Do People with Hoarding Disorder Under-Report Their Symptoms?

Area of Science:

• Psychiatry
• Clinical Psychology
• Behavioral Science

Background:

• Hoarding disorder (HD) is characterized by persistent difficulty discarding possessions, leading to clutter and distress.
• Accurate assessment of hoarding severity is crucial for effective treatment and research.
• Previous research suggests self-reporting of symptom severity in HD can be unreliable, with tendencies towards under- or over-reporting.

Purpose of the Study:

• To evaluate the accuracy of self-reported hoarding disorder symptom severity.
• To compare self-ratings with assessments made by family members and independent evaluators.
• To identify discrepancies in severity ratings and explore potential contributing factors.

Main Methods:

• Two studies were conducted involving participants diagnosed with hoarding disorder (HD).
• Study 1 compared HD participants' self-ratings of clutter and hoarding behaviors with ratings from family or friends.
• Study 2 examined HD participants' self-ratings of specific symptoms versus their overall global impression of severity.

Main Results:

• In Study 1, HD participants rated their clutter and behaviors as less severe than their family members did, potentially influenced by family rejection.
• In Study 2, HD participants under-reported specific hoarding symptoms but over-reported overall severity.
• Discrepancies highlight the limitations of relying solely on self-report for assessing hoarding severity.

Conclusions:

• A multi-faceted assessment approach is essential for accurately evaluating hoarding disorder severity.
• Recommended approach includes ratings from the individual with HD, a family member, and an independent clinician or observer.
• This comprehensive method will enhance future research and inform clinical treatment strategies for hoarding disorder.