Even though it isn’t included in the definition of hoarding disorder in the DSM-5 excessive acquisition is a specifier (along with level of insight). It’s a little bit of a contentious topic with some researchers believing there are a proportion of people who hoard that are not compulsive acquirers. Clutter simply builds up because they just don’t through anything away. At all. Ever.
Some of my colleagues say there is little evidence that this happens with any statistical significance and suggest that excessive acquiring is likely to have occurred at some stage in the person’s life even if they don’t engage in the behaviour at the time of assessment.
To be honest it’s not something I worry about but researchers like that type of esoteric fight.
We talk about dispossession so often; however, often the starting point in my work is halting the flow of objects into the home. Finding an alternative activity to engage the areas of the brain related to novelty and reward is part of the treatment.