Declutter Your Mind: A New Way to Measure Hoarding Tendencies
"Is it hoarding or just collecting? Researchers develop a real-time task to better understand and assess hoarding behavior."
Hoarding disorder (HD) is more than just having a messy house. It's characterized by persistent difficulty discarding or parting with possessions, regardless of their actual value. This can lead to significant clutter, distress, and impairment in various areas of life. Understanding the core behaviors of acquiring and discarding is crucial for effective assessment and treatment.
Traditional methods for assessing hoarding rely heavily on self-report questionnaires and clinical interviews. However, individuals with HD may lack insight into the severity of their symptoms, leading to inaccurate reports. This highlights the need for more objective and real-time measures of hoarding tendencies.
Recent research has validated a new computerized task designed to measure acquiring and discarding behaviors in real-time. This task simulates decisions about acquiring and discarding items of varying value, while recording response times as an indicator of decision-making difficulty. This approach offers a promising way to complement existing assessment methods and potentially improve treatment outcomes.
What the Sources Say About Prevalence
The listed sources describe hoarding disorder statistics and prevalence, but the supplied snippets do not provide a specific prevalence rate. One snippet says the disorder affects “up to 19 million Americans,” while another describes a 2026 report covering prevalence, treatment, and demographic breakdowns without giving figures. Because the snippets do not establish the basis for the 19-million estimate, it should be treated as a figure reported by that source rather than a verified consensus.
The Acquiring and Discarding Task: How It Works
The acquiring and discarding task is a computerized assessment where participants make simulated decisions about saving or discarding virtual items. Here's a breakdown:
- Acquiring Phase: Participants view pictures of items for sale and decide whether to "take" them home for free, with the limitation of filling only one shopping cart.
- Control Task: A control task involving classifying objects as "alive" or "never alive" is included for comparison, ensuring that any observed effects are specific to hoarding-related decisions.
- Real-Time Data: The task records which items participants choose to keep or discard (or acquire/leave) and how long it takes them to make each decision (reaction time).
- Subjective Ratings: Immediately after both tasks, participants rate their subjective feelings of anxiety/fear and sadness/regret.
New Measures and Emerging Research
A study on the Hoarding Behavioral Approach Task (H-BAT) describes a computerized assessment developed by Levy et al. (2019), noting its potential to directly measure acquiring and discarding behaviors, include a wide range of items, and be easy to administer. Separate experiments, Studies 3a (N = 144) and 3b (N = 146), tested whether induced boredom affected acquiring and discarding behaviors. A 2025 state-of-the-science review describes hoarding disorder as a relatively new diagnosis and reviews cognitive-behavioral, biopsychosocial, attachment, and addictions models.
Distinguishing Disorder from Collecting
Mayo Clinic distinguishes hoarding disorder from collecting: collectors seek specific items, organize and display them, and their collections are not usually cluttered or disruptive to functioning. By contrast, the MSD Manual says hoarding can create unsafe living conditions, including fire hazards and fall risks, and may lead to eviction or legal problems. It also reports that approximately 80 to 95% of people with hoarding disorder excessively acquire items, further contributing to the problem.
Different Evidence and Study Populations
The sources represent different kinds of evidence rather than directly comparable studies. One case report discusses three cases classified in different diagnostic categories under DSM-IV-TR in relation to hoarding disorder. A late-life study enrolled 65 participants aged 60 or older to examine whether hoarding severity predicts disability, while another study examined acquiring-related distress and responses to cognitive restructuring in 92 participants. The supplied snippets do not provide results that would support comparing the studies’ findings.
Implications for Treatment and Future Research
This validated task offers a more objective and nuanced way to assess hoarding tendencies, overcoming the limitations of self-report measures. It provides clinicians with a valuable tool to identify specific targets for intervention and track progress during treatment. For example, slower reaction times may indicate difficulty in decision-making, which can be addressed with cognitive strategies.
Family and Frontline Perspectives
A systematic review published January 21, 2026, synthesized qualitative studies on the impact of hoarding disorder on family members, addressing a literature the source describes as largely quantitative and limited in insight into lived experience. A separate review examines care for people with lived expertise of hoarding, evidence-based practice and interventions, and challenges facing frontline practitioners in hoarding-related situations. The supplied snippets identify these concerns but do not specify particular family experiences or practitioner challenges.
The research also found that individuals who completed cognitive-behavioral therapy (CBT) showed improvements in their task performance, suggesting that the task is sensitive to treatment-related changes. This opens up possibilities for using the task as an outcome measure in clinical trials and to personalize treatment approaches.
Future research should focus on replicating these findings in larger and more diverse samples, as well as examining the relationship between task performance and real-world hoarding behaviors. By combining behavioral measures with traditional assessment methods, we can gain a more comprehensive understanding of hoarding disorder and develop more effective interventions to help those who struggle with this challenging condition.