Enhancing Attention in Adults With Compulsive Hoarding

Inclusion Criteria: * Clinically significant compulsive hoarding (Proposed DSM-V criteria) that is principal (i.e. currently most severe and needing of treatment) and has been present for at least one year. * At least moderate attentional difficulties. * Able to provide consent. * Patients can be on or off of serotonin reuptake inhibitors (SRIs) or serotonin and norepinephrine reuptake inhibitors (SNRIs) but dose must be stable for 12 weeks prior to study. Exclusion Criteria: * Currently taking any psychotropic medications other than SRIs or SNRIs. * Presence of psychotic symptoms or lifetime history of schizophrenia, bipolar disorder or other psychotic disorder. * Current major depression is permitted if clearly secondary in importance to the hoarding. * Judged clinically to be at risk of suicide (suicidal ideation, severe depression or other factors) * Any cardiovascular abnormality that increases the risk of participation, including significant history of cardiovascular disease or family history of sudden death. * Any medical or neurological disorder that increases the risk of participation or that is a medical contraindication for taking methylphenidate (e.g. glaucoma or Tourette's syndrome). * Current use of any drug that is contraindicated with methylphenidate (e.g. monoamine oxidase inhibitors). * Female patients who are pregnant or nursing. * Current or previous treatment with methylphenidate or CBT for hoarding. * Current ETOH/drug abuse or dependence disorder of dependency in the past 6 months. * Individuals with mild cognitive impairments, dementia, or significant intellectual deficits.