Taking Time Off

For those of you that read my blog, I'm taking some time off from writing to focus on my client work and writing in other places.

Please visit my website for information about the many services I offer as a professional organizer and ADHD coach.  We look forward to your visit.: www.ahelinghandforyou.com

Pinterest-Crack for Organizers

O.K., I've just discovered crack for us professional organizers. It's called "Pinterest,"http://pinterest.com and I know I'm coming in a little late to the party, but thankfully I got invited to the Party. Thanks to Angela, thanks Angela!!! I also have to thank Standolyn, thanks Standolyn. But that invite didn't work out, cause I don't know what I did wrong that didn't work that first time I tried to invite myself through Standolyn's iPad. Well, actually Standolyn is who was the first person to share Pinterest with me, and I have her to really thank for this wonderful world of Pinterest.

O.K., since I'm a newbie on Pinterest, and still know nothing and have no time right now to get up to speed on this site, I'll have to wait till the weekend to really check it out and go to "Help" as many times as I need to get this new info into my every weary brain.

So, what is Pinterest? As Pinterest explains, "Pinterest is a virtual pinboard. Pinterest allows you to organize and share all the beautiful things you find on the web. You can browse pinboards created by other people to discover new things and get inspiration from people who share your interests."

Wow oh wow! If you can dream it, it's probably out there in Pinterest world somewhere. I have hardly tapped into Pinterest world, but can't wait to figure it out and then go searching for all the great organizing stuff I long to see. I know that I'll add some cool stuff too. O.K., just when I thought I had a grasp of my time, there it goes out the Pinterest window!!!

So, the challenge here will be for me to not fall into the Pinterest hole and only allow myself a certain amount of Pinterest time per "who knows what amount of time at this time." I'll commit to good Pinterest behavior after I figure out how to use this most excellent site. Happy Pinteresing!!!

Clients' brilliant dressing table - Made w/IKEA products

Client's Dressing Table 

This is how my client described how their dressing table made it onto ikeahackers.com. I must admit that I'd never heard of this site before. So, I hopped on over to it, and checked out my client's brilliant masterpiece, then started checking out other entries. I was enthralled by what I found. More ingenious people creating all kinds of useful items from different IKEA products. What they've come up with are some great ideas for me to share with my clients and you to share with your universe.

I'm always recommending IKEA, so it's nice to see more than just what the catalogs show you. You're looking at peoples' IKEA projects explained (so you to can create your own masterpiece). In the case of my clients, it was meticulously broken down into the how-to of each step of the project. I also like that at the end, my client added how she and her husband might have done certain things differently if they had to do it all over again. I like that bit of helpful advice. Here's her email to me and the link to their dressing table. Enjoy!

Over the vacation, RL and I built a customized "dressing table" to help make my morning routine smoother. On a whim, I submitted my project to ikeahackers.net and they picked up my project! I'm so excited! 

I openly talk about my ADHD and need for 'vertical storage', items having a specific home, and being able to see my things in the article. All advice that you gave me! I am so very glad to have you as a resource!! http://www.ikeahackers.net/2012/01/grundtal-beauty-bar-and-laptop-table.html#more

Graduation Party Challenge

We hosted a graduation party this past Saturday for my husband George. He graduated with an MBA in marketing. My oldest brother and his new wife Michelle drove in from New Orleans. We celebrated with our wonderful family and friends and it was a blast, but I must admit that I was sweating this party a little bit and heres why.

I invited a large number of people versus the amount of seating space I have available inside my house. Since we have had really mild weather without rain here in Austin (we've been experiencing a severe drought), we were thinking that we'd put tables on our back porch and patio to make up for the seating we don't have in the house. I didn't want to rent out a hall, too impersonal for us. We wanted a house party, so we thought we'd be all set for inside and outside. Well, just when you pray for rain 365 days a year, who would have thought that we'd be lucky enough to have rain on the day of our party. Well, we were more than lucky, cause it rained substantially.

So, the week before when the weather channel said a 70% chance of rain, I believed Mother Nature and headed over to Party City, one of my most frequented shops as of late, and filled up on party deco for our garage. Yes, I said our 2-car garage. Well you might be thinking that as a professional organizer, my garage must be neat and organized. That's very possible, but that wasn't just my doing, you must give a lot of the credit to George Lyman, the other half of the Lyman family. George isn't a professional organizer; he has some organizing challenges, but in our garage and backyard shed he is as organized as anyone can be (short of being a professional at it). That's cause he loves his tools!!! He knows how to fix everything inside and out, and "has the right tool to do the right job!" He also finished the garage floor with a lovely blue epoxy finish this past summer. He is incredible!!!

Anyway, the reason I started this blog was to show you how I decorated the steel Gorilla utility shelf in our garage to make them party ready. I used blue mylar streamers from Party City that were held up by magnets onto the shelf. We also had all kinds of other decorations and had seating in the garage for 20+ people. There's also music in the garage, so everyone was rockin'. Next time I have to entertain there, I'm going to use candles on the tables to make it more of an intimate environment. Happy celebrating!!!

My Challenges

I've blogged about a lot of professional organizing issues. I'm going to make a change here and talk a bit about my current challenges to hopefully spark a conversation.

This past March and April I had to have four back surgeries, due to complications over an initial surgery for a herniated disk from a car accident. The driver hit me head-on and my car was totaled and I was so lucky to only have minor injuries, instead of ending up flying down the canyon and ending in a fiery blaze.

As a professional organizer, my work is very physical. There was no way in heck I was going to throw in the towel and not be physical anymore. My back surgeries didn't stop me from being physical, and now I have to be so careful to strengthen my back in the healthiest way.

When I first came back home after spending almost a month in ICU, I could hardly walk. I never felt so weak. I had to start by getting my strength back. I started walking and went back to the gym (Anytime Fitness) where I had Carl (owner/trainer) revise my weekly workout to accommodate my new challenges with my lower back. He modified my workout, and I started out slow.

Unfortunately, I also gained some weight from not being able to workout for the past 3+ months. My work was cut-out for me. I had to change the way I eat. Portion control is a huge issue that I deal with. I have to specifically cut down on the amount of food I put on my plate. Also, my husband George has been studying a lot of different health sites, especially those that deal with healthy food combining.

Here's an easy definition: food combining is no singular diet, but a lasting new form of nourishment, with a small but important change of your nutritional habit.

How Food Combining works:
You can eat what you want.
You can eat how much you want.
You can combine food but never protein and carbohydrate.

Currently my challenge is to work-out on a daily basis. Today I wasn't able to go to my gym, so I worked out at home with my big workout ball, doing exercises on my yoga mat, using the ball for doing core exercises. I also took Louie for a walk, with was refreshing after a much needed rain here in Austin. I didn't do so well with the kind of food I ate today, but tomorrow I will strive to eat only healthy things and stick to the food combining rules.

This time of year will be a good challenge to drop weigh. Let's see what I can do in this department. Tomorrow's another day.

Saving Children's Artwork

What is more precious then your children's artwork? They bring it home for you to admire, and admire you do. I've had many clients that have decision making problems and one problematic area is what to do with all of their children's artwork. What to keep, what to toss? Well, that decision is a pretty personal and difficult thing for some parents.

There has been many a time I suggest that my clients choose a number that they are comfortable with, and keep a certain amount of artwork per month. Let's say you like the number 5. You keep 5 items per month and at the end of the year, you and your children sit down and pick one or two from each month. If you have limited space, you limit the number of artwork keeps to suit your storage needs. Decide what will make the cut and what won't. Will you involve your child in the decision making or make the decisions yourself or on your own?

If you have a problem making a decision about what to keep, think about how helpful it will be if you limit what you choose to display and what you choose to archive. You'll be sending a message to your children that we make choices and don't keep everything. Not everything is worth keeping. When we make choices, we help ourselves and our children to understand that decision making is an important process. We also want to honor the artwork our children have created by making sure that these treasures are preserved and stored safely.

There are some really cute ways of displaying children's artwork. Pottery Barn kids has these cute butterfly clips that work as a way to display and string their artwork on a wall. (http://tinyurl.com/7k52a3h) Works of art can be rotated in and out with this idea. Another cute site is Land of Nod. They also offer these cute art clips in different styles. (http://tinyurl.com/3ucnd6o).

Improvements offers a "Dynamic Artwork Frame' that displays one work of art at a time, but holds 50 works of art. You'll always have a new masterpiece to look at with that frame. (http://www.dynamicframes.com)

One last important place for wonderful archive boxes is Container Store. They have them in all different sizes for your needs. Let's celebrate your budding Monet's with some creative displays and storage.

Psychiatric Issues in Hoarding

[I'd like to share this article which originally ran in Psychiatric Times, Volume 28, No. 8.  This is the full version of the original article with the website reference at the end. Randi Lyman]

Psychiatric Issues in Hoarding

Strategies for Diagnosing and Treating Symptoms of Hoarding

By Suzanne Otte, MBA, MSW and Gail Steketee, PhD | August 19, 2011

Ms Otte is Hoarding Research Project Affiliate at Boston University School of Social Work and Dr Steketee is Dean and Professor at Boston University School of Social Work. The authors report no conflicts of interest concerning the subject matter of this article.

In North America, an estimated 30% of the population maintains a collection of some sort.¹ The practice of collecting, in which individuals maintain collections of objects that are generally considered interesting and valuable is distinctly different from that of hoarding.² Compulsive hoarding is characterized by the following criteria^3,4:

• The acquisition of, and failure to discard, a large number of possessions

• Excessive clutter that precludes activities for which the living space was designed

• Significant distress or impairment in functioning caused by the hoarding

Hoarding has broad-reaching implications, including a substantial public health burden linked to occupational impairment, poor physical health, and demand for social services.⁵ For example, it is not uncommon for community public health departments to become overburdened with property complaints regarding unsanitary conditions and fire hazard risks, and the cost to address a problem (eg, repetitive clean-outs, repeated visits by health inspectors, multiple-agency involvement) is high.⁶ These costs have led to the establishment of community-wide task forces in a number of cities.⁷ However, efforts to reconcile the problem are often diminished by the relative unavailability or ineffectiveness of mental health services.⁸
In addition to the effects of hoarding on the community, family dynamics are often strained.⁹ Substantial distress, frustration, hostility, and rejection of hoarders are not uncommon.³ In a recent online study of hoarding, more than half of the participants were described as having poor or no insight into the severity of their hoarding behaviors, and family members’ attitudes of rejection were correlated with less awareness of illness among those who hoard.¹⁰
For the individual who hoards, outcomes may include substantial work impairment, eviction or threat of eviction, or having a child or elder removed from the home.¹⁰ In general, persons with hoarding problems seek treatment after age 40 years, although hoarding symptoms commonly begin in the early teenage years.¹¹ Those who hoard tend to live alone and may have a family member (parent, sibling, older relative) with the problem.^12-14
The prevalence of clinically significant hoarding in the general population ranges from 2% to 5%, and between 6 million and 15 million persons in the United States are affected, according to recent epidemiological studies.^15-17 Hoarding appears to affect more men than women, although women are more likely to participate in research and seek treatment.¹⁷
Hoarding is a significant psychiatric problem that occurs at twice the rate of obsessive-compulsive disorder (OCD) and at almost 4 times the rate of bipolar disorder and schizophrenia.¹³ It has been linked with impulse control disorders and appears to have high comorbid rates of major depressive disorder (MDD), social anxiety disorder, generalized anxiety disorder (GAD), attention-deficit/hyperactivity disorder (ADHD), and personality disorders.^18-26

What is already known about hoarding?

■ Clinically significant hoarding affects between 6 million and 15 million persons in the United States, according to recent epidemiological studies, occurring at twice the rate of obsessive-compulsive disorder (OCD) and at 4 times the rate of bipolar disorder and schizophrenia. It appears that hoarding is accompanied by high rates of comorbidity. A number of self-report and clinician-administered hoarding-specific measures aid in the assessment of symptoms and severity. Treatment for hoarding is guided by a cognitive-behavioral therapy (CBT) approach.

What new information does this article provide?

■ Historically, hoarding has been deemed a subtype of OCD, although forthcoming evidence suggests there are more differences than similarities. Hoarding is under consideration for inclusion in DSM-5 as a stand-alone disorder. A set of provisional criteria for hoarding disorder has been proposed and will require further study in the future. A recent study conducted by Frost and colleagues that examined the largest sample of participants to date confirmed that major depressive disorder was the most frequently occurring comorbid condition (more than 50%) and that kleptomania was a factor in 10% of the sample. This article highlights treatment options for hoarding that are available to practitioners, including alternative approaches focusing on self-help, support group, and Web-based delivery models.

What are the implications for psychiatric practice?

■ Individually administered CBT, following the protocol developed by Steketee and Frost, appears to be the most effective treatment, with a 70% to 80% rate of clinical improvement for patients who complete treatment. Given the expense and limited availability of individual treatment, alternatives, including group CBT, Web-based treatment, in-person self-help groups, and in-home coaching assistance, may provide sustainable and affordable approaches to this significant societal problem. Further research to better understand hoarding and to provide additional cost and resource-sensitive solutions is ongoing.

Historically, hoarding has been considered a subtype of OCD, although recent evidence suggests that there are more differences than similarities.13 Studies of patients with OCD have shown an 18% to 40% frequency of hoarding in adults and children and adolescents, although, hoarding is identified as a major or primary symptom in fewer than 5% of cases.19,26-29 Early studies that support this finding were derived from measures that do not adequately assess the presence or severity of hoarding (ie, Yale-Brown Obsessive Compulsive Scale30).8 Recent studies have incorporated reliable and valid measures (eg, Saving Inventory-Revised [SI-R], Hoarding Rating Scale-Interview [HRS-I], Clutter Image Rating [CIR]) that assess specific symptoms of hoarding as well as changes in symptoms following treatment.8

Comorbidity and implications for diagnosis
The identification of hoarding as a subtype of OCD has influenced scientific understanding of its comorbidity. Progressive research efforts have advanced the definition and measurement of hoarding, providing a more reliable diagnosis and assessment of comorbidity.^12,31,32 A recent study by Frost and colleagues (R. O. Frost, G. Steketee, D. F. Tolin, K. Glossner, unpublished data, 2011) examined 217 hoarding participants, the largest sample to date, who were recruited to meet diagnostic criteria for hoarding disorder (HD) currently under review for DSM-5.¹² The study confirmed that a minority of participants with HD (fewer than 20%) also had OCD diagnoses and that MDD was the most frequent comorbid condition (more than 50%). This was followed by GAD and social phobia in approximately 25% of HD participants.


The rates for posttraumatic stress disorder were relatively low (7%), but the HD sample was more likely than OCD patients to have experienced a traumatic event as an adult or as a child. This finding is consistent with earlier research about the frequency of traumatic events among those who hoard.^17,33,34 Inattentive ADHD was significantly more frequent in hoarding than in OCD (30% vs 3%), which supports the speculation that attention deficits are relatively common among those who hoard, but certainly this is not a universal characteristic.
It is not surprising that compulsive buying and excessive acquiring of free things were common among the hoarding sample (about 60%), and even the prevalence of kleptomania was surprisingly high at 10% of the sample. These findings confirm recent reports that more than 80% of people with self-reported hoarding acquire excessively.³⁵ Obsessive-compulsive personality disorder (OCPD) was the most frequent personality disorder found among hoarding participants, even when hoarding was omitted from the criteria for OCPD.

Status of DSM-5 diagnostic criteria
Today, hoarding is cited in DSM-IV-TR as one of the diagnostic criteria for OCPD and, when hoarding is deemed severe, a symptom of OCD.¹²Hoarding has been a core diagnostic criterion for OCPD only since DSM-III-R and as a possible OCD symptom within the differential diagnosis section OCPD since DSM-IV.^12,36 Given the presumption that hoarding was a symptom of OCD, many studies have evolved from this assumption and have influenced clinical understanding of the disorder.¹³ More recently, however, growing evidence supports the separation of hoarding from OCD.^13,36-38
In the interest of clarifying the clinical phenomenon, increasing public awareness, improving identification of cases, and stimulating further research and development of effective treatments for hoarding, a set of provisional criteria has been proposed (Table).¹² These will require further study in the coming years.

Theoretical model
The manifestations of hoarding (acquisition, difficulty with discarding, clutter), outlined in an emerging cognitive-behavioral model, are hypothesized to evolve from core vulnerabilities based on early life experiences, genetic predisposition, current mood state, and personality traits (Figure).^4,39,40 On the basis of this model, cognitive information processing deficits (focusing attention, decision making, organizing, and possibly perception) are thought to be persistent factors in generating hoarding. A combination of early experiences and cognitive challenges result in mistaken beliefs about and attachments to possessions, with resulting negative emotions that lead to avoidance behaviors (saving unneeded items) and clutter. In addition, objects that evoke feelings of positive attachment and experiences of pleasure may result in excessive acquiring and clutter.⁸

CBT methods and outcomes
The elements of mental health treatment for hoarding are based on the theoretical model for this multidimensional problem. The protocol uses a manualized cognitive-behavioral therapy (CBT) approach that incorporates assessment and goal setting, organizing and problem-solving skills training, exposure practice methods to reduce acquiring and remove clutter, and motivational interviewing to address patient resistance when it arises during treatment.^2,8,41
The tools to measure hoarding symptoms and severity include the SI-R, a 23-item self-report questionnaire that assesses difficulty with discarding, clutter, and excessive acquisition; a score of 41 or higher typically indicates a clinical hoarding problem.³¹ The HRS-I helps clinicians make a diagnostic assessment of the 5 main features of hoarding (clutter, acquisition, difficulty with discarding, distress, impairment), each rated on a 0 to 8 scale; the HRS-I can also be used as a self-report scale.³² The CIR is a pictorial measure of in-home clutter severity intended for use by patients, family members, clinicians, or independent assessors.⁴² The Saving Cognitions Inventory is a 24-item self-report measure of beliefs experienced by patients when they attempt to discard items; subscales of this measure include emotional attachment, concerns about memory, control over possessions, and responsibility toward possessions.⁴⁰

The most effective approach to date appears to be individually administered CBT, following the model and methods of Steketee and Frost.² A recent pilot study of 10 completers and a controlled trial with 37 completers yielded rates of 70% improved or much improved according to the therapists and 80% according to patients. Overall, 60% of patients showed clinically significant improvement following 26 sessions of individual CBT that included monthly in-home visits.¹⁰ Group interventions that included 20 sessions of CBT were only slightly less effective and appear to offer considerable potential for cost-saving solutions.²²

Further research is necessary to examine methods to enhance cognitive function (eg, attention, executive functioning) to improve the effectiveness of CBT.⁴³ Expanding study inclusion criteria to allow men and persons from other cultures, races, and socioeconomic status will help generate more information about outcomes and strategies appropriate for all persons who hoard.

Cost-saving, stepped-care strategies for delivering CBT
The delivery of in-person, individual or group therapy for hoarding depends on skilled clinicians trained to treat persons with this problem. Because individual and even group treatment can be expensive and unavailable to many individuals with this highly prevalent condition, alternative approaches have focused on the application of self-help bibliotherapy, online and in-person support groups, coaching, and Web-based CBT.
Muroff and colleagues⁸ describe a 2009 study undertaken by Pekareva-Kochergina and Frost. The researchers examined the benefits of a 13-week intervention during which 2 undergraduate students supervised by a senior clinician facilitated 2 self-help groups. Participants read Buried in Treasures: Help for Compulsive Hoarding,⁴⁴ a book describing hoarding, and were encouraged to practice the strategies proposed. At the close of the group sessions, 41% of participants rated themselves “much improved.” This student-led group yielded a surprisingly positive outcome for group members in a relatively short period.

In 2010, a Web-based self-help group for hoarding, established in 1998, was studied by Muroff and colleagues.⁴⁵ Members participated in online chats, accessed an archive of resources hosted on the Web site, and were required to post action steps and progress reports at least monthly. Both long-term and recent members showed reductions in clutter and hoarding symptoms over a 15-month period. More active participants on the Web site showed statistically lower levels of hoarding. This group represents an intervention model that holds the potential to economically extend treatment to a geographically dispersed group.

The benefit of in-home assistance by clinicians is time-consuming and costly. Muroff and colleagues8 introduced non-clinician, in-home assistants (trained undergraduate student coaches) into a hoarding treatment group to reinforce skills learned in group treatment and boost CBT-based outcomes for participants. Clinicians who led the group communicated with coaches through in-person and telephone group supervision and use of a system to track and docu-ment home visits throughout the 20-week treatment period. One group of participants received 4 home visits from one of the cotherapists, the second group received an additional 4 home visits from the undergraduate coaches. Although reductions in hoarding symptoms were not statistically significant, additional in-home assistance appeared to offer improved (albeit small) outcomes. Additional studies will help further define the effect of this enhancement to group treatment.
A pilot study is under way to test the feasibility, acceptability, and effectiveness of computer- and Webcam-delivered CBT for hoarding symptoms. Preliminary results show potential for a cost-effective, direct service solution to in-home locations where hoarding occurs.⁸ Initial outcomes of this 26-session, weekly home-based CBT treatment delivered via Webcam showed moderate improvement of participant’s hoarding symptoms and was administered over a 30- to 38-week period compared with an average 49 weeks of in-person treatment.
These stepped-care strategies demonstrate potential to assist a broader spectrum of patients using CBT hoarding interventions and offer a sustainable, economic approach to this societal problem. Given the large number of persons who hoard, the debilitating and potentially deadly consequences, and the sometimes limited insight into the severity of their symptoms, it seems essential to learn more about this complicated problem. Current CBT regimens are effective, but they are costly. Accordingly, more research is needed to better understand the disorder and to provide relief from this chronic problem.

References
1. Pearce S. On Collecting: An Investigation Into Collecting in the European Tradition. London: Routledge; 1995.
2. Steketee G, Frost RO. Compulsive Hoarding and Acquiring: A Therapist Guide. New York: Oxford University Press; 2007.
3. Frost RO, Gross RC. The hoarding of possessions. Behav Res Ther. 1993;31:367-381.
4. Frost, RO, Hartl TL. A cognitive-behavioral model of compulsive hoarding. Behav Res Ther. 1996;34:341-350.
5. Tolin DF, Frost RO, Steketee G, et al. The economic and social burden of compulsive hoarding. Psychiatry Res. 2008;160:200-211.
6. Frost RO, Steketee G, Williams L. Hoarding: a community health problem. Health Soc Care Community. 2000;8:229-234.
7. Steketee G, Frost R. Compulsive hoarding: current status of the research. Clin Psychol Rev. 2003;23:905-927.
8. Muroff J, Bratiotis C, Steketee G. Treatment for hoarding behaviors: a review of the evidence. Clin Soc Work J. 2010. doi:10.1007/s10615-010-0311-4. 2010.
9. Tolin DF, Frost RO, Steketee G, Fitch KE. Family burden of compulsive hoarding: results of an internet survey. Behav Res Ther. 2008;46:334-344.
10. Tolin DF, Frost RO, Steketee G. An open trial of cognitive-behavioral therapy for compulsive hoarding. Behav Res Ther. 2007;45:1461-1470.
11. Grisham JR, Frost RO, Steketee G, et al. Age of onset of compulsive hoarding. J Anxiety Disord. 2006;20:675-686.
12. Mataix-Cols D, Frost RO, Pertusa A, et al. Hoarding disorder: a new diagnosis for DSM-V? Depress Anxiety. 2010;27:556-572.
13. Pertusa A, Frost RO, Fullana MA, et al. Refining the diagnostic boundaries of compulsive hoarding: a critical review. Clin Psychol Rev.2010;30:371-386.
14. Saxena S. Recent advances in compulsive hoarding. Curr Psychiatry Rep. 2008;10:297-303.
15. Iervolino AC, Perroud N, Fullana MA, et al. Prevalence and heritability of compulsive hoarding: a twin study. Am J Psychiatry. 2009;166:1156-1161.
16. Mueller A, Mitchell JE, Crosby RD, et al. The prevalence of compulsive hoarding and its association with compulsive buying in a German population-based sample. Behav Res Ther. 2009;47:705-709.
17. Samuels JF, Bienvenu OJ, Grados MA, et al. Prevalence and correlates of hoarding behavior in a community-based sample. Behav Res Ther.2008;46:836-844.
18. Frost RO, Steketee G, Williams L. Compulsive buying, compulsive hoarding, and obsessive-compulsive disorder. Behav Ther. 2002;33:201-214.
19. Samuels J, Bienvenu OJ 3rd, Riddle MA, et al. Hoarding in obsessive compulsive disorder: results from a case-control study. Behav Res Ther. 2002;40:517-528.
20. Frost RO, Steketee G, Tolin D, Brown T. Co-morbidity and diagnostic issues in compulsive hoarding. Paper presented at: Annual Meeting of the Anxiety Disorders Association of America 2006; Miami.
21. Frost RO, Steketee G, Williams LF, Warren R. Mood, personality disorder symptoms and disability in obsessive compulsive hoarders: a comparison with clinical and nonclinical controls. Behav Res Ther. 2000;38:1071-1081.
22. Muroff J, Steketee G, Rasmussen J, et al. Group cognitive and behavioral treatment for compulsive hoarding: a preliminary trial. Depress Anxiety. 2009;26:634-640.
23. Steketee G, Frost RO, Wincze J, et al. Group and individual treatment for compulsive hoarding: a pilot study. Br Assoc Behav Cognit Psychother. 2000;23:259-268.
24. Hartl TL, Frost RO. Cognitive-behavioral treatment of compulsive hoarding: a multiple baseline experimental case study. Behav Res Ther.1999;37:451-461.
25. Meunier SA, Tolin DF, Frost RO, et al. Prevalence of hoarding symptoms across the anxiety disorders. Paper presented at: Annual Meeting of the Anxiety Disorders Association of America; 2006; Miami.
26. Mataix-Cols D, Rauch SL, Manzo PA, et al. Use of factor-analyzed symptom dimensions to predict outcome with serotonin reuptake inhibitors and placebo in the treatment of obsessive-compulsive disorder. Am J Psychiatry. 1999;156:1409-1416.
27. Frost RO, Krause MS, Steketee, G. Hoarding and obsessive-compulsive symptoms. Behav Modif. 1996;20:116-132.
28. Mataix-Cols D, Nakatani E, Micali N, Heyman I. Structure of obsessive-compulsive symptoms in pediatric OCD. J Am Acad Child Adolesc Psychiatry. 2008;47:773-778.
29. Rasmussen SA, Eisen J. Clinical features and phenomenology of obsessive-compulsive disorder. Psychiatr Ann. 1989;19:67-73.
30. Goodman WK, Price LH, Rasmussen SA, et al. The Yale-Brown Obsessive Compulsive Scale. I. Development, use, and reliability. Arch Gen Psychiatry. 1989;46:1006-1011.
31. Frost RO, Steketee G, Grisham J. Measurement of compulsive hoarding: saving inventory-revised. Behav Res Ther. 2004;42:1163-1182.
32. Tolin DF, Frost RO, Steketee G. A brief interview for assessing compulsive hoarding: the Hoarding Rating Scale-Interview. Psychiatry Res.2010;178:147-152.
33. Wheaton M, Timpano KR, Lasalle-Ricci VH, Murphy D. Characterizing the hoarding phenotype in individuals with OCD: associations with comorbidity, severity and gender. J Anxiety Disord. 2008;22:243-252.
34. Cromer KR, Schmidt NB, Murphy DL. Do traumatic events influence the clinical expression of compulsive hoarding? Behav Res Ther.2007;45:2581-2592.
35. Frost RO, Tolin DF, Steketee G, et al. Excessive acquisition in hoarding. J Anxiety Disord. 2009;23:632-639.
36. Wu KD, Watson D. Hoarding and its relation to obsessive-compulsive disorder. Behav Res Ther. 2005;43:897-921.
37. Abramowitz JD, Wheaton MG, Storch EA. The status of hoarding as a symptom of obsessive-compulsive disorder. Behav Res Ther.2008;46:1026-1033.
38. Pertusa A, Fullana MA, Singh S, et al. Compulsive hoarding: OCD symptom, distinct clinical syndrome, or both. Am J Psychiatry.2008;165:1289-1298.
39. Frost RO, Tolin DF. Compulsive hoarding. In: Taylor S, Abramowitz JS, McKay D, eds. Clinical Handbook of Obsessive-Compulsive Disorder and Related Problems. Baltimore: Johns Hopkins University Press; 2008:76-94.
40. Steketee G, Frost RO, Kyrios M. Cognitive aspects of compulsive hoarding. Cognit Ther Res. 2003;27:463-479.
41. Steketee G, Frost RO. Compulsive Hoarding and Acquiring: Workbook. New York: Oxford University Press; 2007.
42. Frost R, Steketee G, Tolin D, Renaud S. Development and validation of the clutter image rating. J Psychopathol Behav Assess. 2008;30:193-203.
43. Tolin DF, Villavicencio A. Inattention, but not OCD, predicts the core features of hoarding disorder. Behav Res Ther. 2011;49:120-125.
44. Tolin DF, Frost RO, Steketee G. Buried in Treasures: Help for Compulsive Hoarding. New York: Oxford University Press; 2007.
45. Muroff J, Steketee G, Himle J, Frost R. Delivery of internet treatment for compulsive hoarding (D.I.T.C.H.). Behav Res Ther. 2010;48:79-85.
46. American Psychiatric Association. DSM-5 development: F 02 hoarding disorder.http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=398. Accessed July 6, 2011.

This articles' original website: http://www.psychiatrictimes.com/display/article/10168/1932177]