Effects of Trauma, Shame, and Self-Criticism on Hoarding: Comparative Data and Treatment Implications

Abstract

Severe trauma has a significant impact on self-attitudes and emotions, such as self-criticism and shame, and psychological symptoms. This topic has been more well studied among populations with Trauma and Stress-Related Disorders, but examined to a lesser extent in other clinical populations where adverse life events and potentially traumatic events are highly prevalent, such as Hoarding Disorder. The current study examined trauma exposure, and the relationships between trauma, self-criticism, shame, and symptom severity in a sample seeking treatment for hoarding (N = 81), compared to those seeking treatment for traumatic stress (N = 73). Results showed that the hoarding sample reported significantly more lifetime trauma exposure, shame, self-criticism, and less self-reassurance than the trauma sample. Trauma exposure was related to greater posttraumatic stress but not hoarding symptom severity. A path analysis revealed a direct pathway from trauma exposure to posttraumatic stress symptom severity in the trauma sample, but an indirect pathway from trauma exposure through heightened self-criticism associated with greater shame that was subsequently related to greater hoarding symptom severity. The roles of shame and self-criticism on the development of Hoarding Disorder in the context of trauma is discussed. Moreover, a treatment approach addressing self-related difficulties, such as Compassion Focused Therapy, is introduced.