Compulsive Shopping: A Guide to Causes and Treatment

Published in the August issue of Current Opinion in Psychology, an article by D. W. Black reviews the latest research on the classification, assessment, and treatment of compulsive shopping.

What is Compulsive Shopping?

Compulsive shopping (sometimes called compulsive buying or shopping addiction) refers to a preoccupation with purchasing products and spending money.

Compulsive shopping shares several characteristics with other psychological disorders, including anxiety and mood disorders, substance abuse, impulse-control disorders, and obsessive-compulsive disorder (OCD). Therefore, many questions remain about how it should be classified.

More recently, compulsive shopping has been classified as a behavioral addiction. Though behavioral addictions such as gambling disorder do not involve the ingestion of addictive substances, they share some characteristics (e.g., repetitive behaviors).

How Is Compulsive Shopping Diagnosed?

According to a 2021 paper in the Journal of Behavioral Addictions, the proposed criteria for compulsive shopping include recurrent or persistent dysfunctional shopping-related thoughts and behaviors, as indicated by the following (examples in parentheses):

• Preoccupation with shopping (an irresistible urge to buy a product).
• Reduced control over buying behaviors (spending more time/money shopping than intended).
• Buying products but not using them for the purposes they were intended to serve.
• Using shopping to regulate mood (to experience a “high” or to reduce tension and boredom).
• As a result of compulsive buying, experiencing negative consequences or impairment (guilt, shame, debt, relationship problems).
• Negative mood and cognitive symptoms if attempting to stop (e.g., anxiety, agitation, anger, worry, rumination).
• Despite the negative consequences, continuing to engage in dysfunctional shopping behavior.

The prevalence of compulsive shopping in American adults is estimated to be between 2 and 8 percent. About 80 to 94 percent of people with this condition are female. The onset is usually in late teens or early adulthood and, according to the author, “may correspond with emancipation from the nuclear family as well as with the age at which people first establish credit.”

Compulsive shopping can be episodic or chronic. Particularly when chronic, compulsive buying is associated with financial difficulties (debt, bankruptcy, and even shoplifting and other crimes), reduced quality of life, family and marital problems, and subjective distress (e.g., due to inability to control behavior).

Compulsive Shopping: Risk Factors, Comorbidity, and Differential Diagnoses

One major risk factor for compulsive shopping is childhood adversity. This includes having a “physically abusive or neglectful parent,” an “emotionally neglectful parent who demands the child earn their love through ‘good’ behavior,” or an “absent parent who has little time or energy for the child,” but also “families that have experienced financial reversals and fixate on lost luxury.”

In these dysfunctional family environments, possessions often “achieve importance as a means of easing suffering, boosting self-esteem, or restoring lost social status.”

Compared to healthy controls, first-degree relatives of people who shop compulsively are more likely to have the same condition or other mental health issues, such as anxiety disorders, mood disorders, and substance use disorders.

As for differential diagnosis, it is important to differentiate compulsive buying from bipolar disorder, in which case the buying behavior (during mania or hypomania) is driven by euphoria and grandiosity—and to differentiate it from schizophrenia, in which the shopping behavior is more likely to be bizarre and related to delusions.

In terms of comorbidity, research shows that anxiety, mood, substance use, and personality disorders (especially avoidant, dependent, and obsessive-compulsive personality disorder) are prevalent in this group. Also prevalent are compulsive gambling, exercising, and internet use.

On “dimensional ratings,” the author notes, people with this condition “tend to have elevated scores for depression, trait impulsivity, and ratings of attention deficit hyperactivity disorder, but have low self-esteem.”

And on the five-factor model of personality (the Big Five), they have lower scores on agreeableness and conscientiousness but higher scores on neuroticism and novelty-seeking.

How Is Compulsive Shopping Treated?

A variety of group therapies have been used in the treatment of compulsive buying behavior, most of which use cognitive-behavioral therapy techniques.

The goal of treatment is to “help persons interrupt and control their problematic buying behavior, establish healthy purchasing patterns, and develop healthy coping, stress management, and problem-solving skills.” Pharmacotherapy is also useful, especially to manage certain symptoms. Pharmacotherapy includes medications such as naltrexone (an opioid antagonist), memantine (an NMDA antagonist), and antidepressants, particularly serotonin-specific reuptake inhibitors (SSRIs).

A systematic review of treatments for compulsive buying (17 psychotherapies and 12 pharmacotherapies) found that based on the available evidence, group psychotherapy was the “most promising treatment option.”

Concluding Thoughts

According to Black, compulsive shopping is “characterized by excessive or poorly controlled [shopping] preoccupations or urges that lead to subjective distress and can impair functioning.”

Though it is not clear whether it is better classified as an anxiety/mood disorder or a behavioral addiction, compulsive shopping is often comorbid with anxiety disorders, mood disorders, substance abuse, and personality disorders (particularly Cluster C or anxious-fearful disorders).

The most promising treatment is group psychotherapy, which often uses elements of cognitive-behavioral therapy (CBT)—e.g., identifying the cues that trigger compulsive shopping, learning the consequences of engaging in the problem behaviors, stress management, and exposure and response prevention.

Let me end with a note of caution: Frequent shopping or spending a lot of money do not necessarily indicate a compulsion. Indeed, normal buying may appear compulsive on certain occasions (e.g., during holidays, birthdays, after winning the lottery). Therefore, it is important to see a therapist, instead of self-diagnosing, if you are concerned about your shopping behavior.

To find a therapist near you, visit the Psychology Today Therapy Directory.