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J Psychopathol Behav Assess (2008) 30:193203 DOI 10.1007/s10862-007-9068-7
Development and Validation of the Clutter Image Rating
Randy O. Frost & Gail Steketee &
David F. Tolin & Stefanie Renaud
Published online: 12 September 2007# Springer Science + Business Media, LLC 2007
Abstract Few instruments are available to assess compulsive hoarding and severity of clutter. Accuracy of assessment is important to understanding the clinical significance of the problem. To overcome problems associated with over- and under-reporting of hoarding symptoms, the clutter image rating (CIR) was developed. This pictorial scale contains nine equidistant photographs of severity of clutter representing each of three main rooms of most peoples homes: living room, kitchen, and bedroom. The psychometric properties of this measure were examined in two studies. Internal consistency, testretest, and inter-observer reliabilities were good and convergent validity with other questionnaire and interview measures was also good. The CIR correlated more strongly with measures of clutter than with other hoarding and psychopathology scales. The CIRs very brief pictorial assessment method makes it useful in clinical and treatment contexts for measuring the clutter dimension of compulsive hoarding.
Keywords Hoarding . Collecting . Saving .
Visual assessment . Testing
Compulsive hoarding consists of the acquisition of, and failure to discard, large numbers of material possessions resulting in clutter severe enough to cause emotional distress, impair functioning, and preclude the use of living spaces for their intended purposes (Frost and Hartl 1996; Frost et al. 2000a, b; Samuels et al. 2002, 2007). Hoarding has been reported in a variety of Axis I and II disorders including schizophrenia, social phobia, brain injury, depression, eating disorders, organic mental disorder, and dementia, as well as avoidant, dependent, and obsessive compulsive personality disorder (Steketee and Frost 2003). Hoarding behavior has been found in some forms of developmental disabilities as well, such as PraderWilli syndrome (Dykens and Leckman 1996). Most often, however, it has been considered a symptom of obsessive compulsive disorder (OCD), occurring in 2030% of OCD cases (Steketee and Frost 2003). However, several lines of evidence suggest that it is either a distinct subtype (e.g., McKay et al. 2004) or a separate disorder. A large percentage of people with hoarding problems experience no other OCD symptoms (Frost et al. 2006). Hoarding symptoms do not correlate as...