Category: Obsessive Compulsive and Related Disorders

Symposium

Assessment of Hoarding Over the Life Span

Sunday, November 19
8:30 AM - 9:30 AM
Location: Indigo Ballroom B, Level 2, Indigo Level

Keywords: Hoarding | Aging / Older Adults | Assessment
Presentation Type: Symposium

Some research suggests symptoms of hoarding progressively worsen over the lifespan (Ayers et al., 2010). The Saving Inventory – Revised (SI-R) is the most widely used self-report measure to assess severity of symptoms of difficulty discarding, excessive acquisition, and clutter accumulation. To facilitate hoarding research and treatment for older adults, it is important to understand how age interacts with the SI-R and how this may impact conceptualization of results. This study contrasts two competing hypotheses about age and SI-R scores. One hypothesis is that collecting behaviour increases over the lifespan, leading to higher SI-R scores for most people (i.e., independent of hoarding symptoms), which should be reflected in a higher cut-off score associated with hoarding diagnosis. A second contrasting hypothesis stems from research on response bias over the lifespan. Some evidence suggests that response style changes with age so that older adults are less likely to choose extreme options (Batchelor, Miao, & McDaniel, 2013). Hence, similar to the underreporting seen in depression (Lyness et al., 1995), most older adults may tend to score lower on the SI-R (again, irrespective of hoarding symptoms). Sorting out how age relates to SI-R responding is important for how researchers establish diagnostic group inclusion criteria, how clinicians plan treatment and assess progress, and how the course of the disorder is understood. Using archival data from several studies (N = 435) in which all participants completed both the SI-R and a diagnostic interview, we investigated this issue using ROC curve analysis (a commonly used method to determine cut-off scores for self-report measures). Using the clinical interview as a “gold standard”, we computed ROC curves and associated cut-off scores for different age groups among samples comprised of both those who received a hoarding diagnosis and healthy controls. The optimal SI-R cut-off score for hoarding caseness declined from young adults to older adults. The cut-off for 18-39 year olds was 45, it was 41 for 40-61 year-olds, and for 62-83 year olds the cut-off was 36 at a sensitivity of .90. Implications for how we investigate hoarding severity over the life-span are discussed.

Brent Stewart

University of British Columbia

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