|Sponsored by the HealthcareTrainingInstitute.org providing Quality Education since 1979|
Of the 5 cases reported by Krueger and Winestine,[ 9] only one patient appears to have experienced unequivocal improvement following psychoanalysis.
Group cognitive-behavioral therapy has been described by Burgard and Mitchell, consisting of 14 meetings over an 8-week period. The therapy focuses on factors that maintain the problematic buying behavior, and on strategies for controlling impulsive spending and not on the individual group member’s personal problems. (Most of the treatment concepts were taken directly from group therapy models developed for individuals with other types of compulsive behaviors, such as bulimia nervosa.) In a preliminary study of 8 women, each experienced substantial improvement. The authors report that their findings are encouraging, and suggest that further work be done using this treatment model.
Lejoyeux et al. reported on 2 patients with major depression and compulsive buying; in each case, the treatment of the mental disorder led to the resolution of the compulsive buying behavior. In one patient, clomipramine was used (150 mg/day); in the other, no drug was specified. These authors suggest that antidepressant treatment is successful when uncontrolled spending is associated with depression.
Black et al. reported that 9 of 10 individuals with compulsive buying who were recruited through newspaper advertisement improved while receiving fluvoxamine. The study lasted 9 weeks, and patients achieved a mean dosage of 205 mg/day. Three patients improved during the first week, and all had responded by week 5. Study participants were followed for an additional 4 weeks; by that time, 7 of the 10 patients requested continuation therapy. The authors reported that those who improved were less preoccupied with shopping, spent less time shopping and reported spending less money. The fact that none of the patients had major depression appeared to refute the assertion of Lejoyeux et al. that depressed individuals with compulsive buying disorder are more likely to improve with antidepressants than those who are not depressed.
Two subsequent double-blind placebo-controlled trials have been conducted.[28,39] In a study by Black and colleagues, 12 patients were randomly assigned to fluvoxamine and 11 to placebo for a 9-week study. None were depressed. At the conclusion of the trial, 50% of fluvoxamine recipients and 64% of placebo recipients were rated as ‘much’ or ‘very much’ improved. Patients in both treatment cells showed improvement as early as the second week of the trial and, for most, improvement continued during the 9-week study. There were no significant differences between fluvoxamine- and placebo-treated patients on any of the main outcome measures using an intent-to-treat analysis. Mean YBOCS-SV scores of the fluvoxamine-treated individuals fell from 21 at baseline to 15 at week 9, and for the placebo recipients from 24 at baseline to 14 at the end of week 9. Improvement measured from baseline to week 9 was statistically significant for both fluvoxamine and placebo recipients. This report strongly suggests that compulsive buying disorder may have a high placebo response rate, which needs to be taken into account in subsequent studies. The case of a woman enrolled in the study is presented in table VI.
Ninan et al. reported the results of another double-blind 12-week trial comparing fluvoxamine with placebo in 37 patients with compulsive buying disorder treated at 2 sites. An intent-to-treat analysis failed to show a significant difference between fluvoxamine and placebo recipients using a version of the YBOCS or the Clinical Global Improvement (CGI) scale.
Another study is underway to test the efficacy of citalopram in compulsive buying disorder. Koran will enroll 24 individuals in a 12-week open label trial; if results are positive, he will then initiate a double-blind, placebo-controlled trial (L. Koran, personal communication).
Finally, in a single case report Kim described improvement in a woman with a 5-year history of compulsive buying who was treated with naloxone, an opioid antagonist. He noted that he had observed 3 additional cases where naloxone produced improvement.
Self-help books are also available, including Shopaholics – Serious Help for Addicted Spenders,[ 44] Born to Spend – How to Overcome Compulsive Spending, and Women Who Shop too Much – Overcoming the Urge to Splurge. Each book provides sensible recommendations that individuals who exhibit compulsive buying can employ to gain control over their inappropriate shopping and spending behavior.
There has been little consensus on treatment, but individual and group psychotherapy, cognitive-behavioral therapy, and 12-step programs may be helpful. Serotonin reuptake inhibitors may help patients to regulate their buying impulses.
More work is needed to determine the prevalence and risk factors for compulsive buying disorder. Intensive studies of individuals with compulsive buying disorder using standardized and reliable instruments can help establish its course, psychiatric comorbidity and complications. Greater knowledge of compulsive buying will help clinicians to develop more specific and effective therapies.
Reflection Exercise #4
Online Continuing Education QUESTION 11
Others who bought this Addictions/Substance Abuse Course
CEU Continuing Education for
Social Worker CEU, Psychologist CEU, Counselor CEU, MFT CEU
Get Social Worker CEUs, Psychology CEUs, Marriage and Family Therapist CEUS, Counselor CEUS, or Addiction Counselor CEUs for license renewal. OnlineCECredit.com offers 150+ easy, fast, affordable CE courses to earn your Continuing Education Credit. We are an approved provider of CE courses by APA, ASWB, NBCC, NAADAC, and various State Licensing Boards.
Our objective is to provide you… the Social Worker, Psychologist, Marriage and Family Therapist, Counselor, or Addiction Counselor with continuing education courses that contain practical, how-to interventions. Do these CE courses meet the requirements of your state licensing board? Select your state and profession above to view your Licensing Board's continuing education requirements.