Even after completing CBT, many patients with hoarding disorder (HD)  continue to experience clinically significant hoarding symptoms. While CBT challenges the importance of hoarded objects, it does not address patients’ attachment to them – a focus of recent research on HD. Dr. Norberg and her team’s prior research showed that excessive object attachment may be the main cause of hoarding, and a key target for improving treatment. Other research suggested that individuals with an insecure attachment to people may turn to objects for support, and that viewing objects in human-like terms would allow objects to restore needs of belonging.

Based on this, Dr. Norberg and her team tested whether social exclusion leads to object attachment, with a stronger relationship for those people who experience more attachment anxiety. They also examined if social over-inclusion would lead to less attachment to objects. The results showed that an anxious and impersonal attachment style is linked to giving objects human-like features (anthropomorphism), and that stronger anthropomorphism predicts greater object value and excessive buying and collecting. People with HD are more likely to get anthropomorphic items than people who just have problems with collecting objects, and are more likely to have greater anxious attachment and interpersonal problems. Interpersonal problems for people with HD are linked to difficulty with empathy in tense social situations. This difficulty with empathy in social situations can lead to people with HD developing intense attachment to objects. The results of Dr. Norberg’s study show that there is a need for helping people with HD to improve their interpersonal functioning during treatment like CBT, as collected objects can serve as substitutes to satisfy interpersonal needs; focusing solely on whether these objects are “important” should not be the sole focus of a treatment.

Resulting Publications:

*Kwok, C., Crone, C., Arden, Y., & Norberg, M. M. (2018). Seeing human when feeling insecure and wanting closeness: A systematic review into insecure attachment styles and anthropomorphism. Personality and Individual Differences, 127, 1-9.

*Norberg, M. M., Crone, C., Kwok, C., Grisham, J. R. (2018). Anxious attachment and hoarding: The mediating roles of anthropomorphism and distress intolerance. Journal of Behavioral Addictions, 7, 171-180.

Kwok, C., Grisham, J., & Norberg, M. M. (2018). Object attachment: Humanness increases sentimental and instrumental value. Journal of Behavioral Addictions, 7, 1132-1142.

Norberg, M. M., David, J., Crone, C., Kakar, V., Kwok, C., Olivier, J., & Grisham, J. R. (2020). Determinants of object choice and object attachment: Compensatory consumption in compulsive buying-shopping disorder and hoarding disorder. Journal of Behavioral Addictions, 9(1), 153-162. doi:10.1556/2006.8.2019.68

Norberg, M. M., Crone, C., Kakar, V., Kwok, C., & Grisham, J. R. (2020). Greater interpersonal problems differentiate those who excessively acquire and save from those who only excessively acquire possessions. Journal of Obsessive Compulsive and Related Disorders, 27, 100571.

*David, J., Aluh, D. O., Blonner, M., & Norberg, M. M. (2021). Excessive object attachment in hoarding disorder: Examining the role of interpersonal functioning. Behavior Therapy, 5, p. 1226-1236.