Week 9

Question 1

What does the shopping industry look like in NA? (3)

Answer 1

It is a huge industry as literally everybody does it from necessities to luxury

Americans spent 4.8 trillion on retail in 2016 and Canada spent 66.5 billion in 2023

Has also become easier, more accessible and convenient to shop in recent years with the rise of online shopping for all things (especially with COVID) which contributes to the rise in shopping

Question 2

When does shopping turn to compulsive buying? (3)

Answer 2

Excessive preoccupation and low impulse control is what marks the difference between normal and problematic

Needs to be some sort of functional impairment and negative consequences (ignoring daily responsibilities, financial problems)

Purchase alleviates distress and/or produces euphoria (less about what you are buying and more about the act of shopping itself)

Question 3

What is compulsive buying? (6)

Answer 3

Aka oniomania from the Greek words onio meaning buying and mania meaning madness

Created by a German psychiatrist (Emil Kraepelin) in 1915

Experience repetitive, iressistable and overpowering urge to purchase goods

Income is not a major factor as the goods are usually inexpensive and useless

Later defined in the 1900s as chronic repetitive purchasing in response to negative feelings to get short-term relief

Never in the DSM but could be considered an impulse control disorder (but it has no harm to others)

Question 4

What are the 4 phases of compulsive buying? APSS

Answer 4

Anticipation: thoughts and urges start, they may focus on a specific item or the active shopping itself

Preparation: research and decision-making take place, a person may look into sales or debate about where to go shopping

Shopping: shopping happens, this is the so-called “thrill of the hunt” as the person gets a “high” while doing it

Spending: something or many things are purchased, the person is sad that the shopping experience is over and may be disappointed about how much they’ve spent afterwards

Question 5

What are the clinical symptoms of CBD? (6) PIMGCP

Answer 5

Excessive preoccupation with shopping

Poor impulse control (i.e. urges, that can only be satisfied when a purchase is made)

Mood modification (positive and negative reinforcement like buyers high and shopping to dampen unpleasant emotions)

Guilt and remorse in response to shopping (can become a vicious cycle as those negative feelings make them shop more)

Adverse consequences due to shopping (marital conflict, financial problems)

It is about the buying process

Question 6

What are the conceptualization of CBD as existing disorders? (2)

Answer 6

Impulse control disorder as there is a lack of control

OCD as there are preoccupations, obsessions, anxiety, compulsive actions as coping, etc.

Question 7

What did Ridgway argue concerning conceptualizing CBD as a disorder? What are his proposed elements? (5) GFNCU

Answer 7

Argued it has elements of ICD and OCD and therefore should be included on the OCD spectrum

Elements are:

Short term gratification, despite long-term harm

Severe impact on life functioning

Alleviate negative feelings

Lack of control

Urges

Question 8

What is wrong with Ridgway’s conceptualization of CBD? (3)

Answer 8

It does not offer the best conceptualization

Impulse control disorder involves risky behavior, explosive aggressive outburst, violation of societal norms, and harmful behavior to others and self

OCD also doesn’t fit when you look at it closely

Question 9

How is OCD different from CBD? (4)

Answer 9

OCD includes presence of unwanted intrusive thoughts that are extremely distressing and anxiety-inducing (they don’t want to do the things, they have to)

Attempts to ignore these thoughts

Very time-consuming

A vicious cycle that repeats itself daily

Question 10

What is hoarding disorder? (5)

Answer 10

Persistent difficulty disregarding or parting with possessions/objects due to some perceived need to save them for future use, regardless of actual value

Forms an emotional attachment to these items and it is distressing to discard them

Accumulation of possessions that congest and clutter active living areas and substantially compromises their intended use

Significant impairment in functioning

Not attributable to another mental condition or disorder

Question 11

How is compulsive buying different from hoarding? (5) FMAVS

Answer 11

Focus (process of shopping vs. item)

Motivation (elevate social status/relieve negative emotions vs. collect items with sentimental or useful value)

Attachment (little to none vs. strong)

Visibility (flaunting items vs. hiding and accumulating them in the home)

Sex (mostly women vs. mostly men)

Question 12

How did the proposed diagnostic criteria for CBD occur? (2) What are they? (7)

Answer 12

Results of a Delphi study, where experts were convened and determined a consensus list of symptoms

Not in the DSM as there isn’t much evidence or studies supporting it such as twin studies, but it is proposed

Intrusive/irresistible urges/impulses/cravings/preoccupations for buying/shopping

Diminished control over buying/shopping

Excessive purchasing of items without utilizing them

Use of buying/shopping to regulate internal states

Negative consequences and impairment and important areas of functioning due to buying/shopping

Emotional and cognitive symptoms upon cessation of excessive buying/shopping

Maintenance or escalation of dysfunctional buying/shopping behaviors, despite negative consequences

Question 13

What is the compulsive buying scale? (5)

Answer 13

A measurement of CBD

Asks questions regarding impulsivity, amount money spent on shopping, financial problems, emotional impact of shopping, etc.

Does not address preoccupation or functional impairment

Also very much focused on income rather than the act of buying

Not as valid as we’d like it to be

Question 14

What is the Richmond Compulsive Buying Scale? (3)

Answer 14

Created by Ridgway

Measures OCD (kind of, some not OCD related) and ICD characteristics/symptoms

Has been used a lot but is not good or valid at all

Question 15

What is the online shopping addiction scale? (8) STMWRC

Answer 15

Based on 6 core concepts of addictions to measure online shopping addiction

Salience: when I am not shopping, I keep thinking about it

Tolerance: I spend more and more time online shopping

Mood modification: when I feel bad online shopping can make me feel good

Withdrawal: when I can’t do online shopping, I will get depressed or lost

Relapse: I have tried to cut back or stop but failed

Conflict: My productivity for work or study has decreased as a result of online shopping

Could rely on analogistic reasoning and might not work the same way that addictions do

Question 16

What is the prevalence of compulsive buying? (7)

Answer 16

Uncertain due to differences and measures and sampling frames used

Some studies, place it at 8% while others put it as high as 15%

It is hard to define when it becomes a problem since it is so common, so it is hard to determine a prevalence

A 2006 study showed that 5.8% of respondents to a telephone survey in the US have CBD

Studies have shown that it is more prevalent among women and has its onset in the late teens in early adulthood (more independence, money, etc.)

More recently, a meta-analysis of compulsive buying behavior in North America, Europe and Asia indicated that the prevalence of compulsive buying ranged from approximately 5% to 16%

These are very high for a mental health condition, which could be due to the tools that we are using not being very good, so we need more rigorous research to understand what is actually happening

Question 17

What are the biological antecedents of CBD? (3)

Answer 17

Family history of CBD, SUVs, and emotional disorders suggest that CBD may be heritable

Thought to increase dopamine in the brain

However, biological research on CBD is lacking (we need twin studies to determine heritability and biological studies on genes as well as neurobiological studies to look at the brain in the process of shopping)

Question 18

What are the social antecedents of CBD? (3)

Answer 18

Accessibility of shopping (online, Covid)

Ease and availability of credit cards (anyone can get one)

ACEs are common in people with CBD (neglectful parents who use money or gift cards as a replacement for love creates positive reinforcement; dysfunctional household)

Question 19

What are the psychological antecedents of CBD? (5)

Answer 19

Perfectionist traits

Materialism

Impulsiveness

Low self-esteem

Negative affect and stress

Question 20

What is the Escape Theory of Materialism? What are the 6 components/stages? What is wrong with it?

Answer 20

A social psychological theory that argues that materialism is the link to CBD as they see value in possessions, and the acquisition of such possessions is important for their self-worth

Falling short of one standards

Self blame for doing so

Focus on the self (how they are not good enough)

Experience aversive negative emotions

Deconstructed state characterized by cognitive narrowing (dissociate from everything but shopping)

Impulsive behavior to bring short term relief

problem is that not all people with CBD or materialistic and not all of them by expensive things

Question 21

What is a cognitive behavioral model of CBD? What are the 4 phases? ATBP

Answer 21

Materialism is not core or necessary for this theory, but it is about escaping adversive states through the act of buying

Phase 1: Antecedents (early experiences, schemas, specific cognitions)

Phase 2: Triggers (internal state like mental health and external cues like ads and credit)

Phase 3: Buying (attention focused only on shopping, emotions of relief/buzz, disorganized behavior)

Phase 4: Post Purchase (cognitions like awareness of lack of control, emotions like shame, behavior like hiding or avoiding purchases, creates a cycle as it leads back to phase 2)

Question 22

What is preventing SU and addiction about? (4)

Answer 22

About getting to people before they develop problems or more serious problems

Prevention programs involve one or more interventions to reduce or deter specific or predictable problems, protect the current state of well-being, or promote desired outcomes/behaviors

Saves money by investing before becomes a big and expensive problem so that money can be invested in the community

There is more and more evidence, rising that methods such as going to communities and telling youth about the dangers of substance use and addiction can be extremely influential in helping to prevent addiction and reduce substance abuse

Question 23

What is the Preventure Programme? (5)

Answer 23

Created by Canadian psychologist Conrod

Examined how children’s temperament drives their risk for drug use indicating different pathways to addiction

She wanted to identify which kids are more at risk to talk to them and give them tools to prevent drug problems before they can develop

Since most teenagers who try addictive substances do not become addicted, the program focuses on what’s different about the minority who do

Used personality testing to identify the most highest-risk children before their risky traits cause problems

Question 24

What personality traits does the Preventure Programme target and what substances are they risky for? (4) ISHA

Answer 24

Impulsivity (often use stimulants)

Sensation seeking (often use stimulants)

Hopelessness (often use drugs/alcohol)

Anxiety sensitivity (often use sedatives)

Question 25

How does the Preventure Programme work? (4)

Answer 25

An intensive 2 to 3 day training is given for teachers, which is basically a crash course on therapy techniques proven to fight psychological problems

When the school year starts, middle schoolers take a personality test to identify the outliers; months later 2 90 minute workshops (which are framed as a way to channel students personalities towards success) are offered to the whole school with only a limited number of slots (in reality only those who scored high on the test are invited)

The workshops, teach students cognitive behavioral techniques to address, specific, emotional and behavioral problems they have

It is proprietary meaning at cost money and schools have to pay to use it

Question 26

What does the inside of the Preventure Programme look like? (3)

Answer 26

The interventions are conducted using manuals that incorporate components of different kinds of therapies

The goal is to provide participants with the tools to moderate the cognitive and behavioral tendencies stemming from their personality that contribute to their difficulties in life

After the workshops, they track both high risk and low risk students over time using a randomized control trial to determine effectiveness

Question 27

What did the Conrod et al. RCT trial on the effectiveness of the Preventure Programme do? (2) What did it find? (4)

Answer 27

A cluster randomized control trial in secondary schools in London using the Preventure Programme

Looked at drinking binge, drinking and problem, drinking before randomization, and at six month intervals for two years after

Found that both intervention groups, high risk and low risk, had the lowest probability of drinking frequently during that two year period while the control groups (specifically the HR group) had the highest probably of drinking more

The HR intervention group had similar rates of drinking quantity as both LR groups while the HR control group had significantly higher rates

For binge drinking, the rate for the HR intervention group starts lower than the HR control group, but by the end of the two years they were about the same (implies we need longer studies and maybe need to give training again after 2 years)

All this shows that the program is effective overalland there is evidence that prevention works for high-risk individuals

Question 28

Is the Preventure Programme effective for other substances? (3)

Answer 28

One RCT showed that sensation-seeking youth delayed cannabis use onset when compared with the other personality-targeted interventions and when compared to high SS youth who did not receive interventions

Could be because there was more cannabis use amongst sensation-seeking youth or maybe other personality factors play a role in cannabis use during later development

Perhaps other personality-targeted interventions do not target motives, relevant to cannabis use in youth, (like thrill seeking, enjoyment and seeking altered perceptions)