Compulsive buying disorder (CBD), or oniomania (from Greek ὤνιος ṓnios "for sale" and μανία manía "insanity"), is characterized by an obsession with shopping and buying behavior that causes adverse consequences. According to Kellett and Bolton,
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". Most people with CBD meet the criteria for a personality disorder. Compulsive shopping is classified by ICD-10 (F63.8) as an "impulse control disorder, not otherwise classified." Several authors consider compulsive shopping rather as a variety of dependence disorder.
History
Emil Kraepelin originally described oniomania 1924, and he and Bleuler both included the syndrome in their influential early psychiatric textbooks. However, little interest was taken in CBD until the 1990s, and, even in the 21st century, compulsive shopping can be considered a barely recognised mental illness.
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 negative moods. Onset of CBD occurs in the late teens and early twenties and is generally chronic.
Compulsive buying disorder usually mainly affected young people as
several reports put in that most interviewees reported to be in the
range of 17.5-19 years. The phenomenon of compulsive buying tends to
affect women rather than men. The aforementioned reports on this matter
indicated that the dominance of the majority group is so great that it
accounts for about more than 90% of the affected demographic..
Zadka and Olajossy, suggest the
presence of several similar tendencies between consumer type mannerism
and pathologic consumption of psychoactive elements. These tendencies
include a constant need to consume, personal dependence, and an affinity
to lack of sense of control over self-behavior.
Additionally, Zadka and Olajossy stated that one could conclude that
individuals ailing from this disorder are often in the second decade to
fourth decade of their lives and exhibit mannerisms akin to neurotic
personality and impulse control disorders.
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.
Research revealed that 1.8 to 8.1 percent of the general adult
population have CBD and that while the usual onset is late adolescence
or early adulthood, it is often recognized as a problem later in life.
Distinctions
Compulsive
Buying Disorder is tightly associated with excessive or poorly managed
urges related to the purchase of the items and spending of currency in
any form; digital, mobile, credit or cash.
The terms compulsive shopping, compulsive buying, and compulsive
spending are often used interchangeably, but the behaviors they
represent are in fact distinct.
One may buy without shopping, and certainly shop without buying: of
compulsive shoppers, some 30 percent described the act of buying itself
as providing a buzz, irrespective of the goods purchased.
Causes
CBD often has roots in early experience. Perfectionism,
general impulsiveness and compulsiveness, dishonesty, insecurity, and
the need to gain control have also been linked to the disorder.
From a medical
perspective, it can be concluded that impulsive control disorder is
attributed to the yearning of positive stimulus.
The normal method of operation in a healthy brain is that the frontal
cortex regulation handles the activity of rewarding. However, in
individual with behavior disorders, this particular system malfunctions.
Scientists reported compulsive buyers have significant changeable
activity in this area of the brain.
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. 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.
Others, however, object that such psychological explanations for compulsive buying do not apply to all people with CBD.
Social conditions also play an important role in CBD, the rise of
consumer culture contributing to the view of compulsive buying as a
specifically postmodern addiction, particularly with regard to internet buying platforms.
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. Online shopping
also facilitates CBD, with online auction addiction, used to escape
feelings of depression or guilt, becoming a recognizable problem.
What differentiates CBD from healthy shopping is the compulsive,
destructive and chronic nature of the buying. Where shopping can be a
positive route to self-expression, in excess it represents a dangerous
threat.
Materialism and image seeking
A social psychological
perspective suggests that compulsive buying may be seen as an
exaggerated form of a more normal search for validation through
purchasing. Also, pressures from the spread of materialist values and consumer culture over the recent decades can drive people into compulsive shopping.
In a global context where we are all encouraged to "shop till we drop"—compulsive shopping inevitably poses the further question, "Minority pathology or Mass problem?" With advertisements offering not so much products as narratives (of success, glamour) to identify with, compulsive buying may seem only an extreme aspect of what consumer culture demands from us all.
Companies have adopted aggressive neuromarketing by associating
the identification of a high social status with the purchasing of items.
They strive to bring out such an individual as a sort of folk hero for
having the ability to buy several items. As a result, according to Zadka
and Olajossy, the act of shopping is then associated with the feeling
of being of a higher social status or that of one climbing the social
ranks. Zadka holds that these companies are taking advantage the
frailties of peoples’ egos in an attempt to get them to spend their
money.
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.
4. Constant obsessing with buying as well as being dissatisfied all the time.
While initially triggered by a perhaps mild need to feel special,
the failure of compulsive shopping to actually meet such needs may lead
to a vicious cycle of escalation, with sufferers experiencing the highs and lows associated with other addictions. The 'high' of the purchasing may be followed by a sense of disappointment, and of guilt, precipitating a further cycle of impulse buying. With the now addicted person increasingly feeling negative emotions like anger and stress, they may attempt to self-medicate through further purchases, followed again by regret or depression once they return home,
leading to an urge for buying more. The aforementioned symptoms are
aggravated further by the availability of money through access to credit
cards and easy bank loans.
As debt grows, the compulsive shopping may become a more secretive act.
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.
Individuals who can be considered addicted to shopping are
observed to exhibit repetitive and obsessive urges to go buy items
especially when in the vicinity of an environment that supports this
venture such as a mall. In this locations, they mostly purchase things
that are cheap and of low value mainly just to satisfy the urge to
spend. Normally, these items end up being returned to the shop they were
brought from or just disposed of entirely after a while. However,
according to Zadka and Olajossy, this rarely works as these individuals
are known to have low self-esteem.
Consequences
The
consequences of compulsive buying, which may persist long after a
spree, can be devastating, with marriages, long-term relationships, and
jobs all feeling the strain. 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. The resulting stress can lead to physical health problems and ruined relationships, or even suicide.
Additionally, the ingestion of medication to combat this disorder
may lead to more problems. Further issues can come up, for instance;
one may take in substances that they are allergic to thereby leading to
unwanted developments. Also, Zadka and Olajossy state that it is quite
easy for one to develop a tolerance toward these medication which will
force the unfortunate individual to take a larger dosage which is
detrimental to their health overall. They believe that 60% of patients
who have been taking antiviral medication have experienced an occurrence
of neuropsychiatric disorders.
Treatment
Treatment
involves becoming conscious of the addiction through studying, therapy
and group work. Research done by Michel Lejoyeux and Aviv Weinstein
suggests that the best possible treatment for CBD 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.
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." The most effective treatment is to attend therapy and
group work in order to prevent continuation of this addiction.
Hague et al. reports that group therapy rendered the highest
results as far as treatment of compulsive buying disorder is concerned.
He states that group therapy contributed to about 72.8% in positive
change in the reduction of urges of compulsive spending. Additionally,
he notes that psychotherapy may not be the treatment of choice for all
compulsive buying disorder patients since the suitability of the
treatment method to the patient is also an important consideration. He
holds that the treatments of the disorder are required to provide a
certain reflection of the context in which this phenomenon manifests.
Selective serotonin reuptake inhibitors such as fluvoxamine and citalopram may be useful in the treatment of CBD, although current evidence is mixed. Opioid antagonists such as naltrexone and nalmefene are promising potential treatments for CBD. A review concluded that evidence is limited and insufficient to support their use at present, however. Naltrexone and nalmefene have also shown effectiveness in the treatment of gambling addiction, an associated disorder.
Historical examples
- Mary Todd Lincoln was addicted to shopping, running up (and concealing) large bills on credit, feeling manic glee at spending sprees, followed by depressive reactions in the face of the results.
