Compulsive buying disorder

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at October 2, 2016
StartDiseasesCompulsive buying disorder

While not formally acknowledged as a behavioral addiction in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), clinical research internationally has described compulsive buying as a pathological behavior with adverse effects. Compulsive buying disorder or compulsive shopping disorder is estimated to cause impairment and distress for approximately 6 percent of the US population.

Contents

Definition & Facts

A compulsive buying disorder is a disorder in which a person has an overwhelming urge to spend money on purchasing goods or services which they do not really need. The person with the disorder lacks control over how much and how often, that they shop. The act of shopping and buying are closely connected, which can result in debts and relationship problems.

The shopping often goes hand-in-hand with hoarding disorder since the amount of possessions quickly adds up along with many other mental disorders such as obsessive-compulsive disorder, mood disorders (e.g. depression, bipolar disorder, seasonal affective disorder), substance use disorders (e.g. alcohol use disorder, cocaine use disorder), or anxiety disorders (social anxiety disorder, panic disorder).

A person with this disorder may try to hide the fact that they have a problem and conceal all of their purchases from their loved ones or lie about how much they spent on them. It is predominantly women who have this disorder though research suggests that this disparity may result from the notion that men typically identify similar habits as 'collecting' as opposed to shopping.

Symptoms & Complaints

The most obvious symptom of this disorder is the constant urge to shop and spend money. It manifests itself in stages of anticipation, preparation, shopping, spending (which involves a sense of euphoria), and then a come-down in which the person feels shame and guilt.

In order to feel better, they will buy something again. The cycle perpetuates, which is often the case with other behavioral addictions. People with this disorder shop to attain temporary relief from distress. Shopping typically occurs alone.

Most feel out of control about their behavior, have tried to stop compulsively spending but have not succeeded, and feel as though the behavior is harming their relationships or well-being.

People with low incomes tend to suffer disproportionately severe symptoms of the disorder.

Causes

This disorder has been known to begin when a person is in their late teens and early 20's. Personality disorders often occur concurrently or are said to be co-morbid. Common personality disorders include borderline personality disorder and avoidant personality disorder. A person with compulsive buying disorder may also have an eating disorder (e.g. bulimia nervosa, anorexia nervosa).

A person with a low income may be equally likely to have this disorder as someone with a high income, though the types of places where they shop will differ. People who are intelligent or who have intellectual disabilities are also equally likely to have this condition.

Certain cultural forces may contribute to the disorder. Living in a consumer-driven capitalistic society wherein the populace has greater amounts of free time as well as disposable income are all factors that may contribute to this disorder.

Constant advertisements in the media that encourage people to buy things to feel better about themselves may contribute. The media's glorification of material possessions in combination with constant advertisements for credit cards may be causative elements. Access to credit cards may also contribute to the disorder.

Media also transmits societal materialistic values that convey that a person who does not have enough possessions is not as good as a person who has more. This message may psychologically affect those who are already feeling anxious and depressed more than it does in those who have more self-confidence.

There may also be a genetic factor to compulsive buying disorder. A person who has a family history of compulsive spending such as a parent or close relative is much more likely to have it too. 

Diagnosis & Tests

Because people with a compulsive buying disorder often go out of their way to hide their problem, it isn't easy an easy disorder to diagnose unless the individual goes to a doctor or treatment center on their own accord.

A psychological evaluation has to be done to determine what their current state of mind is and whether or not they have any other types of mental illness. Bipolar disorder will need to be ruled out.

Assessments will necessarily involve an inquiry into the person's history of hospitalization, their medical history and family history, their history with psychotherapy, and their use of past and present medications. A physical examination and other physical tests may be necessary to rule out neurological disorders as a possible cause.

Certain clinicians have developed a model that measures the intensity of a person's urge to shop as well as their inability to control said urge. The compulsive buying scale (CBS) is one diagnostic model that assesses compulsive buying. The Yale-Brown Obsessive-Compulsive Scale has a shopping version YBOCS-Shopping Version which measures a person's disorder through ten items of criteria.

Treatment & Therapy

There is no standardized treatment approach to compulsive buying disorder. Treatment of it thus far has involved psychotherapy and psychiatric medications. Cognitive behavioral therapy is one type of psychotherapy that is used to treat this disorder. Group therapy may also assist as may financial counseling. Antidepressants have been used to treat this disorder though their efficacy is still debatable.

During the treatment process, all credit cards must be taken away or limited, so there is no temptation for them to buy things. People with this disorder are also advised to shop with a friend who doesn't have the disorder as well as find activities that are meaningful to substitute for the time spent on shopping and spending money. This is especially important if the affected person is in danger of becoming homeless or hurting others financially.

Prevention & Prophylaxis

Compulsive buying disorder is difficult to prevent because it's etiology is complex and still not properly understood, involving a wide range of societal, genetic, and environmental factors. Adhering to a healthy lifestyle with a healthy diet and regular exercise can help reduce the risk of co-morbid psychological disorders.