Gary A. Christenson

Two Forms of Compulsive Consumption: Comorbidity of Compulsive Buying and Binge Eating

Several authors have articulated the need for broader theories or models to account for multiple forms of compulsive or addictive consumption. Development of these broader theories requires more information regarding the overlap and interrelationship of specific consumption disorders. Two studies are presented here to examine the comorbidity of compulsive buying and eating disorders involving binge eating. Study 1 found that women diagnosed as having binge eating disorder had significantly greater compulsive buying tendencies than nonbinge eaters of similar weight. Study 2 showed that complwive buyers were more likely to have engaged in binge eating, had more symptoms characteristic of both binge eating disorder and bulimia nervosa, and were more likely to be clinically diagnosed as having an eating disorder than a matched control group. Coauthors are Gary A. Christenson, Martina de Zwaan, and James Mitchell. Copyright 1995 by the University of Chicago.

In the mood to buy: Differences in the mood states experienced by compulsive buyers and other consumers

One area of consumption disorders receiving a great deal of attention lately is compulsive buying. Researchers have begun moving from descriptive studies of this phenomenon to attempts to explain some of its causal mechanisms. One possible explanation is that such behavior may serve as a way of self-medicating depression and negative affect for compulsive buyers. This study examines reported mood states prior to and during shopping for 24 compulsive buyers and a matched comparison group. The findings indicated that relative to the comparison group, the compulsive buyers reported feeling most of the mood states more frequently prior to going shopping, especially the more negative moods. Compulsive buyers also more frequently experienced extreme moods (both positive and negative), while shopping than did the comparison group. When within-subject differences were examined for preshopping and shopping moods, compulsive buyers were more likely to move from negative to positive moods, whereas the opposite was true for the comparison group. The findings suggest that compulsive buyers may be using buying behavior to manage undesirable mood states.

Impulse Control Disorders and Attention Deficit Disorder in Pathological Gamblers

Little systematic research has been done on psychiatric comorbidity of pathological gambling, an impulse control disorder. This report describes the occurrence of attention deficit disorder and impulse control disorders in 40 pathological gamblers in treatment for gambling problems and 64 controls. Diagnoses were made by structured interviews which utilized operationalized diagnostic criteria. An impulse control disorder other than pathological gambling was noted in 35% of the pathological gamblers, compared to 3% of the controls (p < .001). Compulsive buying (p < .001) and compulsive sexual behavior (p < .05) were significantly higher in pathological gamblers than controls. A strong association was seen among pathological gambling, attention deficit, and other impulse control disorders. Attention deficit disorder was seen in 20% of the pathological gamblers. Rates of impulse control disorders did not differ by gender. Implications of these high rates of comorbidity are discussed.

A Placebo-Controlled, Double-Blind Crossover Study of Naltrexone Hydrochloride in Outpatients with Normal Weight Bulimia

The endogenous opioid system plays an important role in the control of feeding behavior. Previous research has shown that antagonism of endogenous opioids will suppress feeding in certain models in both human and infrahuman species. In the current study, 16 normal-weight bulimic women were treated with low-dose naltrexone, the long-acting, orally active narcotic antagonist, and placebo in a crossover design. The use of the active drug was not associated with a clinically significant reduction in binge eating or vomiting episodes. Suggestions for further research in this area are offered.

Clinical characteristics and psychiatric comorbidity in children with trichotillomania

Ten children with trichotillomania (hair pulling) were systematically evaluated with structured psychiatric interviews and rating scales assessing anxiety, depression, life events, self-esteem, and family functioning. Six of the subjects met diagnostic criteria for overanxious disorder on the Diagnostic Interview for Children and Adolescents--Revised--Child or Adolescent Version and/or Diagnostic Interview for Children and Adolescents--Revised--Parent Version. Two met the criteria for dysthymia, including one of the subjects with overanxious disorder. No children reported associated obsessions or compulsions. Only one subject experienced tension before hair pulling and relief associated with hair pulling. The DSM-III-R criteria for trichotillomania, which currently require an increasing sense of tension before hair pulling and gratification with hair pulling, may be overly restrictive and in need of redefinition. Additional research with increased sample size is necessary to define diagnostic criteria for trichotillomania and clarify its relationship with other psychiatric diagnoses.

Adult Men and Women With Trichotilomania: A Comparison of Male and Female Characteristics

Trichotillomania (hair pulling) has been considered a disorder that primarily affects women. It is rarely reported in men. Such rarity may reflect distinct clinical features in men that call for different treatment strategies. To investigate potential gender differences in trichotillomania, the authors systematically assessed the descriptive and phenomenological characteristics as well as psychiatric comorbidity of 14 male hair pullers and compared them to 128 female hair pullers who had been similarly assessed. Although a few gender differences existed, male trichotillomania was very similar to that seen in women. These results suggest that gender-specific treatment is not justified at this time; however, a more thorough psychiatric screening should be done with men because they may have additional psychiatric comorbidity.

Problematic Internet use and associated risks in a college sample.

OBJECTIVE The Internet is commonly used among young adults; however, Internet use may become a problematic behavior. Past research has examined Internet behavior in young adults and its relationship to other behaviors and health issues, yet further research is needed to gain a more comprehensive understanding of this relationship. METHOD A sample (n=2108) of college students (56.9% female) was examined using a self-report Internet survey concerning demographic characteristics, Internet use, health behaviors, psychosocial functioning, and psychiatric comorbidities. The IAT was used to determine levels of problematic Internet use (limited use (none or almost no use), mild use (typical user), moderate use (occasional problems) and severe use (frequent, serious problems)) and the MINI for testing for psychiatric problems. RESULTS We found that 237 students (12.9%) met criteria for limited Internet use, 1502 (81.8%) for mild Internet use and 98 (5.3%) for moderate to severe Internet use. Variables significantly associated with greater frequency of Internet use included lower Grade Point Average (p=.006), less frequent exercise (p=.018), higher PHQ-9 scores (p<.0001) (indicative of greater depression symptoms) and higher Perceived Stress Scores (p<.0001). CONCLUSIONS These data indicate that moderate to severe Internet use is associated with a range of psychosocial problems in young adults. More research is needed to better understand the relationship between Internet use and physical and mental health, as well as academic variables.

Skin picking disorder in university students: health correlates and gender differences

OBJECTIVE This study sought to examine the prevalence of skin picking disorder (SPD) in a university sample and assess associated physical and mental health correlates. METHODS A 54-item anonymous, voluntary survey was distributed via random email generation to a sample of 6000 university students. Current psychological and physical status was assessed, along with academic performance. Positive screens for SPD were determined based upon individuals meeting full proposed DSM-V criteria. RESULTS A total of 1916 participants (31.9%; mean age 22.7 ± 5.1; 58.1% female) responded and were included in the analysis. The overall prevalence of SPD was 4.2% (females=5.8%; males=2.0%). SPD was associated with significantly higher lifetime rates of affective, anxiety, eating, substance use and impulse control disorders. Men with SPD had significantly higher BMI ratings and perceived themselves as significantly less attractive to others while women had significantly higher depressive symptoms. CONCLUSION SPD is common in both genders and is associated with significant mental and physical health detriments, including higher levels of stress, more psychiatric comorbidity and poorer perceived health. Academic institutions, clinicians and public health officials should be aware of the multimodal presentation of SPD and screen for it in primary care and dermatologic settings.

The use of pharmacologic pain sensitization in the treatment of repetitive hair-pulling.

A significant problem for many individuals who engage in repetitive hair-pulling is the fact that they experience no discomfort associated with their behavior, and can thus carry on with hair-pulling outside of conscious awareness. The present case study was an attempt to address this problem through the use of a commercially available topical cream which enhances pain sensitivity. A 38-yr-old female applied the cream daily to two affected areas on her scalp. The increased pain sensitization, in conjunction with the habit reversal technique, resulted in markedly decreased hair-pulling.

Mental Health and Clinical Correlates in Lesbian, Gay, Bisexual, and Queer Young Adults

Abstract Objective: This study examined the prevalence of mental health disorders and their clinical correlates in a university sample of lesbian, gay, bisexual, and queer (LGBQ) students. Participants: College students at a large public university. Methods: An anonymous, voluntary survey was distributed via random e-mail generation to university students during April and May of 2011. LGBQ students were compared with their heterosexual counterparts on psychological and physical status as well as academic performance. Results: LGBQ students reported worse depressive symptoms, higher levels of perceived stress, considered themselves less attractive, and were more likely to be overweight. LGBQ students were significantly more likely to report histories of affective, substance use, and certain anxiety disorders as well as compulsive sexual behavior and compulsive buying. Conclusions: The higher rates of many psychiatric conditions among LGBQ students underscore the need for universities to provide LGBQ students a nonjudgmental environment to discuss sexual orientation and health issues.