According to DSM-5, the specifier 'with excessive acquisition' applies to hoarding disorder when the patient:
- A Repeatedly acquires items that are not needed or for which no space is available, experiencing distress when unable to acquire ✓
- B Acquires items only through purchase, never accepting free goods
- C Acquires items solely at the insistence of family members
- D Sells previously hoarded items for profit
Correct answer: A. Repeatedly acquires items that are not needed or for which no space is available, experiencing distress when unable to acquire
Explanation
Excessive acquisition is defined by recurrent difficulty parting with possessions combined with compulsive acquisition of items that are unneeded or exceed available space, whether bought, collected free, or taken from discarded piles, and it affects the large majority of patients with hoarding disorder. Option B is wrong because acquisition includes free items, not only purchases. Family pressure and resale for profit play no role in the definition, eliminating C and D.
Reference: Diagnostic and Statistical Manual of Mental Disorders, DSM-5 ed.
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Written and medically reviewed by the StethoPrep medical team.