Development and Validation of the Clutter Image Rating
ABSTRACT Few instruments are available to assess compulsive hoarding and severity of clutter. Accuracy of assessment is important to
understanding the clinical significance of the problem. To overcome problems associated with over- and under-reporting of
hoarding symptoms, the clutter image rating (CIR) was developed. This pictorial scale contains nine equidistant photographs
of severity of clutter representing each of three main rooms of most people’s homes: living room, kitchen, and bedroom. The
psychometric properties of this measure were examined in two studies. Internal consistency, test–retest, and interobserver
reliabilities were good and convergent validity with other questionnaire and interview measures was also good. The CIR correlated
more strongly with measures of clutter than with other hoarding and psychopathology scales. The CIR’s very brief pictorial
assessment method makes it useful in clinical and treatment contexts for measuring the clutter dimension of compulsive hoarding.
- SourceAvailable from: David F Tolin[Show abstract] [Hide abstract]
ABSTRACT: Previous research indicates that people with hoarding sometimes under- or over-report the severity of their symptoms. This article examines the results of two separate studies that evaluate severity ratings made by participants with hoarding disorder (HD) in comparison to ratings by family members or independent evaluators. In Study 1, HD participants' ratings of the severity of the clutter in their home and their hoarding behaviors were less severe than those made by their friends or family members. This result may be accounted for by family members' rejecting attitudes towards the participant. In Study 2, HD participants appeared to under-report specific hoarding symptoms while over-reporting their overall global impression of hoarding severity. A three-pronged assessment approach is recommended in which ratings of hoarding severity are made by the HD participant, their family member, and an independent observer or clinician. Such an approach would better inform future research, and also clinical treatment.Journal of obsessive-compulsive and related disorders. 04/2013; 2(2):130-136.
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ABSTRACT: Hoarding is a serious and potentially life-threatening mental health problem that, until recently, was considered a subtype of OCD. However, recent research suggests it is distinct and more prevalent than OCD. Three key defining features have emerged in factor analytic studies of hoarding scales: excessive acquisition, difficulty discarding, and excessive clutter. Covariation among these defining features has received limited attention. The primary aim of the current study was to examine the role of the three key features in defining hoarding disorder. Convergent and discriminant validity of the three hoarding factors were examined in a multitrait-multimethod matrix. A secondary aim was to examine the extent to which each hoarding feature distinguished individuals meeting criteria for hoarding from those with OCD and community controls. Although the three-factor model provided an adequate fit for the data and convergent validities were high, the hoarding factors evidenced poor discriminant validity across measures. The findings provide preliminary support for a more parsimonious merging of the clutter, acquisition, and discarding subscales versus parsing out subscale scores. Specifically, the active acquisition of items, buildup of clutter, and difficulty discarding accumulated possessions co-occurred strongly enough to be considered a unidimensional construct. Thus, these symptoms were less attributable to separate phenomena and better conceived as part of a cohesive hoarding phenotype. Each of the three factors discriminated hoarding participants from OCD patients and community controls, but did not discriminate the latter two groups. The findings have implications for treating acquisition as a specifier in DSM-5.Journal of obsessive-compulsive and related disorders. 07/2013; 2(3):273-280.
Article: Epidemiology of hoarding disorder.[Show abstract] [Hide abstract]
ABSTRACT: Hoarding disorder is typified by persistent difficulties discarding possessions, resulting in significant clutter that obstructs the individual's living environment and produces considerable functional impairment. The prevalence of hoarding disorder, as defined in DSM-5, is currently unknown. To provide a prevalence estimate specific to DSM-5 hoarding disorder and to delineate the demographic, behavioural and health features that characterise individuals with the disorder. We conducted a two-wave epidemiological study of 1698 adult individuals, originally recruited via the South East London Community Health (SELCoH) study. Participants screening positively for hoarding difficulties in wave 1, and who agreed to be re-contacted for wave 2 (n = 99), underwent in-home psychiatric interviews and completed a battery of self-report questionnaires. Current DSM-5 diagnoses were made via consensus diagnostic procedure. In total, 19 individuals met DSM-5 criteria for hoarding disorder at the time of interview, corresponding to a weighted prevalence of 1.5% (95% CI 0.7-2.2). Those with hoarding disorder were older and more often unmarried (67%). Members of this group were also more likely to be impaired by a current physical health condition (52.6%) or comorbid mental disorder (58%), and to claim benefits as a result of these issues (47.4%). Individuals with hoarding disorder were also more likely to report lifetime use of mental health services, although access in the past year was less frequent. With a lower-bound prevalence of approximately 1.5%, hoarding disorder presents as a condition that affects people of both genders and is associated with substantial adversity.The British journal of psychiatry: the journal of mental science 10/2013; · 6.62 Impact Factor