Compulsive buying disorder

Compulsive buying disorder (CBD), or oniomania (from Greek ὤνιος ṓnios "for sale" and μανία manía "insanity"[1]), is characterized by an obsession with shopping and buying behavior that causes adverse consequences. According to Kellett and Bolton (2009, p. 83), compulsive buying "is experienced as an irresistible–uncontrollable urge, resulting in excessive, expensive and time-consuming retail activity [that is] typically prompted by negative affectivity" and results in "gross social, personal and/or financial difficulties".[2] Most people with CBD meet the criteria for an axis II disorder. Compulsive shopping may be considered an impulse control disorder, an obsessive-compulsive disorder, a bipolar disorder,[3] or even a clinical addiction, depending on the clinical source.

Shopping as a mood lifter may be an adaptive behavior if no compulsion is involved; it has jokingly been called retail therapy. But like opioid use, it can be either a therapy or an addiction, depending on whether it is adaptive or maladaptive.

History

Emil Kraepelin originally described oniomania over a century ago,[4] and he and Bleuler [1924] both included the syndrome in their influential early psychiatric textbooks.[5] However little interest was taken in CB until the 1990s,[6] and even in the 21st century compulsive shopping can be considered a barely recognised mental illness.[7]

Characteristics

CBD is frequently comorbid with mood, anxiety, substance abuse and eating disorders. People who score highly on compulsive buying scales tend to understand their feelings poorly and have low tolerance for unpleasant psychological states such as bad moods.[8] Onset of CBD occurs in the late teens and early twenties and is generally chronic. CBD is similar to, but distinguished from, OCD hoarding and mania. Compulsive buying is not limited to people who spend beyond their means; it also includes people who spend an inordinate amount of time shopping or who chronically think about buying things but never purchase them. Promising treatments for CBD include medication such as selective serotonin reuptake inhibitors (SSRIs), and support groups such as Debtors Anonymous.[9][10][11][12]

Distinctions

The terms compulsive shopping, compulsive buying, and compulsive spending are often used interchangeably, but the behaviors they represent are in fact distinct. (Nataraajan and Goff 1992) One may buy without shopping, and certainly shop without buying: of compulsive shoppers, some 30% described the act of buying itself as providing a buzz,[13] irrespective of the goods purchased.

Causes

Shopaholism often has roots in early experience, with failed parent-child transactions leading people to turn to objects to fill the sense of void and empty identity.[14] Children who experience parental neglect often grow up with low self-esteem because throughout much of their childhood they felt unimportant as people, and turned to substitute comforts,[15] such as toys or food, in compensation for loneliness. Adults who depended on material objects for emotional support when they were much younger are more likely to become addicted to shopping because of the ongoing sentiment of deprivation they endured as children: the purchase instead of the toy or the food is substituted for affection. Perfectionism, general impulsiveness and compulsiveness, and the need to gain control have also been linked to the disorder.[16]

Compulsive buying seems to represent a search for self in people whose identity is neither firmly felt nor dependable, as indicated by the way purchases often provide social or personal identity-markers.[17] Those with associated disorders such as anxiety, depression and poor impulse control are particularly likely to be attempting to treat symptoms of low self-esteem through compulsive shopping.[18]

Others, however, object that such psychological explanations for compulsive buying do not apply to all people with CBD.[19]

Social conditions also play an important role in oniomania, the rise of consumer culture contributing to the view of compulsive buying as a specifically postmodern addiction.[20]

Readily available credit cards enable casual spending beyond one's means, and some would suggest that the compulsive buyer should lock up or destroy credit cards altogether.[21] Online shopping also facilitates oniomania, with online auction addiction, used to escape feelings of depression or guilt, becoming a recognisable problem.[22]

What differentiates oniomania from healthy shopping is the compulsive, destructive and chronic nature of the buying. Where shopping can be a positive root to self-expression, in excess it represents a dangerous threat.[23]

Identity seeking

A social psychological perspective suggests that compulsive buying serves an identity-construction function. Compulsive buying may be seen as an exaggerated form of a more normal search for validation through purchasing.[24] Without a strong sense of identity, pressures from the spread of materialist values and consumer culture over the recent decades can drive the vulnerable into compulsive shopping.[25]

In a global context where we are all encouraged to "shop till we drop"[26]—to find solace in possessions[27]—compulsive shopping inevitably poses the further question, "Minority pathology or Mass problem?".[25] With advertisements offering not so much products as narratives (of success, glamour) to identify with,[28] compulsive buying may seem only an extreme aspect of what consumer culture demands from us all.[29]

Symptoms and course

Diagnostic criteria for compulsive buying have been proposed: 1. Over-preoccupation with buying; 2. distress or impairment as a result of the activity; 3. compulsive buying is not limited to hypomanic or manic episodes.[30]

While initially triggered by a perhaps mild need to feel special and less lonely, the failure of compulsive shopping to actually meet such needs may lead to a vicious cycle of escalation,[31] with sufferers experiencing the highs and lows associated with other addictions.[32] The 'high' of the purchasing may be followed by a sense of disappointment, and of guilt,[33] precipitating a further cycle of impulse buying in the quest for a sense of special identity.[34] With the now addicted person increasingly feeling negative emotions like anger and stress, they may attempt to self-medicate through further purchases,[35] followed again by regret or depression once they return home[36] - leading to an urge for yet another spree.

As debt grows, the compulsive shopping may become a more secretive act.[32] At the point where bought goods are hidden or destroyed, because the person concerned feels so ashamed of their addiction, the price of the addiction in mental, financial and emotional terms becomes even higher.[37]

Consequences

The consequences of oniomania, which may persist long after a spree, can be devastating, with marriages, long-term relationships, and jobs all feeling the strain.[38] Further problems can include ruined credit history, theft or defalcation of money, defaulted loans, general financial trouble and in some cases bankruptcy or extreme debt, as well as anxiety and a sense of life spiraling out of control.[39] The resulting stress can lead to physical health problems and ruined relationships, or even suicide.[40]

Treatment

Treatment involves becoming conscious of the addiction through studying, therapy, group work, etc... Research done by Michel Lejoyeux and Aviv Weinstein suggests that the best possible treatment for CB is through cognitive behavioral therapy. They suggest that a patient first be "evaluated for psychiatric comorbidity, especially with depression, so that appropriate pharmacological treatment can be instituted." Their research indicates that patients who received cognitive behavioral therapy over 10 weeks had reduced episodes of compulsive buying and spent less time shopping as opposed to patients who did not receive this treatment (251).

Lejoyeux and Weinstein also write about pharmacological treatment and studies that question the use of drugs on CB. They declare "Few controlled studies have assessed the effects of pharmacological treatment on compulsive buying, and none have shown any medication to be effective" (252). The most effective treatment is to attend therapy and group work in order to prevent continuation of this addiction.[41][42]

Selective serotonin reuptake inhibitors such as fluvoxamine and citalopram may be useful in the treatment of CBD, although current evidence is mixed.[43][44] Opioid antagonists such as naltrexone and nalmefene are promising potential treatments for CBD.[43] A review concluded that evidence is limited and insufficient to support their use at present, however.[45] Naltrexone and nalmefene have also shown effectiveness in the treatment of gambling addiction, an associated disorder.[45][46]

Historical and cultural examples

See also

Notes

  1. ↑ OMD. (2000, March 5). Retrieved January 16, 2008, from http://cancerweb.ncl.ac.uk/cgi-bin/omd?oniomania
  2. ↑ Kellett, S., & Bolton, J. V. (2009). Compulsive buying : A cognitive-behavioural model. Clinical Psychology and Psychotherapy, 16, 83–99.
  3. ↑ April Lane Benson/Marie Gengler, "Treating Compulsive Buying" in Robert H. Coombs, Handbook of Addictive Disorders (2004), p. 455
  4. ↑ Donald W. Black, 'A review of compulsive buying disorder'
  5. ↑ R. J. Frances et al., Clinical Textbook of Addictive Disorders (2005) p. 315
  6. ↑ Black
  7. ↑ Jon E. Grant/S. W. Kim, Stop Me Because I Can't Stop Myself (2004) p. 16
  8. ↑ Rose, Paul; Segrist, Daniel J (June 2012). "Difficulty Identifying Feelings, Distress Tolerance and Compulsive Buying: Analyzing the Associations to Inform Therapeutic Strategies". International Journal of Mental Health and Addiction 11 (1): 65–68. doi:10.1007/s11469-012-9389-y. ISSN 1557-1874.
  9. ↑ Hartston, Heidi J.; Koran, Lorrin M (June 2002). "Impulsive behavior in a consumer culture". International Journal of Psychiatry in Clinical Practice 6 (2): 65–68. doi:10.1080/136515002753724045. ISSN 1471-1788.
  10. ↑ Black, Donald W. (2001). "Compulsive Buying Disorder: Definition, Assessment, Epidemiology and Clinical Management.". CNS Drugs 15 (1): 17–27. doi:10.2165/00023210-200115010-00003. ISSN 1172-7047. OCLC 30488303. PMID 11465011.
  11. ↑ Black, Donald W. (February 2007). "A review of compulsive buying disorder". World Psychiatry 6 (1): 14–18. ISSN 1723-8617. OCLC 55586799. PMC 1805733. PMID 17342214.
  12. ↑ Vyse, Stuart (2008). Going broke: why Americans can't hold on to their money. Oxford; New York: Oxford University Press. p. 28. ISBN 0-19-530699-6. OCLC 153773333.
  13. ↑ Helga Dittmar, "Understanding and Diagnosing Compulsive Buying", in Robert H. Coombs, Handbook of Addictive Disorders (2004) p. 438
  14. ↑ Elias Aboujaourde/Lorrin M. Koran, Impulse Control Disorders (Cambridge 2010) p. 8
  15. ↑ Patrick Casement, Further Learning from the Patient (London 1990) p. 127
  16. ↑ April Lane Benson, I Shop Therefore I Am (2000)
  17. ↑ Aboujaourde/Koran, p. 8
  18. ↑ April Lane Benson/Marie Gengler, "Treating Compulsive Buying" in Coombs, p. 451
  19. ↑ Aboujaourde/Koran, p. 9
  20. ↑ Dittmar, p. 417
  21. ↑ Dennis Hayes, Beyond the Silicon Curtain (1989) p. 145
  22. ↑ Elen Lewis, The eBay Phenomenon (2008) p. 95
  23. ↑ April Lane Benson and Marie Gengler, "Treating Compulsive Buying", in Coombs, p. 452
  24. ↑ Helga Dittmar/Emma Halliwell, Consumer Culture, Identity and Well-being (2008) p. 95-7
  25. 1 2 Dittmar/Halliwell, p. 97
  26. ↑ Jenny Diski, The Sixties (London 2009) p. 18-20
  27. ↑ Oliver James, Britain on the Couch (London 1998) p. 301
  28. ↑ William Gibson, Zero History (London 2010) p. 21 and p. 213
  29. ↑ Dittmar/Halliwell, p. 119
  30. ↑ Frances, p. 315
  31. ↑ Pamela Klaffke, Spree (2004) p. 185
  32. 1 2 Klaffke, p. 185
  33. ↑ Lucy Costigan, Women and Healing (2006) p. 208
  34. ↑ Helga Dittmar, "Understanding and Diagnosing Compulsive Buying", in Robert H. Coombs, Handbook of Addictive Disorders (2004) p. 442
  35. ↑ Dittmar, p. 426
  36. ↑ Dittmar, p. 424
  37. ↑ Catalano and Sonenberg, in Costigan, p. 208
  38. ↑ Klaffke, p. 430
  39. ↑ Bruno Zumo, Advances in quality of life research, 2001 (2002) p. 164
  40. ↑ Grant/Kim, p. 36
  41. ↑ http://informahealthcare.com/doi/pdf/10.3109/00952990.2010.493590
  42. ↑ http://uh7qf6fd4h.search.serialssolutions.com/?sid=Refworks%3A&charset=utf-8&__char_set=utf8&genre=article&aulast=Wood&auinit=H.&title=Nature%20Reviews%20Neuroscience&date=2003&volume=4&pages=700-700&issue=9&issn=1471003X&atitle=In%20The%20News%3A%20Retail%20therapy&spage=700&au=Wood%2CHeather%20&doi=10.1038%2Fnrn1211&
  43. 1 2 Aboujaoude, Elias (2014). "Compulsive Buying Disorder: A Review and Update". Current Pharmaceutical Design 20 (25): 4021–4025. doi:10.2174/13816128113199990618. ISSN 1381-6128.
  44. ↑ Black DW (2007). "A review of compulsive buying disorder". World Psychiatry 6 (1): 14–8. PMC 1805733. PMID 17342214.
  45. 1 2 Piquet-Pessôa, Marcelo; Fontenelle, Leonardo F. (2016). "Opioid Antagonists In Broadly Defined Behavioral Addictions: A Narrative Review". Expert Opinion on Pharmacotherapy: 1–10. doi:10.1517/14656566.2016.1145660. ISSN 1465-6566.
  46. ↑ Yip, Sarah W.; Potenza, Marc N. (2014). "Treatment of Gambling Disorders". Current Treatment Options in Psychiatry 1 (2): 189–203. doi:10.1007/s40501-014-0014-5. ISSN 2196-3061.
  47. ↑ D. K. Goodwin, Team of Rivals (2013) p. 305, 401-2 and 681-2
  48. ↑ Kate Cann, Hard Cash (London 2000) p. 218

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