Category: Obsessive Compulsive and Related Disorders


Preliminary Study of Hoarding in Youth With Autism Spectrum Disorder and Anxiety

Friday, November 17
3:30 PM - 5:00 PM
Location: Aqua 310, Level 3, Aqua Level

Keywords: Hoarding | Autism Spectrum Disorders | Comorbidity
Presentation Type: Symposium

Affecting as many as 1 out of every 68 children in the United States (CDC, 2007, 2009, 2014; Fombonne, 2005; Kogan et al., 2009), autism spectrum disorders (ASD) are characterized by deficits in social communication and motivation, language use, and/or inflexible and repetitive behaviors (American Psychiatric Association, 2000). Beyond the core symptoms of ASD, comorbid psychiatric conditions occur with great frequency, complicating the presentation and treatment of these youth, and compounding their level of impairment (de Bruin, Ferdinand, Meester, de Nijs, & Verheij, 2007; Gjevik, Eldevik, Fjæran-Granum, & Sponheim, 2011; Simonoff et al., 2008; van Steensel, Bögels, & de Bruin, 2013). One area of psychopathology that has been underexplored among youth with ASD is hoarding behaviors.

Accordingly, this presentation will report on the nature and correlates of hoarding among youth with ASD. A total of 40 children with ASD and a comorbid anxiety disorder were administered a battery of clinician-administered measures assessing presence of psychiatric disorders (Anxiety Disorders Interview Schedule – Child and Parent Versions) and anxiety severity (Pediatric Anxiety Rating Scale­). Parents completed questionnaires related to child hoarding behaviors (Children’s Saving Inventory – Parent), social responsiveness (Social Responsiveness Scale-Parent), and internalizing and externalizing behaviors (Child Behavior Checklist). We examined the impact of hoarding behaviors on treatment response in a subsample of twenty-six youth who completed a course of personalized cognitive-behavioral therapy targeting anxiety symptoms. Eleven of the 40 parents (27.5%) reported at least moderate levels of hoarding symptoms in their child defined as any domain-level score – or Total score – averaging 2.0 or higher.  Parent-reported hoarding symptoms (CSI-P Total Score) showed a strong association with CBCL Internalizing and Externalizing scales, as well as the CBCL anxiety/depression and attention problems subscales. Discarding items was associated with internalizing and anxious/depressive symptoms, but acquisition was not. Overall parent-reported hoarding in their child were significantly correlated with child age, PARS Severity Score or ASD-related social deficits.  Parents (N=26) reported significant reductions in their child’s hoarding severity from pre-treatment to post-treatment on the CSI-P Total Score, and on all domain scores. These data are among the first to examine hoarding among youth with ASD; implications of study findings and future directions are highlighted.

Eric A. Storch

Professor, College Of Medicine Pediatrics
University of South Florida; Rogers Behavioral Health – Tampa; Johns Hopkins All Children’s Hospital


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