Imaginal Exposure for Hoarding Disorder

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Stanford University

Disqualifiers: Severe depression, Suicide risk, CBT, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 3

Duration: 1 week

32 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Imaginal Exposure Writing for Hoarding Disorder?

The research suggests that intrusive imagery plays a significant role in Hoarding Disorder, and imagery-based interventions could be beneficial. While specific data on Imaginal Exposure Writing is not provided, the potential of imagery-based interventions is highlighted, indicating that addressing intrusive imagery might help reduce hoarding symptoms. ^{1 2 3 4 5}

How is Imaginal Exposure Writing treatment different from other treatments for hoarding disorder?

Imaginal Exposure Writing is unique because it focuses on addressing intrusive imagery (unwanted mental pictures) that people with hoarding disorder experience, especially when discarding items. This approach is different from other treatments as it directly targets the emotional and cognitive aspects of hoarding by helping individuals confront and process these distressing images. ^{3 4 6 7 8}

What is the purpose of this trial?

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.

Research Team

Katie Fracalanza, PhD

Principal Investigator

Stanford University

Eligibility Criteria

This trial is for English-speaking adults over 18 with hoarding disorder as their primary condition, regardless of gender or ethnicity. It's not suitable for those currently in cognitive behavioral therapy, suffering from severe depression, or at risk of suicide.

Inclusion Criteria

You are being treated for Hoarding Disorder as your main medical condition.

Willing and able to understand and complete consent and study procedures

My gender and ethnicity do not limit my participation.

Exclusion Criteria

You have thoughts of hurting or killing yourself and scored 4 or higher on the C-SSRS Suicidal Ideation Subscale.

I have been diagnosed with severe depression.

I am currently undergoing Cognitive Behavioral Therapy.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants engage in imaginal exposure therapy, writing about worst-case scenarios regarding discarding possessions for 20 minutes on each of 3 consecutive days

1 week

3 visits (virtual)

Follow-up

Participants are monitored for changes in hoarding symptoms, intolerance of uncertainty, and emotional avoidance

1 week

Treatment Details

Interventions

• Imaginal Exposure Writing
• Neutral Writing

Trial Overview The study tests imaginal exposure therapy where participants imagine discarding items to reduce hoarding symptoms. This approach is compared to neutral writing and aims to ease the discomfort associated with throwing things away.

Participant Groups

Group I: Imaginal Exposure Writing Experimental Treatment 1 Intervention

People with hoarding disorder will write for 20 minutes on each of 3 consecutive days about their worst-case scenario regarding discarding a possession (i.e., imaginal exposure).

Group II: Neutral Writing Placebo Group 1 Intervention

People with hoarding disorder will write for 20 minutes on each of 3 consecutive days about what they would do if they had a day off work or school.

Who Is Running the Clinical Trial?

Stanford University

Lead Sponsor

Trials

2,527

Recruited

17,430,000+

Brain & Behavior Research Foundation

Collaborator

Trials

63

Recruited

2,900+

Findings from Research

A non-inferiority trial is being conducted to compare the effectiveness of group cognitive-behavioral therapy (CBT) and a structured support group called Buried in Treasures (BiT) for treating hoarding disorder, involving 300 participants over 16 weeks.

The primary goal of the study is to assess whether BiT can effectively reduce hoarding symptoms to a level comparable to that of traditional CBT, potentially increasing treatment accessibility for individuals with hoarding disorder.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comparison of a peer facilitated support group to cognitive behavior therapy: Study protocol for a randomized controlled trial for hoarding disorder. Uhm, SY., Tsoh, JY., Mackin, RS., et al.[2022]

References

1. United States pubmed.ncbi.nlm.nih.gov

Comparison of a peer facilitated support group to cognitive behavior therapy: Study protocol for a randomized controlled trial for hoarding disorder. [2022]

2. England pubmed.ncbi.nlm.nih.gov

A Standardized Approach to Calculating Clinically Significant Change in Hoarding Disorder Using the Saving Inventory-Revised. [2022]

3. United States pubmed.ncbi.nlm.nih.gov

Challenges and advances in treating hoarding. [2011]

4. England pubmed.ncbi.nlm.nih.gov

The Role of Intrusive Imagery in Hoarding Disorder. [2020]

5. England pubmed.ncbi.nlm.nih.gov

An intensive time-series evaluation of the effectiveness of cognitive behaviour therapy for hoarding disorder: a 2-year prospective study. [2019]

6. England pubmed.ncbi.nlm.nih.gov

Acceptability of Treatments and Services for Individuals with Hoarding Behaviors. [2020]

7. United States pubmed.ncbi.nlm.nih.gov

Older adult hoarders' experiences of being helped by volunteers and volunteers' experiences of helping. [2022]

8. Netherlands pubmed.ncbi.nlm.nih.gov

Experiential avoidance and emotion regulation difficulties in hoarding disorder. [2018]