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Validation of a Behavioral Measure of Acquiring and Discarding in Hoarding Disorder

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Abstract

Behavioral assessment is an important component of evidence-based assessment and treatment in anxiety and related disorders. The purpose of the current study was to validate a behavioral measure of difficulty discarding and acquiring, the core features of hoarding disorder (HD). Seventy-eight patients with a primary diagnosis of HD completed a computerized acquiring and discarding task; the task consisted of making simulated decisions about acquiring and discarding items of varying monetary value. A subset of patients (n = 42) went on to receive cognitive-behavioral therapy (CBT) for HD and completed the computer tasks again after treatment. An additional 30 age- and sex-matched healthy control participants (HCs) also completed the acquiring and discarding tasks. Results showed that HD patients saved and acquired more items than the HC group, and had longer response times during the tasks. In support of the convergent validity of the tasks, item decisions and reaction times were positively correlated with established measures of HD symptoms. Among treatment completers, items saved and acquired and response times decreased from pre- to post-CBT, suggesting that the tasks were sensitive to detect treatment-related changes in difficulty discarding and acquiring behaviors. The findings support the validity of the discarding and acquiring tasks in measuring HD symptoms, and are discussed in terms of the potential advantages of behavioral measures in HD treatment and research.

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Acknowledgments

The authors wish to acknowledge Stephanie Preston for her assistance with the design of the computerized tasks.

Funding

The study was funded by the National Institute of Mental Health (R01MH101163; PI: Tolin).

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Authors and Affiliations

  1. Anxiety Disorders Center, Institute of Living, Hartford Hospital, 200 Retreat Avenue, Hartford, CT, 06106, USA

    Hannah C. Levy & David F. Tolin

  2. Olin Neuropsychiatry Research Center, Institute of Living, Hartford Hospital, 400 Washington Street, Hartford, CT, 06106, USA

    Michael C. Stevens

  3. Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT, USA

    Michael C. Stevens & David F. Tolin

Authors
  1. Hannah C. Levy
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  2. Michael C. Stevens
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  3. David F. Tolin
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Correspondence to Hannah C. Levy.

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Conflict of Interest

Authors Hannah Levy, David Tolin, and Michael Stevens declare that they have no conflicts of interest.

Research Involving Human Participants

As reported in the text, the study was approved by the local Institutional Review Board. The statement about ethical approval has been included above, as instructed.

Informed Consent

As reported in the text, participants provided informed consent prior to participating in the study.

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.

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Levy, H.C., Stevens, M.C. & Tolin, D.F. Validation of a Behavioral Measure of Acquiring and Discarding in Hoarding Disorder. J Psychopathol Behav Assess 41, 135–143 (2019). https://doi.org/10.1007/s10862-018-9701-7

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  • DOI: https://doi.org/10.1007/s10862-018-9701-7

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