Object attachment in hoarding disorder and its role in a compensatory process

Hoarding disorder (HD) is characterised by compulsive acquisition and extreme difficulty discarding possessions, resulting in clutter that substantially impacts upon functioning. Heightened object attachment is a central feature of HD according to prominent theoretical models. We review current research on the nature and function of object attachment in HD. In particular, we describe growing evidence that object attachment in HD is a compensatory response to unmet relatedness needs, and recent research underscoring the insecure nature of object attachment in hoarding. Critical gaps include the lack of longitudinal studies and research examining the effects of interpersonal interventions on object attachment in HD. Further elucidation of the compensatory process in HD will have important implications for the treatment of this disabling disorder.