Clinical trial NCT03734705: Imaginal Exposure for Hoarding Disorder
Official title: Efficacy and Feasibility of Intensive Imaginal Exposure for Hoarding Disorder
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Hoarding Disorder
Keywords: hoarding disorder
intolerance of uncertainty
experiential avoidance
imaginal exposure
clutter
attachment
Lead sponsor: Stanford University
Sponsor class: OTHER
Collaborators: name: Brain & Behavior Research Foundation
First posted: 2018-11-08
Enrollment: 32
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: BASIC_SCIENCE

Brief summary: 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.

Detailed description: 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.

Eligibility criteria: Inclusion Criteria:

1. Age 18 and older
2. Any gender and all ethno-racial categories
3. Hoarding Disorder primary condition
4. Willing and able to understand and complete consent and study procedures
5. English speaking

Exclusion Criteria:

1. Severe depression
2. 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)
3. Currently receiving Cognitive Behavioral Therapy (CBT)

Primary outcomes:
measure: Savings Inventory Revised (Frost, Steketee & Grisham, 2004; Tolin, Meunier, Frost & Steketee, 2011)
timeFrame: Baseline (Pre Writing) and Follow Up (week 1)
Secondary outcomes:
measure: Compulsive Acquisitions Scale (Frost et al. 2002)
timeFrame: Baseline (Pre Writing) and Follow Up (week 1)
measure: Intolerance of Uncertainty Scale (Buhr & Dugas, 2002)
timeFrame: Baseline (Pre Writing) and Follow Up (week 1)
measure: Acceptance and Action Questionnaire - II (Hayes, Luoma, Bond, Masuda and Lillis, 2006)
timeFrame: Baseline (Pre Writing) and Follow Up (week 1)
Other outcomes:
Locations:
city: Palo Alto
country: United States
facility: Stanford University
state: California
Study officials:
affiliation: Stanford University
name: Katie Fracalanza, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Fracalanza K, Raila H, Avanesyan T, Rodriguez CI. Written Imaginal Exposure for Hoarding Disorder: A Preliminary Pilot Study. J Nerv Ment Dis. 2024 May 1;212(5):289-294. doi: 10.1097/NMD.0000000000001719.