Hoarding Disorder Assessment and Treatment

Flashcards covering the assessment and treatment of hoarding disorder based on lecture notes.

What does the Hording Rating Scale-Interview (HRS-I) assess?

It assesses clutter, difficulty discarding, acquisition, distress, and impairment.

What is the purpose of the Clutter Image Rating?

To select the photo that most accurately reflects the amount of clutter in a person's bedroom.

What indicates a significant level of acquiring items according to the Saving Inventory-Revised?

An acquiring score greater than or equal to 9.

What are some common comorbid conditions associated with hoarding?

Major depressive disorder (~50%), GAD (25%), social anxiety disorder (25%), OCD (18%), PTSD (75%), substance use disorders (1.5%), ADHD/executive functioning difficulties.

Treatment

Pull from DBT→ Distress tolerance

CBT→ Identify distortions related to hoarding promoting beliefs

• This can be used in the future/repurposed

• Wasteful to throw away •Goodwill or Salvation Army won’t take care of the item

• others won’t appreciate the item as much as me

• If I have these items, I am worth something myself- Books- “I am smart”

• I am responsible for this item.

• It MUST go to a good home.

• Perfectionism→ I need enough time to do everything, not just some of it. In combination with Motivational Interviewing

motivational interviewing in the context of hoarding treatment?

• Express empathy through reflective listening

• Develop discrepancy between clients goals or values and their current behavior

• Avoid direct confrontation and argument

• Adjust to client resistance rather than opposing it directly

• Support self-efficacy and optimism

• helps people engage in treatment

• can be as effective as other psychosocial treatments but in fewer sessions

• often combined with other treatments to increase motivation

• recognizing “change talk” and stages of change

• be supportive of their need for autonomy

• collaborative

• avoid righting reflex: correction/advice giving/data

• express empathy

• develop discrepancy: “change talk”

• roll with resistance

• support self-efficacy: goal setting, positive focus

Harm Reduction

• Safety—FIRST

  • Electrical or fire hazards

  • Paths to get to person/people if needed

  • Doors and windows not blocked for ventilation and access in emergencies.

• Health

  • Food safety- bacteria, infestations, working refrigerator, sink to wash items

  • Bathroom

  • Pets

• Comfort of the patient.

  • Place to sleep, eat and ADL’s

What self-reported attitudes does the Savings Cognitions Inventory measure?

Emotional attachment, memory, responsibility, and need for control.

What is an important safety consideration in harm reduction for hoarding?

Ensuring paths for ventilation and access are clear in case of emergencies.

How does cognitive restructuring contribute to treatment of hoarding disorder?

It helps identify and change cognitive distortions leading to changes in emotional responses and behaviors.

What is a key characteristic of the Activities of Daily Living for Hoarding (ADL-H)?

It rates the extent to which clutter interferes with daily living activities.

What does CBT focus on when treating hoarding disorder?

Identifying cognitive distortions related to hoarding beliefs and behaviors.