Developing a measure of beliefs about items in hoarding disorder (BIHD)

The profile of executive function in OCD hoarders and hoarding disorder

ABSTRACTHoarding disorder is a debilitating psychological disorder that is difficult to treat. Poor treatment response to current interventions indicates that new perspectives are needed. This systematic review examines qualitative and case study research on patient‐centred strategies for reducing hoarding disorder symptoms and improving wellbeing. We conducted a comprehensive search of PsycInfo, Medline Complete, CINAHL, SocINDEX and Scopus in May 2025 to identify peer‐reviewed qualitative research and case studies, published in English that examined hoarding disorder patients' first‐hand experiences with strategies that improved their symptoms and wellbeing. We excluded papers that examined animal or digital hoarding, hoarding in the context of another disorder, hoarding in children or animals and papers with perspectives from only service providers or carers. The quality of studies was assessed using the Critical Appraisal Checklist for Qualitative Research Studies. Results were synthesized using thematic analysis. Twenty‐one studies were included for review. Thematic analysis identified five key themes: interconnection, recognition of individuality and autonomy, self‐care and acceptance, cognitive and behaviour change, and practical help. The papers included descriptions of therapeutic strategies (e.g., discarding tasks) and other factors identified as beneficial (e.g., meditation). Interconnection was the strongest theme, emphasizing the pivotal role trusted relationships play in helping individuals with hoarding disorder. The review indicates that individuals with HD may benefit from personalized care that focuses on interpersonal relationships, emotion regulation strategies, self‐care, and in‐home help for managing their symptoms and improving wellbeing.

Characteristics of Hoarding in Older Adults

Objective Hoarding behaviour is a common but poorly characterised problem in real-world clinical practice. Although hoarding behaviour is the key component of Hoarding Disorder (HD), there are people who exhibit hoarding behaviour but do not suffer from HD. The aim of the present study was to characterise a clinical sample of patients with clinically relevant hoarding behaviour and evaluate the differential characteristics between patients with and without HD. Methods This study included patients who received treatment at the home visitation program in Barcelona (Spain) from January 2013 through December 2020, and scored ≥ 4 on the Clutter Image Rating scale. Sociodemographic, DSM-5 diagnosis, clinical data and differences between patients with and without an HD diagnosis were assessed. Results A total of 243 subjects were included. Hoarding behaviour had been unnoticed in its early stages and the median length in the sample was 10 years (IQR 15). 100% of the cases had hoarding-related complications. HD was the most common diagnosis in 117 patients (48.1%). Conclusions The study found several differential characteristics between patients with and without HD diagnosis. Alcohol use disorder could play an important role among those without HD diagnosis. Home visitation programs could improve earlier detection, preventing hoarding-related complications.

Compulsively Moral: OCD, Ethics, and the Law.

Complete Remission of Obsessive Compulsive Disorder After N-acetylcystein Treatment

ABSTRACTHoarding has become increasingly prominent in clinical practice and popular culture in recent years, giving rise to extensive research and commentary. Critical responses in the social sciences have criticised the cultural assumptions built in to the construct of ‘hoarding disorder’ and expressed fears that it may generate stigma outweighing its benefits; however, few of these studies have engaged directly with ‘hoarders’ themselves. This paper reports on in-depth, semi-structured interviews with 10 individuals living in England, who received assessment and intervention for hoarding from Social Services. Their narratives drew on the cultural repertoire of values and discourses around waste and worth, the mediation of sociality and relationships through material objects, physical constraints on keeping order and the role played by mental health. Analysing these perspectives anthropologically shows how dominant models of hoarding, such as the DSM-5 paradigm, potentially lend themselves to reductionist understandings that efface the meaning ‘hoarding’ may have and thereby deny agency to the person labelled as ‘hoarder’. More culturally informed analysis, by contrast, affords insights into the complex landscape of value, waste, social critique, emotion, interpersonal relationships and practical difficulties that may underlie hoarding cases, and points the way to more person-centred practice and analysis.

BackgroundObsessions and compulsions are heterogenous but can be classified into obsessive-compulsive disorder (OCD), body dysmorphic disorder (BDD), hoarding disorder (HD), hair-pulling disorder (HPD), and skin-picking disorder (SPD). OCD is in itself heterogenous, with symptoms clustering around four major symptom dimensions: contamination/cleaning, symmetry/ordering, taboo obsessions, and harm/checking. No single self-report scale captures the full heterogeneity of OCD and related disorders, limiting assessment in clinical practice and research on nosological relations among the disorders.MethodsTo provide a single self-report scale of OCD and related disorders that respects the heterogeneity of OCD, we expanded the DSM-5-based Obsessive-Compulsive and Related Disorders-Dimensional Scales (OCRD-D) so that is also includes the four major symptom dimensions of OCD. A psychometric evaluation and an exploration of the overarching relations among the dimensions were conducted using an online survey which was completed by 1,454 Spanish adolescents and adults (age span = 15–74 years). Approximately 8 months after the initial survey, 416 participants completed the scale again.ResultsThe expanded scale showed excellent internal psychometric properties, adequate test-retest correlations, known groups validity, and correlations in the expected directions with well-being, depression/anxiety symptoms, and satisfaction with life. The higher-order structure of the measure indicated that harm/checking and taboo obsessions formed a common disturbing thoughts factor and that HPD and SPD formed a common body-focused repetitive behaviors factor.ConclusionThe expanded OCRD-D (OCRD-D-E) shows promise as a unified way to assess symptoms across the major symptom dimensions of OCD and related disorders. The measure may be useful in clinical practice (e.g., screening) and research, but more research on construct validity, incremental validity, and clinical utility is needed.

Effectiveness of group cognitive behavioral therapy for Hoarding Disorder: Evaluation of outcomes

BackgroundHoarding disorder is associated with significant impairment for the individual such as lower rates of employment and social isolation. However, less is known about the impact of this condition on the children of people with hoarding disorder (HD). No qualitative research to date has focussed exclusively on the experiences of adult offspring of parents with hoarding difficulties. The present qualitative study set out to investigate the experiences of adult offspring of parents with hoarding difficulties, exploring the present, and longer‐term impacts of parental hoarding.MethodSeven females between the ages of 35 and 62-years were interviewed using a semi‐structured format; all reported parental hoarding within the clinically significant range. Interpretative phenomenological analysis was utilised to analyse interview transcripts.ResultsFour superordinate themes were extracted from the data: psychological and emotional outcomes, coping strategies, perceptions of parental hoarding, and impact on relationships.ConclusionsThe research demonstrated the significant impacts of parental hoarding on their offspring, both individually and on a relational level. The outcomes of this research provide clinical implications for working with this population, as well as suggestions for future research.

The obsessive-compulsive and related disorders (OCRDs) category in DSM-5 is comprised not only of OCD but also of body dysmorphic disorder (BDD), hoarding disorder, trichotillomania (hair-pulling disorder) (TTM), and skin picking (excoriation) disorder (SPD). A review of the literature on the phenomenology, psychobiology, pharmacotherapy, and psychotherapy of these OCRDs was undertaken with a specific focus on gender. OCRDs (e.g. BDD) may have a roughly equal gender ratio, may be more common in females (e.g. HPD) or may be more common in males (e.g. hoarding disorder). Comorbidity in OCRDs may also differ across gender; e.g. in SPD, females present with increased depressive symptomatology compared to males. The literature on treatment differences by gender in the OCRDs is, however, sparse. Thus, a range of questions arise for future research and for clinical practice.

Objectives Several studies consistently showed that patients with attention deficit hyperactivity disorder (ADHD) have high rates of hoarding disorder (HD) comorbidity. The aim of the present study was to compare the clinical and cognitive features of adult ADHD patients with and without hoarding comorbidity according to a self-report measure, and a sample of healthy controls. Methods Fifty-seven consecutive adult outpatients with a primary diagnosis of ADHD with comorbid hoarding disorder (ADHD+HD), 57 matched ADHD patients without hoarding disorder comorbidity (ADHD-HD), and a control group of 47 healthy controls (HCs) were enrolled. All subjects undergone a comprehensive clinical assessment and a neurocognitive assessment focused on attention, memory, and executive functions. Results The ADHD groups differed on most of the clinical and cognitive measures compared to HCs. ADHD+HD patients showed similar ADHD symptoms but greater subjective impulsivity, mood and anxiety symptoms, and a greater functional impairment compared to ADHD-HD patients as well as greater attentional and executive functioning impairments. Conclusions ADHD patients with comorbid hoarding disorder present a more complex clinical and neuropsychological phenotype correlated to a greater functional impairment compared to ADHD patients without this comorbidity. These results further highlight the relevance of assessing and treating hoarding behaviours in adults with ADHD.

Although compulsive buying is receiving increasing attention in research, it is largely ignored in clinical practice. Compulsive buying disorder (CBD) is defined as excessive and mostly senseless spending or excessive shopping impulses that cause marked distress, interfere with social or occupational functioning, and often results in financial problems. It is currently conceptualized as an "impulse control disorder not otherwise specified" (ICD-10 F63.9). CBD is associated with significant psychiatric co-morbidity particularly mood and anxiety disorders, obsessive-compulsive disorders, binge eating disorder, substance use disorders, personality disorders, and other impulse control disorders. Previous research indicates that many compulsive buyers also suffer from compulsive hoarding. There is no evidence-based treatment approach for CBD and treatment research on this topic is limited. Open label trials suggest that antidepressants could improve compulsive buying. However, small randomized controlled trials failed to demonstrate significant improvement over Placebo and the high placebo-response rate prevents any definitive statement on the efficacy of antidepressants. Two controlled cognitive-behavioral therapy (CBT) trials reported that group CBT is significantly more effective compared to waiting list control groups in the treatment of compulsive buying. Clinical and therapeutic implications are discussed.

Research Article| January 11 2021 Becoming a Warrior Monk: First, Second, and Third Shifts in Academia Kakali Bhattacharya Kakali Bhattacharya Kakali Bhattacharya is a multiple award–winning professor at University of Florida housed in the Research, Evaluation, and Measurement Program. She is the 2018 winner of AERA’s Mid-Career Scholar of Color Award. Her co-authored text with Kent Gillen, Power, Race, and Higher Education: A Cross-Cultural Parallel Narrative, won a 2017 Outstanding Publication Award from AERA (SIG 168) and a 2018 Outstanding Book Award from International Congress of Qualitative Research. Search for other works by this author on: This Site PubMed Google Scholar Journal of Autoethnography (2021) 2 (1): 123–127. https://doi.org/10.1525/joae.2021.2.1.123 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Kakali Bhattacharya; Becoming a Warrior Monk: First, Second, and Third Shifts in Academia. Journal of Autoethnography 11 January 2021; 2 (1): 123–127. doi: https://doi.org/10.1525/joae.2021.2.1.123 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentJournal of Autoethnography Search “Yodhya-Acharya” is a term I invented as a little girl in India hearing stories about my ancestry from Thakuma,1 my paternal grandmother. “Yodhya” means warrior in various Indian languages. “Acharya,” which is part of my last name, has several meanings, including one who teaches by their conduct, guided by an internal ethical barometer, and a connection to a higher power. An unfaithful translation of Yodhya-Acharya is Warrior Monk. Listening to Thakuma’s stories, I’d imagine I had lived incarnated lives as a warrior, a peacekeeper, a teacher, a principled being compelled by an inner sense of righteousness that existed at the core of her spirit. Only much later, once I became an academic, did I ask: What should I do when the moral compass of the context in which I teach and conduct research is horribly bent? How do I unbend such an unyielding compass? Should I even try? I... You do not currently have access to this content.

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