Neural correlates of cue-reactivity and craving in individuals with buying-shopping disorder.

Background: Individuals with buying-shopping disorder (BSD) have diminished control over their buying behavior and recurrently buy unneeded consumer goods despite experiencing negative consequences in daily life, such as severe conflicts with family and friends, or indebtedness and even delinquency. Recent studies emphasize parallels to behavioral addictions and demonstrate cue-reactivity and craving on subjective and peripheral physiological levels in individuals with BSD. However, the neural basis of cue-reactivity and craving in individuals with BSD has not been investigated, so far. The current study aimed at examining neural correlates of cue-induced craving reactions in a clinical sample of individuals with BSD by using functional Magnetic Resonance Imaging (fMRI).

Methods: A cue-reactivity paradigm comprising shopping-related and neutral pictures was applied in a Siemens 7-Tesla high field fMRI whole body scanner. During fMRI scanning, individuals with BSD and age/gender matched control participants watched and rated the pictures with respect to pleasantness and desires to buy. Symptom severity of BSD and craving reactions were assessed outside the scanner prior the examination.

Results: Individuals with BSD had higher baseline craving prior the investigation, rated the shopping pictures as more pleasant, and had higher desires to buy in comparison to control participants. In contrasting the shopping cues with the control cues, the BSD group had higher striatal activations compared to the control group.

Conclusion: The results demonstrate cue-reactivity and craving reactions on subjective and neural levels in individuals with BSD. The ventral and the dorsal striatum is a key structure of the mesolimbic reward system and is involved in changes in reward processing across different substance-use disorders and behavioral addictions, such as gambling disorder and gaming disorder. Given the parallels between BSD and disorders due to addictive behaviors, we argue for a classification of BSD as behavioral addiction.