Study of compulsive buying in depressed patients

Psychosocial Functioning of Individuals at Risk of Developing Compulsive Buying Disorder

(1) Background: This study aimed to establish the connection between depressiveness, workaholism, eating disorders, and personality traits, according to the five-point model called the Big Five, in women with a risk of compulsive buying disorder. (2) Methods: The study was conducted on 556 Polish women from the West Pomeranian Voivodeship. The study employed the diagnostic survey method using a questionnaire technique including Personality Inventory NEO-FFI, the Buying Behaviour Scale, the Beck Depression Inventory I-II, the Three-Factor Eating Questionnaire, and a self-questionnaire. (3) Results: The analysis revealed the risk of compulsive buying being accompanied by a higher median score for depressiveness, neuroticism, Cognitive Restraint of Eating, Uncontrolled Eating, and a risk of workaholism. A lower score in the respondents in the compulsive buying risk group was observed in an assessment of agreeableness and conscientiousness. Work addiction was exhibited by 26% of people with compulsive buying disorder vs. 12% of people without it. (4) Conclusion: This study found that a high risk of compulsive buying disorder is accompanied by a high risk of moderate depressiveness, neuroticism, Cognitive Restraint of Eating, Uncontrolled Eating, and workaholism. It also confirmed the view that compulsive buying is a behavioural addiction which is a consequence of ineffective coping and being dissatisfied with one's social life.

Psychometric properties and measurement invariance across gender of the Compulsive Online Shopping Scale (COSS) among Iranians

The present study aimed to investigate the psychometric properties and measurement invariance of the Compulsive Online Shopping Scale (COSS) in an Iranian population. The total sample of 802 participants (257 females; Mean age = 22.27, SD = 2.83) were selected via convenience sampling from Tehran, Iran. Confirmatory Factor Analysis supported the 7-factor structure of the COSS as proposed in the original study. The measurement invariance found in this study suggests that the COSS provides sufficiently unbiased use among males and females. The current findings also support the concurrent validity of the Persian COSS, which exhibited positive and significant associations with loneliness, impulsivity, obsession, internalized symptoms, and Internet use. Furthermore, results confirm the convergent validity of the Persian COSS and showcased acceptable internal consistency for all factors, and the total score. The findings of the present study indicate that compulsive online shopping could be assessed adequately in Iranian samples using the COSS.

The Roles of Anxiety and Self-Esteem in the Risk of Eating Disorders and Compulsive Buying Behavior

In contemporary society, following the sudden changes that occur, different forms of addiction are becoming popular. Of note are the new addictions and concepts of poly-dependencies that involve common behaviors and trap people who suffering from them in a vicious circle. The main goal of this study is to investigate the possible mediating role that self-esteem had between trait anxiety and two specific new addictions: compulsive buying behavior and eating disorders. Furthermore, it was verified through a multigroup analysis that trait anxiety had a greater effect on eating disorders in a group of compulsive consumers. Three-hundred and fifty-two participants (67.9% women) were enrolled to participate in this study. The results showed that there was a direct effect of trait anxiety on eating disorders and on compulsive buying behavior; self-esteem mediated the effect of trait anxiety on eating disorders and compulsive buying behavior with specific differences; multi-group analysis showed differences in anxiety's effect on eating disorders between compulsive and non-compulsive consumers; the group of compulsive consumers revealed a significant and stronger effect of trait anxiety on eating disorders in all domains identified. Further research is recommended to better understand the predictors of these disorders and to contribute to a more effective preventive intervention.

Loneliness and the Degree of Addiction to Shopping and Work among Polish Women: The Mediating Role of Depression

(1) The aim of the research was to try to define the mediating role of depression in the relationship between addiction to shopping and work and loneliness, understood in terms of general loneliness among Polish women. (2) The study was conducted among 556 women. The research was carried out with the use of the diagnostic survey method, using the questionnaire technique: the De Jong Gierveld Loneliness Scale, the Purchasing Behavior Scale, the Work Addiction Risk Test, Beck Depression Inventory, and our own questionnaire. (3) Depression is a mediator in the relationship between the feeling of loneliness and the degree of addiction to shopping (β = −0.0246, z = −2.03, p = 0.043) and in the relationship between the feeling of loneliness and the degree of addiction to work (β = −0.0722, z = −4.002, p < 0.001). The direct impact of the feeling of loneliness on the degree of addiction to shopping (p = 0.237) and work (p = 0.576) is statistically insignificant. (4) Depression plays the role of a mediator between the feeling of loneliness and the degree of addiction to shopping and work. An increase in the level of depression increases the degree of addiction to shopping and work. The mediator’s participation lowers the loneliness feeling level.

The impact of long-term orientation on compulsive buying behavior: A cross-cultural study

The overall purpose of this study was to investigate the wider impacts of cultural values on consumer compulsive buying from a cross-cultural perspective. This study considers the long-term orientation as an extended antecedent to explore the moderating role of materialism value and money attitude on compulsive buying behavior in different cultures. Survey results from 313 Chinese and 309 U.S. consumers indicate that the higher materialistic values drive compulsive buying though some differences exist between consumers in both countries. To specify, American buyers had a higher materialistic orientation and higher compulsive buying tendencies than Chinese consumers. Furthermore, the results indicate that money attitudes are negatively related to compulsive buying behaviors among two countries' consumers. Lastly, this study found that long-term orientations were found to significantly influence money attitudes and compulsive buying among Chinese consumers.

Relating Compulsivity and Impulsivity With Severity of Behavioral Addictions: A Dynamic Interpretation of Large-Scale Cross-Sectional Findings

BACKGROUND AND AIM

Impulsivity and compulsivity are two key temperament traits involved in behavior regulation. The aim of this study was to test several existing theories in explaining the role of impulsivity and compulsivity in symptom severity in various behavioral addictions.

METHODS

Data were collected from a (representative) general population sample (N = 2,710, mean age:39.8 years (SD:13.6), 51% woman), and from people who are at increased risk of having a behavioral addiction (N = 9,528 in total, mean age: 28.11 (SD:8.3), 34.3% woman), including people with problematic gaming and internet use, pathological gambling, exercise dependence, compulsive buying and work addiction. Symptom severity, reward driven impulsivity and relief driven compulsivity were assessed.

RESULTS

For non-problematic groups, impulsivity is present to about the same extent as compulsivity, whereas for problematic groups, compulsivity dominates over impulsivity in all groups (except for gambling). The strength of the correlation between impulsivity and compulsivity is higher in more severe forms of the disorders (from r = 0.18 to r = 0.59 in the representative population).

DISCUSSION

Based on these data, it appears that relief-driven behavior (negative reinforcement) dominates over reward-driven behavior (positive reinforcement) in more severe cases of a behavioral addiction.

CONCLUSION

This is the first large-scale study to find empirical support for the neuroscientific theory on the dominance of compulsivity ("needing") over impulsivity ("wanting") in more severe cases of a behavioral addiction. Although longitudinal research is needed, a possible shift from impulsivity to compulsivity takes place, similar to substance use addictions, which maintains the circle of addiction.

Life Aspirations, Generativity and Compulsive Buying in University Students

The study of goal-oriented behaviour, because of its undeniable repercussions on physical and mental health, is one of the target topics of contemporary research. However, the content of life aspirations, emphasised from the self-determination theory, has received little attention from the field of compulsive buying although it plays an important role in the regulation of behaviour and well-being. Generativity, the personal construct that captures the intentions and/or the need to contribute (leave a legacy) to others, has never been analysed with respect to compulsive buying although it has been the source of interest of related fields (responsible consumption). Accordingly, this study seeks to shed light on the role of both constructs (life aspirations and generativity) in compulsive buying among university students. The sample consisted of 1093 Spanish university students classified either as non-compulsive buyers or compulsive buyers. Estimated prevalence of compulsive buying was 7.9%. The results of Student's test confirm that, besides gender (women report greater propensity to the phenomenon), compulsive buyers score higher and show statistically significant differences with respect to non-compulsive buyers in all extrinsic goals (financial success, image, popularity and conformity) and hedonism. Non-compulsive buyers show significantly higher scores for the intrinsic goals of self-acceptance, affiliation and community feeling and also report a higher generative concern. The logistic regression analysis confirms that being female and the life aspirations of image, popularity and hedonism act as risk factors in compulsive buying in university students while generativity and the importance granted to the intrinsic goals of self-acceptance and affiliation are protective factors. Potential lines of action for this worrying phenomenon are discussed in the light of the findings.

How user knowledge of psychotropic drug withdrawal resulted in the development of person-specific tapering medication

Coming off psychotropic drugs can cause physical as well as mental withdrawal, resulting in failed withdrawal attempts and unnecessary long-term drug use. The first reports about withdrawal appeared in the 1950s, but although patients have been complaining about psychotropic withdrawal problems for decades, the first tentative acknowledgement by psychiatry only came in 1997 with the introduction of the 'antidepressant-discontinuation syndrome'. It was not until 2019 that the UK Royal College of Psychiatrists, for the first time, acknowledged that withdrawal can be severe and persistent. Given the lack of a systematic professional response, over the years, patients who were experiencing withdrawal started to work out practical ways to safely come off medications themselves. This resulted in an experience-based knowledge base about withdrawal which ultimately, in The Netherlands, gave rise to the development of person-specific tapering medication (so-called tapering strips). Tapering medication enables doctors, for the first time, to flexibly prescribe and adapt the medication required for responsible and person-specific tapering, based on shared decision making and in full agreement with recommendations in existing guidelines. Looking back, it is obvious that the simple practical solution of tapering strips could have been introduced much earlier, and that the traditional academic strategy of comparisons from randomised trials is not the logical first step to help individual patients. While randomised controlled trials (RCTs) are the gold standard for evaluating interventions, they are unable to accommodate the heterogeneity of individual responses. Thus, a more individualised approach, building on RCT knowledge, is required. We propose a roadmap for a more productive way forward, in which patients and academic psychiatry work together to improve the recognition and person-specific management of psychotropic drug withdrawal.

Scales to assess impulsive and compulsive behaviors in Parkinson's disease: Critique and recommendations

Impulse control disorders (ICDs) and related impulsive and compulsive behaviors (together called ICBs) have been increasingly recognized in the context of Parkinson's disease (PD) and treatment. The International Parkinson's and Movement Disorder Society commissioned a task force to assess available clinical screening instruments and rating scales, including their clinimetric properties, make recommendations regarding their utility, and suggest future directions in scale development and validation. The literature was systematically searched for scales measuring a range of reported ICBs in PD. A scale was designated "recommended" if the scale had been employed in PD studies, been used beyond the group that developed it, and had adequate clinimetric data published for PD. Numerous diagnostic screening tools and severity rating scales were identified for a range of ICBs, including compulsive medication use, punding/hobbyism, walkabout, pathological gambling, hypersexuality, compulsive or binge eating, compulsive buying, reckless driving, compulsive exercise, pyromania, trichotillomania, hoarding, kleptomania, intermittent explosive disorder, and internet addiction. For screening across the range of ICBs (except compulsive medication use), the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's disease (QUIP) and QUIP-Rating Scale (QUIP-RS) are recommended, and for severity rating across the range of ICBs the QUIP-RS and the Ardouin Scale of Behavior in Parkinson's Disease are recommended. The Scale for Outcomes in Parkinson's Disease-Psychiatric Complications is recommended for rating of hypersexuality and the compulsive behaviors gambling/shopping. Further testing of established scales against gold standard diagnostic criteria is urgently required for all other individual ICBs in PD. © 2019 International Parkinson and Movement Disorder Society © 2019 International Parkinson and Movement Disorder Society.

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.

Pathological buying symptoms are associated with distortions in judging elapsed time

BACKGROUND AND AIMS

Pathological buying (PB) is often assumed to be related to deficits in impulse control. Distortions in judging elapsed time are one component of behavioral impulsivity. This study was set out to examine the hypothesis that PB propensity is associated with distorted time perception, such that time is perceived to pass more slowly.

METHODS

The study is based on a convenience sample of 78 adults. Symptom severity of PB and related problems/disorders (substance use, borderline, depression, mania, and obsessive-compulsive disorder) as well as four dimensions of trait impulsivity were assessed. A time-production task was employed that required participants to produce prespecified time intervals ranging from 1 to 60 s.

RESULTS

PB propensity was associated with the belief that time elapses more slowly, even when controlling for symptoms of related disorders and general trait impulsivity. Neither trait impulsivity nor symptoms of related disorders were predictive of distortions in judging elapsed time.

DISCUSSION AND CONCLUSION

These results suggest that PB propensity is related with non-specific, general deficits in judging elapsed time as a specific component of behavioral impulsivity.

Component Model of Addiction Treatment: A Pragmatic Transdiagnostic Treatment Model of Behavioral and Substance Addictions

Behavioral addictions such as gambling, video games, sex, and shopping share many clinical features with substance use addictions including etiology, course, and neurobiology. Yet, the treatment of behavioral and substance use addictions tends to be separated. However, we argue that a more effective and efficient treatment approach is to conceptualize behavioral and substance use addictions as different expressions of a common underlying disorder and, in treatment, to address the underlying mechanisms common to both. To this end, the article presents a developing transdiagnostic treatment model of addictions that targets underlying similarities between behavioral and substance use addictions, called the component model of addiction treatment (CMAT). The CMAT is transdiagnostic in that it can be used in the treatment of both behavioral and substance use addictions. It is pragmatic in that it targets component vulnerabilities, which are enduring, yet malleable, individual psychological, cognitive, and neurobiological characteristics that are common to all addictive disorders and have been demonstrated to be modifiable. A working model of CMAT is presented, including proposed component vulnerabilities: lack of motivation, urgency, maladaptive expectancies, deficits in self-control, deficits in social support, and compulsivity, as well as their potential intervention possibilities. Future directions and potential implications of the CMAT are discussed.

Longitudinal analysis of impulse control disorders in Parkinson disease

OBJECTIVE

To investigate the longitudinal dose-effect relationship between dopamine replacement therapy and impulse control disorders (ICDs) in Parkinson disease (PD).

METHODS

We used data from a multicenter longitudinal cohort of consecutive patients with PD with ≤5 years' disease duration at baseline followed up annually up to 5 years. ICDs were evaluated during face-to-face semistructured interviews with movement disorder specialists. Generalized estimating equations and Poisson models with robust variance were used to study the association between several time-dependent definitions of dopamine agonist (DA) use, taking dose and duration of treatment into account, and ICDs at each visit. Other antiparkinsonian drugs were also examined.

RESULTS

Among 411 patients (40.6% women, mean age 62.3 years, average follow-up 3.3 years, SD 1.7 years), 356 (86.6%) took a DA at least once since disease onset. In 306 patients without ICDs at baseline, the 5-year cumulative incidence of ICDs was 46.1% (95% confidence interval [CI] 37.4-55.7, DA ever users 51.5% [95% CI 41.8-62.1], DA never users 12.4% [95% CI 4.8-30.0]). ICD prevalence increased from 19.7% at baseline to 32.8% after 5 years. ICDs were associated with ever DA use (prevalence ratio 4.23, 95% CI 1.78-10.09). Lifetime average daily dose and duration of treatment were independently associated with ICDs with significant dose-effect relationships. Similar analyses for levodopa were not in favor of a strong association. ICDs progressively resolved after DA discontinuation.

CONCLUSION

In this longitudinal study of patients with PD characterized by a high prevalence of DA treatment, the 5-year cumulative incidence of ICDs was ≈46%. ICDs were strongly associated with DA use with a dose-effect relationship; both increasing duration and dose were associated with ICDs. ICDs progressively resolved after DA discontinuation.

CLINICALTRIALSGOV IDENTIFIER

NCT01564992.

Dissociating Pathological Buying From Obsessive-Compulsive Symptoms Using Delay Discounting

Abstract. Pathological buying (PB) has been associated with elevated impulsivity in personality inventories, yet limited research has considered components of behavioral impulsivity. This study examined the relationship between discounting of delayed rewards, symptoms of PB, comorbid disorders (including obsessive-compulsive disorder, OCD), and trait impulsivity. One hundred three participants completed two delay discounting tasks (DDT). In addition to the traditional DDT, a loan variant assessing the preference to receive a certain amount of money immediately when a fixed amount has to be returned after a certain delay was included in this study. Regression analysis revealed that PB symptoms predicted steeper discounting functions in both variants of the DDT over and above the remaining symptom measures and trait impulsivity. In contrast, symptoms of OCD were associated with less delay discounting. With regard to delay discounting, PB seems to be more similar to behavioral addictions than to OCD.

Compulsive buying and quality of life: An estimate of the monetary cost of compulsive buying among adults in early midlife

The aims of this study were to examine the associations between compulsive buying and quality of life and to estimate the monetary cost of compulsive buying for a cohort of men and women at mean age 43. Participants came from a community-based random sample of residents in two New York counties (N=548). The participants were followed from adolescence to early midlife. The mean age of participants at the most recent interview was 43.0 (SD=2.8). Fifty five percent of the participants were females. Over 90% of the participants were white. Linear regression analyses showed that compulsive buying was significantly associated with quality of life, despite controlling for relevant demographic and psychosocial factors. The estimated monetary cost of compulsive buying for this cohort was significant. The fact that the monetary cost of CB is not trivial suggests that individuals are both consciously and unconsciously plagued by their CB. The findings are important for interventionists and clinicians for cost-effective intervention and treatment programs.

Psychiatric and socioeconomic aspects as possible predictors of compulsive buying behavior

Introduction:

Compulsive buying can be characterized as an almost irresistible urge to buy various items. Compulsive buying disorder is a subject of growing interest to health professionals. It is a current issue and the prevalence rate in the global population is around 5 to 8%.

Objectives:

The main objective of this study was to identify predictors of compulsive buying in the Brazilian population, assessing possible relationships between compulsive buying, depression and anxiety.

Methods:

The Richmond Compulsive Buying Scale was administered to screen for compulsive buying and the Hospital Anxiety and Depression Scale was used to assess anxiety and depression in a sample of 359 participants. Pearson coefficients were used to test for correlations.

Results:

Our study identified an interaction between female gender and compulsion to purchase. Furthermore, people's occupations also appear to have an influence on the problem. We found a correlation between depressive symptoms and oniomania.

Conclusion:

Our study has certain limitations, such as the difficulty in recruiting individuals with compulsive buying disorder. Since compulsive buying is a phenomenon that is seldom investigated, it therefore remains unidentified. However, this is nevertheless a pioneering paper on the Brazilian population.

Effects of mood state on impulsivity in pathological buying

Pathological buying is characterized by irrepressible buying behaviour and its negative consequences. A possible mechanism contributing to its development and maintenance is that buying episodes act as a maladaptive strategy to cope with negative emotions. Accordingly, pathological buying has been repeatedly associated with impulsivity, in particular with the tendency to experience strong reactions under negative affect. Relying on an experimental mood induction procedure, the present study tested in a sample of 100 individuals (a) whether individuals with pathological buying symptoms respond more impulsively in the Go/No-Go Task (as a measure of the behavioural inhibition aspect of impulsivity) and (b) whether this association is more pronounced in a negative mood. While controlling for comorbidities, the results show that pathological buying is associated with faster responses and a larger number of commission errors. Moreover, a significant interaction indicated that the association between pathological buying and performance the Go/No-Go Task was stronger in the negative mood condition. The present study thus shows that pathological buying is associated with deficits in the behavioural inhibition component of impulsivity. These deficits are most pronounced when mood is negative; in turn, this provides an explanation for the occurrence of excessive buying episodes following negative affect.

A multidimensional approach to impulsivity in Parkinson's disease: measurement and structural invariance of the UPPS Impulsive Behaviour Scale

BACKGROUND

Poor impulse control is a common feature in patients with Parkinson's disease (PD). However, before testing whether patients with PD and controls differ in impulsivity, one must assess whether impulsivity measures are invariant across groups. Consequently, we examined (a) the measurement and structural invariance of a scale assessing changes in four dimensions of impulsivity (urgency, lack of premeditation, lack of perseverance and sensation seeking) among patients with PD and controls; and (b) whether the four impulsivity traits relate differentially to risky decisions by patients.

METHOD

Close relatives of 78 patients with idiopathic PD and 96 control participants were given the short Urgency-Premeditation-Perseverance-Sensation seeking Impulsive Behaviour Scale (UPPS), which assesses changes in four dimensions of impulsivity. Participants also completed the Game of Dice Task (GDT), a laboratory measure of risk taking.

RESULTS

Multigroup confirmatory factor analyses supported measurement invariance across groups, whereas structural invariance was not confirmed. Patients with PD showed greater variability and higher impulsivity than controls. Furthermore, patients with impulse control disorders (ICDs) demonstrated even greater levels of sensation seeking than patients without ICDs. Finally, lower premeditation and greater perseverance were significantly associated with greater risk taking in patients with PD, and higher agonist dopaminergic doses with less risky choices on the GDT.

CONCLUSIONS

The questionnaire appears to function comparably across patients and controls. Thus, group comparisons on the questionnaire can be considered valid. Mean differences between groups on the dimensions of impulsivity may reflect executive impairments and/or abnormal reward processing in patients with PD, which may lead to risky behaviours.

Treatments for compulsive buying: A systematic review of the quality, effectiveness and progression of the outcome evidence

Background and aims This review appraises the progression and status of the evidence base for the treatment of compulsive buying disorder (CBD), in order to highlight what currently works and to prompt useful future research. Methods Online databases ISI Web of Knowledge, PsycINFO, and PubMed via Ovid were searched at two time points. Two quality checklists and an established model of therapy evaluation (hourglass model) evaluated the quality and progression of both psychotherapy and pharmacotherapy treatments for CBD. Uncontrolled effect sizes were calculated and meta-regression analyses were performed regarding treatment duration. Results A total of 29 articles met the inclusion criteria, which were divided into psychotherapy (n = 17) and pharmacotherapy treatments (n = 12). Of the 29 studies, only 5 studies have been tested under conditions of high methodological quality. Both forms of treatment had been evaluated in a haphazard manner across the stages of the hourglass model. Although large effects were demonstrated for group psychotherapy and pharmacotherapy, such evidence of effectiveness was undermined by poor study quality and risk of publication bias. Long-term CBD treatment was associated with improved outcome with pharmacotherapy, but not when delivering psychotherapy. Discussion Group psychotherapy currently appears the most promising treatment option for CBD. Poor methodological control and sporadic evaluation of specific treatments have slowed the generation of a convincing evidence base for CBD treatment. Defining the active ingredients of effective CBD treatment is a key research goal.

Associations between compulsive buying and substance dependence/abuse, major depressive episodes, and generalized anxiety disorder among men and women

The objective of this study was to examine the associations between compulsive buying and substance dependence/abuse, major depressive episodes, and generalized anxiety disorder at the mean age of 43. Participants came from a community-based random sample of residents in 2 New York counties in 1975 (N = 548). The participants were followed from adolescence to early midlife. The mean age of participants at the most recent interview was 43.0 (standard deviation = 2.8). Of the participants, 55% were females. Over 90% of the participants were Caucasian. The prevalence of substance dependence/abuse, major depressive episodes, and generalized anxiety disorder (during the past 5 years before the interviews) was 6.6, 13.7, and 11.5%, respectively. Logistic regression analyses showed that compulsive buying was significantly associated with substance dependence/abuse (adjusted odds ratio = 1.60), major depressive episodes (adjusted odds ratio = 1.70), and generalized anxiety disorder (adjusted odds ratio = 1.63), despite controlling for substance dependence/abuse, major depressive episodes, and generalized anxiety disorder, respectively, at the mean age of 37, and demographic factors. Since the study sample is limited to predominantly Caucasian participants (over 90%) with a close association to a small geographic area, the findings may not be generalizable to racial/ethnic minority groups or individuals living in other parts of the country. Nevertheless, it is important that clinicians treating substance dependence/abuse, major depressive episodes, and generalized anxiety disorder consider the role of compulsive buying.

Addictive behaviors and personality traits in adolescents

INTRODUCTION

Behavioral addictions refer to repeated dysfunctional behaviors that do not involve the ingestion of addictive substances. Studies on the association between behavioral addictions and personality traits have noted in individuals with problematic behaviors a high proclivity toward impulsivity and sensation-seeking and a low predisposition to harm avoidance. The majority of these studies have focused on adults, while far fewer have involved adolescents.

METHODS

The study population was 109 high school students (age range 15-18 years) in Turin, Italy. Participants completed an assessment that comprised a demographic questionnaire and 3 self-report questionnaires: the Shorter PROMIS Questionnaire (SPQ), the Internet Addiction Test (IAT), and the Multidimensional Questionnaire for Adolescents (QMA).

RESULTS

A gender-related difference in the risk of developing an addictive behavior was observed, with a significantly higher percentage of risk seen for several addiction tendencies among the males. Statistically significant correlations emerged between some personality determinants and certain addictive behaviors.

DISCUSSION

The study pinpoints epidemiological indicators for the extent of this growing problem among adolescents.

CONCLUSIONS

The findings have implications for identifying protection factors and risk factors for addictive behaviors and related psychiatric disorders, and the development of primary prevention strategies derived from such factors.

Compulsive buying and depressive symptoms among female citizens of the United Arab Emirates

Compulsive buying is particularly relevant in nations with high levels of consumer spending. Most previous studies have focused on European and North America populations. This study explores compulsive buying amongst citizens of the United Arab Emirates, an Arab nation with high retail outlet density, and high levels of consumer spending. Female college students (N=100) completed an English/Arabic version of the compulsive buying scale along with a measure of depression. Rates of compulsive buying were higher than those reported in any previously published study. Furthermore, in line with previous findings from other nations, compulsive buying was associated with elevated depressive symptomatology.

Accuracy of screening instruments for detection of neuropsychiatric syndromes in Parkinson's disease

Parkinson's disease includes neuropsychiatric manifestations, such as depression, anxiety, apathy, psychosis, and impulse control disorders, which often are unreported by patients and caregivers or undetected by doctors. Given their substantial impact on patients and caregivers as well as the existence of effective therapies for some of these disorders, screening for neuropsychiatric symptoms is important. Instruments for screening have a particular methodology for validation, and their performance is expressed in terms of accuracy compared with formal diagnostic criteria. The present study reviews the attributes of the screening instruments applied for detection of the aforementioned major neuropsychiatric symptoms in Parkinson's disease. A quasi-systematic review (including predefined selection criteria, but not evaluating the quality of the reviewed studies) was carried out on the basis of previous systematic reviews (commissioned by the American Academy of Neurology and the Movement Disorder Society) and made current by conducting a literature search (2005-2014). For depression, 11 scales and questionnaires were shown to be valid for Parkinson's disease screening. The recently developed Parkinson Anxiety Scale and the Geriatric Anxiety Inventory demonstrate satisfactory properties as screening instruments for anxiety, and the Lille Apathy Rating Scale for detection of apathy. No scale adequately screens for psychosis, so a specific psychosis instrument should be developed. The Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease (Questionnaire and Rating Scale) are valid for comprehensive screening of impulse control disorders, and the Parkinson's Disease-Sexual Addiction Screening Test for hypersexuality specifically.

Prevalence and construct validity of compulsive buying disorder in shopping mall visitors

Compulsive buying is a relatively new psychopathological concept and very few data are currently available regarding the prevalence and validity of compulsive buying disorder. In this cross-sectional study, we establish the prevalence of compulsive buying disorder in shopping mall visitors and explore the construct validity of the concept using the revised version of the Edwards Compulsive Buying Scale in 1441 shopping mall visitors looking at shopping habits, current substance use (smoking, alcohol and illicit drug) and various psychological characteristics. Overall, 8.7% (95% CI: 7.3-10.3) of our sample was classified as having a compulsive buying disorder. Compulsive buyers were younger, less educated and more likely to be female than non-compulsive buyers. They were also more likely to have used licit and illicit substances. Compulsive buyers also reported higher levels of impulsivity and obsessive-compulsive symptoms, lower levels of well-being and self-esteem and more psychological distress. Finally, compulsive buyers were five times more likely to meet criteria for borderline personality disorder than non-compulsive buyers. Compulsive buying is a frequent disorder in shopping mall visitors and is associated with important and robust indicators of psychopathology thus supporting the validity of the construct.

Compulsive buying: Earlier illicit drug use, impulse buying, depression, and adult ADHD symptoms

This longitudinal study examined the association between psychosocial antecedents, including illicit drug use, and adult compulsive buying (CB) across a 29-year time period from mean age 14 to mean age 43. Participants originally came from a community-based random sample of residents in two upstate New York counties. Multivariate linear regression analysis was used to study the relationship between the participant's earlier psychosocial antecedents and adult CB in the fifth decade of life. The results of the multivariate linear regression analyses showed that gender (female), earlier adult impulse buying (IB), depressive mood, illicit drug use, and concurrent ADHD symptoms were all significantly associated with adult CB at mean age 43. It is important that clinicians treating CB in adults should consider the role of drug use, symptoms of ADHD, IB, depression, and family factors in CB.

Co-occurrence of alcohol use disorder and behavioral addictions: relevance of impulsivity and craving

PURPOSE

The aims of the study were to evaluate the occurrence of behavioral addictions (BAs) in alcohol use disorder (AUD) subjects and to investigate the role of impulsivity, personality dimensions and craving.

METHODS

95 AUD outpatients (DSM-5) and 140 homogeneous controls were assessed with diagnostic criteria and specific tests for gambling disorder, compulsive buying, sexual, internet and physical exercise addictions, as well as with the Barratt Impulsiveness Scale (BIS-11) and Temperamental and Character Inventory-Revised (TCI-R). The Obsessive Compulsive Drinking Scale (OCDS) and Visual Analogue Scale for craving (VASc) were also administered to the AUD sample.

RESULTS

28.4% (n=27) of AUD subjects had at least one BA, as compared to 15% (n=21) of controls (χ(2)=6.27; p=.014). In AUD subjects, direct correlations between BIS-11 and Compulsive Buying Scale (CBS), Internet Addiction Disorder test (IAD), Exercise Addiction Inventory-Short Form (EAI-SF) scores (p<.01), between OCDS obsessive and CBS and VASc and CBS, IAD scores (p<.003), were found. BIS-11 (t=-2.36; p=.020), OCDS obsessive (Z=-4.13; p<.001), OCDS compulsive (Z=-2.12; p=.034) and VASc (Z=-4.94; p<.001) scores were higher in AUD subjects with co-occurring BAs. The occurrence of BAs was associated with higher impulsivity traits (BIS-11 scores; OR=1.08; p=.012) and higher craving levels (VASc scores; OR=2.48; p<.001).

CONCLUSIONS

Our findings emphasize a significant rate of co-occurrence of BAs in AUD. High levels of impulsivity and craving for alcohol seem to be associated with other addictive behaviors.

Measuring compulsive buying behaviour: psychometric validity of three different scales and prevalence in the general population and in shopping centres

Due to the problems of measurement and the lack of nationally representative data, the extent of compulsive buying behaviour (CBB) is relatively unknown. The validity of three different instruments was tested: Edwards Compulsive Buying Scale (ECBS; Edwards, E.A., 1993. Development of a new scale for measuring compulsive buying behaviour. Financial Counseling and Planning. 4, 67-85), Questionnaire About Buying Behavior (QABB; Lejoyeux, M., Ades, J., 1994. Les achats pathologiques: une addiction comportementale. Neuro-Psy. 9, 25-32.) and Richmond Compulsive Buying Scale (RCBS; Ridgway, N.M., Kukar-Kinney, M., Monroe, K.B., 2008. An expanded conceptualization and a new measure of compulsive buying. Journal of Consumer Research. 35, 622-639.) using two independent samples. One was nationally representative of the Hungarian population (N=2710) while the other comprised shopping mall customers (N=1447). As a result, a new, four-factor solution for the ECBS was developed (Edwards Compulsive Buying Scale Revised (ECBS-R)), and confirmed the other two measures. Additionally, cut-off scores were defined for all measures. Results showed that the prevalence of CBB is 1.85% (with QABB) in the general population but significantly higher in shopping mall customers (8.7% with ECBS-R, 13.3% with QABB and 2.5% with RCBS-R). Conclusively, due to the diversity of content, each measure identifies a somewhat different CBB group.

A study investigating the association between compulsive buying with measures of anxiety and obsessive-compulsive behavior among internet shoppers

BACKGROUND

Compulsive buying is a chronic, repetitive behavior that becomes a primary response to negative events and feelings. Compulsive buyers are obsessed by buying and their behavior occurs in response to negative emotions and results in a decrease in the intensity of negative emotions. Euphoria or relief from negative emotions is the most common consequence of compulsive buying. A large number of studies have investigated the association between compulsive buying and anxiety, and some studies have used the Spielberger trait-state anxiety inventory.

PROCEDURE

Compulsive buying, state and trait anxiety and general obsessive-compulsive measures were assessed among 120 habitual internet shoppers (2+ times a week, 70 men and 50 women).

RESULTS

Results showed that Edwards Compulsive Buying scale measures were associated with Spielberger trait and not state anxiety measures. Spielberger Trait anxiety measures were also correlated with measures of Yale-Brown Obsessive-Compulsive scale (Y-Bocs). Finally, there were no sex differences in this sample.

CONCLUSIONS

The results of this study support existing evidence for an association between compulsive buying and anxiety and they will be discussed in view of current research on comorbidity of behavioural addiction.

Different facets of compulsive buying among Chinese students

BACKGROUND AND AIMS

Compulsive buying is a severe phenomenon, especially among younger consumers. It is well documented in Western industrial societies like the USA and Germany, and nowadays an increasing interest in compulsive buying in non-Western countries is on the rise.

METHODS

In the current study, we measured the prevalence of compulsive buying tendencies among Chinese female and male students by using a Chinese translation of the German Compulsive Buying Scale (Raab, Neuner, Reisch & Scherhorn, 2005). We examined the influence of gender, location and age using ANCOVA, and binary logistic regression.

RESULTS

Factor analysis identified three factorial dimensions of compulsive buying tendencies which are impairment of impulse control and reactive or compensatory aspects, reduced rationality according to money spending, and post-purchase guilt. Our results indicated that about 6.7% of the sample shows a compulsive buying pattern, and that females are more affected. For location, a geographic difference between Chongqing and Fuzhou was found for the overall compulsive tendencies, but not for the percentages of compulsive buyers.

CONCLUSIONS

In sum, the existing study provides evidence that Chinese consumers have a factorial structure which differs somewhat in compulsive buying from Western samples. Observations about gender and location were considered. These findings give a deeper understanding of China’s compulsive buying behavior.

Reactive and regulative temperament in patients with compulsive buying and non-clinical controls measured by self-report and performance-based tasks

OBJECTIVE

To examine reactive and regulative temperament in patients with compulsive buying (CB) by means of self-report measures and performance-based tasks and to explore the relationship between both measurement approaches.

METHOD

The study included 31 treatment-seeking patients with CB (25 women, 6 men) and an age and gender matched non-clinical control group without CB (CG). All participants answered the Compulsive Buying Scale (CBS). Reactive temperament was assessed using the Behavioral Inhibition System/Behavioral Activation System Scales (BIS/BAS) and the Iowa Gambling Task (IGT). Regulative temperament was measured using the Effortful Control subscale of the Adult Temperament Questionnaire (ATQ-EC) and a computerized version of the Stroop Task. To control the results for depression, the Patient Health Questionnaire-Depression Scale (PHQ-9) was administered.

RESULTS

Crude group comparisons revealed higher BIS and BAS scores, poorer IGT performance and lower ATQ-EC scores in the CB-group compared to the CG. The groups did not differ in their performance on the Stroop task. After controlling for depressive symptoms that were significantly higher in the CB-group, only the group differences in BAS reactivity remained significant. No significant associations were found between questionnaires and performance-based tasks.

CONCLUSION

Overall, the findings indicate that CB in the present clinical sample of treatment-seeking patients was mainly associated with higher approach tendencies and more depressive symptoms. The lacking correlation between self-reports and performance-based tasks is in line with prior research and suggests that both methodologies tap into different aspects of temperament.

How the economic situation moderates the influence of available money on compulsive buying of students - A comparative study between Turkey and Greece

BACKGROUND AND AIMS

Few studies about compulsive buying consider the economic framing situation. This study is concerned with the impact of different economic environments - the crisis in Greece vs. the boom in Turkey - on compulsive buying tendencies of students, while taking the role of gender and available money into account.

METHODS

Compulsive buying was measured by a Greek and Turkish translation of the German Compulsive Buying Scale (Raab, Neuner, Reisch & Scherhorn, 2005) in Greece and Turkey, which enabled an identification of compulsive and compensatory buyers. The questionnaires were administered to 119 Turkish and 123 Greek students (n = 242) enrolled in several universities in Athens and Istanbul. The data collection was conducted in a controlled and standardized way, namely in group-sessions lasting about 5 minutes, which were conducted and supervised by co-workers of the involved universities.

RESULTS

The results have shown that the percentage of compensatory buyers, but not compulsive buyers, within the Greek students sample was significantly smaller than within the Turkish student sample. Further as assumed the moderation of the economic situation could be confirmed: More available money only has a facilitating effect on compulsive buying tendencies under a positive economic environment.

CONCLUSIONS

Anticipations about the financial situation and the general economic climate are more relevant for compulsive buying tendencies than one's actual available money. Compensatory, but not compulsive buying was significantly smaller under crisis.

Internet addictive individuals share impulsivity and executive dysfunction with alcohol-dependent patients

Internet addiction disorder (IAD) should belong to a kind of behavioral addiction. Previous studies indicated that there are many similarities in the neurobiology of behavior and substance addictions. Up to date, although individuals with IAD have difficulty in suppressing their excessive online behaviors in real life, little is known about the patho-physiological and cognitive mechanisms responsible for IAD. Neuropsychological test studies have contributed significantly to our understanding of the effect of IAD on the cognitive function. The purpose of the present study was to examine whether Internet addictive individuals share impulsivity and executive dysfunction with alcohol-dependent individuals. Participants include 22 Internet addictive individuals, 22 patients with alcohol dependence (AD), and 22 normal controls (NC). All participants were measured with BIS-11, go/no-go task, Wisconsin Card Sorting Test, and Digit span task under the same experimental condition. Results showed that Barratt impulsiveness scale 11 scores, false alarm rate, the total response errors, perseverative errors, failure to maintain set of IAD and AD group were significantly higher than that of NC group, and hit rate, percentage of conceptual level responses, the number of categories completed, forwards scores, and backwards scores of IAD and AD group were significantly lower than that of NC group, however, no differences in above variables between IAD group and AD group were observed. These results revealed that the existence of impulsivity, deficiencies in executive function and working memory in an IAD and an AD sample, namely, Internet addictive individuals share impulsivity and executive dysfunction with alcohol-dependent patients.

Impulse control disorders in elderly patients

OBJECTIVE

There is no epidemiological study on the prevalence of impulse control disorders (ICDs) in the elderly population. The studies on ICDs in elderly patients are limited and some of them are case reports about pathological gambling and kleptomania. The comorbidity of other psychiatric disorders makes diagnosis difficult and has negative effects on both treatment and the prognosis of ICDs. The aim of this study was to determine the prevalence of ICDs among elderly patients and to evaluate the related sociodemographic and clinical features.

METHOD

A total of 76 patients aged 60 and over who have been referred to our outpatient clinics in a one-year period were included in the study. A demographic data form was completed. The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) was used to determine axis I psychiatric disorders. The prevalence of ICDs was investigated by using the modified version of the Minnesota Impulse Disorders Interview (MIDI). Impulsivity was measured with the Barratt Impulsiveness Scale Version 11 (BIS-11). The Mini-Mental State Examination (MMSE) test was performed to evaluate the cognitive status of patients and to exclude the diagnosis of dementia. In addition, all patients completed Symptom Check List-90 (SCL-90).

RESULTS

The prevalence rate of at least one comorbid ICD in our sample was 17%. When patients with a diagnosis of ICDs not otherwise specified (ICD-NOS) were included, the prevalence rate increased to 22.4%. The most common ICD was intermittent explosive disorder (15.8%), followed by pathological gambling (9.2%). The majority of the sample was men (54%), married (80%), had a high school education (51%), and mid-level socioeconomic status (79%). The only statistically significant difference between the sociodemographic characteristics of patients with or without ICDs was gender. The lifetime prevalence of ICDs was 34.1% in men and 8.6% in women. The prevalence of childhood conduct disorder was significantly higher in the group with ICD. There was no statistically significant difference in the number of suicide attempts, history of physical illness and family history of psychiatric disorders between the groups with or without ICDs. Comorbidity of alcohol/substance abuse was found to be 17.6% in patients with ICD whereas no cases were found in the group without ICD.

CONCLUSION

The result of this study has shown that approximately one fifth of patients over 60years had at least one lifetime ICD comorbidity. The prevalence rates of ICDs seem to decrease with aging. The male gender and childhood conduct disorder are related with higher prevalence rates of ICDs in elderly.

Is compulsive buying related to materialism, depression or temperament? Findings from a sample of treatment-seeking patients with CB

The aim of the present work was to examine the influence of reactive and regulatory temperament on compulsive buying (CB) in a sample of 102 patients (79 women, 23 men) with clinical CB. All participants answered the Compulsive Buying Scale (CBS), the Behavioral Inhibition System and Behavioral Activation System Scales (BIS/BAS), and the Effortful Control subscale (ATQ-EC) of the Adult Temperament Questionnaire-Short Form. Based on previous studies demonstrating that depression and materialism are linked with CB, in addition, the Patient Health Questionnaire depression scale (PHQ-9) and the Materialistic Values Scale (MVS) were administered. CBS scores were significantly correlated with the MVS, PHQ-9, and BAS scores. The findings of the hierarchical regression analysis, however, indicated that in the present sample of treatment-seeking patients the only significant association was found between CB and depression. The results highlight the prominent role of depression in CB. There is a need for longitudinal studies in order to answer the question whether depression is the cause or the consequence of CB.

Cross-cultural adaptation, validation and reliability of the brazilian version of the Richmond Compulsive Buying Scale

OBJECTIVE

To present the process of transcultural adaptation of the Richmond Compulsive Buying Scale to Brazilian Portuguese.

METHODS

For the semantic adaptation step, the scale was translated to Portuguese and then back-translated to English by two professional translators and one psychologist, without any communication between them. The scale was then applied to 20 participants from the general population for language adjustments. For the construct validation step, an exploratory factor analysis was performed, using the scree plot test, principal component analysis for factor extraction, and Varimax rotation. For convergent validity, the correlation matrix was analyzed through Pearson's coefficient.

RESULTS

The scale showed easy applicability, satisfactory internal consistency (Cronbach's alpha=.87), and a high correlation with other rating scales for compulsive buying disorder, indicating that it is suitable to be used in the assessment and diagnosis of compulsive buying disorder, as it presents psychometric validity.

CONCLUSION

The Brazilian Portuguese version of the Richmond Compulsive Buying Scale has good validity and reliability.

Prescribing ANtiDepressants Appropriately (PANDA): a cluster randomized controlled trial in primary care

BACKGROUND

Inappropriate use of antidepressants (AD), defined as either continuation in the absence of a proper indication or continuation despite the lack of therapeutic efficacy, applies to approximately half of all long term AD users.

METHODS/DESIGN

We have designed a cluster randomized controlled clinical trial to assess the (cost-) effectiveness of an antidepressant cessation advice in the absence of a proper indication for maintenance treatment with antidepressants in primary care.We will select all patients using antidepressants for over 9 months from 45 general practices. Patients will be diagnosed using the Composite International Diagnostic Interview (CIDI) version 3.0, extended with questions about the psychiatric history and previous treatment strategies. General practices will be randomized to either the intervention or the control group. In case of overtreatment, defined as the absence of a proper indication according to current guidelines, a cessation advice is given to the general practitioner. In the control groups no specific information is given. The primary outcome measure will be the proportion of patients that successfully discontinue their antidepressants at one-year follow-up. Secondary outcomes are dimensional measures of psychopathology and costs.

DISCUSSION

This study protocol provides a detailed overview of the design of the trial. Study results will be of importance for refining current guidelines. If the intervention is effective it can be used in managed care programs.

TRIAL REGISTRATION

NTR2032.

Neuropsychological performance, impulsivity, ADHD symptoms, and novelty seeking in compulsive buying disorder

We examined the neuropsychological performance of people with compulsive buying disorder (CBD) and control subjects, along with trait impulsivity, symptoms of attention deficit hyperactivity disorder (ADHD), and selected personality characteristics. Subjects received a comprehensive neuropsychological test battery, depression and ADHD symptom assessment, the Barratt Impulsiveness Scale, and a version of the Temperament and Character Inventory. Persons with CBD (n=26) and controls (n=32) were comparable in terms of age, sex, and years of education. Subjects with CBD had a mean age of 36.3 years (S.D.=15.7) and an age at onset of 19.7 years (S.D.=7.0). Compulsive buyers had more lifetime mood, anxiety, and impulse control disorders. People with Compulsive buying performed significantly better on the Wechsler Abbreviated Scale of Intelligence Picture Completion task, a test of visual perception; otherwise, there were no consistent differences in neuropsychological measures. They also had elevated levels of self-reported depression, ADHD symptoms, trait impulsivity, and novelty seeking. In conclusion, compulsive buyers have greater lifetime psychiatric comorbidity than controls, and higher levels of self-rated depression, ADHD symptoms, trait impulsivity, and novelty seeking. The present study does not support the notion that there is a pattern of neuropsychological deficits associated with CBD.