Hostname: page-component-8448b6f56d-sxzjt Total loading time: 0 Render date: 2024-04-23T07:44:41.066Z Has data issue: false hasContentIssue false

Two types of squalor: findings from a factor analysis of the Environmental Cleanliness and Clutter Scale (ECCS)

Published online by Cambridge University Press:  08 April 2013

John Snowdon*
Affiliation:
Discipline of Psychiatry, Sydney Medical School, and Old Age Psychiatrist, Sydney Local Health District, Concord Hospital, Sydney, NSW 2139, Australia
Graeme Halliday
Affiliation:
Discipline of Psychiatry, Sydney Local Health District, Concord Hospital, Sydney, NSW 2139, Australia
Glenn E. Hunt
Affiliation:
Discipline of Psychiatry, Sydney Medical School, Centre for Mental Health, Concord Hospital, Sydney, NSW 2139, Australia
*
Correspondence should be addressed to: John Snowdon, Clinical Professor, Jara Unit, Concord Hospital, NSW 2139, Australia. Phone: +61-2-97675000; Fax: +61-2-97678951. Email: jsnowdon@mail.usyd.edu.au.

Abstract

Background: Most people who collect and hoard, and then have difficulty discarding items, do not live in squalor, even though accumulation of hoarded items can make cleaning very difficult. Commonly, people living in squalor accumulate garbage, but relatively few fulfill proposed criteria for “hoarding disorder.” We examined the overlap between hoarding and squalor among people referred because of unacceptable living conditions.

Methods: Ongoing collection of data by a Squalor Project team, including ratings on the Environmental Cleanliness and Clutter Scale (ECCS), allowed (1) description of characteristics of cases and (2) examination of ratings of uncleanliness, and of the effect of accumulation of items or material on access within dwellings. Principal component analysis was used to examine latent variables underlying the ECCS.

Results: The mean age of the referred occupants (108 male, 95 female) was 61.9 years. The mean ECCS score in 186 rated cases was 18.5. Factor analysis of ECCS data showed a two-factor solution as the most plausible. Factor 1, comprising seven squalor items, accounted for 33.7% of the variance. Factor 2 comprised reduced accessibility and accumulation of items of little value (variance 17.6%). Accumulation of garbage loaded equally on the two factors. High levels of squalor and/or accumulation were recorded in 105 (56%) of the 186 dwellings. One-third scored high on accumulation/hoarding, while 38% scored high on squalor; 15% scored high on both squalor and accumulation. A quarter of those scoring high on squalor scored low on hoarding/accumulation.

Conclusions: The ECCS is useful when describing whether referred cases show high levels of squalor, hoarding, or both.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Frost, R. O., Steketee, G. and Williams, L. (2000). Hoarding: a community health problem. Health & Social Care in the Community, 8, 229234.CrossRefGoogle ScholarPubMed
Halliday, G., Banerjee, S., Philpot, M. and Macdonald, A. (2000). Community study of people who live in squalor. Lancet, 355, 882886.CrossRefGoogle ScholarPubMed
Halliday, G. and Snowdon, J. (2009). The Environmental Cleanliness and Clutter Scale (ECCS). International Psychogeriatrics, 21, 10411050.CrossRefGoogle ScholarPubMed
Kelly, P. A., Dyer, C. B., Pavlik, V., Doody, R. and Jogerst, G. (2008). Exploring self-neglect in older adults: preliminary findings of the self-neglect severity scale and next steps. Journal of the American Geriatrics Society, 56, S253S260.CrossRefGoogle ScholarPubMed
Kim, H. J., Steketee, G. and Frost, R. O. (2001). Hoarding by elderly people. Health and Social Work, 26, 176184.CrossRefGoogle ScholarPubMed
Maier, T. (2004). On phenomenology and classification of hoarding: a review. Acta Psychiatrica Scandinavica, 110, 323337.CrossRefGoogle ScholarPubMed
Mataix-Cols, D. (2012). Hoarding and severe domestic squalor. In: Snowdon, J., Halliday, G. and Banerjee, S. (eds.), Severe Domestic Squalor. Cambridge: Cambridge University Press.CrossRefGoogle Scholar
Mataix-Cols, D.et al. (2010). Hoarding disorder: a new diagnosis for DSM-V? Depression & Anxiety, 27, 556572.CrossRefGoogle ScholarPubMed
Mataix-Cols, D., Pertusa, A. and Snowdon, J. (2011). Neuropsychological and neural correlates of hoarding: a practice friendly review. Journal of Clinical Psychology, 67, 467476.CrossRefGoogle ScholarPubMed
McDermott, S. and Gleeson, R. (2009). Evaluation of the Severe Domestic Squalor Project: Final Report. Sydney: Social Policy Research Centre, University of New South Wales.Google Scholar
Snowdon, J. and Halliday, G. (2011). A study of severe domestic squalor: 173 cases referred to an old age psychiatry service. International Psychogeriatrics, 23, 308314.CrossRefGoogle Scholar
Snowdon, J., Halliday, G. and Banerjee, S. (2012). Severe Domestic Squalor. Cambridge: Cambridge University Press.CrossRefGoogle Scholar
Snowdon, J., Mataix-Cols, D. and Pertusa, A. (2012). On hoarding and squalor: a few considerations for DSM-5. Depression and Anxiety, 29, 417424.CrossRefGoogle ScholarPubMed
Volle, E., Beato, R., Levy, R. and Dubois, B. (2002). Forced collectionism after orbitofrontal damage. Neurology, 58, 488490.CrossRefGoogle ScholarPubMed