Compulsive buying disorder (CBD) occurs when obsessive buying — basically a shopping addiction — leads to negative consequences. The condition affects nearly six percent of the population of the United States. In addition to the distress that arises from the disorder itself, compulsive buying disorder is also strongly indicative of a comorbid condition.
The great majority — around 80% — of the individuals who have been identified as suffering from compulsive buying disorder are women. However, the World Psychiatry Journal speculates that this discrepancy may be “artifactual” rather than inherent; that is, the bias may extend from the way in which the information was gathered. When self-reporting about their habits, for example, women are much more inclined to admit to a fondness for shopping.
Impulse control disorders
Compulsive buying disorder was first described during the early 1900s, and was added to the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). The DSM-III placed CBD under the category of “impulse control disorder not otherwise specified.”
Impulse control disorders cover a diverse range of conditions that include addiction. In general, individuals with an impulse control disorder are unable to resist the urge to act in a certain way in spite of the risk the actions pose.
The characteristics of CBD include an obsession with shopping, and a relief of anxiety and tension following a purchase. This pattern of preoccupation with a certain behavior and relief after a “fix” has similarities to the various behavioral addictions. While there are currently relatively few scientific studies on the topic of CBD, it is possible that with more evidence the DSM may eventually classify compulsive buying disorder as a buying addiction.
Consequences of a shopping addiction
Financial difficulties are the most common direct result of compulsive buying disorder. Persons with CBD often incur significant credit card debt, have negative bank balances due to overspending, and fail to pay their bills in a timely manner because they have used up their disposable income. Studies have shown that severe cases of CBD are more common among individuals whose income falls below the national median, making financial concerns more likely. Surveys of those with CBD have found that as many as 85% of them report anxiety and stress over debts incurred as a result of their behavior.
Compulsive buying disorder can also result in a dereliction of other responsibilities as a result of a preoccupation with shopping and buying. While shopping is a social habit for many, CBD may lead individuals to devalue their personal and work obligations.
Compulsive buying disorder and comorbidity
Comorbid psychiatric conditions are very common in persons with compulsive buying disorder. Disorders that frequently co-occur with CBD are mood and anxiety disorders, along with other kinds of impulse control disorders. CBD may also appear in individuals who have not been diagnosed with a comorbid condition but who have a significant history of substance abuse, mood disorders, or anxiety disorders in their family.
Most of the psychiatric disorders associated with CBD comorbidity are what the DSM calls Axis I disorders, which cover all psychiatric conditions except mental retardation and personality disorders. The most common Axis I comorbid disorders with CBD are mood disorders, including depression and bipolar disorder. CBD is particularly common in bipolar individuals who when experiencing a manic episode, exhibit poor impulse control, lack of judgment, and it is not uncommon for many to go on they would term “spending sprees.”
Anxiety disorders are the next most common comorbid disorders with compulsive buying disorder. Compulsive buying may be a way for anxious individuals to temporarily relieve stress. Substance use disorders and eating disorders — themselves different examples of impulse control disorders — are the other Axis I conditions commonly found in co-occurrence with CBD.
Many individuals with CBD also meet the criteria for certain Axis II personality disorders. The behaviors found with compulsive buying disorder in concert with other personality characteristics have led to the diagnosis of obsessive-compulsive disorder, avoidant personality disorder, and borderline personality disorder.
Skepticism of compulsive buying disorder
While many researchers feel that compulsive buying disorder may be categorized and diagnosed as a legitimate illness, there has been some resistance to that idea. Criticism has been directed at CBD in the form of concern over the “medicalization” of problems that should be considered behavioral problems. This criticism questions the efficacy and expense of attempting to treat such problems with medication, counseling, and other standard psychiatric treatment options. However, this is currently a minority viewpoint.