American Board of Psychiatry and Neurology (ABPN) Practice Exam

Difficulty discarding possessions leading to a cluttered living space is most characteristic of which disorder?

1. Obsessive-compulsive disorder

2. Hoarding disorder

3. Obsessive-compulsive personality disorder

4. Shubo-kyofu

The correct answer is: Hoarding disorder

The difficulty in discarding possessions, which results in a cluttered living space, is most characteristic of hoarding disorder. This condition is defined by a persistent difficulty in parting with possessions, regardless of their actual value, leading to significant distress or impairment in functioning. Individuals with hoarding disorder frequently experience a strong emotional attachment to their items, resulting in excessive accumulation that creates a living environment that is no longer usable. In contrast, while obsessive-compulsive disorder (OCD) may involve compulsions or rituals and can indirectly include hoarding-like behaviors in some cases, it is primarily focused on intrusive thoughts and repetitive behaviors not specifically related to possession accumulation. Obsessive-compulsive personality disorder involves a preoccupation with orderliness and perfection, which can manifest in a different way and is not primarily about difficulty discarding items. Shubo-kyofu, a cultural variant of specific phobias related to body image, does not relate to hoarding behaviors. Therefore, the distinguished feature of intense difficulty in discarding possessions and the resulting clutter aligns directly with hoarding disorder, making it the most appropriate answer in this context.