Imaginal Exposure for Hoarding Disorder

Stanford University

Status: Completed

Conditions: Hoarding Disorder

Treatments: Behavioral: Imaginal Exposure Writing; Other: Neutral Writing

Study type: Interventional

Funder types: Other

Identifiers

NCT03734705

48109

Details and patient eligibility

About

The present study will test a potential new treatment strategy, imaginal exposure, for hoarding disorder. Although cognitive behavioral therapy often reduces hoarding, some people do not want to start, or cannot handle, that option. To help such individuals, the present study will provide imaginal exposure therapy to people with hoarding disorder, wherein they imagine discarding possessions as a way of becoming acclimated to the idea. We predict that imaginal exposure will improve hoarding symptoms as well as two psychological experiences linked to the condition: intolerance of uncertainty and emotional avoidance.

Full description

Hoarding disorder is a common mental illness characterized by difficulty parting with possessions and by clutter that makes living spaces unusable. Cognitive behavioral therapy (CBT) is an effective treatment for hoarding disorder, but new approaches are needed to engage those who are reluctant to start or cannot tolerate CBT. Both intolerance of uncertainty and emotional avoidance are linked to hoarding disorder and may interfere with treatment engagement. Imaginal exposure, a therapeutic technique which involves repeatedly imagining feared scenarios and experiencing the evoked emotions, effectively targets both intolerance of uncertainty and emotional avoidance. The present study is the first to test whether imagining discarding possessions can improve hoarding symptoms more than does a control exercise. We hypothesize that compared to a control exercise, imaginal exposure will improve hoarding symptoms, intolerance of uncertainty and emotional avoidance.

Enrollment: 32 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Age 18 and older
2. Any gender and all ethno-racial categories
3. Hoarding Disorder primary condition
4. Willing and able to understand and complete consent and study procedures
5. English speaking

Exclusion criteria

1. Severe depression
2. Clinically at risk of suicide with Columbia Suicide Severity Rating Scale (C-SSRS) Suicidal Ideation Subscale of 4 or higher (i.e. suicidal intent without specific plan)
3. Currently receiving Cognitive Behavioral Therapy (CBT)

Trial design

Primary purpose: Basic Science

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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32 participants in 2 patient groups

Imaginal Exposure Writing

Experimental group

Description:

People with hoarding disorder will write for 20 minutes on each of 3 consecutive days about their worst-case scenario regarding discarding a possession (i.e., imaginal exposure).

Treatment:

Behavioral: Imaginal Exposure Writing

Neutral Writing

Sham Comparator group

Description:

People with hoarding disorder will write for 20 minutes on each of 3 consecutive days about what they would do if they had a day off work or school.

Treatment:

Other: Neutral Writing