What is shopping/spending addiction?
The causes of shopping and spending addiction are debated. German psychiatrist Emil Kraepelin was the first medical expert to describe the condition in 1915; he called it oniomania (from two Greek words meaning “to sell” and “insanity”). Eugen Bleuler, a Swiss expert on schizophrenia, defined shopping addiction in 1924 as an impulse-control disorder in the same category as kleptomania and pyromania.
The vast majority of persons with the disorder also meet the Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria for anxiety or mood disorders, eating disorders, substance abuse disorders, and axis II disorders (personality disorders). Obsessive-compulsive, borderline, and narcissistic personality disorders in particular have been associated with compulsive buying disorder (CBD). An estimated 40 percent of people with CBD also hoard, which is an obsessive-compulsive behavior in which the affected individual acquires and cannot or will not dispose of possessions. Because of these extensive overlaps, some observers question whether compulsive spending is a separate mental disorder or simply a secondary feature of other disorders. Furthermore, there is no evidence of a genetic factor in shopping or spending addiction.
Some experts regard CBD’s underlying cause as poor ability to tolerate anger, sadness, boredom, or other negative feelings. Others believe that a search for personal identity through purchasing prestigious brand-name products is the underlying cause. Other causes that have been suggested include early childhood deprivation, leading to compensating in adult life by purchasing special items; a need for excitement and stimulation; seeking approval by purchasing clothing or other items owned by one’s peers; social isolation and loneliness; perfectionism (needing to dress or look perfect); and a feeling of inner emptiness.
Risk factors for CBD include being female; being in one’s late teenage years through early twenties; living in a developed country with a market-based economy; and a family history of substance abuse or mood disorders. It is estimated that about 6 percent of the general population are compulsive shoppers.
The disorder also has been reported and studied by psychiatrists in France, Canada, the United Kingdom, Germany, and Brazil. The rate is expected to increase worldwide because of widespread access to the Internet and online shopping, the easy availability of credit cards, and advertising that encourages the purchase of consumer goods as a way to increase self-esteem and social acceptance.
The symptoms of CBD include excessive time spent shopping and excessive spending, in most cases leading to impaired cognitive, social, and occupational functioning. Spending beyond the person’s means (beyond available income) usually creates tension in interpersonal relationships and financial and legal difficulties; these difficulties may include bankruptcy, ruined credit, or prosecution for shoplifting, check forgery, or embezzlement.
The person typically displays anxiety or emotional distress regarding the shopping and spending behavior. Denial is relatively uncommon; most affected persons acknowledge that their shopping behavior is problematic. Research also suggests that CBD is associated with diminished self-regulation of inappropriate and disruptive actions, poor risk adjustment, and deficits in spatial working memory.
Some psychiatrists identify four distinct phases or stages in an episode of compulsive shopping: anticipation, in which the person develops an urge to buy a specific item or to go on a shopping trip; preparation, in which the person decides which stores to go to, how to get there, what to wear, and even which credit cards to use; the actual shopping, which some persons describe as exciting or even sexually arousing; and the act of purchase, which is often followed by feelings of disappointment or anxiety over one’s loss of self-control. Compulsive shopping is a solitary behavior in most cases, although some persons with CBD report that they go shopping with a friend or partner who shares the addiction.
The most common items purchased by both men and women are clothing, shoes, compact discs (CDs), and household items. Women with CBD often purchase jewelry and cosmetics, while men typically splurge on hardware, electronic gadgets, or automotive equipment. In most cases the individual items purchased are not expensive; however, persons with CBD often buy in quantity, such as eight or ten CDs instead of one. Researchers report that the average cost of a compulsive buying spree is between $100 and $150 (in US dollars).
There are no standardized diagnostic criteria for shopping and spending addiction. An earlier edition of the DSM (DSM-III-R) classified CBD as an impulse-control disorder not otherwise specified, while neither the DSM-IV nor the DSM-5 mentions it at all. Proposed diagnostic criteria for the disorder considered (but ultimately rejected) for the DSM-5 included intense preoccupation with shopping or spending, significant impairment in functioning, and shopping or spending that does not occur as part of a manic episode.
Several questionnaires and “screeners” for shopping addiction have been developed since the late 1980s. The oldest English-language instrument is the compulsive buying measurement scale (CBMS; 1988), which measures four dimensions of compulsive buying: the urge to spend, guilt after making the purchase, a general tendency to spend money freely, and a troubled family environment. In 1990, a German version of the CBMS, known as the Hohenheimer Kaufsuchttest or Hohenheim shopping addiction test, was published and used in several European studies.
The Minnesota impulsive disorder interview (MIDI; 1994), includes a subsection intended to diagnose compulsive buying, although no data have been published regarding its reliability or validity. The Yale-Brown obsessive-compulsive scale (Y-BOCS) was modified in 1996 to develop a ten-item scale called the Y-BOCS shopping version, or Y-BOCS-SV. In 2005 an English-language screener called the "compulsive buying scale" was introduced and rated for validity and reliability.
In some cases affected persons will screen themselves for the disorder through an online shopaholics self-test, by reading a book on the disorder, or by completing the fifteen-question assessment tool of Debtors Anonymous (DA), and will then seek professional help after admitting to themselves that they have a problem.
A number of different treatments for CBD have been tried. Antidepressant medications, particularly the selective serotonin reuptake inhibitors, have been used but appear to be relatively ineffective, as does psychodynamic psychotherapy. Group therapy and a twelve-step program such as DA are helpful to some persons with CBD, as are simplicity study circles—small groups that meet to redefine the good life, to encourage self-reflection, and to help people make such changes as turning away from shopping or other forms of social competition.
Some compulsive shoppers also benefit from bibliotherapy (reading self-help books) or from bibliotherapy combined with cognitive-behavioral therapy (CBT). In some cases financial counseling is a useful adjunct to CBT. One expert in CBD offers patients five points of advice: they should not rely on antidepressants or other medications to treat CBD,; they should acknowledge that they have the disorder; they should destroy all credit cards and checkbooks; they should go shopping only with friends or companions who do not have CBD; and they should find activities other than shopping to fill leisure time.
Researchers are also investigating the therapeutic possibilities of mindfulness, motivational interviewing, dialectical behavior therapy, and acceptance and commitment therapy for compulsive buying. The Stopping Overshopping model, a hybrid of all of these approaches and CBT, was developed in 2005, and preliminary trial results of the twelve-week group program reductions in the amounts of time and money spent, the numbers of episodes experienced, and overall measures six months after the intervention.
Prevention of CBD is difficult because shopping and spending addiction is often rooted in the affected person’s family of origin—which means that the behavior typically develops before the person recognizes that he or she is at risk for a behavioral addiction and may already suffer from an eating disorder or other impulse control disorder. Adolescents are particularly susceptible; however, there is no single family structure or characteristic that is useful in predicting the likelihood that a specific family member will develop CBD. Possible preventive strategies include parental oversight of teenagers’ spending habits and early training in the responsible use of income, whether the money comes from allowances or part-time employment.
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