Open trial of inference-based therapy in the treatment of compulsive hoarding
Open trial of inference-based therapy in the treatment of compulsive hoarding

Summary/Abstract: Background and aims: Non-pharmaceutic approaches to the treatment of hoarding disorder (HD) use interventions based of cognitive-behavioral therapy (CBT). Inferencebased therapy (IBT) focuses on the doubts which form the basis of preoccupation in HD and deals with ego syntonic values in hoarding by exposing how the hoarding-self sabotages the authentic self. The objective was to establish if the IBT would lead to the clinically significant decrease of hoarding symptoms. Methods: 18 participants (17 completers) received 20 –weeks of IBT therapy. Hoarding was assessed in pre-treatment, post-treatment and at 6-month follow-up with the Vancouver Obsessional Compulsive Inventory Hoarding Subscale (VOCI-H) (n=14) and the Savings Inventory Revised (SI-R) (n=7). A general linear model for paired observations was used to assess treatment effect. The participants were divided into OCD -/+ according to a clinical diagnosis on the SCID-I and the VOCI-H scores were compared between the two groups. Results: Twelve of 14 completers where outcome was measured in VOCI-H (86%; CI 67%-100%) showed positive changes in hoarding; four crossed the threshold for clinically significant changes (28%, CI 5%-55%); all of them maintained the gain at follow-up. Three of 9 participants at follow-up crossed over the threshold to non-clinical status (33%, CI 3%-64%) (VOCI-H=6); six of nine participants (66%, CI 35%-97%) had positive changes in hoarding between baseline and 6-month follow-up. There were no differences in outcome on hoarding in participants classified by severe or moderate OC Discussion: The IBT showed significant diminution of hoarding symptoms in the range previously reported for CBT.The cognitive aspects of IBT add new dimensions to existing CBT approaches.

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