Abstract
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.
Highlights
Buying-shopping disorder (BSD) is characterized by extreme preoccupation with buying/ shopping, an overwhelming urge to possess consumer goods, recurrent purchases of unnecessary things and irrational beliefs about material possessions [1,2,3,4]
There was no linear [R2 = .07, F (1, 37) = 2.91, p = .096] and no u-shaped [R2 = .11, F (2, 36) = 2.18, p = .128] relationship between the Pathological Buying Screener (PBS) and the CE-bias score of the GNG. This case-control study investigated cognitive processes and inhibitory control ability in treatment-seeking patients with buying-shopping disorder (BSD) compared to healthy control participants
The main findings are that patients with BSD reported more general craving for buying/shopping and stronger subjective craving reactions towards buying/shopping-related visual cues than the healthy control (HC)-group, but that they did not differ from control participants with regard to attentional bias, implicit cognitive associations and deficits of response inhibition toward buying/shopping-related
Summary
Buying-shopping disorder (BSD) is characterized by extreme preoccupation with buying/ shopping, an overwhelming urge to possess consumer goods, recurrent purchases of unnecessary things and irrational beliefs about material possessions [1,2,3,4]. Population-based surveys of BSD have been carried out since more than 30 years [7,8]. The release version of the 11th edition of the International Classification of Diseases (ICD-11) [17] does not include BSD as an independent mental health condition, but lists”compulsive buying-shopping disorder” as an example in the residual category”Other specified impulse control disorders” (category 6C7Y). . .should be defined by the repeated failure to resist an impulse, drive, or urge to perform an act that is rewarding to the person (at least in the short-term), despite longer term harm either to the individual or others” according to the ICD-11 working group on obsessive-compulsive disorder and related disorders [18]. Analogous to substance use disorders and gambling disorder, experimental studies emphasized the prominent role of cue-induced craving and reward processing, attentional bias, dysfunctional decision-making and deficits in response inhibition in BSD [21,22,23,24,25,26,27,28,29,30]
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