com/science/article/pii/S0165032718316781
27. Mohammadzadeh A. Validation of Saving Inventory-Revised (SI-R): Compulsive Hoarding Measure. ijpcp [Internet]. 2009 May 1;15(1):33–41. Available from: http://ijpcp.iums.ac.ir/article-1-662-fa.html
28. Song Y-M, Lee D, Lee MK, Lee K, Lee HJ, Hong EJ, et al. Validity of the zygosity questionnaire and characteristics of zygosity-misdiagnosed twin pairs in the Healthy Twin Study of Korea. Twin Res Hum Genet Off J Int Soc Twin Stud. 2010 Jun;13(3):223–30.
29. Moser JS, Slane JD, Alexandra Burt S, Klump KL. Etiologic relationships between anxiety and dimensions of maladaptive perfectionism in young adult female twins. Depress Anxiety. 2012;29(1):47–53.
30. Coles ME, Frost RO, Heimberg RG, Steketee G. Hoarding behaviors in a large college sample. Behav Res Ther [Internet]. 2003;41(2):179–94. Available from: https://www.sciencedirect.com/science/article/pii/S000579670100136X
31. Ivanov VZ, Mataix-Cols D, Serlachius E, Brander G, Elmquist A, Enander J, et al. The developmental origins of hoarding disorder in adolescence: a longitudinal clinical interview study following an epidemiological survey. Eur Child Adolesc Psychiatry [Internet]. 2021;30(3):415–25. Available from: https://doi.org/10.1007/s00787-020-01527-2
32. Plimpton EH, Frost RO, Abbey BC, Dorer W. Compulsive Hoarding in Children: Six Case Studies. Int J Cogn Ther [Internet]. 2009 Mar 1;2(1):88–104. Available from: https://doi.org/10.1521/ijct.2009.2.1.88
33. Storch EA, Lack CW, Merlo LJ, Geffken GR, Jacob ML, Murphy TK, et al. Clinical features of children and adolescents with obsessive-compulsive disorder and hoarding symptoms. Compr Psychiatry. 2007;48(4):313–8.
34. Turkheimer E. Three laws of behavior genetics and what they mean. Curr Dir Psychol Sci. 2000;9(5):160–4.
35. Everitt BS, Howell DC. Encyclopedia of Statistics in Behavioral Science--Volume 2. John Wiley & Sons, Ltd; 2021.
| Files | ||
| Issue | Vol 19 No 4 (2024) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijps.v19i4.16555 | |
| Keywords | ||
| clutter difficulty discarding excessive acquisition heritability hoarding genetic etiology | ||
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How to Cite
1.
Pourkhalili S, Soltani Shal R, Abolghasemi A, Dianatkhah M, Gharipour M. Estimating the Heritability of Hoarding Symptoms: Insights from a Classical Twin Study. Iran J Psychiatry. 2024;19(4):424-430.
