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| Name | Class |
|---|---|
| Brain & Behavior Research Foundation | OTHER |
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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.
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Imaginal Exposure Writing | Experimental | 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). |
|
| Neutral Writing | Sham Comparator | 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. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Imaginal Exposure Writing | Behavioral | Imaginal exposure is a psychotherapy strategy that has been studied and shown to be helpful in the improvement of symptoms (e.g., anxiety, worry) for other psychiatric conditions, including excessive worry and obsessive-compulsive disorder symptoms. |
| Measure | Description | Time Frame |
|---|---|---|
| Savings Inventory Revised (Frost, Steketee & Grisham, 2004; Tolin, Meunier, Frost & Steketee, 2011) | Gold-standard 23-item self-report measure of hoarding disorder symptoms. Scale scores range from 0 to 92, with higher scores indicating more severe hoarding symptoms. More severe hoarding symptoms are considered a worse outcome. | Baseline (Pre Writing) and Follow Up (week 1) |
| Measure | Description | Time Frame |
|---|---|---|
| Compulsive Acquisitions Scale (Frost et al. 2002) | Self-report 18-item measure of behaviors associated with hoarding disorder (i.e., acquiring).Scale scores range from 18 to 126, with higher scores indicating more severe hoarding behaviors. More severe hoarding behaviors are considered a worse outcome. | Baseline (Pre Writing) and Follow Up (week 1) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Katie Fracalanza, PhD | Stanford University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Stanford University | Palo Alto | California | 94304 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 38598729 | Background | 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. |
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| ID | Title | Description |
|---|---|---|
| FG000 | Imaginal Exposure Writing | 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). Imaginal Exposure Writing: Imaginal exposure is a psychotherapy strategy that has been studied and shown to be helpful in the improvement of symptoms (e.g., anxiety, worry) for other psychiatric conditions, including excessive worry and obsessive-compulsive disorder symptoms. |
| FG001 | Neutral Writing | 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. Neutral Writing: Used in prior research as a control condition for imaginal exposure. Neutral writing will involve writing about what one would do on a day off work or school. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
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| ID | Title | Description |
|---|---|---|
| BG000 | Imaginal Exposure Writing | 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). Imaginal Exposure Writing: Imaginal exposure is a psychotherapy strategy that has been studied and shown to be helpful in the improvement of symptoms (e.g., anxiety, worry) for other psychiatric conditions, including excessive worry and obsessive-compulsive disorder symptoms. |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Savings Inventory Revised (Frost, Steketee & Grisham, 2004; Tolin, Meunier, Frost & Steketee, 2011) | Gold-standard 23-item self-report measure of hoarding disorder symptoms. Scale scores range from 0 to 92, with higher scores indicating more severe hoarding symptoms. More severe hoarding symptoms are considered a worse outcome. | Posted | Mean | Standard Deviation | score on a scale | Baseline (Pre Writing) and Follow Up (week 1) |
|
Adverse events were followed for 1 week for each participant.
The definitions are the same as clinicaltrials.gov.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Imaginal Exposure Writing | 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). Imaginal Exposure Writing: Imaginal exposure is a psychotherapy strategy that has been studied and shown to be helpful in the improvement of symptoms (e.g., anxiety, worry) for other psychiatric conditions, including excessive worry and obsessive-compulsive disorder symptoms. |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Katie Fracalanza, PhD | Stanford University | 408-769-0589 | kfracalanza@stanford.edu |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Apr 14, 2025 | Apr 14, 2025 | Prot_SAP_000.pdf |
| ICF | No | No | Yes | Informed Consent Form | Apr 13, 2020 | Apr 14, 2025 | ICF_001.pdf |
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| ID | Term |
|---|---|
| D000067836 | Hoarding Disorder |
| D013064 | Speech Disorders |
| ID | Term |
|---|---|
| D009771 | Obsessive-Compulsive Disorder |
| D001008 | Anxiety Disorders |
| D001523 | Mental Disorders |
| D007806 | Language Disorders |
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Participants will be randomly assigned to imaginal exposure writing intervention or neutral control writing.
|
| Neutral Writing | Other | Used in prior research as a control condition for imaginal exposure. Neutral writing will involve writing about what one would do on a day off work or school. |
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| Intolerance of Uncertainty Scale (Buhr & Dugas, 2002) | Self-report 27-item measure of a cognitive process related to hoarding called intolerance of uncertainty. Scale scores range from 27 to 135 (some items are reverse scored), with higher scores indicating more severe intolerance of uncertainty. More severe intolerance of uncertainty is considered a worse outcome. | Baseline (Pre Writing) and Follow Up (week 1) |
| Acceptance and Action Questionnaire - II (Hayes, Luoma, Bond, Masuda and Lillis, 2006) | Self-report 7-item measure of a cognitive process related to hoarding called experiential avoidance. Scale scores range from 7 to 49, with higher scores indicating more severe experiential avoidance. More severe hoarding behaviors are considered a worse outcome. | Baseline (Pre Writing) and Follow Up (week 1) |
| BG001 | Neutral Writing | 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. Neutral Writing: Used in prior research as a control condition for imaginal exposure. Neutral writing will involve writing about what one would do on a day off work or school. |
| BG002 | Total | Total of all reporting groups |
| years |
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| Sex: Female, Male | Count of Participants | Participants |
|
| Race/Ethnicity, Customized | Count of Participants | Participants |
|
| Employment Status | Count of Participants | Participants |
|
| OG001 | Neutral Writing | 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. Neutral Writing: Used in prior research as a control condition for imaginal exposure. Neutral writing will involve writing about what one would do on a day off work or school. |
|
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| Secondary | Compulsive Acquisitions Scale (Frost et al. 2002) | Self-report 18-item measure of behaviors associated with hoarding disorder (i.e., acquiring).Scale scores range from 18 to 126, with higher scores indicating more severe hoarding behaviors. More severe hoarding behaviors are considered a worse outcome. | Posted | Mean | Standard Deviation | score on a scale | Baseline (Pre Writing) and Follow Up (week 1) |
|
|
|
| Secondary | Intolerance of Uncertainty Scale (Buhr & Dugas, 2002) | Self-report 27-item measure of a cognitive process related to hoarding called intolerance of uncertainty. Scale scores range from 27 to 135 (some items are reverse scored), with higher scores indicating more severe intolerance of uncertainty. More severe intolerance of uncertainty is considered a worse outcome. | Posted | Mean | Standard Deviation | score on a scale | Baseline (Pre Writing) and Follow Up (week 1) |
|
|
|
| Secondary | Acceptance and Action Questionnaire - II (Hayes, Luoma, Bond, Masuda and Lillis, 2006) | Self-report 7-item measure of a cognitive process related to hoarding called experiential avoidance. Scale scores range from 7 to 49, with higher scores indicating more severe experiential avoidance. More severe hoarding behaviors are considered a worse outcome. | Posted | Mean | Standard Deviation | score on a scale | Baseline (Pre Writing) and Follow Up (week 1) |
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|
| 0 |
| 17 |
| 0 |
| 17 |
| 0 |
| 17 |
| EG001 | Neutral Writing | 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. Neutral Writing: Used in prior research as a control condition for imaginal exposure. Neutral writing will involve writing about what one would do on a day off work or school. | 0 | 15 | 0 | 15 | 0 | 15 |
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| D003147 |
| Communication Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |