The role of distress tolerance, anxiety sensitivity, and intolerance of uncertainty in predicting hoarding symptoms in a clinical sample

Hoarding disorder (HD) is characterized primarily by difficulty discarding possessions, leading to severe clutter and significant distress and impairment. Although promising psychological treatments have emerged, treating HD remains a clinical challenge. A greater understanding of the role of psychological vulnerability factors in predicting hoarding symptoms in a clinical HD sample could further enhance treatments. To investigate the role of proposed individual difference factors (i.e., distress tolerance, anxiety sensitivity, intolerance of uncertainty), we administered a diagnostic and self-report battery to 73 individuals diagnosed with HD who were seeking treatment for hoarding at a community clinic. Results indicated that when controlling for depression and anxiety symptoms, only distress tolerance predicted the severity of hoarding symptoms. Furthermore, meditation analyses revealed that the impact of distress tolerance on hoarding severity was partially mediated by hoarding beliefs. These results have important theoretical and clinical implications for HD.