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Validation of the clutter image rating in older adults with hoarding disorder

  • Mary E. Dozier (a1) (a2) and Catherine R. Ayers (a1) (a3) (a4)



The Clutter Image Rating (CIR) was created to meet a gap in the research on compulsive hoarding: how to ascertain clutter level in an individual's home without a home visit, as not all clinicians have the ability to conduct a home visit. The CIR has proven itself to be both reliable and valid for use in adults with compulsive hoarding symptoms. However, there is currently a dearth of information on performance of the CIR in older adults diagnosed with hoarding disorder (HD). Because older adults have increased medical issues, including fall risks, evaluating the level of clutter in the house is especially critical in geriatric populations.


The current study was an investigation of the reliability and validity of the CIR in assessing late life HD. The internal consistency, convergent and divergent validity, and norms of the CIR were investigated in a large geriatric HD sample and compared with a midlife sample of individuals with HD. Criterion validity of the CIR was investigated through the comparison of participant ratings conducted in the clinic and clinician ratings conducted in the home.


The current study found similar levels of reliability and validity in a late life sample as in previous studies conducted in mid-life adults.


Unlike previous studies, the current study did not find a significant relationship between the CIR and the non-clutter related subscales of the Savings Inventory-Revised. The CIR appears to be both reliable and valid for assessing clutter levels in older adults diagnosed with HD.


Corresponding author

Correspondence should be addressed to: Catherine Ayers, Ph.D., Department of Psychiatry, University of California San Diego School of Medicine, ABPP 3350 La Jolla Village Drive 116B San Diego, CA 92161. Phone: +(858) 552-8585; ext. 2976. Email:


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International Psychogeriatrics
  • ISSN: 1041-6102
  • EISSN: 1741-203X
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