Treatment of Compulsive Hoarding, NIMH (R21 MH068539-01), 2003-2006 (co-Investigator).

Compulsive hoarding has proved refractory to both medication and psychosocial treatments usually effective for obsessive compulsive disorder. This project focuses on developing and testing an ecologically valid psychosocial treatment based on identified psychopathology features and a cognitive-behavioral model of this complex syndrome. The specific aims of this proposed 2-site project are to:

• Revise and expand a cognitive-behavioral treatment manual for compulsive hoarding that has been used previously with moderate success to treat people with this syndrome. Specifically, we will:
• Complete the revision of the existing treatment manual, including additional sections on motivational enhancement and on relapse prevention;
• Treat a small sample of clients with compulsive hoarding and make appropriate modifications preparatory for a subsequent trial.
• Test the CBT treatment in a randomized trial on a larger sample of 40 clients with primary complaints of compulsive hoarding in a 2-site project (20 clients per site). For this purpose we will:
• Conduct full-scale assessments in the clinic and in clients’ homes at pretest, posttest and follow-ups;
• Conduct monthly assessments during treatment to study process aspects of the CBT;
• Determine effect size of active treatment by comparing outcomes for CBT with outcomes for the waitlist control condition;
• Conduct preliminary analyses of potential predictors of outcome on the combined treated samples if statistically appropriate.

Psychopathology of Compulsive Hoarding, NIMH (R01 MH068008-01), 2004-2008 (Principal Investigator).

This 2-site project aims to examine the psychopathology of a common and problematic syndrome, compulsive hoarding. Three studies are proposed to examine core features of hoarding in relationship to OCD and community controls, to test portions of a cognitive behavioral model of hoarding, and to study behavioral aspects of discarding and acquiring in natural settings. All studies will be conducted simultaneously using identical procedures in two sites (Boston, Hartford/Smith) over a period of 4 years. Dr. Gail Steketee will serve as the PI for the Boston University site where research activities will take place on site at the Center for Anxiety and Related Disorders directed by Co-Investigator Dr. Tim Brown. Dr. Randy Frost of Smith College will serve as PI for studies that will take place at the Institute of Living, Hartford Hospital subcontract site where Co-Investigator Dr. David Tolin directs the Anxiety Disorders Center. The timetable includes a 4-month start-up phase to hire and train staff, recruit participants, and finalize measures and procedures. Study 1 on phenomenological and explanatory features begins immediately thereafter. Studies 2 and 3 test hypotheses about emotion, beliefs and behavior derived from a model of compulsive hoarding behavior and begin later in Year 1 after procedures have been piloted. All studies run concurrently through month 6 of Year 4 when data reduction and analyses begin.

Cross-Cultural Intrusive Thoughts

This research project is part of an international study on unwanted intrusive thoughts in university students from various countries around the world. The interview for this project is to obtain information on individuals’ experience of unwanted intrusive thoughts, images and impulses that might have relevance for understanding the origins of obsessive-compulsive disorder (OCD).The questions in the interview concern the experience of various types of unwanted intrusive thoughts, images or impulses that pop into your mind without too much effort on your part.We ask about whether participants have ever experienced unwanted thoughts of contamination/illness, harm/injury/aggression, doubt, sex, religion or being a victim of aggression.We know from research as well as clinical and personal experiences that the vast majority of people (over 80%) have many different types of unwanted intrusive thoughts and these thoughts can be quite distressing at times.Because unwanted intrusive thoughts are so common, we are interested in learning more about the nature of this thinking, how people respond to the thoughts and how they try to control their unwanted mental intrusions.So we ask questions about the frequency of these thoughts, what types of intrusive thoughts are experienced, whether the thoughts are meaningful or significant, and the participant tries to control them. The interview concludes with some specific questions about one or two of the most frequent and distressing intrusions.