A Comparison of Cognitive Restructuring and Thought Listing for Excessive Acquiring in Hoarding Disorder

  • Hannah C. LevyEmail author
  • Randy O. Frost
  • Elizabeth A. Offermann
  • Gail Steketee
  • David F. Tolin
Original Article


Excessive acquiring is a common symptom of hoarding disorder (HD). Little is known about subjective distress associated with acquiring in HD. The present study examined acquiring-related distress and reactions to cognitive restructuring (CR) in 92 individuals with HD and 66 community control (CC) participants. All participants identified an item of interest at a high-risk acquiring location and then decided whether or not to acquire the item. HD participants completed the acquiring task while receiving a CR-based intervention or a thought-listing (TL) control condition. Results showed that HD participants reported more severe distress and greater urges to acquire the item of interest than did CC participants. Nevertheless, subjective distress decreased in both groups following the acquiring task. There were no differences in acquiring-related distress between the CR and TL conditions. The findings indicate that subjective distress may decrease after relatively short periods of time in individuals with HD, but that a single session of CR may not alleviate acquiring-related distress in HD participants.


Hoarding Acquiring Cognitive restructuring Collecting 


Compliance with Ethical Standards

Conflicts of Interest

This work was supported by Grants from NIMH to Randy Frost (R01 MH068008) and Gail Steketee (R01 MH068007). Drs. Frost, Steketee, and Tolin receive royalties from sales of books related to hoarding and its treatment.

Research Involving Human and Animal Rights

Ethical approval: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. No animal studies were carried out by the authors for this article

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Anxiety Disorders CenterInstitute of Living/Hartford HospitalHartfordUSA
  2. 2.Department of PsychologySmith CollegeNorthamptonUSA
  3. 3.Department of NeuropsychologyKennedy Krieger InstituteBaltimoreUSA
  4. 4.Boston University School of Social WorkBostonUSA
  5. 5.Department of PsychiatryYale University School of MedicineNew HavenUSA

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