Hoarding DisorderNCT03734705
Imaginal Exposure for Hoarding Disorder
A study testing Imaginal Exposure Writing and Neutral Writing in people with Hoarding Disorder, run by Stanford University at 1 site in United States.
Trial summary
The present study will test a potential new treatment strategy, imaginal exposure, for hoarding disorder. Although cognitive behavioral therapy often reduces hoarding, some people do not want to start, or cannot handle, that option. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Hoarding Disorder
- What is being tested?
- Imaginal Exposure Writing and Neutral Writing
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 32 participants
- Where
- 1 siteUnited States
- Study dates
- 13 Jan 2020to 27 Jan 2021
- Phase
- Interventional
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Age 18 and older
- Any gender and all ethno-racial categories
- Hoarding Disorder primary condition
- Willing and able to understand and complete consent and study procedures
- English speaking
Who cannot join
- Severe depression
- Clinically at risk of suicide with Columbia Suicide Severity Rating Scale (C-SSRS) Suicidal Ideation Subscale of 4 or higher (i.e. suicidal intent without specific plan)
- Currently receiving Cognitive Behavioral Therapy (CBT)
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Efficacy and Feasibility of Intensive Imaginal Exposure for Hoarding Disorder
The present study will test a potential new treatment strategy, imaginal exposure, for hoarding disorder. Although cognitive behavioral therapy often reduces hoarding, some people do not want to start, or cannot handle, that option. To help such individuals, the present study will provide imaginal exposure therapy to people with hoarding disorder, wherein they imagine discarding possessions as a way of becoming acclimated to the idea. We predict that imaginal exposure will improve hoarding symptoms as well as two psychological experiences linked to the condition: intolerance of uncertainty and emotional avoidance.
Read the detailed description
Hoarding disorder is a common mental illness characterized by difficulty parting with possessions and by clutter that makes living spaces unusable. Cognitive behavioral therapy (CBT) is an effective treatment for hoarding disorder, but new approaches are needed to engage those who are reluctant to start or cannot tolerate CBT. Both intolerance of uncertainty and emotional avoidance are linked to hoarding disorder and may interfere with treatment engagement. Imaginal exposure, a therapeutic technique which involves repeatedly imagining feared scenarios and experiencing the evoked emotions, effectively targets both intolerance of uncertainty and emotional avoidance. The present study is the first to test whether imagining discarding possessions can improve hoarding symptoms more than does a control exercise. We hypothesize that compared to a control exercise, imaginal exposure will improve hoarding symptoms, intolerance of uncertainty and emotional avoidance.
- Conditions
- Hoarding Disorder
- Being tested
- Imaginal Exposure Writing, Neutral Writing
- Keywords
- hoarding disorder, intolerance of uncertainty, experiential avoidance, imaginal exposure, clutter, attachment
- Medical subject headings
- Hoarding Disorder, Speech Disorders
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Imaginal Exposure WritingBehavioural
Imaginal exposure is a psychotherapy strategy that has been studied and shown to be helpful in the improvement of symptoms (e.g., anxiety, worry) for other psychiatric conditions, including excessive worry and obsessive-compulsive disorder symptoms.
Neutral WritingOther
Used in prior research as a control condition for imaginal exposure. Neutral writing will involve writing about what one would do on a day off work or school.
| Study group | Role | What they receive |
|---|---|---|
| Imaginal Exposure Writing | Experimental | People with hoarding disorder will write for 20 minutes on each of 3 consecutive days about their worst-case scenario regarding discarding a possession (i.e., imaginal exposure). Receives: Behavioral: Imaginal Exposure Writing |
| Neutral Writing | Sham comparator | People with hoarding disorder will write for 20 minutes on each of 3 consecutive days about what they would do if they had a day off work or school. Receives: Other: Neutral Writing |
What is being measured
The primary outcome is the main question the study is designed to answer.
Savings Inventory Revised (Frost, Steketee & Grisham, 2004; Tolin, Meunier, Frost & Steketee, 2011)
Gold-standard 23-item self-report measure of hoarding disorder symptoms. Scale scores range from 0 to 92, with higher scores indicating more severe hoarding symptoms. More severe hoarding symptoms are considered a worse outcome.
Measured: Baseline (Pre Writing) and Follow Up (week 1)
Secondary outcomes (3)
Compulsive Acquisitions Scale (Frost et al. 2002)
Self-report 18-item measure of behaviors associated with hoarding disorder (i.e., acquiring).Scale scores range from 18 to 126, with higher scores indicating more severe hoarding behaviors. More severe hoarding behaviors are considered a worse outcome.
Measured: Baseline (Pre Writing) and Follow Up (week 1)
Intolerance of Uncertainty Scale (Buhr & Dugas, 2002)
Self-report 27-item measure of a cognitive process related to hoarding called intolerance of uncertainty. Scale scores range from 27 to 135 (some items are reverse scored), with higher scores indicating more severe intolerance of uncertainty. More severe intolerance of uncertainty is considered a worse outcome.
Measured: Baseline (Pre Writing) and Follow Up (week 1)
Acceptance and Action Questionnaire - II (Hayes, Luoma, Bond, Masuda and Lillis, 2006)
Self-report 7-item measure of a cognitive process related to hoarding called experiential avoidance. Scale scores range from 7 to 49, with higher scores indicating more severe experiential avoidance. More severe hoarding behaviors are considered a worse outcome.
Measured: Baseline (Pre Writing) and Follow Up (week 1)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted8 Nov 2018
- Study start13 Jan 2020
- Primary completion27 Jan 2021
- Study completion27 Jan 2021
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Hoarding DisorderStudies of the same condition, open and under way.
- More trials run by Stanford UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Basic science
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 32 participants (actual)
Sponsor and investigators
- Lead sponsor
- Stanford University
- Sponsor type
- University, hospital or other
- Collaborators
- Brain & Behavior Research Foundation
- Responsible party
- Principal investigator, Carolyn Rodriguez, Stanford University
- Investigators
- Katie Fracalanza, PhD, Principal investigator, Stanford University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03734705
- Sponsor's protocol ID
- 48109
- Status last verified
- May 2025
- First submitted
- 5 Nov 2018
- Last updated
- 29 May 2025
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Publications
Fracalanza K, Raila H, Avanesyan T, Rodriguez CI. Written Imaginal Exposure for Hoarding Disorder: A Preliminary Pilot Study. J Nerv Ment Dis. 2024 May 1;212(5):289-294. doi: 10.1097/NMD.0000000000001719.
PubMed 38598729
Study at a glance
From the registry record, last updated by the sponsor on 29 May 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Efficacy and Feasibility of Intensive Imaginal Exposure for Hoarding Disorder
- ClinicalTrials.gov ID
- NCT03734705
- Acronym / sponsor ID
- 48109
- Conditions
- Hoarding Disorder
- Keywords
- hoarding disorder, intolerance of uncertainty, experiential avoidance, imaginal exposure, clutter, attachment
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 32 participants (actual)
- Lead sponsor
- Stanford UniversityUniversity, hospital or other
- Collaborators
- Brain & Behavior Research Foundation
- Study start
- 13 Jan 2020 (actual)
- Primary completion
- 27 Jan 2021 (actual)
- Study completion
- 27 Jan 2021 (actual)
- First posted
- 8 Nov 2018 (actual)
- Results
- Posted 29 May 2025
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The present study will test a potential new treatment strategy, imaginal exposure, for hoarding disorder. Although cognitive behavioral therapy often reduces hoarding, some people do not want to start, or cannot handle, that option. To help such individuals, the present study will provide imaginal exposure therapy to people with hoarding disorder, wherein they imagine discarding possessions as a way of becoming acclimated to the idea. We predict that imaginal exposure will improve hoarding symptoms as well as two psychological experiences linked to the condition: intolerance of uncertainty and emotional avoidance.
Detailed description
Hoarding disorder is a common mental illness characterized by difficulty parting with possessions and by clutter that makes living spaces unusable. Cognitive behavioral therapy (CBT) is an effective treatment for hoarding disorder, but new approaches are needed to engage those who are reluctant to start or cannot tolerate CBT. Both intolerance of uncertainty and emotional avoidance are linked to hoarding disorder and may interfere with treatment engagement. Imaginal exposure, a therapeutic technique which involves repeatedly imagining feared scenarios and experiencing the evoked emotions, effectively targets both intolerance of uncertainty and emotional avoidance. The present study is the first to test whether imagining discarding possessions can improve hoarding symptoms more than does a control exercise. We hypothesize that compared to a control exercise, imaginal exposure will improve hoarding symptoms, intolerance of uncertainty and emotional avoidance.
Study design
- Primary purpose
- Basic science
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Imaginal Exposure Writing | Experimental | Behavioral: Imaginal Exposure WritingPeople with hoarding disorder will write for 20 minutes on each of 3 consecutive days about their worst-case scenario regarding discarding a possession (i.e., imaginal exposure). |
| Neutral Writing | Sham comparator | Other: Neutral WritingPeople with hoarding disorder will write for 20 minutes on each of 3 consecutive days about what they would do if they had a day off work or school. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- Age 18 and older
- Any gender and all ethno-racial categories
- Hoarding Disorder primary condition
- Willing and able to understand and complete consent and study procedures
- English speaking
Key exclusion criteria (3 listed)
- Severe depression
- Clinically at risk of suicide with Columbia Suicide Severity Rating Scale (C-SSRS) Suicidal Ideation Subscale of 4 or higher (i.e. suicidal intent without specific plan)
- Currently receiving Cognitive Behavioral Therapy (CBT)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Imaginal Exposure WritingImaginal exposure is a psychotherapy strategy that has been studied and shown to be helpful in the improvement of symptoms (e.g., anxiety, worry) for other psychiatric conditions, including excessive worry and obsessive-compulsive disorder symptoms. | Behavioural | Imaginal Exposure Writing |
| Neutral WritingUsed in prior research as a control condition for imaginal exposure. Neutral writing will involve writing about what one would do on a day off work or school. | Other | Neutral Writing |
Primary outcome
Savings Inventory Revised (Frost, Steketee & Grisham, 2004; Tolin, Meunier, Frost & Steketee, 2011)
Time frame: Baseline (Pre Writing) and Follow Up (week 1)
Gold-standard 23-item self-report measure of hoarding disorder symptoms. Scale scores range from 0 to 92, with higher scores indicating more severe hoarding symptoms. More severe hoarding symptoms are considered a worse outcome.
3 secondary outcomes
Compulsive Acquisitions Scale (Frost et al. 2002)
Time frame: Baseline (Pre Writing) and Follow Up (week 1)
Intolerance of Uncertainty Scale (Buhr & Dugas, 2002)
Time frame: Baseline (Pre Writing) and Follow Up (week 1)
Acceptance and Action Questionnaire - II (Hayes, Luoma, Bond, Masuda and Lillis, 2006)
Time frame: Baseline (Pre Writing) and Follow Up (week 1)
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 29 May 2025.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Background: PubMed 38598729Fracalanza K, Raila H, Avanesyan T, Rodriguez CI. Written Imaginal Exposure for Hoarding Disorder: A Preliminary Pilot Study. J Nerv Ment Dis. 2024 May 1;212(5):289-294. doi: 10.1097/NMD.0000000000001719.
- Individual participant dataSharing planned: Undecided
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Katie Fracalanza, PhD principal investigator
Stanford University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Imaginal Exposure Writing and Neutral Writing in people with Hoarding Disorder, run by Stanford University at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 29 May 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Yes. Results are posted in the registry (first posted 29 May 2025). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Savings Inventory Revised (Frost, Steketee & Grisham, 2004; Tolin, Meunier, Frost & Steketee, 2011) (time frame: Baseline (Pre Writing) and Follow Up (week 1)). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT03734705, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 May 2025.