Accuracy of self and informant reports of symptom severity and insight in Hoarding Disorder

Background: Previous literature on Hoarding Disorder (HD) has largely recruited individuals with selfidentified hoarding difficulties or informant-ratings of individuals who are not seeking help. Little is known about the reliability of selfand informant-ratings of hoarding severity and insight, and whether individuals who self-identify with HD differ from those who do not. Method: Twenty-four pairs of individuals meeting criteria for HD and their relatives took part in the study, plus 40 relatives of individuals meeting likely criteria for HD who did not agree to participate. All participants completed a clinician-administered diagnostic interview for HD and online questionnaires assessing hoarding severity, squalor and insight. Results: Good correspondence was found between selfand informant-ratings of hoarding severity, although informants gave significantly higher squalor ratings. Relative to clinician-ratings, informants under-estimated the insight of HD individuals. Higher hoarding severity and lower insight informantratings were made for individuals with HD who did not agree to participate, compared to those who did. Conclusions: A multi-informant approach guided by expert clinicians is desirable for the assessment of HD, particularly in low-insight individuals. When individuals do not seek help for HD, family members may benefit from education and support to help them understand how best to assist their relatives. & 2015 Elsevier Inc. All rights reserved.