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

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores a new treatment strategy called imaginal exposure for individuals with hoarding disorder. Imaginal exposure involves imagining the act of discarding possessions to help reduce the anxiety associated with letting go of items. The study compares this method to a neutral writing activity to determine its effectiveness in improving hoarding symptoms and reducing related issues like fear of uncertainty and emotional avoidance. Individuals with hoarding disorder as their primary condition who are not currently in cognitive behavioral therapy might be suitable for this trial. As an unphased trial, it offers participants the chance to contribute to groundbreaking research that could lead to new treatment options for hoarding disorder.

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 prior data suggests that imaginal exposure writing is safe for people with hoarding disorder?

Research has shown that imaginal exposure writing for hoarding disorder is safe and well-tolerated. In past studies, this treatment improved hoarding symptoms without causing major side effects, and participants felt comfortable with the process. Although one study found it no more effective than a different writing task, it was still seen as beneficial overall. These findings suggest that imaginal exposure writing is a safe option for people with hoarding disorder. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Imaginal Exposure Writing is unique because it tackles hoarding disorder by having individuals face their fears about discarding possessions through guided writing exercises. Unlike traditional therapies like cognitive-behavioral therapy (CBT), which often require in-person sessions over a longer period, this treatment involves just three short writing sessions, making it more accessible and less time-consuming. Researchers are excited because this method could offer a new, effective way to address the emotional barriers of hoarding with minimal resources and effort.

What evidence suggests that imaginal exposure writing could be an effective treatment for hoarding disorder?

Research has shown that imaginal exposure, a therapy where individuals imagine discarding their belongings, might help reduce hoarding disorder symptoms. In this trial, participants will join either the Imaginal Exposure Writing arm or the Neutral Writing arm. Previous studies indicate that patients find imaginal exposure both manageable and acceptable. Specifically, one study found significant improvement in hoarding symptoms after imaginal exposure therapy, with benefits lasting at least a week. These findings suggest that imaginal exposure could be a promising option for those who find traditional cognitive behavioral therapy challenging. ^{1 2 3 4 6}

Who Is on the Research Team?

Katie Fracalanza, PhD

Principal Investigator

Stanford University

Are You a Good Fit for This Trial?

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 for a Trial Participant

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

What Are the Treatments Tested in This Trial?

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.

How Is the Trial Designed?

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+

Published Research Related to This Trial

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]

Citations

1.

withpower.com

withpower.com/trial/phase-hoarding-disorder-2020-90a85

Imaginal Exposure for Hoarding Disorder

We predict that imaginal exposure will improve hoarding symptoms as well as two psychological experiences linked to the condition: intolerance of uncertainty ...

2.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC11008768/

Written imaginal exposure for hoarding disorder

Based on these previous studies, the present study investigates whether written imaginal exposure yields greater improvement in HD symptoms, particularly self- ...

3.

sciencedirect.com

sciencedirect.com/science/article/abs/pii/S2211364921000178

Could written imaginal exposure be helpful for hoarding ...

Results indicate that this intervention was tolerable, acceptable, and may reduce hoarding disorder-related symptoms, suggesting that it merits further ...

4.

clinicaltrials.gov

clinicaltrials.gov/study/NCT03734705

NCT03734705 | Imaginal Exposure for Hoarding Disorder

Scale scores range from 0 to 92, with higher scores indicating more severe hoarding symptoms. More severe hoarding symptoms are considered a worse outcome.

5.

journals.lww.com

journals.lww.com/jonmd/fulltext/2024/05000/written_imaginal_exposure_for_hoarding_disorder__a.8.aspx

Written Imaginal Exposure for Hoarding Disorder

The IE condition showed significant improvements in HD symptoms from preintervention to 1-week follow-up, with medium to large effects.

6.

researchgate.net

researchgate.net/publication/349330903_Could_Written_Imaginal_Exposure_be_Helpful_for_Hoarding_Disorder_A_Case_Series

Could Written Imaginal Exposure be Helpful for Hoarding ...

Results indicate that this intervention was tolerable, acceptable, and may reduce hoarding disorder-related symptoms, suggesting that it merits ...