How Effective is the Saving Inventory-Revised for Assessing Hoarding Symptoms?

What you need to know

• The Saving Inventory-Revised (SI-R) is a widely used tool for assessing hoarding symptoms, but its structure and validity needed further examination.
• This study confirmed the three main factors measured by the SI-R: difficulty discarding, clutter, and excessive acquisition.
• While the SI-R is a valid tool overall, some items may need rewording to better capture hoarding experiences.
• The strong connection between difficulty discarding and clutter suggests these may be core features of hoarding disorder.

Understanding hoarding disorder and its assessment

Hoarding disorder is a mental health condition characterized by persistent difficulty parting with possessions, regardless of their actual value. This leads to the accumulation of clutter that disrupts living spaces and daily functioning. People with hoarding disorder often experience distress at the thought of discarding items and may engage in excessive acquiring behaviors.

To effectively diagnose and treat hoarding disorder, mental health professionals need reliable assessment tools. The Saving Inventory-Revised (SI-R) is one of the most commonly used questionnaires for measuring hoarding symptoms. It consists of 23 questions designed to assess three key aspects of hoarding:

1. Difficulty discarding possessions
2. Excessive clutter
3. Excessive acquisition of new items

While the SI-R has been widely used in research and clinical practice, some inconsistencies have been noted in how well its questions measure these three factors across different studies. This new research aimed to take a fresh look at the SI-R’s structure and validity using advanced statistical techniques.

A new approach to validating the SI-R

The researchers used a method called congeneric modeling, which allows for a more flexible and theory-driven approach to examining how well questionnaire items measure underlying concepts. This is different from more rigid statistical techniques used in previous studies of the SI-R.

They recruited 139 adults who reported experiencing significant hoarding symptoms. Participants completed the SI-R online, and their responses were analyzed using this new modeling approach.

Confirming the three-factor structure with some adjustments

Overall, the study supported the three-factor structure of the SI-R, confirming that it does indeed measure difficulty discarding, clutter, and excessive acquisition. However, some interesting findings emerged:

1. The difficulty discarding and clutter factors were closely related. This suggests these two aspects of hoarding may be particularly central to the disorder.

2. Some items on the questionnaire didn’t perform as well as others in measuring their intended factor. For example, questions about feeling in control over urges to save or acquire items were less strongly related to the overall concepts.

3. The excessive acquisition factor stood out as somewhat separate from difficulty discarding and clutter. This aligns with how hoarding disorder is defined in diagnostic manuals, where excessive acquisition is considered an additional feature rather than a core symptom for all cases.

Implications for using the SI-R

While the study confirmed that the SI-R is a valid tool for assessing hoarding symptoms overall, the findings suggest some potential improvements:

• Rewording of some questions: Particularly those related to control over urges, as these didn’t seem to capture the intended concepts as well as other items.

• Considering subscale scores separately: Given that excessive acquisition emerged as a distinct factor, it may be helpful for clinicians to look at scores on each subscale in addition to the total SI-R score.

• Focusing on difficulty discarding and clutter: The strong relationship between these factors suggests they may be especially important in understanding an individual’s hoarding symptoms.

Limitations and future directions

It’s important to note some limitations of this study:

• The sample was primarily female and had relatively high rates of employment compared to typical clinical samples of people with hoarding disorder. This may limit how well the findings apply to all individuals with hoarding symptoms.

• The study relied on self-reported hoarding symptoms rather than clinical diagnoses.

• Data was collected during the COVID-19 pandemic, which may have influenced acquiring behaviors and feelings of uncertainty.

Future research could:

• Test the revised 17-item version of the SI-R suggested by this study in more diverse samples, including those with clinically diagnosed hoarding disorder.

• Explore how other psychological factors (like intolerance of uncertainty or difficulties with emotional regulation) relate to scores on different SI-R subscales.

• Investigate whether adding new items to capture additional aspects of hoarding experiences could improve the questionnaire’s ability to measure the full range of symptoms.

Conclusions

• The SI-R remains a valid tool for assessing hoarding symptoms, measuring three key factors: difficulty discarding, clutter, and excessive acquisition.
• Some refinement of individual questions may help improve how well the SI-R captures the full range of hoarding experiences.
• The close relationship between difficulty discarding and clutter highlights the importance of these features in understanding hoarding disorder.
• Clinicians and researchers should consider looking at subscale scores in addition to total SI-R scores when assessing hoarding symptoms.