Social networks in the context of hoarding disorder: A cross-sectional study

Hoarding disorder is characterised by distress and difficulty in discarding items, leading to excessive accumulation. People with hoarding disorder experience difficulties in social relationships, including familial conflict and frustration, and less adaptive interpersonal styles. Analysing their social networks can help develop interventions for improved interpersonal functioning. This research investigated social network structure (size and frequency of contact), social isolation and loneliness in relation to hoarding disorder, accounting for depression. Participants (N = 158) completed online questionnaires including measures of hoarding severity, social network structure, loneliness, conditions and functioning in the home, and depression. Hoarding symptom severity was negatively correlated with social network size and strength of relationship with neighbours while controlling for depression. Loneliness, however, was better predicted by depression rather than hoarding. We also compared participants who met criteria for a diagnosis of hoarding disorder (n = 57) and 60 healthy controls, controlling for both age and depression. People with hoarding disorder had significantly weaker family networks and stronger feelings of loneliness. Depression, but not hoarding symptoms, correlated with risk of social isolation. Among participants with hoarding, social network size was negatively correlated with functional interference (activities of daily living) and conditions in the home. Our findings stress the need for addressing social functioning when treating hoarding. Depression, integrally related to hoarding and social functioning, also needs to be considered.