Predictors of treatment outcome and attrition in adults with hoarding disorder

Abstract

While a number of hoarding disorder-specific therapeutic interventions have been developed over recent years, hoarding disorder (HD) remains difficult to treat. The purpose of this investigation is to inform HD treatment efforts by examining factors that influence treatment attrition and treatment response. Secondary data analysis of baseline and post-treatment data from two previously published psychotherapy treatment studies for hoarding were performed to identify predictors of hoarding symptom improvement and treatment attrition in 106 adults with HD. No demographic variables were associated with symptom improvement or treatment attrition. However, higher levels of avoidant coping (i.e., self-distraction combined with behavioral disengagement) significantly predicted symptom improvement. The maintenance stage of change along with high readiness for change also significantly predicted symptom improvement. Participants who dropped from treatment had significantly higher baseline levels of denial and clutter, both of which independently predicted treatment attrition. The findings from this study suggest that emotion-related constructs, such as managing stress and motivation for change, may play an important role in patients' response to and participation in HD treatment.

Investigating the diagnostic specificity of attachment and relational needs in hoarding disorder

“…The identification of attachment and relational concerns in this population may also represent factors that influence response to treatment. CBT interventions for hoarding can be emotionally taxing, requiring consistent effort from clients (Ayers et al, 2018). High treatment attrition in CBT interventions for hoarding has been identified as a factor that interferes with treatment gains (Tolin et al, 2015).…”