Compulsive buying disorder
Compulsive buying disorder (CBD), or Oniomania (from Greek ὤνιος onios "for sale" and μανία mania "insanity") 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". 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, or even a clinical addiction, depending on the clinical source.
CBD is found in 5.8% of the United States population and may be almost as common in males as it is in females.
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.
Emil Kraepelin originally described oniomania over a century ago, and he and Bleuler  both included the syndrome in their influential early psychiatric textbooks. However little interest was taken in CB until the 1990s, and even in the 21st century compulsive shopping can be considered a barely recognised mental illness.
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. 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.
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)[page needed] 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, irrespective of the goods purchased.
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. 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, 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.
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.
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 oniomania, with online auction addiction, used to escape feelings of depression or guilt, becoming a recognisable problem.
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.
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. 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.
In a global context where we are all encouraged to "shop till we drop"—to find solace in possessions—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.
Symptoms and course
Four diagnostic criteria for compulsive buying have been proposed: 1. Over-preoccupation with buying; 2. distress or impairment as a result of the activity; 3. the compulsive buying is not limited to hypomanic or manic episodes.
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, 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 in the quest for a sense of special identity. 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 yet another spree.
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.
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. 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 spiralling out of control.
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 depression, so that appropriate pharmacological treatment can be instituted." Their research proves that patients who received cognitive behavioral therapy over 10 weeks had reduced episodes of compulsive buying and spent less time shopping as opposed to the patients who did not receive this treatment (251).
Lejoyeux and Weinstein also write about pharmacological treatment and the studies that have been done to 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).
Historical and cultural 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.
- In Kate Cann's novel, Hard Cash, it was a point of pride for the anti-heroine to say "my credit card is so far into the red it's turning purple".
- Vyse, Stuart (2008). Going broke: why Americans can't hold on to their money. Oxford; New York: Oxford University Press. ISBN 0-19-530699-6. OCLC 153773333.
- OMD. (2000, Mar 5). Retrieved, January 16, 2008, from http://cancerweb.ncl.ac.uk/cgi-bin/omd?oniomania
- Kellett, S., & Bolton, J. V. (2009). Compulsive buying : A cognitive-behavioural model. Clinical Psychology and Psychotherapy, 16, 83-99.
- April Lane Benson/Marie Gengler, "Treating Compulsive Buying" in Robert H. Coombs, Handbook of Addictive Disorders (2004), p. 455
- Koran, L. M., Faber, R. J., Aboujaoude, E., Large, M. D., & Serpe, R. T. (2006). Estimated prevalence of compulsive buying behavior in the United States. American Journal of Psychiatry, 163, 1806-1812.
- Donald W. Black, 'A review of compulsive buying disorder'
- R. J. Frances et al., Clinical Textbook of Addictive Disorders (2005) p. 315
- Jon E. Grant/S. W. Kim, Stop Me Because I Can't Stop Myself (2004) p. 16
- 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.
- 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.
- 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.
- 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.
- Vyse 2008, p. 28
- Helga Dittmar, "Understanding and Diagnosing Compulsive Buying", in Robert H. Coombs, Handbook of Addictive Disorders (2004) p. 438
- Elias Aboujaourde/Lorrin M. Koran, Impulse Control Disorders (Cambridge 2010) p. 8
- Patrick Casement, Further Learning from the Patient (London 1990) p. 127
- April Lane Benson, I Shop Therefore I Am (2000)
- Aboujaourde/Koran, p. 8
- April Lane Benson/Marie Gengler, "Treating Compulsive Buying" in Coombs, p. 451
- Aboujaourde/Koran, p. 9
- Dittmar, p. 417
- Dennis Hayes, Beyond the Silicon Curtain (1989) p. 145
- Elen Lewis, The eBay Phenomenon (2008) p. 95
- April Lane Benson and Marie Gengler, "Treating Compulsive Buying", in Coombs, p. 452
- Helga Dittmar/Emma Halliwell, Consumer Culture, Identity and Well-being (2008) p. 95-7
- Dittmar/Halliwell, p. 97
- Jenny Diski, The Sixties (London 2009) p. 18-20
- Oliver James, Britain on the Couch (London 1998) p. 301
- William Gibson, Zero History (London 2010) p. 21 and p. 213
- Dittmar/Halliwell, p. 119
- Frances, p. 315
- Pamela Klaffke, Spree (2004) p. 185
- Klaffke, p. 185
- Lucy Costigan, Women and Healing (2006) p. 208
- Helga Dittmar, "Understanding and Diagnosing Compulsive Buying", in Robert H. Coombs, Handbook of Addictive Disorders (2004) p. 442
- Dittmar, p. 426
- Dittmar, p. 424
- Klaffke, p. 185
- Catalano and Sonenberg, in Costigan, p. 208
- Klaffke, p. 430
- Bruno Zumo, Advances in quality of life research, 2001 (2002) p. 164
- Grant/Kim, p. 36
- D. K. Goodwin, Team of Rivals (2013) p. 305, 401-2 and 681-2
- Kate Cann, Hard Cash (London 2000) p. 218
- Few controlled studies have assessed the effects of phar- macological treatment on compulsive buying, and none have shown any medication to be effective
- Benson, A. To Buy or Not to Buy: Why We Overshop and How to Stop Boston: Trumpeter Books, 2008.
- Black, D.W. (2007). A review of compulsive buying disorder. World Psychiatry, 6, 1, pp. 14–18.
- Bleuler, E. Textbook of Psychiatry. New York: Macmillan, 1924.
- Catalano E. and Sonenberg, N. Consuming Passions: Help for Compulsive Shoppers. Oakland: New Harbinger Publications, 1993.
- DeSarbo WS and Edwards EA. “Typologies of Compulsive Buying Behavior: A Constrained Cluster-Wise Regression Approach.” Journal of Consumer Psychology 1996; 5: 231-252, 1996.
- Elliott, R. “Addictive Consumption: Function and Fragmentation in Postmodernity.” Journal of Consumer Policy, 17, 159-179, 1994.
- Faber, R. J., O’Guinn, T. C. and Krych, R. “Compulsive Consumption.” Advances in Consumer Research, 14, 132-135, 1987.
- Kraepelin, E. Psychiatrie (8th ed.). Leipzig: Verlag von Johann Ambrosius Barth, 1915.
- McElroy, SL, Phillips KA, Keck PE, Jr. “Obsessive Compulsive Spectrum Disorder.” Journal of Clinical Psychiatry; 55[10, suppl]: 33-51,1994
- Nataraajan, R. and Goff, B. “Manifestations of Compulsiveness in the Consumer-Marketplace Domain.” Psychology and Marketing, 9 (1), 31-44,1992.
- Ridgway NM, Kukar-Kinney M, Monroe K. “An expanded conceptualization and a new measure of compulsive buying.” Journal of Consumer Research, 35, #4, 350-406, Dec. 2008.