Posted by drmarkgriffiths
Although shopping is a necessity in modern life, it is also a leisure activity and a form of entertainment with a rewarding value for some people. However, as I have noted in a number of my previous blogs, when taken to the extreme, shopping (or buying) can be a harmful and destructive activity for a minority of individuals. The consequences of compulsive buying behaviour (CBB) are often underestimated.
For instance, CBB can result in (i) large debts, (ii) inability to meet payments, (iii) criticism from partners, friends and acquaintances, (iv) legal and financial consequences, (v) criminal legal problems, and (vi) guilt. Furthermore, individuals with CBB often describe an increasing level of urge or anxiety that can only be alleviated and lead to a sense of completion when a purchase is made. Research has demonstrated that compulsive buying is a frequent disorder in a small minority of shopping mall visitors and is associated with important and robust indicators of psychopathology such as psychiatric distress, borderline personality disorder, and substance abuse. Compared to non-compulsive buyers, compulsive buyers are over twice as likely to abuse substances, have any mood or anxiety disorder, and three times more likely to develop eating disorder than non-compulsive buyers. However, most of these findings are based on a small number of studies, all of which have sampling limitations.
Despite many studies highlighting the severe negative consequences that compulsive buying can lead to, the latest (fifth) edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) did not include compulsive buying disorder due to insufficient research in the field. Therefore, individuals with the condition are classified within the residual category of “Unspecified disruptive, impulse-control, and conduct disorders”. Diagnostic criteria elsewhere include (i) maladaptive preoccupation with buying or shopping, or maladaptive buying or shopping impulses; (ii) generation of marked distress by the buying preoccupations, impulses or behaviours, which are time consuming, significantly interfere with social or occupational functioning or result in financial problems; and (iii) lack of restriction of the excessive buying or shopping behaviour to periods of hypomania or mania.
The age of onset for CBB appears to be in the late teens or early twenties, although some studies have reported a later mean age of 30 years. There is also a lack of consensus relating to gender differences. Most clinical studies report that women are much more likely to become compulsive buyers than men, but not all surveys have found significant differences in buying tendencies between men and women. Cultural mechanisms have been proposed to recognize the fact that CBB mainly occurs among individuals living in developed countries. Elements reported as being necessary for the development of CBB include the presence of a market-based economy, the availability of a wide variety of goods, disposable income, and significant leisure time. For these reasons, most working in the area agree that CBB is unlikely to occur in poorly developed countries, except among the wealthy elite.
Given this background, Aniko Maraz, Zsolt Demetrovics and I recently carried out a meta-analytic review that was published in the journal Addiction using all the empirical data concerning the prevalence of compulsive buying in non-clinical populations. We attempted to estimate a pooled prevalence of compulsive buying behaviour (CBB) in different populations across the world where studies have been carried out. We also examined the effect of age, gender, geographical location of the study.
Our initial literature search identified 638 publications. We then excluded case studies (n=23), reviews or theoretical works (n=192), studies involving data from clinical samples (n=244), qualitative studies (n=26), studies that used a compulsive buying scale to determine shopping severity but didn’t report a prevalence rate (n=73), studies written in a foreign language (n=15), dissertations and conference abstracts (n=7), studies written in a foreign language (n=15), small studies with a sample size of below 145 participants (n=16), and studies involving adolescents (n=2). This left 40 studies that met the inclusion criteria for the review. We then extracted sample mean age, proportion of females (in %), the study’s geographical location, and the screening instrument used to assess CBB, and the reported prevalence estimate of CBB.
The 40 relevant studies identified reported 49 different prevalence rate estimates for 32,333 participants. We then divided the data into four sub-samples: adult representative, adult non-representative, university student and shopping-specific. The mean prevalence of compulsive buying was 4.9% in adult representative samples [10,102 participants], 12.3% in adult non-representative samples [3,929 participants], 8.3% in university student samples [14,947 participants] and 16.2% in shopping-specific samples [4,686 participants]. Unsurprisingly, the highest prevalence rates were among shopping-specific samples.
We noted that the heterogeneity in prevalence rates of CBB may be because of the lack of consensus regarding the definition of compulsive buying. Studies used different measures to assess CBB, each having a different conceptual background. Most definitions include cognitive-affective indicators as well as maladaptive behavioural consequences when defining the disorder (e.g., debts). The screening instruments used across studies differed in indicators of financial consequences (e.g., credit card use, debts, loan etc.) and are subject to differences according to countries, sub-cultures and/or age groups.
Another problem we identified was that measures used to assess CBB didn’t explicitly distinguish current and lifetime assessment of CBB. Prevalence rates assessed with an instrument that assessed lifetime prevalence report 1.6 times higher rates on average than those that assessed current prevalence. We also observed that non-representative samples (e.g., adults, university students, shoppers) tended to recruit younger participants who were more likely to be female than representative studies. However, we also noted that the mean age of the sample and the proportion of males and females did not have a reliable effect on the prevalence estimates.
Being of a younger age was predictive of CBB according to individual study results and also according to the regression analysis that we carried out in the representative samples. However, it remains open as to whether compulsive buying tendency decreases with age or this difference reflects generational differences. If the latter was the case, then the prevalence of compulsive buying behaviour is expected to increase in the future. We also found some evidence for increasing rates of CBB in Germany and in Spain, but longitudinal studies are needed to clarify this.
In relation to data collection, estimates from the United States (18 out of 49) were over-represented compared to countries other than the USA, although there was no difference in the reported estimates between the U.S. and non-U.S. countries. However, it is difficult to draw reliable conclusions regarding the cultural variance of CBB given that adult representative estimates are only available from the USA, Spain, Germany and Hungary.
The fact that compulsive buying behaviour is a relatively common disorder with severe consequences for a minority of individuals should not be overlooked. It appears that approximately one in 20 individuals suffer from CBB at some point in their lives and that being young and female are associated with a higher risk of CBB. High heterogeneity is likely to be the result of methodological variability within studies, such as assessment screens with different time frames and conceptual background. We concluded that future studies should therefore think carefully about how to conceptualise the disorder and to clearly separate out current versus lifetime prevalence in the samples used.
Dr. Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Please note : This article was co-written with Aniko Maraz and Zsolt Demetrovics (Institute of Psychology, Eötvös Loránd University, Budapest, Hungary)
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