Treatment of compulsive buying disorder: comparing the effectiveness of cognitive behavioural therapy with person-centred experiential counselling

Criteria for the establishment of a new behavioural addiction •

When does repeated behaviour constitute behavioural addiction? There has been considerable debate about non-substance-related addictions and how to determine when impaired control over a behaviour is addiction. There are public health benefits to identifying new behavioural addictions if intervention can improve outcomes. However, criteria for establishing new behavioural addictions must guard against diagnostic inflation and the pathologizing of normal problems of living. Criteria should include clinical relevance (Criterion 1), alignment with addiction phenomenology (Criterion 2) and theory (Criterion 3), and taxonomic plausibility (Criterion 4). Against such criteria, evidence does not yet support classification of pornography-use and buying-shopping disorders as addictions.

Therapeutic management of buying/shopping disorder: A systematic literature review and evidence-based recommendations

The prevalence of buying/shopping disorder (B/SD) has been increasing in the last two decades, and this disorder has a substantial negative impact on general functioning and quality of life. Therefore, a systematic review of the studies dedicated to the efficacy and tolerability of therapeutic interventions, both psychological and pharmacological, might help clinicians to decide on the most evidence-based treatment for these patients. In order to further increase the clinical usefulness of the current review, GRADE-based recommendations were formulated, where enough evidence was found to support such an approach. A number of five electronic databases were searched for single case reports, case series, open-label and double-blind, placebo/active intervention-controlled trials, but other secondary reports (i.e., systematic reviews and meta-analyses) were also included in this analysis. Studies with unspecified designs or those that do not report either qualitatively or quantitively the evolution of B/SD core manifestations were excluded. All data included in the secondary analysis were evaluated using the Joanna Briggs Institute critical appraisal checklists. A total number of 24 manuscripts (i.e., 12 clinical trials, eight case reports, and four reviews) were included. Most of the reviewed studies were of moderate quality, representing a certain limitation of this review and preventing the formulation of high-validity recommendations. Psychotherapy, especially cognitive behavioral therapy (CBT) seems to be the main intervention supported by the current evidence, followed by the combination of antidepressants and CBT, and serotoninergic antidepressants as monotherapy. There is an obvious need to further develop good-quality trials with a more significant number of participants with B/SD and longer follow-up periods.

Effectiveness of the unified protocol for treating co-morbid health anxiety and depression: an empirical case study

AIMS

The unified protocol (UP) is indicated when patients present with co-morbidity, but no studies have previously investigated the effectiveness of the UP with co-morbid health anxiety and depression.

METHOD

An A/B single case design evaluated outcomes for a 27-year-old male presenting with health anxiety and co-morbid depression. Following a 21-day assessment-baseline period containing three sessions, the manualised UP was delivered across a 42-day period containing seven intervention sessions. Four idiographic measures (occurrence and duration of health checking, sleep duration and food intake satisfaction) were collected daily throughout, and two nomothetic measures were collected at four time points.

RESULTS

All sessions were attended. Number of health checking episodes reduced from four per day to two per day. A 59 minute per day reduction in time spent health checking occurred, and sleep increased by 100 minutes per night. There was little apparent change in terms of food intake satisfaction. There was a reliable and clinically significant reduction in depression.

DISCUSSION

Further testing of the effectiveness of the UP with co-morbid health anxiety and depression in true single case experimental designs is now indicated.