Hoarding in Youth with Autism Spectrum Disorders and Anxiety: Incidence, Clinical Correlates, and Behavioral Treatment Response.
One in four anxious kids with autism also hoard, so add brief hoarding items to your intake.
01Research in Context
What this study did
The team looked at kids who had both autism and anxiety. They asked: how many also hoard things?
They ran a small case series. After normal CBT for anxiety, they checked if hoarding lessened too.
What they found
One in four anxious kids with autism also hoarded objects.
These children had more mood and behavior problems than those who did not hoard.
After regular CBT, their hoarding dropped a little, but not by much.
How this fits with other research
Van Hees et al. (2018) later saw even higher rates—about one in three kids—in a bigger group aged 7-13. The two studies overlap; the newer one simply enlarges the map.
Frost et al. (1996) found almost the same share of hoarding in pure OCD patients. The match hints that hoarding cuts across diagnoses once anxiety is in the mix.
Richards et al. (2017) showed that youth with autism can tell us when repetitive behaviors climb alongside anxiety. Their self-reports line up with the hoarding picture seen here.
Why it matters
If you serve anxious clients with autism, add three quick hoarding questions to your intake form. Spotting the behavior early lets you fold simple exposure or sorting practice into the current anxiety plan. No extra diagnosis is needed—just watch for piles of saved items and repeated distress when they are touched.
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02At a glance
03Original abstract
This study examined the nature and correlates of hoarding among youth with autism spectrum disorders (ASD). Forty children with ASD and a comorbid anxiety disorder were administered a battery of clinician-administered measures assessing presence of psychiatric disorders and anxiety severity. Parents completed questionnaires related to child hoarding behaviors, social responsiveness, internalizing and externalizing behaviors, and functional impairment. We examined the impact of hoarding behaviors on treatment response in a subsample of twenty-six youth who completed a course of personalized cognitive-behavioral therapy targeting anxiety symptoms. Hoarding symptoms were common and occurred in a clinically significant manner in approximately 25 % of cases. Overall hoarding severity was associated with increased internalizing and anxiety/depressive symptoms, externalizing behavior, and attention problems. Discarding items was associated with internalizing and anxious/depressive symptoms, but acquisition was not. Hoarding decreased following cognitive-behavioral therapy but did not differ between treatment responders and non-responders. These data are among the first to examine hoarding among youth with ASD; implications of study findings and future directions are highlighted.
Journal of autism and developmental disorders, 2016 · doi:10.1007/s10803-015-2687-z