Category: Obsessive Compulsive and Related Disorders
Keywords: Hoarding | Mediation / Mediators | Cognitive Schemas / Beliefs
Presentation Type: Symposium
Though an empirically supported treatment, meta-analytic systems suggest that cognitive-behavioral therapy (CBT) is only modestly effective for hoarding disorder (HD), and that a significant number of individuals with HD remain symptomatic following treatment (Tolin et al., Depression and Anxiety 2015; 32:158-166). Historically, cognitive restructuring has been a primary element of CBT; however, recent research has questioned whether cognitive change is necessary for functional symptom change in HD (e.g., Frost et al., Behavior Research and Therapy 2016; 85:13-22). To this end, the current study examined whether change in saving beliefs mediated symptom change in CBT for HD. Adult patients with primary HD (N = 62, 81% female, 11% nonwhite, M age = 56.6 years) were treated with 26 sessions of individual CBT or 16-20 sessions of group CBT, all based on a cognitive behavioral treatment manual (Steketee & Frost, 2007; Compulsive hoarding and acquiring: Therapist guide, Oxford University Press). Participants completed the Saving Cognitions Inventory (SCI), which assessed participants’ maladaptive beliefs about saving, and the Saving Inventory-Revised (SI-R), a measure of hoarding severity, at pre-, mid-, and post-CBT. Results from an ordinary least squares regression-based analysis showed that decreases in maladaptive saving cognitions in all four SCI domains (i.e., emotional attachment, memory concerns, responsibility towards possessions, and control over possessions) mediated decreases in HD symptoms in all three SI-R domains (i.e., acquiring, difficulty discarding, and excessive clutter) over the course of treatment. As will be discussed at the conference, these findings suggest that cognitive change is a mechanism of treatment response in CBT and that it is worth exploring how to best target maladaptive savings beliefs when employing CBT for HD.
Institute of Living
Saturday, November 18
8:30 AM – 10:00 AM
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