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State of the Science: Hoarding Disorder and Its Treatment
David F Tolin1, Blaise L Worden2, Hannah C Levy2
1The Institute of Living; Yale University School of Medicine.
Behavior Therapy
|June 20, 2025
Summary
Hoarding disorder (HD) is a new diagnosis involving difficulty discarding possessions. Cognitive-behavioral therapy for hoarding disorder (CBT-HD) shows some efficacy, but more research is needed on its cultural effectiveness.
Area of Science:
- Psychiatry
- Clinical Psychology
- Mental Health
Background:
- Hoarding disorder (HD) is a distinct diagnosis characterized by excessive acquisition, difficulty discarding, and living space clutter.
- Several theoretical models attempt to explain HD, including cognitive-behavioral, biopsychosocial, attachment, and addiction perspectives.
Purpose of the Study:
- To provide a state-of-the-science review of hoarding disorder.
- To examine current theoretical models and interventions for HD.
- To discuss future research and clinical directions.
Main Methods:
- Literature review of theoretical models of hoarding disorder.
- Review of interventions for hoarding disorder, with a focus on cognitive-behavioral therapy for hoarding disorder (CBT-HD).
Main Results:
- Cognitive-behavioral therapy for hoarding disorder (CBT-HD) is the only intervention with conclusive evidence of efficacy for HD.
- Clinical results for CBT-HD have been modest.
- The cross-cultural efficacy of CBT-HD and the impact of cultural modifications remain unclear.
Conclusions:
- Hoarding disorder is a complex condition with multiple theoretical underpinnings.
- CBT-HD is a promising, though not fully established, treatment for HD.
- Further research is needed to understand and optimize HD treatment across diverse cultural contexts.
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