The Family Impact Scale for Hoarding (FISH): Measure development and initial validation

• Introduces the FISH: a tool to assess the Family Impact of Hoarding Disorder.
• Details the scale's development and initial item content.
• Examines the factor structure of the FISH.
• Tests the scale's internal consistency, convergent and discriminant validity.

BackgroundThe Family Impact Scale for Hoarding (FISH) was designed to assess the disruption experienced, by members of a familial or social circle, due to one individual's hoarding difficulties. The scale was drafted to examine two aspects of impact: accommodation and burden. The current study describes the scale's development and preliminary validation.MethodsOne hundred thirty-four adults, identifying as the relative of someone with problematic hoarding (n=102) or normative collecting behavior (n=32), completed the FISH alongside measures of hoarding severity, burden, functional impairment, and quality of life (QoL). Exploratory factor analysis (FA) was used to examine the scale’s factor structure. Internal consistency, known-groups and convergent validity were also investigated.ResultsFA supported two factors, accounting for 65.43% of variance. Of the scale items, 16 were determined to load onto these factors. Items that did not load were omitted. The revised scale accounted for 67.41% of variance and was characterized by good internal consistency (α=0.86). This measure also differentiated between study groups and demonstrated strong correlations with measures of severity and burden. Regression indicated the FISH better predicted group membership than existing measures of burden, impairment or quality of life.DiscussionThe FISH is a promising measure of family impact in the context of (HD). Its psychometric properties and utility in monitoring outcomes of caregiver-based interventions should be investigated further.