At what point does click-bait susceptibility become a mental health disorder?

Summary: One-third of patients seeking help for buying-shopping disorder (BSD) reported an addiction to online shopping. They also reported higher levels of anxiety and depression, in addition to greater severity of BSD symptoms.

Source: Elsevier

A new study in Comprehensive Psychiatry found that one third of a group of patients seeking treatment for buying-shopping disorder (BSD) also reported symptoms of addictive online shopping. These patients tended to be younger than the others in the study sample, experienced greater levels of anxiety and depression, and were likely to exhibit a higher severity of BSD symptoms.

“It really is time to recognize BSD as separate mental health condition and to accumulate further knowledge about BSD on the Internet,” explained lead investigator Astrid Müller, MD, PhD, Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany. At present, BSD is not categorized as a separate mental health condition; it is characterized as “other specified impulse control disorder” in the recently released 11th revision of the International Classification of Diseases.

BSD is a cross-national problem that afflicts an estimated five percent of the population. It is characterized by extreme preoccupation with and craving for buying and/or shopping, as well as irresistible and identity-seeking urges to possess consumer goods. Patients with BSD buy more consumer goods than they can afford, need, or use. Their excessive purchasing serves to regulate emotions, e.g., to get pleasure, relief from negative feelings or cope with self-discrepancy. In the long run, the recurrent breakdown in self-control leads to extreme distress, psychiatric comorbidity, familial discord, clutter due to pathological hoarding of goods, and indebtedness and/or deception and embezzlement to enable continued spending despite insufficient finances.

This shows people on their cell phones
Previous studies showed that certain Internet-specific aspects of buying and shopping, such as availability, anonymity, accessibility, and affordability, contribute to the development of an online subtype of BSD. The image is in the public domain.

As e-commerce has gained increasing popularity as a primary method for buying and shopping for goods over the past decade, a need has developed for mental health experts to explore whether traditional BSD manifests differently in the online retail market. The Internet offers a vast variety of shopping information and simultaneous access to many online stores, thereby meeting expectations for immediate reward, emotional enhancement, and identity gain.

Previous studies showed that certain Internet-specific aspects of buying and shopping, such as availability, anonymity, accessibility, and affordability, contribute to the development of an online subtype of BSD. However, there is a paucity of studies investigating addictive online shopping as a phenotype of BSD related to the problematic use of the Internet. This study, which analyzed data from earlier studies reporting on 122 treatment-seeking patients, is among the first to quantify and explore the phenomenon of online shopping in BSD diagnosed-patients.

Dr. Müller added, “We hope that our results showing that the prevalence of addictive online shopping among treatment-seeking patients with BSD will encourage future research addressing the distinct phenomenological characteristics, underlying features, associated comorbidity, and specific treatment concepts.”

About this neuroscience research article

Media Contacts:
Astrid Müller – Elsevier
Image Source:
The image is in the public domain.

Original Research: Open access
“Online shopping in treatment-seeking patients with buying-shopping disorder”. Astrid Müller, Sabine Steins-Loeber, Patrick Trotzke, Birte Vogel, Ekaterini Georgiadou, Martina de Zwaan.
Comprehensive Psychiatry doi:10.1016/j.comppsych.2019.152120.


Online shopping in treatment-seeking patients with buying-shopping disorder

Background and aims
With e-commerce becoming an important shopping activity, it has been argued that traditional buying-shopping disorder (BSD) migrates to the online retail market resulting in BSD predominantly online. The aims of the current study were to investigate how many patients with BSD report symptoms of online BSD, and to determine whether symptoms of probable online BSD are related to sociodemographic variables, anxiety, depression, and a higher severity of general BSD.


A post hoc analysis of pooled data collected within previous studies (n = 122 treatment-seeking patients with BSD; age Mdn = 42.50, range 20–68 years; 76% women) was conducted. Assessment included the short version of the Internet Addiction Test modified for online shopping sites (s-IATshop), the Pathological Buying Screener (PBS) as an instrument assessing BSD in general, regardless of the buying or shopping environment, and measures for anxiety and depression.

33.6% of the sample met the s-IAT threshold for probable online BSD. Higher s-IAT scores were related to lower age and to a higher severity of anxiety, depression and general BSD. A hierarchical regression analysis with general BSD (PBS score) as dependent variable and partnership status, symptoms of anxiety, depression and online BSD (s-IAT-shop) as predictors indicated a significant positive association of probable online BSD with the severity of general BSD above and beyond anxiety and depression.


The findings may encourage future studies addressing phenomenological characteristics, underlying features, associated comorbidity, and clinical relevance of online BSD.

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