What is Compulsive Buying Disorder?
Compulsive buying disorder (CBD) is a strong preoccupation with shopping that causes distress in the sufferer and can have negative impacts on the sufferer’s ability to function well in daily life. Studies have suggested that the disorder may affect about 6% of the general population, and some studies have indicated that the frequency of CBD might be even higher.
CBD is characterized by a preoccupation with shopping and buying. Sufferers usually report having a feeling of anxiety before they buy an item, and that anxiety is relieved when they actually make a purchase.
About 80% or more of people who are clinically described as suffering from CBD are women. Some studies have suggested, however, that the difference in diagnosis rates in men and women might come from differences in the way behavior is described. Women are more likely to admit to a preoccupation with shopping, while men are more likely to describe their buying behavior as “collecting.” Research is mixed on whether there is a real difference in frequency of CBD between the sexes.
CBD is only prevalent in societies with a consumer-driven economy, where disposable income, available credit, and an abundance of leisure time are common.
Symptoms of Compulsive Buying Disorder
Symptoms of CBD generally include a tendency to engage in shopping behavior that is driven by anxiety. Typical symptoms include:
- Persistent thoughts about shopping or about owning a specific item
- Intensive preparation for the shopping experience, including research and planning
- Intense feeling of pleasure, relief, or excitement when a purchase is made
- Use of shopping and buying as a way to cope with negative emotions or situations
- Feelings of guilt or remorse after purchases
What Causes Compulsive Buying Disorder?
The cause of CBD is still unknown. Some scientists believe that the disorder is linked to the action of brain chemicals called neurotransmitters. These chemicals are responsible for passing signals between nerve cells in the brain. Certain neurotransmitters such as serotonin and dopamine have been associated with other mental disorders. CBD bears some similarities to those other disorders, leading some scientists to believe that a similar chemical mechanism is at play in CBD.
Serotonin has been associated with obsessive-compulsive disorder (OCD). CBD shares some characteristics with OCD, and the same medications used to treat OCD are sometimes used to treat CBD.
Other researchers believe that CBD is more closely related to addictions and substance use disorders. These disorders are typically associated with the action of the neurotransmitter dopamine.
Other theories suggest that CBD is a mood disorder similar to major depressive disorder or bipolar disorder, or that it is triggered by early-life traumatic events such as sexual abuse.
Risk Factors for Compulsive Buying Disorder
Certain factors appear to increase an individual’s risk of developing CBD or of experiencing more severe CBD symptoms. One study found that participants with below-median income suffered the most severe CBD symptoms. People with CBD also very often suffer from other mental disorders, suggesting that these disorders may be risk factors. Common associated disorders include:
- Major depressive disorder
- Anxiety disorders
- Substance use disorders
- Eating disorders
- Impulse control disorders
- Obsessive-compulsive disorder (OCD)
- Avoidant personality disorder
- Borderline personality disorder
Is Compulsive Buying Disorder Hereditary?
Some evidence suggests that CBD can run in families, but no study has yet found a link between CBD and a specific inherited genetic trigger. Studies have found that people who suffer from CBD are significantly more likely than the general population to have a first-degree relative (a parent or sibling) who suffers from CBD, depression, anxiety, alcoholism, substance use disorders, or other mental health disorder. However, studies that have attempted to find a genetic connection between these disorders and CBD have been inconclusive.
How Is Compulsive Buying Disorder Detected?
People suffering from CBD may be willing to admit that their shopping behavior is a problem. However, they often experience a feeling of guilt or shame associated with shopping, leading them to attempt to hide their behavior. Deceptive shopping behavior can make it hard for loved ones to identify CBD in its early stages. Some warning signs to watch for include:
- Impulse buying of items that the sufferer doesn’t need
- Leaving items unopened or unused
- Accumulating large quantities of unnecessary items
- Shopping by themselves
- Using shopping as a way to cope with negative emotions
CBD can first appear at any time of life, but it most often initially appears in early adulthood. Onset of the disorder often happens when the sufferer becomes financially independent and is able to obtain credit on their own.
How Is Compulsive Buying Disorder Diagnosed?
CBD is not recognized by the Diagnostic and Statistical Manual of Mental Disorders (DSM) as a diagnosable disorder, so there are no official diagnostic criteria for the disorder. To determine whether CBD is present, a mental health practitioner is likely to interview the patient about their shopping behaviors and their feelings before and after shopping. The process will also usually include assessments to look for other mental health disorders.
The goal of the CBD diagnostic process is to determine whether the patient’s shopping behavior fits the pattern of the disorder or is in line with normal buying behavior. The practitioner will look for a distinctive pattern of CBD behavior that includes:
- A preoccupation with thoughts about shopping and a tendency to anticipate the shopping experience
- Negative emotions such as anxiety, boredom, self-criticism, or anger that precede shopping or buying
- A sense of euphoria or relief from the negative emotions at the time of the purchase
- A feeling of disappointment, shame, or guilt after the purchase
PLEASE CONSULT A PHYSICIAN FOR MORE INFORMATION.
How Is Compulsive Buying Disorder Treated?
Treatment for CBD usually involves a type of psychotherapy called cognitive behavioral therapy (CBT). This type of therapy focuses on helping the patient to recognize the thought patterns and emotional triggers that precede the problematic buying behavior. When the triggers are identified, CBT helps the patient develop strategies for coping with the triggers without resorting to the problematic behavior.
No reliable research has shown that any medications are consistently effective at reducing the symptoms of CBD. Multiple studies have examined the effectiveness of antidepressants in treating CBD, but the results have been mixed. One study presented limited evidence that the drug naltrexone, which is used to treat opioid addiction, may help CBD sufferers, but research into this and other potential drug-based treatments is still ongoing.
How Does Compulsive Buying Disorder Progress?
Untreated CBD is likely to continue throughout the sufferer’s lifetime, and in many cases, the problematic buying behavior becomes more severe over time. Left unchecked, the behavior can result in complications that have a significant impact on the sufferer’s life, including:
- Relationship problems, including divorce
- Social isolation
- Financial problems, including excessive debt and bankruptcy
- Depression and/or anxiety
- Worsening of co-incident disorders such as substance use disorders
How Is Compulsive Buying Disorder Prevented?
There is no known way to prevent the initial development of CBD, but there may be ways to help prevent problematic buying behavior.
Preventive steps include:
- Logging or journaling to track the emotional triggers that lead to problematic buying
- Finding other activities to help you relieve the negative feelings associated with the triggers
- Shopping with others instead of shopping alone
- Getting rid of credit cards. Shoppers who are forced to use cash are less likely to engage in problematic impulsive buying.
- Get someone else (such as a spouse or partner) to manage your personal finances
- Get financial counseling from a finance professional
Compulsive Buying Disorder Caregiver Tips
Compulsive buying disorder is invariably hard on relationships, especially when the problematic buying behavior directly impacts that financial situation of the sufferer’s loved ones. Keep these tips in mind to help prevent CBD from having a significant negative impact on your and your loved one’s lives:
- Be a supportive shopping partner. Compulsive shoppers are most vulnerable when they’re shopping on their own. Find time to go with your loved one on shopping trips, and be a gentle voice of reason against impulse buys and unnecessary purchases.
- Learn how to support your loved one’s coping skills. Compulsive shopping helps your loved one soothe negative feelings. Help them to find other ways to make themselves feel better, and be supportive of their efforts to redirect their behavior.
- Call in the professionals. It’s important to know when you need help. Seek the advice of a mental health professional or support group before the disorder has major negative consequences.
Compulsive Buying Disorder Brain Science
Compulsive buying behavior has been a controversial topic in the fields of psychiatry and neuroscience. One point of controversy is disagreement over whether CBD should be considered an addiction like addictions to drugs and other substances. In general, the field of psychiatry has been reluctant to classify behavior-related disorders like CBD as addictions. In the current version of the DSM, the only behavioral addiction officially considered to be a diagnosable disorder is gambling disorder.
CBD does have some similarities with substance and behavioral addictions like gambling disorder in terms of behavior patterns and patterns of brain activity in sufferers. But there are significant differences, too. Substance addictions tend to initially occur at a young age, while CBD usually first appears in early adulthood. CBD also tends to occur only in developed, affluent societies, in contrast to other addictions, which occur more universally.
More research is needed to determine whether the same brain chemical processes that produce substance addictions are also present in CBD. A better understanding of the cause and underlying neurological mechanism of the disorder is a key to developing more effective treatments.
Compulsive Buying Disorder Research
Title: Memantine Treatment of Compulsive Buying
Principal Investigator: Jon Grant, MD
University of Minnesota
The goal of the proposed study is to evaluate the efficacy of memantine in the treatment of compulsive buying. Sixteen subjects meeting criteria for compulsive buying will receive 8 weeks of open-label memantine. The hypothesis to be tested is that memantine will be effective and well tolerated in patients with compulsive buying. The proposed study will provide needed data on the treatment of a disabling disorder that currently lacks a clearly effective treatment.
Title: Naltrexone for Impulse Control Disorders in Parkinson’s Disease
Contact: Daniel Weintraub, MD
University of Pennsylvania
Impulse control disorders (ICDs), including compulsive gambling, sexual behavior, buying, and eating, are increasingly recognized as a significant clinical problem in Parkinson’s disease (PD), occurring in up to 15% of patients. Dopamine agonist (DA) treatment is thought to be the primary risk factor for the development of ICDs in PD. ICDs often lead to significant impairments in psychosocial functioning, interpersonal relationships, and quality of life. The management of ICDs in the context of PD can be complex. Patients may be reluctant to discontinue DA treatment due to the motor benefits derived from treatment, so patients often have chronic symptoms. Thus, additional treatment approaches are needed.
A medication shown to be efficacious for the treatment of ICDs with minimal impact on parkinsonism would allow many ICD patients to continue on full-dose DA treatment. Naltrexone, a long-acting opioid receptor antagonist, helps in the treatment of alcohol and opioid dependence. In addition, placebo-controlled studies have demonstrated that it helps in the treatment of pathological gambling in the general population. Opioids regulate dopamine pathways in areas of the brain linked with impulse control disorders, and opioid antagonists block opioid receptors in these regions. In this study, 48 PD patients with an ICD will be treated either with naltrexone (50-100 mg/day) or placebo for a period of 8 weeks. The study will assess if naltrexone improves ICD symptoms in PD and is well tolerated. To our knowledge, the proposed study is the first controlled trial of an agent to treat ICDs in PD.
Title: Online Coping Skills Counseling for Problem Gambling and Trauma
Contact: Lisa Najavits, PhD
Newton Center, MA
Our key study question is whether an integrated focus on PG and PTSD (Seeking Safety; SS) offers a useful new option for clinical care compared to a purely problem gambling approach (Cognitive-Behavioral Therapy for PG; CBT-PG). This question—the impact of integrated versus non-integrated treatment for co-occurring disorders—is one of the key issues in the field currently and has never been studied in relation to PG and PTSD.
Our aims are:
To conduct an RCT of SS versus CBT-PG in a sample of 84 people with current PG and PTSD (full or subthreshold).
To evaluate outcomes from baseline to end of treatment and 12 month followup on two primary variables (money lost gambling and number of gambling sessions) and several secondary variables.
Our hypotheses are: (a) SS will do no worse than CBT-PG on the primary PG outcomes as both treatments are designed to address addiction; i.e., both will show improvement from baseline to end of treatment and maintenance of gains through the followup. (b) SS will show superior results on trauma symptoms as SS is designed to address those, whereas CBT-PG is not.