Development and Validation of the Clutter Image Rating

Journal of Psychopathology and Behavioral Assessment (Impact Factor: 1.55). 01/2008; 30(3):193-203. DOI: 10.1007/s10862-007-9068-7

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.

  • [Show abstract] [Hide abstract]
    ABSTRACT: The cognitive-behavioral approach to hoarding implicates dysfunctional beliefs about possessions (i.e., “saving cognitions”). Acquiring and saving possessions can be conceptualized as avoidance behaviors that prevent feeling the distress provoked by such beliefs in certain situations (e.g., discarding). Experiential avoidance (EA) involves an unwillingness to endure upsetting emotions, thoughts, memories, and other private experiences, and deliberate efforts to control or escape from them. EA has been investigated in several clinical disorders, but to date little investigation of the role of EA in hoarding has been made. The present study examined EA in the prediction of hoarding symptoms. A large sample of unscreened undergraduates completed measures of EA, saving cognitions, and hoarding symptoms. EA predicted the acquisition and clutter components of hoarding even after controlling for saving cognitions and general distress. However, EA was not uniquely associated with the difficulty discarding component of hoarding. Implications for future research are discussed.
    Cognitive Therapy and Research 01/2011; · 1.70 Impact Factor
  • Source
    [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
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background Hoarding Disorder (HD), a new diagnostic entity in DSM-5, is associated with substantial functional impairment and family frustration but data from well-characterized samples is lacking. Method Participants were 37 individuals meeting DSM-5 criteria for HD, 55 relatives of individuals meeting criteria for HD, and comparison groups of 51 self-identified collectors and 25 relatives of collectors. All participants completed a clinician-administered diagnostic interview for HD and an online battery of standardized measures of health, well-being, and impairment. Results Substantial functional impairment was found for both HD individuals and their relatives. HD relatives reported significantly greater carer burden and accommodation of hoarding behaviors than relatives of collectors. Perceived level of squalor, co-habiting with, and increasing age of the HD individual were significant predictors of carer burden and functional impairment in the relatives. Limitations The use of self-identified HD individuals may have produced a bias towards participants with relatively good insight. Subjective biases in self-reported symptoms cannot be ruled out, although the use of informant-report data provided some independent validation. Conclusions HD is associated with substantial functional impairment for both sufferers and their relatives. The level of carer burden experienced by HD relatives was comparable to or greater than that reported in the literature by relatives of individuals with dementia. The findings indicate that relatives of individuals with HD may benefit from increased support and suggest that it may be beneficial to involve family members in the treatment of HD.
    Journal of Affective Disorders 04/2014; 159:7–14. · 3.76 Impact Factor


Available from
Dec 19, 2014