Hoarding symptoms among psychiatric outpatients: confirmatory factor analysis and psychometric properties of the Saving Inventory - Revised (SI-R)

A latent factor approach to the Saving Inventory - Revised: Congeneric evaluation of construct and content validity

BACKGROUND

Inconsistencies have been identified in the three-factor structure and item loadings of the most commonly used self-report hoarding screening tool, the Saving Inventory - Revised (SI-R), which assesses difficulty discarding, clutter and acquisition. The current study aimed to confirm the factor structure of the SI-R using congeneric modelling, and evaluate the construct and content validity of this measure.

METHODS

139 participants with self-identified hoarding completed the SI-R. Congeneric structural equation modelling was then performed to validate the SI-R factor structure.

RESULTS

The three-factor structure of the SI-R was confirmed as a valid, reliable and good fitting model. However, the difficulty discarding and clutter subscales were required to covary.

CONCLUSIONS

The SI-R was confirmed as an appropriate screening tool for hoarding severity; however, revision of item wording may improve content validity. Future research could consider exploring the relationships between a range of hoarding-related constructs and the differential endorsement of SI-R subscales.

LIMITATIONS

As data were collected during the 2020 COVID-19 pandemic, panic buying and hoarding-related acquiring behaviours may have been exacerbated. In addition, the diagnostic status of participants was not verified, despite the inclusion of individuals endorsing clinically significant hoarding symptoms.

A systematic review and psychometric evaluation of self-report measures for hoarding disorder

BACKGROUND

Hoarding disorder (HD) affects approximately 2.5% of the general population, leads to significant distress and impairment, and is notoriously difficult to treat. The crux of developing effective treatments for HD is our ability to reliably and validly measure relevant constructs in HD to better understand its presentation and, subsequently, formulate appropriate interventions.

METHODS

We identified measures specific to HD and evaluated their psychometric properties using rating criteria formulated by the Consensus-based Standards for the selection of health Measurement INstruments (COSMIN) group.

RESULTS

The 17 included measures were developed to assess adult and pediatric hoarding severity, functional impairment, and maladaptive processes (e.g., material scrupulosity). The Saving Inventory-Revised, the most widely used measure of HD severity showed the strongest psychometric properties. However, psychometric investigations were generally of poor quality across all measures and results indicated unsatisfactory performance of measures.

LIMITATIONS

The current review excluded non-English measures and ratings inherently contain some element of subjectivity despite use of predetermined criteria and two independent reviewers.

CONCLUSIONS

We suggest that clinical researchers continue to develop and modify measures used to conceptualize and, ultimately, improve treatment for HD.

Saving inventory - Revised: Psychometric performance across the lifespan

BACKGROUND

The Saving Inventory - Revised (SI-R) is the most widely used self-report measure of hoarding symptom severity. The goal of this study is to establish a firm empirical basis for a cutoff score on the SI-R and to examine the functioning of the SI-R as a screening tool and indicator of hoarding symptom severity across the lifespan.

METHODS

This study used archival data from 1,116 participants diagnosed with a clinical interview in 14 studies conducted by research groups who focus on hoarding. We used receiver operating characteristic (ROC) analysis and the Youden's J statistic to determine optimal cutoff scores for classifying participants who would be likely to receive a hoarding diagnosis.

RESULTS

Overall, the discriminant performance of the SI-R Total score and each of the three subscales was high, confirming the status of the SI-R is an excellent screening tool for differentiating hoarding from non-hoarding cases. The optimal SI-R Total cutoff score is 39, although analyses suggested that older adults require a significantly lower cutoff and adults younger than 40 years require a significantly higher cutoff score.

LIMITATIONS

The confidence interval around the optimal cutoff for the SI-R Total score for oldest age group was wide in comparison to those reported for the younger groups, creating more uncertainty around the optimal cutoff score for this group.

CONCLUSIONS

This paper provides investigators and clinicians with the data necessary to select evidence-based cutoff scores on the SI-R that optimally suit their relative need for sensitivity and specificity in different age groups.

Validation of the clutter image rating (CIR) scale among psychiatric outpatients in Singapore

BACKGROUND

The Clutter Image Rating (CIR) Scale though extensively used to assess hoarding behavior, has mainly been validated in Western populations.

METHODS

The current study sought to validate the CIR in a sample of psychiatric outpatients (n = 500) in Singapore. Convergent and divergent validity as well as inter-observer reliabilities between participant CIR and interviewer-rated CIR were calculated.

RESULTS

The CIR performed fairly in identifying participants with and without hoarding problems according to the Savings Inventory Revised (SI-R). The CIR composite demonstrated good convergent validity with the SI-R clutter subscale, the SI-R total and the Activities of Daily Living Scale for Hoarding (ADL-H) scale and discriminant validity with the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and Quality of Life Enjoyment and Satisfaction Questionnaire - Short Form (Q-LES-Q-SF) scale.

CONCLUSIONS

Findings add valuable knowledge to the utility of the CIR in an Asian population.