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Completed

NCT Number: NCT03734705

Imaginal Exposure for Hoarding Disorder

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.

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Key information

Conditions

Hoarding Disorder Anxiety Disorders Communication Disorders Language Disorders Mental Disorders Nervous System Diseases Neurobehavioral Manifestations Neurologic Manifestations Obsessive-Compulsive Disorder Pathological Conditions, Signs and Symptoms Signs and Symptoms Speech Disorders

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Stanford University

Palo Alto, California, 94304, United States

About this study

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.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Age 18 and older
  • Any gender and all ethno-racial categories
  • Hoarding Disorder primary condition
  • Willing and able to understand and complete consent and study procedures
  • English speaking

Exclusion criteria

  • Severe depression
  • 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)
  • Currently receiving Cognitive Behavioral Therapy (CBT)

Treatment and study plan

Imaginal Exposure Writing

Behavioral

Imaginal exposure is a psychotherapy strategy that has been studied and shown to be helpful in the improvement of symptoms (e.g., anxiety, worry) for other psychiatric conditions, including excessive worry and obsessive-compulsive disorder symptoms.

Neutral Writing

Other

Used in prior research as a control condition for imaginal exposure. Neutral writing will involve writing about what one would do on a day off work or school.

Primary outcomes

  1. Savings Inventory Revised (Frost, Steketee & Grisham, 2004; Tolin, Meunier, Frost & Steketee, 2011)

    Time frame: Baseline (Pre Writing) and Follow Up (week 1)

    Gold-standard 23-item self-report measure of hoarding disorder symptoms. Scale scores range from 0 to 92, with higher scores indicating more severe hoarding symptoms. More severe hoarding symptoms are considered a worse outcome.

Secondary outcomes

  1. Compulsive Acquisitions Scale (Frost et al. 2002)

    Time frame: Baseline (Pre Writing) and Follow Up (week 1)

    Self-report 18-item measure of behaviors associated with hoarding disorder (i.e., acquiring).Scale scores range from 18 to 126, with higher scores indicating more severe hoarding behaviors. More severe hoarding behaviors are considered a worse outcome.

  2. Intolerance of Uncertainty Scale (Buhr & Dugas, 2002)

    Time frame: Baseline (Pre Writing) and Follow Up (week 1)

    Self-report 27-item measure of a cognitive process related to hoarding called intolerance of uncertainty. Scale scores range from 27 to 135 (some items are reverse scored), with higher scores indicating more severe intolerance of uncertainty. More severe intolerance of uncertainty is considered a worse outcome.

  3. Acceptance and Action Questionnaire - II (Hayes, Luoma, Bond, Masuda and Lillis, 2006)

    Time frame: Baseline (Pre Writing) and Follow Up (week 1)

    Self-report 7-item measure of a cognitive process related to hoarding called experiential avoidance. Scale scores range from 7 to 49, with higher scores indicating more severe experiential avoidance. More severe hoarding behaviors are considered a worse outcome.

Sponsors and collaborators

Lead sponsor

Stanford University

Other

Collaborators

  • Brain & Behavior Research Foundation

Registry information

Official study title

Efficacy and Feasibility of Intensive Imaginal Exposure for Hoarding Disorder

Important dates

Study start
2020
Primary completion
2021
Study completion
2021
First posted
Nov 8, 2018
Registry last updated
May 29, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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