Compulsive buying disorder clustering based on sex, age, onset and personality traits

Obsessive-compulsive, harm-avoidance and persistence tendencies in patients with gambling, gaming, compulsive sexual behavior and compulsive buying-shopping disorders/concerns

BACKGROUND AND AIMS

There is a growing interest in determining the specific role of obsessive-compulsive features in different behavioral addictions. However, more studies comparing sizable clinical populations with different addictions are needed.Therefore, a main aim of the present study was to explore the presence of obsessive-compulsive features among people with different behavioral addictions (gambling disorder, internet gaming disorder, compulsive sexual behavior disorder and compulsive buying-shopping concerns). Through a clustering procedure, the existence of empirical clusters among treatment-seeking patients based on obsessive-compulsive measures was explored.

MATERIALS AND METHODS

The Symptom Checklist-Revised, and the Temperament and Character Inventory-Revised were obtained from 4,010 treatment-seeking patients. Obsessive-compulsive features were measured with the obsessive-compulsive subscale of the Symptom Checklist-Revised and the harm avoidance and persistence dimensions of the Temperament and Character Inventory-Revised. Cluster analysis was applied to explore the existence of empirical groups based on obsessive-compulsive features.

RESULTS

Patients with compulsive sexual behavior disorder and compulsive buying-shopping disorder reported the highest scores on the obsessive-compulsive subscale, while patients with gambling disorder showed the lowest scores on harm avoidance, and patients with internet gaming disorder the lowest scores on persistence. Two mutually exclusive clusters were identified. Cluster 1 exhibited a more maladaptive psychopathological and personality profile than cluster.

DISCUSSION AND CONCLUSIONS

These results provide new evidence regarding obsessive-compulsive features in specific behavioral addictions. Therapeutic approaches should consider that different addictions may present distinct levels of obsessive-compulsive features.

Latent Classes for the Treatment Outcomes in Women with Gambling Disorder and Buying/Shopping Disorder

BACKGROUND

The risk for behavioral addictions is rising among women within the general population and in clinical settings. However, few studies have assessed treatment effectiveness in females. The aim of this work was to explore latent empirical classes of women with gambling disorder (GD) and buying/shopping disorder (BSD) based on the treatment outcome, as well as to identify predictors of the different empirical groups considering the sociodemographic and clinical profiles at baseline.

METHOD

A clinical sample of n = 318 women seeking treatment for GD (n = 221) or BSD (n = 97) participated. Age was between 21 to 77 years.

RESULTS

The four latent-classes solution was the optimal classification in the study. Latent class 1 (LT1, good progression to recovery) grouped patients with the best CBT outcomes (lowest risk of dropout and relapses), and it was characterized by the healthiest psychological state at baseline, the lowest scores in harm avoidance and self-transcendence, and the highest scores in reward dependence, persistence, self-directedness and cooperativeness. Latent classes 3 (LT3, bad progression to drop-out) and 4 (LT4, bad progression to relapse) grouped women with the youngest mean age, earliest onset of the addictive behaviors, and worst psychological functioning.

CONCLUSIONS

GD and BSD are complex conditions with multiple interactive causes and impacts, which need wide and flexible treatment plans. Specific interventions should be designed according to the specific profiles of women for achieving early inclusion, retention and well-maintained long-term effects.

Proposed diagnostic criteria for compulsive buying-shopping disorder: A Delphi expert consensus study

BACKGROUND AND AIMS

Consensus in acknowledging compulsive buying-shopping disorder (CBSD) as a distinct diagnosis has been lacking. Before research in this area can be advanced, it is necessary to establish diagnostic criteria in order to facilitate field trials.

METHODS

The study consisted of the following phases: (1) operationalization of a broad range of potential diagnostic criteria for CBSD, (2) two iterative rounds of data collection using the Delphi method, where consensus of potential diagnostic criteria for CBSD was reached by an international expert panel, and (3) interpretation of findings taking into account the degree of certainty amongst experts regarding their responses.

RESULTS

With respect to diagnostic criteria, there was clear expert consensus about inclusion of the persistent and recurrent experience of (a) intrusive and/or irresistible urges and/or impulses and/or cravings and/or preoccupations for buying/shopping; (b) diminished control over buying/shopping; (c) excessive purchasing of items without utilizing them for their intended purposes, (d) use of buying-shopping to regulate internal states; (e) negative consequences and impairment in important areas of functioning due to buying/shopping; (f) emotional and cognitive symptoms upon cessation of excessive buying/shopping; and (g) maintenance or escalation of dysfunctional buying/shopping behaviors despite negative consequences. Furthermore, support was found for a specifier related to the presence of excessive hoarding of purchased items.

CONCLUSIONS

The proposed diagnostic criteria can be used as the basis for the development of diagnostic interviews and measures of CBSD severity.

Measurement of shopping addiction and its relationship with personality traits and well-being among Polish undergraduate students

There is still a scarcity of studies showing the relative contribution of different personality characteristics differentiating various behavioral addictions within an integrated model. In comparison to other addictions, fairly little is known about the role of specific personality traits in compulsive shopping. In addition, few studies have investigated the unique contribution of shopping addiction in terms of explaining different facets of well-being above and beyond personality characteristics previously shown to be related to psychosocial functioning. The present study shows validation of the Bergen Shopping Addiction Scale (BSAS) and a tentative integrated model of potential shopping addiction personality risk factors. BSAS was administered to 1156 Polish students. In addition, demographic variables, and personality traits (Big Five), self-esteem, self-efficacy, perceived narcissism, loneliness, social anxiety, and well-being indicators were measured. BSAS had acceptable fit with the data and demonstrated good reliability. The investigated model showed that shopping addiction was related to higher extraversion, perceived narcissism, and social anxiety, and lower agreeableness and general self-efficacy. Woman and older participants scored higher on BSAS. Shopping addiction was further related to all facets of impaired well-being and explained worse general health, and decreased sleep quality above and beyond other variables in the model. The results support the notion that shopping addiction may have specific personality risk factors with low agreeableness as an outstanding characteristic. This has implications for the development of early prevention and intervention programs.

Buying-shopping disorder, emotion dysregulation, coping and materialism: a comparative approach with gambling patients and young people and adolescents

OBJECTIVE

The comorbidity between gambling disorder (GD) and buying-shopping disorder (BSD) has led to explore the core features that could be interacting between them. The main aim of this study was to examine the differences in both conditions considering emotion dysregulation, coping and materialism, as well as the relationship between these variables and their interaction with age and sex.

METHODS

A community sample (n = 281 adolescents) and a sample of individuals with GD (n = 31) was compared. Both samples were split into a group with BSD and a group without it.

RESULTS

The prevalence of participants who met the criteria for BSD was higher in the GD sample than in the community sample; the GD sample also presented higher values in the psychological variables studied. In the community sample group, positive associations were found between BSD severity and materialism and emotion dysregulation levels. In the GD sample, BSD severity was higher for participants who reported higher levels in materialism and lower scores in coping strategies. Variables impacted BSD severity differently according to sex and age covariates.

CONCLUSIONS

The results of the interaction of the variables could be useful to design prevention and treatment approaches addressed to specific groups of age and sex. KEY POINTS Buying-shopping disorder (BSD) has been compared in clinical and community samples. The clinical sample was constituted by Gambling disorder (GD) patients. The variables emotion dysregulation, coping and materialism have been considered. Variables impacted BSD severity differently according to sex and age covariates.

The concept of buying-shopping disorder: Comparing latent classes with a diagnostic approach for in-store and online shopping in a representative sample in Switzerland

BACKGROUND AND AIMS

Buying-shopping disorder and its transferability to the online sector is controversial. This study investigates in-store and online shopping patterns by comparing data-based modeling to a diagnostic cut-off approach. Further aims were to test model equivalence for gender and identify socio-demographic risk factors.

METHODS

In a representative survey, the Bergen Shopping Addiction Scale (BSAS) was applied, using both an online and in-store version. Latent class analyses were followed by multinomial logistic regression analyses to investigate socio-demographic variables. Measurement invariance across genders was tested with multi-group comparisons.

RESULTS

With N = 1,012, 3-class solutions provided the best model fit for both in-store and online shopping. Most individuals (76, 86%) were grouped in non-addicted classes, followed by risky (21, 11%) and addicted classes (both 3%). Twenty-eight percent of individuals in the online addicted shopping class remained unidentified using the cut-off. For online shopping, only lower age and education differentiated classes significantly.

DISCUSSION

Results indicate a close link between online and in-store shopping, albeit with distinguishing features. The cut-off yielded findings discrepant from class probabilities. That buying-shopping disorder mainly affects younger women of lower educational level must be questioned, given the limited associations identified.

CONCLUSIONS

It is important not only to consider different settings of pathological shopping, but also to focus on groups that may not have appeared at risk in previous investigations (e.g., men, older age). The BSAS cut-off warrants further research.

A Typology of Buyers Grounded in Psychological Risk Factors for Compulsive Buying (Impulsivity, Self-Esteem, and Buying Motives): Latent Class Analysis Approach ina Community Sample

Our objective was to identify meaningful subgroups of buyers based on psychological risk factors for compulsive buying. A community sample of 242 adult women fulfilled an online survey exploring buying habits and motives, impulsivity, self-esteem, and severity of compulsive buying. A latent class cluster analysis was performed. A nonproblematic cluster (28%) was characterized by low levels of impulsivity and buying motives. An intermediary cluster (51%) was characterized by higher levels of positive and negative reinforcement-related buying motives. Both clusters were characterized by a low frequency of compulsive buying (2 and 8%, respectively), but the severity of compulsive buying was higher for the intermediary cluster. A third cluster (21%) was characterized by a higher frequency of compulsive buying (43%), a higher severity of compulsive buying, a stronger feeling of losing control, and higher levels of negative urgency and coping motive. These results present similarities with the Interaction of Person-Affect-Cognition-Execution (I-PACE) model of addiction and the negative reinforcement model of drug addiction, which both postulate that negative feelings play a central role in motivating and maintaining addiction. These results also echo other typologies performed in problem gamblers and problematic videogame users. These similarities of psychological profiles with other addictive behaviors, and with common symptoms and clinical expressions, are supplementary arguments to consider conceptualizing compulsive buying as an addictive disorder.

An experimental examination of cognitive processes and response inhibition in patients seeking treatment for buying-shopping disorder

There is an ongoing debate about whether buying-shopping disorder (BSD) should be acknowledged as a behavioral addiction. The current study investigated if mechanisms that play a prominent role in disorders due to substance use or addictive behaviors are relevant in BSD, particularly cue reactivity, craving, cognitive bias and reduced inhibitory control regarding addiction-relevant cues. The study included 39 treatment-seeking patients with BSD and 39 healthy control (HC) participants (29 women and 10 men in each group). Subjective responses toward buying/shopping-relevant visual cues were compared in patients vs. control participants. Experimental paradigms with neutral and semi-individualized buying/shopping-related pictures were administered to assess attentional bias, implicit associations and response inhibition with respect to different visual cues: Dot-probe paradigm (DPP), Implicit Association Task (IAT), Go/nogo-task (GNG). The severity of BSD, craving for buying/shopping, and symptoms of comorbid mental disorders (anxiety, depressive and hoarding disorders) were measured using standardized questionnaires. The BSD-group showed more general craving for buying/shopping, stronger subjective craving reactions towards buying/shopping-related visual cues, and more symptoms of anxiety, depression and hoarding disorder than control participants. Task performance in the DPP, IAT and GNG paradigm did not differ between the two groups. The present findings confirm previous research concerning the crucial role of craving in BSD. The assumption that attentional bias, implicit associations and deficient inhibitory control with respect to buying/shopping-related cues are relevant in BSD could not be proven. Future research should address methodological shortcomings and investigate the impact of acute psychosocial stress and present mood on craving responses, cognitive processing, and response inhibition in patients with BSD.

Spanish validation of the pathological buying screener in patients with eating disorder and gambling disorder

BACKGROUND AND AIMS

Pathological buying (PB) is a behavioral addiction that presents comorbidity with several psychiatric disorders. Despite the increase in the prevalence estimates of PB, relatively few PB instruments have been developed. Our aim was to assess the psychometric properties of the Spanish version of the pathological buying screener (PBS) and to explore the associations between PB, psychopathology, and personality traits.

METHODS

A total of 511 participants, including gambling disorder (GD) and eating disorder (ED) patients diagnosed according to DSM-5 criteria, as well as healthy controls (HCs), took part in the study.

RESULTS

Higher PB prevalence was obtained in ED patients than in the other two study groups (ED 12.5% vs. 1.3% HC and 2.7% GD). Confirmatory factor analysis (CFA) verified the 13-item structure of the PBS, and indexes of convergent and discriminant capacity were estimated. CFA confirmed the structure in two factors (excessive buying behavior and loss of control) with excellent internal consistency (α = .92 and .86, respectively). Good convergent capacity was obtained with external psychopathology and personality measures (positive correlations with novelty seeking and negative associations with self-directedness and harm avoidance were found). Good discriminative capacity to differentiate between the study groups was obtained.

DISCUSSION AND CONCLUSIONS

This study provides support for the reliability and validity of the Spanish adaptation of the PBS. Female sex, higher impulsivity, and higher psychopathology were associated with PB.

Compulsive buying in Paris psychology students: Assessment of DSM-5 personality trait domains

Compulsive buying is associated with significant psychiatric comorbidity, such as personality disorders. Few studies have focused on the dimensional model of personality disorders in compulsive buying. We aimed to assess the eventual presence of personality dysfunctions in compulsive buying according to the Diagnostic and Statistical Manual of Mental Disorder, 5th edition (DSM-5) dimensional conception of personality disorders. We screened online compulsive buying (QABB), characterized purchasing behavior and explored DSM-5 personality trait domains (Personality Inventory for DSM-5-Brief Form [PID-5-BF]) in 233 Paris psychology students using an online self-reporting questionnaire. The prevalence of compulsive buying among students was 7.7% (n = 18). The favorite items purchased by compulsive buyers were clothing and cosmetic products. Three mean trait domain scores were significantly higher for CB+ than CB- students: negative affect, detachment and disinhibition. Our findings suggest that compulsive buyers distinctively feature pathological DSM-5 dimensional personality trait domains.

The Contribution of Sex, Personality Traits, Age of Onset and Disorder Duration to Behavioral Addictions

Background and aims: Increases in the prevalence of behavioral addictions worldwide have led to a growth in the etiological research of the specific contribution of risk/protective factors to these disorders. The objective of this study was to assess the relative role of patients' sex, age of disorder onset and disorder duration on the clinical profile of behavioral addictions. Methods: Our sample included treatment-seeking patients diagnosed with gambling disorder (GD, n = 3,174), internet gambling disorder (IGD, n = 45), compulsive buying (CB, n = 113), and sex addiction (SA, n = 34). Results: The pattern of associations between the independent variables and the outcomes were strongly related to the behavioral addiction subtype: (a) for GD-men early onset of the disorder was related to GD severity, while for GD-women early onset was linked to novelty seeking; (b) for IGD-men, late onset correlated with addiction severity, worse psychopathological state, and high harm avoidance and self-transcendence levels; (c) for CB-women, early onset was related to higher reward-dependence scores and lower self-transcendence levels, and longer duration predicted higher cumulate debts; for CB-men, early onset and long duration correlated with high scores in harm-avoidance, self-directedness, self-transcendence, and cooperativeness; and (d) for SA-men, late onset and longer duration correlated with high disorder severity. Discussion and Conclusions: These findings are relevant for developing prevention and treatment programs specific to different behavioral addictions.

Behavioural lateralization in domestic pigs (Sus scrofa)-variations between motor functions and individuals

Motor lateralization is hypothesized to depend on the complexity of the motor function, but it might at the same time reflect hemispheric dominance within an individual across motor functions. We investigated possible motor lateralization patterns in four motor functions of different complexity (snout use in a manipulative task, foot use in two-stepping tasks and tail curling) in the domestic pig, a tetrapod species relevant as farm animal but also as a model in human neuroscience. A significant majority of our sample showed individual biases for manipulation with their snout and for curling their tail. Interestingly, the tail curling was lateralized towards the right at the population level and showed stronger lateralization patterns than the snout. Using a cluster analysis with combined tail and snout laterality, we identified groups of individuals with different lateralization patterns across motor functions that potentially reflect the individuals' hemispheric dominance. To conclude, our results suggest that pigs show lateralization patterns that depend on the motor function and on the individual. Such individual lateralization patterns might have broader implications for animal personality and welfare. Our study lays the methodological groundwork for future research on laterality in pigs.

Food Addiction in Gambling Disorder: Frequency and Clinical Outcomes

Background: The food addiction (FA) model is receiving increasing interest from the scientific community. Available empirical evidence suggests that this condition may play an important role in the development and course of physical and mental health conditions such as obesity, eating disorders, and other addictive behaviors. However, no epidemiological data exist on the comorbidity of FA and gambling disorder (GD), or on the phenotype for the co-occurrence of GD+FA.

Objectives: To determine the frequency of the comorbid condition GD+FA, to assess whether this comorbidity features a unique clinical profile compared to GD without FA, and to generate predictive models for the presence of FA in a GD sample.

Method: Data correspond to N = 458 treatment-seeking patients who met criteria for GD in a hospital unit specialized in behavioral addictions.

Results: Point prevalence for FA diagnosis was 9.2%. A higher ratio of FA was found in women (30.5%) compared to men (6.0%). Lower FA prevalence was associated with older age. Patients with high FA scores were characterized by worse psychological state, and the risk of a FA diagnosis was increased in patients with high scores in the personality traits harm avoidance and self-transcendence, and low scores in cooperativeness (R² = 0.18).

Conclusion: The co-occurrence of FA in treatment-seeking GD patients is related to poorer emotional and psychological states. GD treatment interventions and related behavioral addictions should consider potential associations with problematic eating behavior and aim to include techniques that aid patients in better managing this behavior.

Compulsive Buying Behavior: Characteristics of Comorbidity with Gambling Disorder

Compulsive buying behavior (CBB) has begun to be recognized as a condition worthy of attention by clinicians and researchers. Studies on the commonalities between CBB and other behavioral addictions such as gambling disorder (GD) exist in the literature, but additional research is needed to assess the frequency and clinical relevance of the comorbidity of CBB and GD. The aim of the study was to estimate the point-prevalence of CBB+GD in a clinical setting. Data corresponded to n = 3221 treatment-seeking patients who met criteria for CBB or GD at a public hospital unit specialized in treating behavioral addictions. Three groups were compared: only-CBB (n = 127), only-GD (n = 3118) and comorbid CBB+GD (n = 24). Prevalence for the co-occurrence of CBB+GD was 0.75%. In the stratum of patients with GD, GD+CBB comorbidity obtained relatively low point prevalence (0.77%), while in the subsample of CBB patients the estimated prevalence of comorbid GD was relatively high (18.9%). CBB+GD comorbidity was characterized by lower prevalence of single patients, higher risk of other behavioral addictions (sex, gaming or internet), older age and age of onset. CBB+GD registered a higher proportion of women compared to only-GD (37.5 vs. 10.0%) but a higher proportion of men compared to only-CBB (62.5 vs. 24.4%). Compared to only-GD patients, the simultaneous presence of CBB+GD was associated with increased psychopathology and dysfunctional levels of harm avoidance. This study provides empirical evidence to better understand CBB, GD and their co-occurrence. Future research should help delineate the processes through which people acquire and develop this comorbidity.