Hoarding Disorder: 2018

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Table of Contents

1 Description
1.1 Terminology
1.2 Definition
1.3 Epidemiology
1.4 Course and Prognosis
1.5 Differential Diagnosis
1.5.1 Obsessive-Compulsive Disorder
1.5.2 Other Conditions
1.5.3 Hoarding Versus Collecting
1.6 Co-Occurring Disorders
1.7 Diagnostic Procedures and
1.7.1 Structured Diagnostic Interviews
1.7.2 Clinician-Administered Symptom
1.7.3 Self- or Other-Report Symptom
1.7.4 OCD Measures With Hoarding Items
1.7.5 Summary of Diagnostic Procedures
and Documentation
2 Theories and Models of the Disorder
2.1 Cognitive Behavioral Model
2.1.1 Vulnerability Factors
2.1.2 Beliefs
2.1.3 Emotions and Reinforcement
2.1.4 Summary of the Cognitive Behavioral
2.2 Biological Models
2.2.1 Genetics
2.2.2 Neurobiology
3 Diagnosis and Treatment Indications
3.1 Diagnostic Assessment
3.1.1 In-Office Assessment
3.1.2 Home Visit
3.1.3 Additional Assessment
4 Treatment
4.1 Methods of Treatment
4.1.1 Cognitive Behavior Therapy for
Hoarding Disorder
4.2 Mechanisms of Action
4.3 Efficacy and Prognosis
4.4 Variations and Combinations of Methods
4.4.1 Group-Based Approaches
4.4.2 Technology-Based Approaches
4.4.3 Family Approaches
4.4.4 Other Psychosocial Approaches
4.4.5 Pharmacological Interventions
4.4.6 Multimodal Treatment
4.5 Problems in Carrying Out the Treatments
4.5.1 Treatment Ambivalence
4.5.2 Lack of Awareness
4.5.3 Secondary Gains
4.5.4 Co-Occurring Conditions
4.5.5 Animal Hoarding
4.5.6 Logistical Barriers
4.5.7 Ethical and Legal Barriers
4.6 Multicultural Issues and Other Individual
5 Further Reading
6 References
7 Appendix: Tools and Resources

About the Author

Gregory S. Chasson, PhD, is a licensed clinical psychologist, Associate Professor, Department of Psychology, Illinois Institute of Technology, and owner of Obsessive- Compulsive Solutions of Chicago. His research laboratory at Illinois Tech (i.e., Repetitive Experiences and Behavior Lab - REBL) and clinical work focus on obsessive-compulsive spectrum conditions (including hoarding), autism spectrum conditions, and anxiety and traumatic stress. He received his PhD from the University of Houston and completed pre- and postdoctoral fellowships at Harvard Medical School at McLean Hospital and Massachusetts General Hospital, respectively .
Jedidiah Siev, PhD, is a licensed clinical psychologist and Assistant Professor, Department of Psychology, Swarthmore College, where he directs the Swarthmore OCD, Anxiety, and Related Disorders (SOAR) Lab. Previously, he founded and directed the OCD and Related Disorders Program, Nova Southeastern University, after completing training at the Massachusetts General Hospital and the University of Pennsylvania. Dr. Siev has considerable clinical and research experience with individuals who have hoarding, obsessive- compulsive, body dysmorphic, and anxiety disorders.


Hoarding disorder is a difficult problem to treat, yet clinicians can learn to treat it once they understand the condition and the evidence-based treatment for it. This thoughtful, concise, and well-written text presents the most current treatment approaches for this challenging condition. If you wish to help those who suffer with the debilitating problem of hoarding, get this book and learn from these experienced scientist-practitioners. ; Michael A. Tompkins, PhD, ABPP, Co-Director, San Francisco Bay Area Center for Cognitive Therapy; Assistant Clinical Professor, University of California at Berkeley; Since hoarding disorder was made a new DSM-5 diagnosis, it has attracted increased attention. In addition, pathological hoarding has increased ... 4% to 5% of inhabitants of major cities. Hoarding disorder is a difficult problem to manage. The concise and well-written text by Chasson and Siev summarizes the latest knowledge on the assessment and treatment of hoarding disorder and presents the current treatment approaches. Pharmacotherapeutic trials with venlafaxine and paroxetine have been rather unsatisfactory. The authors recommend multimodal treatment, with an emphasis on modified cognitive behavior treatment. Rich anecdotes and clinical observations elucidate the recommendations, and the book also includes information for particular client groups, such as older individuals and those who hoard animals. Particularly useful are practical tools and resources provided in the appendix. This book is useful reading for clinical psychiatrists, psychotherapists, psychologists, and mental health practitioners.; Reviewed by Paul Grof, MD, PhD, FRCPC, Ottawa/Toronto, in Canadian Journal of Psychiatry (2019), 64 (7), 517; This evidence-based guide walks through the complexity of hoarding disorder and provides practical treatments and approaches to help clients. The authors cover the basic terminology, epidemiology, diagnosis, comorbidity, scale assessments, and various pharmacological and nonpharmacological treatment options, and give an unbiased and empirically supported discussion with great examples and wonderful charts. There is an excellent discussion of the various treatment modalities from individual to group to family approaches. Tools and resources that serve as printable handouts for clinicians are especially helpful. With the introduction of the DSM-5 and the use of the ICD-10, this book is undoubtedly needed. As someone who regularly teaches on hoarding behaviors and their complexity, I was especially excited for this book to be added to the field. I continue to be impressed with the content and quality of the books in this Advances in Psychotherapy series.; Reviewed by Nicholas Greco IV, MS, BCETS, CATSM, FAAETS, C3 Education and Research, Inc., in Doody's Reviews (January 2020);This is a compact, comprehensive book that has been eloquently written by experts in the field to help the reader navigate the topic of hoarding disorder. The book is laid out in an easy to read, clear, and practical format which lends itself well to being used by clinicians in their clinical practice. A strength is the bold marginal notes that appear throughout and help make key points stand out on the page [and] boxed clinical “pearls” with useful bite-sized chunks of information that can be applied in clinical practice. Hoarding disorder is a new disorder in both DSM-V and ICD-11 - I think that this book is a good guide to aid clinicians in their understanding.”;Reviewed by Saloni Peatfield-Bakhshi in British Journal of Psychiatry (March 2020), 216(3), 169-169. doi:10.1192/bjp.2020.16;

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