!

SELECTED'READINGS'IN''
CONSUMER)NEUROSCIENCE)&)
NEUROMARKETING)
!
2nd$edition$

!
Compiled$by$
Thomas$Zoëga$Ramsøy$$
2014

 CONSUMER ABERRATIONS

One$approach$to$understand$consumer$choice$is$to$study$cases$in$which$those$behaviors$go$
awry.$What$happens$to$a$consumer$when$he$starts$gambling,$or$what$happens$in$compulsive$
buying$disorder$(“shopaholics”)?$Besides$allowing$us$to$better$understand$and$treat$those$
disorders,$this$knowledge$also$allows$us$to$better$understand$the$mechanisms$of$choice$in$
normal$consumer$behavior.$

Here,$we$focus$on$a$few$selected$aberrant$consumer$behaviors$that$highlight$some$of$the$basic$
mechanisms$of$choice.$This$also$provides$an$important$and$often$forgotten$aspect$of$
consumer$neuroscience$and$neuromarketing:$the$knowledge$and$insights$we$are$gaining$can$
be$used$to$help$sufferers$in$exactly$the$kinds$of$daily$situations$that$things$go$wrong.

Finally,$the$aspect$of$aberrant$consumer$behaviors$also$suggests$that$consumer$behavior$and$
marketing$can$be$used$as$an$important$and$viable$path$to$understand$the$basic$brain$
mechanisms$of$choice.$Thus,$cognitive$neuroscientists$should$look$to$consumer$behavior$with$
a$more$keen$interest$than$we$have$seen$until$now.
 Editorial

Is Compulsive Buying a Real Disorder,

and Is It Really Compulsive?

T he article in this issue by Koran et al. raises several intriguing questions regarding a
novel proposed psychiatric disorder: compulsive buying. DSM provides a working
model of categories and diagnostic criteria for psychiatric disorders. DSM is constantly
evolving and research planning is underway for DSM-V. Changes to DSM-V being con-
sidered include the creation of two broad new categories that may influence the con-
ceptualization of compulsive buying.
A category related to obsessive-compulsive-related disorders might include disorders
such as obsessive compulsive disorder, obsessive compulsive personality disorder,
hoarding, body dysmorphic disorder, eating disorders, hypochondriasis, Tourette’s syn-
drome, Sydenham’s chorea or pediatric autoim-
mune neuropsychiatric disorders associated
“Changes to DSM-V being with streptococcal infections, and pathological
considered include the grooming disorders, such as trichotillomania,
skin picking, and nail biting. Compulsive buying
creation of two broad was not determined to be a good fit for this cate-
new categories that gory. On the other hand, a parallel category un-
may influence the der consideration is behavioral and substance
addictions, which might include substance-re-
conceptualization of lated disorders and several impulse-control dis-
compulsive buying.” orders (pathological gambling, pyromania, and
kleptomania), as well as others currently in the
category of impulse control disorders not other-
wise specified (Internet addiction, impulsive-compulsive sexual behavior, and compul-
sive buying). The National Institute on Drug Abuse has considered behavioral addic-
tions (such as compulsive buying) to be “cleaner” and more homogeneous models of
substance addictions because these conditions may share clinical features and perhaps
underlying brain circuitry, and these features and circuitry are not altered by the inges-
tion of exogenous substances. Similar phases seem to occur for behavioral and sub-
stance addictions: initially, episodes are characterized by increasing physiological and
emotional arousal before the act; pleasure, high, or gratification associated with the act;
and a decrease in arousal and feelings of guilt and remorse afterward. Tolerance and
physiological withdrawal can also develop. Because an impulsive component (pleasure,
arousal, or gratification) is involved in initiating the cycle, and a compulsive component
is involved in the persistence of the behavior, these conditions may also be thought of
as impulsive-compulsive disorders.
The creation of a condition such as compulsive buying might be associated with con-
troversy and criticized by some as creating a trivial disorder; “medicalizing” a “moral”
problem or creating a new disorder in order to sell more pharmaceuticals. Similar criti-
cisms of attention deficit hyperactivity disorder (ADHD) and social anxiety disorder
have been raised: that children with minor and natural levels of excess activity should
not be “medicalized” or medicated or that because so many people are socially anxious,
this is a natural trait not worthy of diagnosis or treatment. However, the issues involved
in creating new diagnoses is complex.
In this issue, Koran et al. reported on a study of compulsive buying. They surveyed a
large random sample of U.S. adults to estimate a prevalence rate and to characterize
compulsive buyers. They and others have proposed names and diagnostic criteria for
this problem and, as required for most DSM disorders, the criteria include significant

1670 ajp.psychiatryonline.org Am J Psychiatry 163:10, October 2006

 EDITORIAL

distress or functional impairment, as well as criteria specific to the disorder. As is typical

at this stage, the specific name and criteria differ from researcher to researcher and
study to study, complicating the development of knowledge about the condition. Until
a certain amount of evidence of a new disorder is accumulated, not enough is known to
define criteria, but at a certain point, there is enough information to propose criteria.
Including a disorder in DSM is very helpful for the advance of knowledge because re-
searchers can then use the defined criteria in their new research, and the criteria can be
refined over time as more research is completed.
Clearly, the behavioral addictions or impulse control disorders can be viewed from
different perspectives, including: a medical perspective; a moral, ethical, or religious
perspective; and a legal perspective. These behaviors exist on a continuum, perhaps in
a normal distribution in the general population, with many individuals having some of
the behaviors, a few showing none, and a few showing a great deal. However, in a sub-
group of individuals, a biological vulnerability may result in impairment of control that
leads to behavioral excess or disinhibition and is associated with significant levels of
distress and functional impairment. Consideration that shopping is universal and mak-
ing an unwise purchase from time to time is common, although research has shown
that there are individuals whose compulsive buying is extreme and leads to significant
distress and impairment. Using scores on the Compulsive Buying Scale (1) of 2 standard
deviations below the mean, Koran et al. estimated the prevalence of compulsive buying
to be 5.8%; even with a very strict criterion of 3 standard deviations below the mean, the
prevalence would be 1.4%. Previous estimates based on smaller, less representative
samples have ranged from 1.8% to 16%. Thus, whatever estimate is used, the prevalence
is higher than or similar to disorders that receive considerable research and clinical at-
tention, and it represents a sizable group suffering distress and or functional impair-
ment. The impairment criteria are important because it is how compulsive buying as a
disorder is differentiated from more normal, if excessive, buying. Koran et al. found that
when using the criterion of 2 standard deviations on the Compulsive Buying Scale, the
individuals had significantly more maladaptive shopping and buying attitudes and be-
haviors and more financial problems than the other respondents. The data for the
group with 3 standard deviations shows consequences that were even more extreme.
This sort of distribution applies to many disorders. As mentioned above, ADHD and so-
cial anxiety disorder are two examples. One might also look at a long-accepted disorder:
major depressive disorder. Many people suffer from occasional sadness and days on
which they are “blue,” but that does not diminish the importance of recognizing, re-
searching, and treating major depressive disorder.
One can ask if people are morally responsible for their behavior if they commit uneth-
ical acts because of what has been classified as a mental disorder? Similarly, if an indi-
vidual diagnosed with an impulse control disorder does something illegal, is he or she
responsible? Having a diagnosable disorder does not eliminate the moral or legal con-
sequences of bad behavior, although courts can require that the individuals receive
treatment in order to prevent a recurrence of the problem. This can be seen with alco-
holism, which has long been considered a disorder. If an alcoholic has an accident while
driving under the influence, that is not considered a mitigating circumstance but the
courts can require that the individual undergo treatment for their alcohol problem,
along with any other sentencing requirements. Viewing compulsive buying from a
medical perspective and as a diagnosable mental disorder has several advantages. It
might facilitate routine screening for the condition by mental health professionals, and
perhaps, even inclusion of the disorder in national prevalence surveys, which would
help define the true prevalence of the disorder. It might also lead to the study of vulner-
ability factors for the development of the disorder, better characterization of brain-
based circuits, and the development of effective psychosocial and medication treat-
ments. Although prevention of overdiagnosis or possible misuse of diagnostic labels is

Am J Psychiatry 163:10, October 2006 ajp.psychiatryonline.org 1671

EDITORIAL

important, these concerns should be balanced against the advancement of knowledge

that could potentially lead to new treatments or prevention strategies for serious hu-
man problems.

Reference
1. Faber RJ, O’Guinn TC: A clinical screener for compulsive buying. J Consumer Res 1992; 19:459–469

ERIC HOLLANDER, M.D.

ANDREA ALLEN, PH.D.

Address correspondence and reprint requests to Dr. Hollander, Department of Psychiatry, Mt. Sinai School of
Medicine, One Gustave L Levy Place, New York, NY 10029; eric.hollander@mssm.edu (e-mail.)

Dr. Hollander has been a consultant to Ortho-McNeil, Abbott, and Forest; and has received research grants
from NIMH, NIDA, NINDS, and OPD-FDA. Dr. Freedman has reviewed this editorial and found no evidence of
influence from these relationships. Dr. Allen reports no competing interests.

1672 ajp.psychiatryonline.org Am J Psychiatry 163:10, October 2006

 COVER LETTER

poster submission

Arousal, Executive Control and Decision Making in Compulsive Buying Disorder

Thomas Zoëga Ramsøy 1, 2 *

Farah Qureshi Zuraigat 1
Catrine Jacobsen 1
Dalia Bagdžiūnaitė 1
Maiken Klindt Christensen 1
Martin Skov 1
Antoine Bechara 4

1. Decision Neuroscience Research Group, Department of Marketing, Copenhagen Business School,

Frederiksberg, Denmark
2. Danish Research Centre for Magnetic Resonance, Copenhagen University Hospital Hvidovre, Hvidovre,
Denmark
3. DTU Informatics, Technical University of Denmark, Lyngby, Denmark
4. Department of Psychology, University of Southern California, Loa Angeles, California, USA

* Corresponding author: TZ Ramsøy, DNRG, Department of Marketing, Copenhagen Business School,

Solbjerg Plads 3, 2000 Frederiksberg, Denmark. E-mail: tzr.marktg@cbs.dk; phone: (+45) 2181 1945
ABSTRACT
Compulsive buying disorder (CBD) is noted by an obsession with shopping and a chronic,
repetitive purchasing behavior with adverse consequences for the sufferer and their social
surroundings. While CBD is often classified as an impulse control disorder (ICD), little is
still known about the actual psychological and physiological mechanisms underlying the
phenomenon. By comparing subjects with CBD to a control group, we find that CBD is not
associated with lower performance on executive function or emotional responses. Rather,
an observed increase in willingness to pay (WTP) specifically for fashion products was
associated with a stronger emotional response in CBD subjects, while no relationship
between emotions and WTP could be observed in healthy controls. This suggests that
CBD, instead of being tentatively classified as an ICD, should rather be understood as a
behavioral addiction. By this token, products of interest (e.g. fashion items) produce
bottom-up emotional responses that skews the decision-making process, leading CBD
sufferers to make bad purchase decisions.
Arousal, Executive Control and Decision Making in Compulsive Buying Disorder

EXTENDED ABSTRACT
Compulsive buying disorder (CBD) is a condition characterized by an obsession with
shopping and a chronic, repetitive purchasing behavior that has adverse consequences
both for the sufferer and their social surroundings. Today, the prevalence of CBD is
estimated to be somewhere between 5% and 7% (Koran, Faber, Aboujaoude, Large, &
Serpe, 2006; Mueller et al., 2010b), and it is often reported that CBD is significantly more
prevalent in women than men, although other studies report relatively equal distributions (,
2010b). While CBD is not formally classified as a psychiatric disorder in diagnostic
manuals, it shares characteristics of other clinical disorders such as pathological gambling,
including impulsivity, dysexecutive functions and mood disorders (Di Nicola et al., 2010; de
Ruiter et al., 2009; van Holst, van den Brink, Veltman, & Goudriaan, 2010). As with
pathological gambling (Kessler et al., 2008), CBD has also been reported to be
characterized by comorbidities including Axis I disorders such as mood and especially
anxiety disorders (Mueller et al., 2010a), lending further support to a possible common
foundation between pathological gambling and CBD.

However, little is known about the neurobiological and neurophysiological underpinnings of

CBD (Lejoyeux & Weinstein, 2010). On the one hand, studies have suggested that CBD is
related to lower executive control and self-control (Claes et al., 2010), while others have
reported emotion-related issues, such as elevated levels of anxiety, depression and other
mood disorders (Black, 2001; Mueller et al., 2010a, 2010b). Thus, it is still unknown
whether CBD is caused by a failing executive system, altered emotion responses, or both.
Moreover, advances in understanding drug addiction have suggested that addiction
behaviors could be the result of a “failing willpower” (Bechara, 2005), in which sufferers
may display an aberrant relationship between emotional responses and value-based
decision making. Taken together, these suggest at least three different, yet not mutually
exclusive, causal mechanisms underlying CBD.

The aim of the present study was to provide a better insight into the basic
neuropsychological and neurophysiological foundations of CBD. Based on the prior
literature, three specific hypotheses were formed. The hypotheses pertained to 1)
executive control, 2) emotional responses per se, and 3) the effect of emotional on
decision making. Following the literature on impulse control disorders (Black, Shaw, &
Blum, 2010; Lejoyeux & Weinstein, 2010; Regard, Knoch, Gütling, & Landis, 2003; van
Holst et al., 2010), CBD could be related to dysexecutive function and a general lack of
impulse control, and thus we would expect that CBD sufferers would score lower on tests
of executive control, when compared to healthy subjects.

Sixty-three women (age range 19-51, mean/std = 26.5±7.5, all right handed) were
recruited from the Copenhagen and Frederiksberg regions, Denmark, using both online
(www.forsoegsperson.dk and www.videnskab.dk) and direct recruitment procedures. At
enrollment, subjects read and signed an informed consent, and were initially informed and
trained with the experimental procedure. They also filled out questionnaires relating to their
overall health state, including the Compulsive Buying Scale (CBS) (Faber & O'Guinn,
1992a).

All stimuli were presented on a screen running with a 1920x1200 pixel resolution. Subjects
were placed at an approximate distance of 60 cm from the screen, and underwent a
fixation calibration. The test consisted of three phases: i) an ISI phase which displayed a
fixation cross for 3 seconds; ii) product image phase in which a product from one of four
categories (purses, clothes, women’s shoes, and fast-moving consumer goods) were
shown for three seconds; and iii) a rating phase, in which subjects were asked to report
how much they would like to pay for the product they had just seen, by using an on-screen
visual analogue scale ranging from zero to 2.000 Danish Kroner (≈$330). The
experimental design is illustrated in Figure 1. To increase the external validity of the test,
subjects were instructed that the choices from two of the subjects from the cohort would be
randomly selected and given 1.500 DKK each, and that five of each subject’s choices
would be randomly selected, and the product receiving the highest bid of those five would
be realized. Should the highest bid not amount to 1.500 DKK, they would be paid the
remaining amount in cash. This meant that subjects were motivated to optimize their
product choices, which allowed us to better estimate the actual WTP, instead of subjective
estimates of WTP.

CAPTION: The shopping task. Subjects first saw a fixation cross, followed by the display of a product, and
then a self-paced WTP task. Here, subjects decided how much they were willing to actually pay for the
product, ranging from zero to DKK 2.000, by moving a visual analogue slider on the screen

Subjects were grouped according to their CBS score into three groups: healthy (range:
0-32), compensatory (range: 33-42), compulsive (range: 43-54) (Faber & O'Guinn, 1992b).
The groups thus differed significantly on the CBS (one-way ANOVA F=147.2, p<0.0001)
where the healthy individuals had the lowest CBS score (n=23, mean±std = 26.1±3.6),
followed by the compensatory group (n=19, mean±std = 37.2±2.6) and finally the
compulsive group (n=9, mean±std = 46.8±3.4). In the following analyses, we focus on
direct comparisons between the CBD group and healthy controls.

Willingness To Pay
We first analyzed whether compulsive buyers showed an altered WTP for products
compared to healthy controls by running an independent samples samples t-test. Here, we
find a significant group effect, in that the CBD group displayed a disproportionately higher
WTP (mean±SEM = 402.22±1.99 DKK) than the control group (171.94±1.4, independent
sample t-test=-81.6, p<0.0001). Further post-hoc testing showed that this difference was
significant for certain products, such as shoes, clothing and especially purses, but not for
FMCG (see Figure 2).
Executive functions
Second, to compare whether CBD was related to dysfunctional executive processes, we
analyzed the relationship between CBD and test results. Here, the neuropsychological
tests were first analyzed using direct comparison between the CBD group and the healthy
volunteers, using an independent samples t-test. In doing so, we find no group differences
on the executive tests (Table 1), and only the Stroop response time (RT) shows a
significant group effect, as the CBD group had significantly faster RT than the control
group.

TEST T KS p

Eriksen Flanker Test 0.12 0.731

Stroop Test

- normal -2.59 0.0078*

- interference -1.33 0.0965(*)

- difference 0.28 0.389

Visual reaction 0.17 0.348

Go/No-go

- result 0.12 0.771

 TEST T KS p

- time 0.17 0.289

- combined 0.12 0.71

* = significance at p<0.05 level; (*)= trend significance at p<0.1

Emotional responses
We then turned to the effect of CBD on emotional responses. Here, we analyzed the
relationship between the CBD and emotional arousal during product viewing by comparing
emotional responses in the CBD group to the healthy subjects using an independent
samples t-test. CBD subjects had a lower pupil dilation responses (3.23±0.01) than
controls (3.26±0.01, independent samples t-test=6.03, p<0.0001).

From emotion to decision

Finally, we wanted to test whether compulsive buying was associated with an alteration in
the impact that emotions could have on WTP choice. Here, we ran a linear regression
analysis using WTP as the dependent variable and using pupil dilation, group and the
interaction between pupil dilation and group as the independent variables.

Here, we find that the effects of pupil dilation on WTP was significantly different between
the groups. While controls shower little relationship between pupil dilation and WTP, CBD
subjects showed a strong relationship (Figure 3).

CAPTION: Relationship between pupil dilation response and WTP for CBD (red) and controls (blue)

Discussion
These results provide novel and compelling insights into the mechanisms of compulsive
buying disorder. Notably, our data suggest that CBD is not due to a difference in executive
functions, but rather a specifically stronger effect of arousal in making WTP choices.
Notably, CBD subjects did not show a general stronger emotional response, but still
showed a stronger effect of such responses on WTP choices.
Together, these results suggest that CBD may be erroneously linked to impulse control
disorders. Rather, it seems that CBD is due to a stronger influence of emotions on
decision-making. One possibility is that CBD should rather be classified as a behavioral
addiction, in which urges and impulses have a stronger impact on decisions (Bechara,
2005).

References
Bechara, A. (2005). Decision making, impulse control and loss of willpower to resist drugs:
A neurocognitive perspective. Nature Neuroscience, 8(11), 1458-63. doi:10.1038/nn1584
Black, D. W. (2001). Compulsive buying disorder: Definition, assessment, epidemiology
and clinical management. CNS Drugs, 15(1), 17-27.
Black, D. W., Shaw, M., & Blum, N. (2010). Pathological gambling and compulsive buying:
Do they fall within an obsessive-compulsive spectrum? Dialogues in Clinical
Neuroscience, 12(2), 175-85.
Claes, L., Bijttebier, P., Eynde, F. V. D., Mitchell, J. E., Faber, R., Zwaan, M. D., & Mueller,
A. (2010). Emotional reactivity and self-regulation in relation to compulsive buying.
Personality and Individual Differences, 49(5), 526-530. doi:10.1016/j.paid.2010.05.020
Di Nicola, M., Tedeschi, D., Mazza, M., Martinotti, G., Harnic, D., Catalano, V., . . . Janiri, L.
(2010). Behavioural addictions in bipolar disorder patients: Role of impulsivity and
personality dimensions. Journal of Affective Disorders, 125(1-3), 82-8. doi:10.1016/j.jad.
2009.12.016
Faber, R. J., & O'Guinn, T. C. (1992a). A clinical screener for compulsive buying. Journal of
Consumer Research, 459-469. Retrieved from Google Scholar.
Faber, R. J., & O'Guinn, T. C. (1992b). A clinical screener for compulsive buying. Journal of
Consumer Research, 19(3), 459-69. Retrieved from http://ideas.repec.org/a/ucp/jconrs/
v19y1992i3p459-69.html
Kessler, R. C., Hwang, I., LaBrie, R., Petukhova, M., Sampson, N. A., Winters, K. C., &
Shaffer, H. J. (2008). DSM-IV pathological gambling in the national comorbidity survey
replication. Psychological Medicine, 38(9), 1351-60. doi:10.1017/S0033291708002900
Koran, L., Faber, R., Aboujaoude, E., Large, M., & Serpe, R. (2006). Estimated prevalence
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Mueller, A., Mitchell, J. E., Crosby, R. D., Gefeller, O., Faber, R. J., Martin, A., . . . de
Zwaan, M. (2010b). Estimated prevalence of compulsive buying in germany and its
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Regard, M., Knoch, D., Gütling, E., & Landis, T. (2003). Brain damage and addictive
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j.neubiorev.2009.07.007
IMP. 14-18 26-01-2007 11:31 Pagina 14

SPECIAL ARTICLE

A review of compulsive buying disorder

DONALD W. BLACK
Department of Psychiatry, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, IA 52242, USA

Compulsive buying disorder (CBD) is characterized by excessive shopping cognitions and buying behavior that leads to distress or im-
pairment. Found worldwide, the disorder has a lifetime prevalence of 5.8% in the US general population. Most subjects studied clinical-
ly are women (~80%), though this gender difference may be artifactual. Subjects with CBD report a preoccupation with shopping, pre-
purchase tension or anxiety, and a sense of relief following the purchase. CBD is associated with significant psychiatric comorbidity, par-
ticularly mood and anxiety disorders, substance use disorders, eating disorders, and other disorders of impulse control. The majority of
persons with CBD appear to meet criteria for an Axis II disorder, although there is no special “shopping” personality. Compulsive shop-
ping tends to run in families, and these families are filled with mood and substance use disorders. There are no standard treatments. Psy-
chopharmacologic treatment studies are being actively pursued, and group cognitive-behavioral models have been developed and are
promising. Debtors Anonymous, simplicity circles, bibliotherapy, financial counseling, and marital therapy may also play a role in the
management of CBD.

Key words: Compulsive shopping, compulsive buying, impulse control disorders

(World Psychiatry 2007;6:14-18)

Compulsive buying disorder (CBD) was first described
clinically in the early 20th century by Bleuler (1) and Krae-
pelin (2), both of whom included CBD in their textbooks.
Bleuler writes: “As a last category Kraepelin mentions the
buying maniacs (oniomaniacs) in whom even buying is
compulsive and leads to senseless contraction of debts with
continuous delay of payment until a catastrophe clears the
situation a little – a little bit never altogether because they
never admit to their debts” (1). Bleuler described CBD as an
example of a “reactive impulse”, or “impulsive insanity”,
which he grouped alongside kleptomania and pyromania.
CBD attracted little attention throughout the 20th centu-
ry except among consumer behaviorists (3-6) and psycho-
analysts (7-9). Interest was revived in the early 1990s, when
clinical case series from three independent research groups
appeared (10-12). The disorder has been described world-
wide, with reports coming from the US (10-12), Canada (5),
England (4), Germany (6), France (13), and Brazil (14).
The appropriate classification of CBD continues to be
debated. Some researchers have linked CBD to addictive
disorders (15), while others have linked it to obsessive-com-
pulsive disorder (16), and still others to mood disorders
(17). While not included in DSM-IV (18), CBD was in-
cluded in DSM-III-R (19) as an example of an “impulse-
control disorder not otherwise specified”. Research criteria
have been developed that emphasize its cognitive and be-
havioral aspects (10). Some writers have criticized attempts
to categorize CBD as an illness, which they see as part of a
trend to “medicalize” behavioral problems (20). Yet, this ap-
proach ignores the reality of CBD, and both trivializes and
stigmatizes attempts to understand or treat the disorder.
EPIDEMIOLOGY
Koran et al (21) recently estimated the point prevalence
of CBD to be 5.8% of respondents, based on results from a
random telephone survey of 2,513 adults conducted in the
US. Earlier, Faber and O’Guinn (22) had estimated the
prevalence of CBD to fall between 2% and 8% of the gen-
eral population of Illinois. Both research groups had used
the Compulsive Buying Scale (CBS) (23) to identify com-
pulsive buyers. Other surveys have reported figures ranging
from 12% to 16% (24,25). There is no evidence that CBD
has increased in prevalence in the past few decades.
Community based and clinical surveys suggest that 80%
to 95% of persons with CBD are women (10-12,23). The re-
ported gender difference could be artifactual: women read-
ily acknowledge that they enjoy shopping, whereas men are
more likely to report that they “collect”. The report of Ko-
ran et al (21) suggests that this may be the case: in their
survey, a near equal percentage of men and women met
criteria for CBD (5.5% and 6.0%, respectively). However,
Dittmar (26) concluded from a general population survey in
the United Kingdom, in which 92% of respondents consid-
ered compulsive shoppers were women, that the gender dif-
ference is real and is not an artifact of men being underrep-
resented in samples.
The age of onset of CBD appears to be in the late teens or
early twenties (11,12,27), though McElroy et al (10) report-
ed a mean age at onset of 30 years. It may be that the age of
onset corresponds with emancipation from the home, and
the age at which people first establish credit accounts.
There are no careful longitudinal studies of CBD, but the
majority of subjects studied by Schlosser et al (12) and McEl-
roy et al (10) describe their course as continuous. Abou-
jaoude et al (28) suggested that persons with CBD who re-
sponded to treatment with citalopram were likely to remain
in remission during one-year follow-up, a finding that sug-
gests that treatment could alter the natural history of the dis-
order. The authors’ personal observation is that subjects
with CBD typically report decades of compulsive shopping

14 World Psychiatry 6:1 - February 2007

IMP. 14-18 26-01-2007 11:31 Pagina 15
behavior at the time of presentation, although it might be ar-
gued that clinical samples are biased in favor of severity.
There is some evidence that CBD runs in families and that
within these families mood, anxiety, and substance use dis-
orders are excessive. McElroy et al (8) reported that, of 18 in-
dividuals with CBD, 17 had one or more first-degree relatives
(FDRs) with major depression, 11 with an alcohol or drug
use disorder, and three with an anxiety disorder. Three had
relatives with CBD. Black et al (29) used the family history
method to assess 137 FDRs of 33 persons with CBD. FDRs
were significantly more likely than those in a comparison
group to have depression, alcoholism, a drug use disorder,
“any” psychiatric disorder, and “more than one psychiatric
disorder”. CBD was identified in 9.5% of the FDRs of the
CBD probands (CBD was not assessed in the comparison
group). In molecular genetic studies, Devor et al (30) failed
to find an association between two serotonin transporter
gene polymorphisms and CBD, while Comings (31) report-
ed an association of CBD with the DRD1 receptor gene.
CLINICAL SYMPTOMS
Persons with CBD are preoccupied with shopping and
spending, and devote significant time to these behaviors.
While it might be argued that a person could be a compul-
sive shopper and not spend, and confine his or her interest
to window shopping, this pattern is uncommon. The au-
thor’s personal observation is that the two aspects – shop-
ping and spending – are intertwined. Persons with CBD of-
ten describe an increasing level of urge or anxiety that can
only lead to a sense of completion when a purchase is made.
The author has been able to identify four distinct phases
of CBD: 1) anticipation; 2) preparation; 3) shopping; and 4)
spending. In the first phase, the person with CBD develops
thoughts, urges, or preoccupations with either having a spe-
cific item, or with the act of shopping. In the second phase,
the person prepares for shopping and spending. This can in-
clude decisions on when and where to go, on how to dress,
and even which credit cards to use. Considerable research
may have taken place about sale items, new fashions, or new
shops. The third phase involves the actual shopping experi-
ence, which many individuals with CBD describe as intense-
ly exciting, and can even lead to a sexual feeling (12). Final-
ly, the act is completed with a purchase, often followed by a
sense of let down, or disappointment with oneself (21). In a
study of the antecedents and consequences of CBD, Mil-
tenberger et al (32) reported that negative emotions (e.g., de-
pression, anxiety, boredom, self-critical thoughts, anger)
were the most commonly cited antecedents to CBD, while
euphoria or relief from the negative emotions were the most
common consequence.
Individuals with CBD tend to shop by themselves, al-
though some will shop with friends who may share their in-
terest in shopping (11,12). In general, CBD is a private
pleasure which could lead to embarrassment if someone
not similarly interested in shopping accompanied them.
Shopping may occur in just about any venue, ranging from
high fashion department stores and boutiques to consign-
ment shops or garage sales. Income has relatively little to do
with the existence of CBD: persons with a low income can
still be fully preoccupied by shopping and spending, al-
though their level of income will lead them to shop at a con-
signment shop rather than a department store.
Typical items purchased by persons with CBD include
(in descending order) clothing, shoes, compact discs, jew-
elry, cosmetics, and household items (11,12,32). Individu-
ally, the items purchased by compulsive shoppers tend not
to be particularly expensive, but the author has observed
that many compulsive shoppers buy in quantity resulting in
out of control spending. Anecdotally, patients often report
buying a product based on its attractiveness or because it
was a bargain. In the study by Christenson et al (11), com-
pulsive shoppers reported spending an average of $110 dur-
ing a typical shopping episode compared with $92 reported
in the study by Schlosser et al (12).
Although research has not identified gender specific buy-
ing patterns, in the author’s experience men tend to have a
greater interest than women in electronic, automotive, or
hardware goods. Like women, they are also interested in
clothing, shoes, and compact discs.
Subjects generally are willing to acknowledge that CBD
is problematic. Schlosser et al (10) reported that 85% of
their subjects expressed concern with their CBD-related
debts, and that 74% felt out of control while shopping. In
the study by Miltenberger et al (32), 68% of persons with
CBD reported that it negatively affected their relationships.
Christenson et al (11) reported that nearly all of their sub-
jects (92%) tried to resist their urges to buy, but were rarely
successful. The subjects indicated that 74% of the time they
experienced an urge to buy, the urge resulted in a purchase.
CBD tends to occur year round, although it may be more
problematic during the Christmas or other important holi-
days, and around the birthdays of family members and
friends (12). Schlosser et al (12) found that subjects report-
ed a range of behaviors regarding the outcome of a purchase,
including returning the item, failing to remove the item from
the packaging, selling the item, or even giving it away.
In a study of 44 subjects with CBD, Black et al (33) re-
ported that greater severity was associated with lower gross
income, less likelihood of having an income above the me-
dian, and spending a lower percentage of income on sale
items. Subjects with more severe CBD were also more like-
ly to have comorbid Axis I or Axis II disorders. These data
suggest that the most severe forms of CBD are found in per-
sons with low incomes who have little ability to control or
to delay their urge to make impulsive purchases.
PSYCHIATRIC COMORBIDITY
Persons with CBD frequently meet criteria for Axis I dis-
15
IMP. 14-18 26-01-2007 11:31 Pagina 16
orders, particularly mood disorders (21-100%) (27,34),
anxiety disorders (41-80%) (10,12), substance use disorders
(21-46%) (11,29), and eating disorders (8-35%) (10,27).
Disorders of impulse control are also relatively common in
these individuals (21-40%) (10,11).
Schlosser et al (12) found that nearly 60% of subjects with
CBD met criteria for at least one Axis II disorder. While there
was no special “shopping” personality, the most frequently
identified personality disorders were the obsessive-compul-
sive (22%), avoidant (15%), and borderline (15%) types.
Krueger (7), a psychoanalyst, described four patients who he
observed to have aspects of narcissistic character pathology.
ETIOLOGY
The etiology of CBD is unknown, though speculation
has settled on developmental, neurobiological, and cultur-
al influences. Psychoanalysts (7-9) have suggested that ear-
ly life events, such as sexual abuse, are causative factors.
Yet, no special or unique family constellation or pattern of
early life events has been identified in persons with CBD.
Neurobiological theories have centered on disturbed
neurotransmission, particularly involving the serotonergic,
dopaminergic, or opioid systems. Selective serotonin reup-
take inhibitors (SSRIs) have been used to treat CBD (27,34-
38), in part because investigators have noted similarities be-
tween CBD and obsessive-compulsive disorder, a disorder
known to respond to SSRIs. Dopamine has been theorized
to play a role in “reward dependence”, which has been
claimed to foster “behavioral addictions” (e.g., CBD, patho-
logical gambling) (39). Case reports suggesting benefit from
the opiate antagonist naltrexone have led to speculation
about the role of opiate receptors (40,41). There is current-
ly no direct evidence to support the role of these neuro-
transmitter systems in the etiology of CBD.
Cultural mechanisms have been proposed to recognize the
fact that CBD occurs mainly in developed countries (42). El-
ements which appear necessary for the development of CBD
include the presence of a market-based economy, the avail-
ability of a wide variety of goods, disposable income, and sig-
nificant leisure time. For these reasons, CBD is unlikely to oc-
cur in poorly developed countries, except among the wealthy
elite (Imelda Marcos and her many shoes come to mind).
ASSESSMENT
The goal of assessment is to identify CBD through in-
quiries regarding the person’s attitudes and behaviors to-
wards shopping and spending (43). Inquiries might include:
“Do you feel overly preoccupied with shopping and spend-
ing?”; “Do you ever feel that your shopping behavior is ex-
cessive, inappropriate or uncontrolled?”; “Have your shop-
ping desires, urges, fantasies, or behaviors ever been overly
time consuming, caused you to feel upset or guilty, or lead
16
to serious problems in your life such as financial or legal
problems or the loss of a relationship?”.
Clinicians should note past psychiatric treatment, includ-
ing medications, hospitalizations, and psychotherapy. A his-
tory of physical illness, surgical procedures, drug allergies, or
medical treatment is important to note, because it may help
rule out medical explanations as a cause of the CBD (e.g.,
neurological disorders, brain tumors). Bipolar disorder needs
to be ruled out as a cause of the excessive shopping and
spending. Typically, the manic patient’s unrestrained spend-
ing corresponds to manic episodes, and is accompanied by
euphoric mood, grandiosity, unrealistic plans, and often a
giddy, expansive affect. The pattern of shopping and spend-
ing in the person with CBD lacks the periodicity seen with
bipolar patients, and suggests an ongoing preoccupation.
Normal buying behavior should also be ruled out. In the
US and other developed countries, shopping is a major pas-
time, particularly for women, and frequent shopping does
not necessarily constitute evidence in support of a diagno-
sis of CBD. Normal buying can sometimes take on a com-
pulsive quality, particularly around special holidays or
birthdays. Persons who receive an inheritance or win a lot-
tery may experience shopping sprees as well.
Several instruments have been developed to either identi-
fy CBD or rate its severity. The CBS (23), already mentioned,
consists of seven items representing specific behaviors, moti-
vations, and feelings associated with compulsive buying, and
reliably distinguishes normal buyers from those with CBD.
Edwards (44) has developed a useful 13-item scale that as-
sesses important experiences and feelings about shopping
and spending. Monahan et al (45) modified the Yale Brown
Obsessive-Compulsive Scale to create the YBOCS-Shopping
Version (YBOCS-SV) to assess cognitions and behaviors as-
sociated with CBD. This 10-item scale rates time involved, in-
terference, distress, resistance, and degree of control for both
cognitions and behaviors. The instrument is designed to
measure severity of CBD, and change during clinical trials.
TREATMENT
There are no evidence-based treatments for CBD. In re-
cent years, treatment studies of CBD have focused on the
use of psychotropic medication (mainly antidepressants)
and cognitive-behavioral therapy (CBT).
Interest in CBT has largely replaced earlier interest in
psychodynamic therapies. Several competing CBT models
have been developed, the most successful involving the use
of group treatment (46-49). The first use of group therapy
was described by Damon (46). Subsequent group models
were developed by Burgard and Mitchell (47), Villarino et
al (48), and more recently by Benson and Gengler (49).
Mitchell et al (50) reported that their group CBT model pro-
duced significant improvement compared to a wait list in a
12-week pilot study; improvement was maintained during a
6-months follow-up. Benson (51) has recently developed a
World Psychiatry 6:1 - February 2007
IMP. 14-18 26-01-2007 11:31 Pagina 17
comprehensive self-help program which combines cogni-
tive-behavioral strategies with self-monitoring. A detailed
workbook, a shopping diary, and a CD-ROM are included.
Several self-help books (bibliotherapy) are available (52-
54), and may be helpful to some persons with CBD. Debtors
Anonymous, patterned after Alcoholics Anonymous, is a
voluntary, lay-run group that provides an atmosphere of
mutual support and encouragement for those with substan-
tial debts. Simplicity circles are available in some US cities;
these voluntary groups encourage people to adopt a simple
lifestyle, and to abandon their CBD (55). Many subjects
with CBD develop substantial financial problems, and may
benefit from financial counseling (56). The author has seen
cases in which a financial conservator has been appointed
to control the patient’s finances, and appears to have
helped. While a conservator controls the person’s spending,
this approach does not reverse his or her preoccupation
with shopping and spending. Marriage (or couples) coun-
seling may be helpful, particularly when CBD in one mem-
ber of the dyad has disrupted the relationship (57).
Psychopharmacologic treatment studies have yielded
mixed results. An early case series suggested that antide-
pressants could curb CBD (58), and an early open-label tri-
al using fluvoxamine showed benefit (34). Yet, two subse-
quent randomized controlled trials found that fluvoxamine
did no better than placebo (35,36). In another open-label
trial (28), citalopram produced substantial improvement. In
this particular study, responders to open-label citalopram
were then enrolled in a nine-week randomized placebo
controlled trial (38). Compulsive shopping symptoms re-
turned in five of eight subjects assigned to placebo com-
pared with none of the seven who continued taking citalo-
pram. By comparison, escitalopram showed little effect for
CBD in an identically designed discontinuation trial by the
same investigators (39). Grant (40) and Kim (41) have de-
scribed cases in which persons with CBD improved with
naltrexone, suggesting that opiate antagonists might play a
role in the treatment of CBD. Interpretation of treatment
studies is complicated by the high placebo response rate as-
sociated with CBD (ranging to 64%) (35).
The author has developed a set of recommendations
(59). First, pharmacologic treatment trials provide little
guidance, and patients should be informed that they cannot
rely on medication. Further, patients should: a) admit that
they have CBD; b) get rid of credit cards and checkbooks,
because they are easy sources of funds that fuel the disor-
der; c) shop with a friend or relative; the presence of a per-
son without CBD will help curb the tendency to overspend;
and d) find meaningful ways to spend one’s leisure time oth-
er than shopping.
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World Psychiatry 6:1 - February 2007
PAGES_11_AG_1009_BA.qxd:DCNS#45 9/06/10 10:27
Clinical research
Pathological gambling and compulsive
buying: do they fall within an
obsessive-compulsive spectrum?
Donald W. Black, MD; Martha Shaw, BA; Nancee Blum, MSW
Both compulsive buying (CB) and pathological gambling
(PG) have been proposed as members of a spectrum of
disorders related to obsessive-compulsive disorder (OCD).
The spectrum hypothesis originated in the early 1990s and
has gained considerable support, despite the lack of
empirical evidence. Interest in this hypothesis has become
critical because some investigators have recommended the
creation of a new category that includes these disorders
in DSM-5, now under development. In this article, the
authors describe the origin of the obsessive-compulsive
(OC) spectrum and its theoretical underpinnings, review
both CB and PG, and discuss the data both in support of
and against an OC spectrum. Both disorders are described
in terms of their history, definition, classification, phe-
nomenology, family history, pathophysiology, and clinical
management. The authors conclude that: (i) CB and PG
are probably not related to OCD, and there is insufficient
evidence to place them within an OC spectrum in DSM-V;
(ii) PG should stay with the impulse-control disorders
(ICDs); and (iii) a new diagnosis of CB should be created
and be classified as an ICD.
© 2010, LLS SAS Dialogues Clin Neurosci. 2010;12:175-185.
Copyright © 2010 LLS SAS. All rights reserved
Page 175
I n the early 1990s, interest began to grow
around the concept of an obsessive-compulsive (OC)
spectrum. Hollander and others1-3 wrote of a spectrum of
disorders related to obsessive-compulsive disorder
(OCD). Based on his experience as an OCD researcher,
Hollander considered OCD to be at the center of the
spectrum, and described its breadth and overlap with
many other psychiatric disorders. These disorders were
considered to lie along orthogonal axes of impulsivity vs
compulsiveness, uncertainty vs certainty, and cognitive
vs motoric (features). The OC spectrum concept was
quickly embraced by other investigators because it
offered a new way to think about the relationship among
many neglected disorders, and it potentially offered new
treatment options.4,5 Not all investigators have agreed,
and several critical reviews have appeared.6-9
Despite the criticism, the concept of a group of disorders
being related to OCD remains of great theoretical inter-
est. The idea that disorders are related is crucial to clas-
sification schemes, and why should a group of disorders
not be related to OCD? This question is now of singular
interest because those responsible for developing the
fifth edition of the Diagnostic and Statistical Manual of
Mental Disorders (DSM-5) must decide whether to cre-
ate a separate category for OCD and potentially related
disorders, or to keep OCD with the anxiety disorders. If
Keywords: compulsive buying; pathological gambling; obsessive-compulsive spec-
trum; impulse control disorder; behavioral addiction
Author affiliations: Department of Psychiatry, University of Iowa Roy J. and
Lucille A. Carver College of Medicine, Iowa City, Iowa, USA
Address for correspondence: Dr Donald Black, Psychiatry Research/2-126B MEB,
University of Iowa Carver College of Medicine, Iowa City, Iowa 52242, USA
(e-mail: donald-black@uiowa.edu)
175 www.dialogues-cns.org
PAGES_11_AG_1009_BA.qxd:DCNS#45 9/06/10 10:27 Page 176
Clinical research
Selected abbreviations and acronyms
CB compulsive buying
ICD impulse-control disorder
OC obsessive-compulsive
OCD obsessive-compulsive disorder
PG pathological gambling
SSRI selective serotonin reuptake inhibitor
they create a new category for the OC spectrum they
will need to determine its breadth.
The OC spectrum’s boundaries have expanded or con-
tracted according to the views of the investigator con-
cerned. It has been described as including disorders of
impulse control such as pathological gambling (PG), tri-
chotillomania, and kleptomania; Tourette’s and other tic
disorders; impulsive personality disorders (eg, borderline
personality disorder); hypochondriasis and body dysmor-
phic disorder; eating disorders; and several disorders not
currently recognized in DSM-IV-TR10 such as compulsive
buying (CB) and sexual addiction.1-4 Few investigators
have offered evidence to validate a relationship among
the disorders. Typically, such evidence might include com-
parisons of phenomenology, natural history, family history,
biological markers, and treatment response.11
OCD holds an important place at the center of the spec-
trum. Currently classified in DSM-IV-TR10 as an anxiety
disorder, OCD is independent of other anxiety disorders
in the International Classification of Diseases (ICD) sys-
tem,12 and a strong rationale has been presented by
Zohar et al13 for its separation from these disorders. First,
OCD often begins in childhood, whereas other anxiety
disorders typically have a later age of onset. OCD has a
nearly equal gender distribution, unlike the other anxi-
ety disorders, which are more common in women.
Studies of psychiatric comorbidity show that, unlike the
other anxiety disorders, persons with OCD generally
tend not to have elevated rates of substance misuse.
Family studies have not shown a clear association
between OCD and the other anxiety disorders. Brain cir-
cuitry that mediates OCD appears to be different from
that involved in other anxiety disorders. Lastly, OCD is
unique with regard to its response to the serotonin reup-
take inhibitors (SSRIs), while noradrenergic medica-
tions, effective in mood disorders, and somewhat effec-
tive in anxiety disorders, are largely ineffective in OCD.
On the other hand, the benzodiazepines, which have lit-
tle effect on OCD, are often effective for the other anx-
iety disorders. Further, Zohar et al13 have argued that
176
recognizing the spectrum would contribute to improved
classification, thus enabling a more precise description
of endophenotype and biological markers that charac-
terize these conditions, and that better classification
could lead to more specific treatments.
Apart from the possibility of an OC spectrum, there has
been no consistent approach to categorizing impulsive
and compulsive disorders. While some have decried the
“medicalization” of problematic behaviors such as CB,14
discussion has mainly focused on how these disorders
should be classified, their relationship to other putative
OC spectrum disorders, and whether some of them stand
alone as independent disorders (eg, CB, compulsive sex-
ual behavior).
Alternative classification schemes have emphasized the
relationship of a putative OC spectrum disorder to
depression or other mood disorders, to the impulse-con-
trol disorders (ICDs), or to the addictive disorders.
Recently, it has been suggested that at least some of the
disorders included in the OC spectrum be placed within
a new diagnostic category that combines behavioral and
substance addictions.15 “Behavioral addictions” include
disorders that the National Institute on Drug Abuse
(NIDA) considers to be relatively pure models of addic-
tion because they are not contaminated by the presence
of an exogenous substance.
With this background in mind, this article will focus on
the status of PG and CB. Are these disorders part of an
OC spectrum as defined by Hollander and coworkers?
Are they more appropriately considered impulse con-
trol disorders (ICDs) or addictions? Are they related to
one another? These and other questions will be consid-
ered as we explore CB, PG, and the OC spectrum.
Compulsive buying
CB has been described in the psychiatric nomenclature
for nearly 100 years. German psychiatrist Emil
Kraepelin16 wrote about the uncontrolled shopping and
spending behavior called oniomania (“buying mania”).
He was later quoted by Swiss psychiatrist Eugen
Bleuler17 in his Lehrbuch der Psychiatrie:
As a last category, Kraepelin mentions the buying maniacs
(oniomaniacs) in whom even buying is compulsive and
leads to senseless contraction of debts with continuous
delay of payment until a catastrophe clears the situation
a little – a little bit never altogether because they never
admit all their debts. …. The particular element is impul-
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Compulsive buying and pathological gambling - Black et al
siveness; they cannot help it, which sometimes even
expresses itself in the fact that not withstanding a good
school intelligence, the patients are absolutely incapable of
thinking differently and conceiving the senseless conse-
quences of their act, and the possibilities of not doing it.”
(p 540).
Kraepelin and Bleuler each considered “buying mania”
an example of a reactive impulse or impulsive insanity,
and placed it alongside kleptomania and pyromania.
They may have been influenced by French psychiatrist
Jean Esquirol’s18 earlier concept of monomania, a term
he used to describe otherwise normal persons who had
some form of pathological preoccupation.
CB attracted little attention until the late 1980s and early
1990s when consumer behavior researchers showed the
disorder to be widespread19-21 and descriptive studies
appeared in the psychiatric literature.22-25 McElroy et al22
developed an operational definition that encompasses
the cognitive and behavioral aspects of CB. Their defin-
ition requires evidence of impairment from marked sub-
jective distress, interference in social or occupational
functioning, or financial/legal problems. Further, the syn-
drome could not be attributed to mania or hypomania.
Other definitions have come from consumer behavior
researchers or social psychologists. Faber and O’Guinn26
defined the disorder as “chronic buying episodes of a
somewhat stereotyped fashion in which the consumer
feels unable to stop or significantly moderate his behav-
ior” (p 738). Edwards,27 another consumer behaviorist,
suggests that compulsive buying is an “abnormal form of
shopping and spending in which the afflicted consumer
has an overpowering uncontrollable, chronic and repet-
itive urge to shop and spend (that functions) … as a
means of alleviating negative feelings of stress and anx-
iety.” (p 67). Dittmar28 describes three cardinal features:
irresistible impulse, loss of control, and carrying on
despite adverse consequences. Some consumer behavior
researchers consider CB part of a spectrum of aberrant
consumer behavior, which includes pathological gam-
bling, shoplifting, and credit abuse).29
CB is not included in either the DSM-IV-TR10 or the
World Health Organization International Classification
of Diseases, Tenth Edition.12 Whether to include CB in
DSM-5 is being debated.30 McElroy et al23 suggest that
compulsive shopping behavior might be related to
“mood, obsessive-compulsive or impulse control disor-
ders.” Lejoyeux et al31 have linked it to the mood disor-
ders. Some consider CB to be related to the substance
177
Dialogues in Clinical Neuroscience - Vol 12 . No. 2 . 2010
use disorders.32,33 Others suggest classifying CB as a dis-
order of impulse control34 or a mood disorder.35
Faber and O’Guinn26 estimated the prevalence of CB at
between 1.8% and 8.1% of the general population,
based on results from a mail survey in which the
Compulsive Buying Scale (CBS) was administered to
292 individuals selected to approximate the demo-
graphic makeup of the general population of Illinois.
(The high and low prevalence estimates reflect different
score thresholds set for CB.) More recently, Koran et al36
used the CBS to identify compulsive buyers in a random
telephone survey of 2513 US adults, and estimated the
point prevalence at 5.8% of respondents. Grant et al37
utilized the MIDI to assess CBD and reported a lifetime
prevalence of 9.3% among 204 consecutively admitted
psychiatric inpatients.
CB has an onset in the late teens/early 20s, which may
correlate with emancipation from the nuclear family, as
well as with the age at which people can first establish
credit.34 Research suggests that 80% to 94% of persons
with CBD are women.38 In contrast, Koran et al36
reported that the prevalence of CBD in their random
telephone survey was nearly equal for men and women
(5.5% and 6.0%, respectively). Their finding suggests
that the reported gender difference may be artifactual,
in that women more readily acknowledging abnormal
shopping behavior than men. Men are more likely to
describe their compulsive buying as “collecting.”
Data from clinical studies confirm high rates of psychi-
atric comorbidity, particularly for the mood (21% to
100%), anxiety (41% to 80%), substance use (21% to
46%), and eating disorders (8% to 35%).38 Disorders of
impulse control are also relatively common (21% to
40%). The frequency of Axis II disorders in individuals
with CB was assessed by Schlosser et al25 using a self-
report instrument and a structured interview. Nearly
60% of 46 subjects met criteria for at least one person-
ality disorder through a consensus of both instruments.
The most commonly identified personality disorders
were the obsessive-compulsive (22%), avoidant (15%),
and borderline (15%) types.
A distinctive and stereotyped clinical picture of the com-
pulsive shopper has emerged. Black39 has described four
phases including: (i) anticipation; (ii) preparation; (iii)
shopping; and (iv) spending. In the first phase, the per-
son with CB becomes preoccupied either with having a
specific item, or with the act of shopping. This is followed
by a preparation phase in which plans are made. This
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phase is followed by the actual shopping experience,
which many individuals with CB describe as intensely
exciting.25 The act is completed with the purchase, often
followed by a sense of let-down or disappointment.36
Perhaps the hallmark of CB is preoccupation with shop-
ping and spending. This typically leads the individual to
spend many hours each week engaged in these behav-
iors.24,25 Persons with CB often describe increasing ten-
sion or anxiety that is relieved when a purchase is made.
CB behaviors occur all year, but can be more problem-
atic during the Christmas season and other holidays, as
well as around the birthdays of family members and
friends. Compulsive buyers are mainly interested in con-
sumer goods such as clothing, shoes, crafts, jewelry, gifts,
makeup, and compact discs (or DVDs)24,25 CB has little
to do with intellect or educational level, and has been
documented in mentally retarded persons.40 Similarly,
income has relatively little to do with CB, because per-
sons with a low income can be as preoccupied with shop-
ping and spending as wealthier individuals.38,40
Nataraajan and Goff42 have identified two independent
factors in CB: (i) buying urge or desire, and (ii) degree
of control over buying. In their model, compulsive shop-
pers combine high urge with low control. This view is
consistent with clinical reports that compulsive buyers
are preoccupied with shopping and spending and will try
to resist their urges, often with little success.24,38
Cross-sectional studies suggest the disorder is chronic,
though fluctuating in severity and intensity.22,25
Aboujaoude et al43 reported that persons who responded
to treatment with citalopram were likely to remain in
remission during a 1-year follow-up, suggesting that
treatment can alter the natural history of the disorder.
Lejoyeux et al44 report that CB is associated with suicide
attempts, although there are no reports of the disorder
leading to completed suicide.
There is some evidence that CB runs in families and that
within these families mood, anxiety, and substance-use
disorders exceed population rates. Black et al45 used the
family history method to assess 137 first-degree relatives
of 31 persons with CB. Relatives were significantly more
likely than those in a comparison group to have depres-
sion, alcoholism, a drug use disorder, “any psychiatric
disorder” and “more than one psychiatric disorder.” CB
was identified in nearly 10% of the first-degree relatives,
but was not assessed in the comparison group.
Neurobiologic theories have centered on disturbed neu-
rotransmission, particularly involving the serotonergic,
178
dopaminergic, or opioid systems. Selective serotonin reup-
take inhibitors (SSRIs) have been used to treat CB,46-50 in
part because of hypothetical similarities between CB and
OCD, a disorder known to respond to SSRIs. Dopamine
has been theorized to play a role in “reward dependence,”
which has been claimed to foster behavioral addictions,
such as CB and PG.15 Case reports suggesting benefit from
the opioid antagonist naltrexone have led to speculation
about the role of opioid receptors51 There is no direct evi-
dence, however, to support the role of these neurotrans-
mitter systems in the etiology of CB.
Because CB occurs mainly in developed countries, cul-
tural and social factors have been proposed as either
causing or promoting the disorder.39 Interestingly,
Neuner et al52 reported that the frequency of CB in
Germany increased following reunification, suggesting
that societal factors can contribute to the development
of CB. These may include the presence of a market-
based economy, the availability of goods, easily obtained
credit, and disposable income.14
There are no standard treatments, and both psychotherapy
and medication have been recommended. Several case
studies report the psychoanalytic treatment of CB.53-55 More
recently, cognitive-behavioral treatment (CBT) models
have been developed for CB, many of them employing
group therapy.56,57 Mitchell et al57 found that group CBT
produced significant improvement compared with a wait-
list in a 12-week pilot study. Improvement attributed to
CBT was maintained during a 6-month follow-up. Benson58
has developed a comprehensive self-help program that can
be used by both individuals and groups.
Treatment studies employing psychotropic medications
have produced mixed results. Early reports suggested
the benefit of antidepressants in treating CB22,23 Black et
al46 reported the results of an open-label trial in which
subjects given fluvoxamine showed benefit. Two subse-
quent randomized controlled trials (RCTs) found flu-
voxamine treatment to be no better than placebo.47,48
Koran et al51 later reported that subjects with CB
improved with open-label citalopram. In a subsequent
study, subjects received open-label citalopram; those
who were considered responders were randomized to
citalopram or placebo. Compulsive shopping symptoms
returned in 5/8 subjects (62.5%) assigned to placebo
compared with 0/7 who continued taking citalopram. In
an identically designed discontinuation trial, escitalo-
pram did not separate from placebo.52 Because the med-
ication study findings are mixed, no empirically well-sup-
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Compulsive buying and pathological gambling - Black et al
ported treatment recommendations can be made. Open-
label trials have generally produced positive results, but
RCTs have not. Interpretation of these study results is
complicated by placebo response rates as high as 64%.47
Pathological gambling
PG is increasingly being recognized as a major public
health problem.59 PG is estimated to cost society approx-
imately $5 billion per year and an additional $40 billion
in lifetime costs for reduced productivity, social services,
and creditor losses.The disorder substantially impairs
quality of life in addition to its association with comor-
bid psychiatric disorders, psychosocial impairment, and
suicide.59-61 Family-related problems include financial dis-
tress, child and spousal abuse, and divorce and separa-
tion.61
While problematic gambling behavior has been recog-
nized for centuries, it was often ignored by the psychiatric
community. Bleuler,17 citing Kraepelin,16 considered PG,
or “gambling mania,” a special impulse disorder. Criteria
for PG were first enumerated in 1980 in DSM-III.62 The
criteria were subsequently modified, and in DSM-IV-TR,10
are patterned after those used for substance dependen-
cies and emphasize the features of tolerance and with-
drawal. PG is defined as "persistent and recurrent mal-
adaptive gambling behavior (criterion A) that disrupts
personal, family, or vocational pursuits…" Ten specific
maladaptive behaviors are listed, and 5 are required for
the diagnosis. The criteria focus on loss of control of gam-
bling behavior; progressive deterioration of the disorder;
and continuation despite negative consequences. The
diagnosis can only be made when mania is ruled out
(Criterion B). In an attempt to reconcile nomenclature
and measurement methods, Shaffer and Hall63 developed
a generic multilevel classification scheme that is now
widely accepted by gambling researchers.
PG is presently classified as a disorder of impulse con-
trol in DSM-IV-TR.10 On the one hand, some investiga-
tors have suggested that PG is related to OCD,1,64 yet
others argue against such a relationship.65 On the other
hand, PG is widely considered an addictive disorder.66,67
It has recently been proposed as a candidate for inclu-
sion in a new category for “behavioral addictions.” 15
Recent estimates of lifetime prevalence for PG range
from 1.2% to 3.4% in the general population.68,69
Prevalence rates have risen in areas where gambling
availability has increased.70.71 A national survey showed
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Dialogues in Clinical Neuroscience - Vol 12 . No. 2 . 2010
that the availability of a casino within 50 miles is associ-
ated with a nearly twofold increase in PG prevalence.59
Gambling behavior typically begins in adolescence, with
PG developing by the late 20s or early 30s,72 though it can
begin at any age through senescence. Rates of PG are
higher in men, but the gender gap may be narrowing.PG
has a later onset in women yet progresses more rapidly
(“telescoping”) than in men,73 at a rate similar to that
observed in alcohol disorders. Populations at risk include
adults with mental health or substance-use disorders, per-
sons who have been incarcerated, African-Americans,
and persons with low socioeconomic status.74,75
Research has not validated PG subtypes, but perhaps the
most widely discussed distinction is between “escape-seek-
ers” and “sensation-seekers.” 76 Escape-seekers are often
older persons who gamble out of boredom, from depres-
sion, or to fill time, and choose passive forms of gambling
such as slot machines. Sensation-seekers tend to be
younger, and prefer the excitement of card games or table
games that involve active input.76 Blaszczynski and Nower77
have proposed a “pathways” model that integrates bio-
logical, developmental, cognitive, and other determinants
of disordered gambling. They have identified three sub-
groups: a) behaviorally-conditioned gamblers; b) emo-
tionally vulnerable gamblers; and c) antisocial, impulsive
gamblers. Behaviorally conditioned gamblers have no spe-
cific predisposing psychopathology, but make bad judg-
ments regarding gambling. Emotionally vulnerable gam-
blers suffer premorbid depression or anxiety, and have a
history of poor coping. Finally, antisocial, impulsive gam-
blers are highly disturbed and have features of antisocial
personality disorder and impulsivity that suggest neurobi-
ological dysfunction.
Psychiatric comorbidity is the rule, not the exception, in
persons with PG. Both community and clinic-based stud-
ies suggest that substance use disorders, mood disorders,
and personality disorders are highly prevalent in persons
with PG.78 In clinical samples, from 25% to 63% of patho-
logical gamblers meet lifetime criteria for a substance use
disorder.79 Correspondingly, from 9% to 16% of sub-
stance abusers are probable pathological gamblers.79 PG
is also associated with increased prevalence of mood dis-
orders, and overall 13% to 78% of persons with patho-
logical gambling are estimated to experience a mood dis-
order.79 On the other hand, patients with mood disorders
have not been found to have elevated rates of PG.
Rates of other impulse-control disorders (ICDs) appear
higher in persons with pathological gambling than in the
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general population. Investigators have reported rates
ranging from 18% to 43% for one or more ICD.79 CB
appears to be the most frequent comorbid ICD in per-
sons with PG, perhaps because both disorders share
characteristics of focused attention, monetary gratifica-
tion, and monetary exchange. Subjects with one ICD
appear more likely to have another, suggesting consid-
erable overlap among them.
Personality disorders are relatively common among indi-
viduals with PG, particularly those in “cluster B.”
Antisocial personality disorder has been singled out as
having a close relationship with PG, perhaps because crime
and gambling frequently co-occur, with rates ranging from
15% to 40%.79,80 At least one study of persons with antiso-
cial personality disorder showed high rates of PG.81
PG is widely thought to be chronic and progressive.82,83
This view is embedded in DSM-IV-TR10 which holds that
the essential feature of PG is “persistent and recurrent
maladaptive gambling behavior …that disrupts personal,
family, or vocational pursuits” (p 671). These views were
influenced by the pioneering observations of Custer84
who described PG as a progressive, multistage illness
that begins with a winning phase, followed in turn by a
losing phase, and a desperation phase. The final phase,
giving up, represented feelings of hopelessness.85 Some
contend that many pathological gamblers experience a
“big win” early in their gambling careers that leads
directly to their becoming addicted. Custer’s four phases
of PG have gained wide acceptance despite the absence
of empirical data.
Recent work is leading to a reconsideration of these
views. LaPlante et al86 reviewed five studies87-91 that met
their criteria of reporting longitudinal data pertaining to
gambling that did not involve a treatment sample.
LaPlante et al report that, from the four studies that
included level 3 gamblers (ie, persons with PG), most
gamblers improved, and moved to a lower level, and that
rates of classification improvement were “at least sig-
nificantly greater than 29%.” Results were similar for
level 2 (ie, “at-risk”) gamblers. Those who were level 0
to 1 gamblers at baseline were unlikely to progress to a
higher (ie, more severe) level of gambling behavior, and
with one exception,91 the studies suggested that few level
2 gamblers improved by moving to level 1. La Plante et
al86 conclude that these studies challenge the notion that
PG is intractable, and suggest that many gamblers spon-
taneously improve, as do many substance addicted per-
sons. The findings suggest that those who do not gamble
180
or gamble without problems tend to remain problem-
free; those with disordered gambling move from one
level to another, though the general direction is toward
improved classification.
Family history data suggests that PG, mood disorders,
and substance-use disorders are more prevalent among
the relatives of persons with PG than in the general pop-
ulation.92,93 Twin studies also suggest that gambling has a
heritable component.94 Functional neuroimaging studies
suggest that among persons with PG, gambling cues elicit
gambling urges and a temporally dynamic pattern of
brain activity changes in frontal, paralimbic, and limbic
brain structures, suggesting to some extent that gambling
may represent dysfunctional frontolimbic activity.95
There is little consensus about the appropriate treatment
of PG. Few persons with PG seek treatment,96 and until
recently the treatment mainstay appeared to be partici-
pation in Gamblers Anonymous (GA), a 12-step program
patterned after Alcoholics Anonymous. Attendance at
GA is free and chapters are available throughout the US,
but follow-through is poor and success rates disappoint-
ing.97 Inpatient treatment and rehabilitation programs
similar to those for substance-use disorders have been
developed, and are helpful to some98,99 Still, these pro-
grams are unavailable to most persons with PG because
of geography or lack of access (ie, insurance/financial
resources). More recently, CBT and motivational inter-
viewing have been become established treatment meth-
ods.100 Self-exclusion programs have also gained accep-
tance and appear to benefit selected patients.101 While
rules vary, they generally involve voluntary self-exclusion
from casinos for a period of time at the risk of being
arrested for trespassing. Medication treatment studies
have gained momentum, but their results are inconsistent.
Briefly, the opioid antagonists naltrexone and nalmefene
were superior to placebo in randomized controlled trials
(RCTs)102,103 but controlled trials of paroxetine and bupro-
pion were negative.104,105 Open-label studies of nefazodone,
citalopram, carbamazepine, and escitalopram have been
encouraging, but need to be followed up with adequately
powered and controlled studies.106-109
Putative relationship between
CB/PG and OCD
The relationship between CB/PG and OCD remains
uncertain. The inclusion of CB and PG within an OC
spectrum, while intriguing, rests on hypothesis and not
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Compulsive buying and pathological gambling - Black et al
empirical data. How these disorders should be classified
has been debated for nearly 100 years. Opinion has
mainly favored their inclusion among disorders of
impulse control. For historical reasons, and because of
the lack of empirical data, we believe that the two dis-
orders should remain with the ICDs until convincing evi-
dence is presented to favor their inclusion either with
the addictive disorders or an OC spectrum.
The most obvious connection between CB and PG and
OCD is phenomenologic. Each disorder involves repet-
itive behavior that generally occurs in response to over-
whelming thoughts and urges; engaging in the behav-
ior—at least temporarily—will satisfy the urge, and/or
reduce tension and anxiety that preceded the behavior.
Nonetheless, a fundamental distinction between CB/PG
and OCD is that the behaviors (shopping, gambling) are
considered ego-syntonic; that is, they are viewed as plea-
surable and desirable, while behaviors associated with
OCD never are, and nearly all patients want to be rid of
them. Not so with shopping and gambling: the person
with CB or PG finds the behaviors highly pleasurable,
and only wants to stop the behaviors when their delete-
rious secondary consequences become overwhelming.
Proponents of the OC spectrum point to the overlap
between these disorders and OCD. Comorbidity studies
have found that in clinical samples from 3% to 35% of
individuals with CB have comorbid OCD.22,46 In fact, the
presence of CB may characterize a specific subset of
OCD patients,110,111 particularly those who hoard.
Hoarding is a special symptom that involves the acqui-
sition of and failure to discard, possessions that are of
limited use or value.112 Yet, unlike the items retained by
the typical hoarder, the items purchased by the person
with CB are not inherently valueless or useless.
CB frequently appears to be comorbid with the ICDs.
Black and Moyer80 and Grant and Kim72 each reported
elevated rates of CB among samples of pathological
gamblers (23% and 8%, respectively). Likewise, other
impulse control disorders are common among compul-
sive shoppers.39 Comorbidity studies of PG are more
mixed, although they generally report higher rates of
OCD than in the general population. The reverse does
not seem to be true. Axis II comparisons show that the
predominant disorders associated with OCD are the
“cluster C” disorders. While there are no axis II disor-
ders specifically associated with PG or CB, “cluster B”
disorders appear overrepresented, particularly antisocial
personality disorder.
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Dialogues in Clinical Neuroscience - Vol 12 . No. 2 . 2010
Direct investigations into OC characteristics of persons
with PG found that those with PG scored higher than
those without on scales measuring OC traits.64 CB and
PG also share high trait impulsivity.19,113
Other evidence could come from family studies of CB,
PG, or OCD. There are few family studies regarding
these disorders, and none have supported a familial rela-
tionship among these disorders. In the only controlled
family history study of CB, Black et al45 did not find a
relationship with OCD. In two family studies, one using
the family history method, the other using the family
interview method, the investigators were unable to
establish a connection between PG and OCD.114,115
Looking at this connection through OCD family studies
has also failed to find a connection. Neither Black et al114
nor Bienvenu et al115 were able to establish a familial
relationship between OCD and PG.
Demographic similarities are often used to suggest that
disorders might be linked, for example the fact that both
alcohol disorders and antisocial personality disorder are
predominantly found in men. Yet, there is no similarity
in gender distribution among these disorders. With PG
there is a clear male preponderance; with CB a female
preponderance; with OCD, the gender distribution is
evenly split.
If these disorders were related, their natural history and
course might be similar as well. CB and OCD appear to
have an onset in the late teens or early 20s. PG appears to
have a slightly later onset, with women developing the dis-
order much later than men, but having a briefer course
from onset of gambling to development of a disorder. This
is what is seen with alcohol disorders, but not OCD. With
CB, PG, and OCD are all considered mostly chronic, but
the similarity stops there. For CB and PG, while there are
no careful, longitudinal studies, the data suggest that the
disorders may be episodic, that is, may remit for varying
lengths of time depending on a host of external factors
such as fear of consequences, eg, bankruptcy or divorce,
or lack of income; OCD rarely remits. In terms of suicide
risk, PG has been reported to carry a risk for suicide
attempts and completed suicides; with CB, there are anec-
dotal reports of suicide attempts, but not completed sui-
cides; with OCD, the data is somewhat mixed, but over-
all, the risk of completed suicide is considered low.
Here, too, when one considers treatment response, OCD
is well known to respond well to serotonin reuptake
inhibitor antidepressants, and to cognitive behavioral
therapy. CB and PG have no clear response to medica-
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tion, and the most robust treatment data suggests that PG
may respond to opioid antagonists. Both CB and PG are
reported to respond to CBT, but the completeness and
quality of the response is unlike that seen with OCD.
The presence of similar biological markers is another way
to assess the connection between these disorders. This
task is hampered by the fact that none of these disorders
has reliable markers. Nonetheless, a functional magnetic
resonance imaging (fMRI) study of PG suggests that the
disorder shows an abnormal pattern of activation in spe-
cific subcortical-frontal regions following cue exposure.
Potenza et al86 interpret these findings as evidence for the
similarity of brain pathways in PG and drug addiction,
while the opposite direction of higher brain activation is
found in OCD. Similarly, Goodriaan et al116 review the
research on neurochemical and molecular genetic data
involving PG. They conclude that there is evidence of dis-
turbed neurotransmission involving dopamine (DA),
serotonin, and norepinephrine; and “… are in accordance
with the findings of abnormal brain activation in reward
pathways, where DA is an important transmitter” (p 134).
Dopamine is noted to play an important role in craving
and withdrawal in the substance use disorders. While the
neurotransmission involved in OCD has not been fully
elucidated, the central serotonin system has been the most
actively studied. This is perhaps due to the robust effect
of SSRIs in the treatment of OCD.
On the whole, neuropsychological studies of PG indicate
that pathological gamblers have impaired performance in
several aspects of executive function including attention,
delay discounting, and decision-making.115-117 With OCD,
neuropsychological research is less consistent; there is evi-
dence of impaired response-inhibition and in attentional
set-shifting, but little evidence of impaired reversal learn-
ing and decision-making.118 To our knowledge, there are
no neuropsychological studies of persons with CB.
Alternate classification schemes
If CB and PG are not part of an OC spectrum, where
should they be classified? Because there is almost no
evidence suggesting a relationship with the mood disor-
ders, that possibility can probably be eliminated outright.
Of the remaining schemes, the most likely candidates are
to include PG and CB with the ICDs, or to move them
to a category involving the substance-use disorders.
Keeping PG and CB with the ICDs is the easiest option:
PG is already classified as an ICD, and while CB is not
182
currently included in DSM-IV-TR, it has historically
been considered an impulsive disorder. Both PG and CB
share similar clinical features involving the presence of
irresistible, ego-syntonic urges that prompt a behavioral
response. The response (ie, gambling, shopping) satisfies
the urge and/or temporarily reduces tension or anxiety,
but is often followed by a sense of guilt or shame, and
ultimately leads to adverse, secondary consequences. The
behaviors are chronic or intermittent, and may sponta-
neously remit, sometimes in response to external cir-
cumstances. Age of onset and gender distribution differ,
as discussed earlier. Possibly, CB may be considered the
female equivalent of PG, because they tend to have a
reverse gender distribution: men predominate among
those with PG; women predominate among those with
CB. Both appear to respond to CBT, yet neither has a
clear response to medication; SSRIs do not produce con-
sistent improvement. Comorbidity studies show overlap
among the disorders, as a disproportionate number of
pathological gamblers have CB and vice versa.
On the other hand, data suggest many commonalities
with the substance use disorders. PG and CB are both
associated with cravings that are not unlike those
reported by substance abusers; PG is noted to produce
“withdrawal” symptoms when the gambler is absti-
nent,119 though this has not been studied in CB. Research
shows that persons with PG or CB often have comorbid
substance use disorders. Conversely, substance abusers
have high rates of PG; there are no comparable data for
CB. Family studies show that relatives of probands with
PG or CB have high rates of psychiatric illness, partic-
ularly alcohol and drug use disorders. Further, Slutske et
al94 have reported that, based on twin data, PG appears
to be related to the substance-use disorders and antiso-
cial personality disorder. Finally, as noted earlier, the
neuroimaging studies, and both neurotransmitters and
molecular genetic research on PG suggest a relationship
with the substance-use disorders.116 These data support
the inclusion of PG and perhaps CB in a category for
“behavioral addictions,” possibly comprising a subset of
the substance-use disorders, but they do not support a
relationship with OCD.
Conclusions
The review suggests that CB and PG are probably not can-
didates for inclusion in an OC spectrum. The review was
not meant to judge the merit of the OC spectrum concept.
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Compulsive buying and pathological gambling - Black et al
In fact, we have suggested that there appears to be suffi-
cient evidence to support the existence of a limited OC
spectrum that might include body dysmorphic disorder,
Tourette’s disorder, trichotillomania, subclinical OCD, and
perhaps the grooming disorders.8,120 While there are super-
ficial phenomenologic similarities between CB/PG and
OCD, other evidence suggests they are not associated: gen-
der distribution, age at onset, and course; comorbidity
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Dialogues in Clinical Neuroscience - Vol 12 . No. 2 . 2010
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Clinical research
El juego patológico y el comprar compulsivo:
¿corresponde incluirlos dentro del espectro
obsesivo-compulsivo?
Se ha propuesto que el comprar compulsivo (CC)
y el juego patológico (JP) se integren en el espec-
tro de los trastornos relacionados con el trastorno
obsesivo compulsivo (TOC). La hipótesis del espec-
tro se originó a comienzos de la década de 1990 y
ha conseguido bastante apoyo, a pesar de la falta
de evidencias empíricas. El interés en esta hipóte-
sis ha llegado a un punto crítico ya que algunos
investigadores han recomendado la creación de
una nueva categoría que incluya estos trastornos
en el DSM-V, que está actualmente en desarrollo.
En este artículo los autores describen el origen del
espectro obsesivo-compulsivo (OC) y sus funda-
mentos teóricos, revisan el CC y el JP, y discuten los
datos a favor y en contra de un espectro OC.
Ambos trastornos son descritos en términos de su
historia, definición, clasificación, fenomenología,
historia familiar, fisiopatología y manejo clínico.
Los autores concluyen que: 1) el CC y el JP proba-
blemente no se relacionan con el TOC y no es sufi-
ciente la evidencia para incluirlos en el espectro OC
dentro del DSM-V, 2) el JP debiera incluirse dentro
de los trastornos del control impulsivo (TCI) y 3) se
debe crear un nuevo diagnóstico del CC y clasifi-
carlo como un TCI.
46. Black DW, Monahan P, Gabel J. Fluvoxamine in the treatment of com-
pulsive buying. J Clin Psychiatry. 1997;58:159-163.
47. Black DW, Gabel J, Hansen J, et al. A double-blind comparison of flu-
voxamine versus placebo in the treatment of compulsive buying disorder.
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48. Ninan PT, McElroy SL, Kane CP, et al. Placebo-controlled study of flu-
voxamine in the treatment of patients with compulsive buying. J Clin
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sive shopping disorder: an open-label study followed by a double-blind dis-
continuation. J Clin Psychiatry 2003;64:793-798.
50. Koran, LM, Aboujaoude EN, Solvason B, Gamel N, Smith EH.
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tion study. J Clin Psychopharmacol. 2007;27:225-227. Letter.
51. Grant JE. Three cases of compulsive buying treated with naltrexone.
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52. Neuner M, Raab G, Reisch L. Compulsive buying in maturing consumer
societies: an empirical re-inquiry. J Econ Psychol. 2005;26:509-522.
53. Krueger DW. On compulsive shopping and spending: a psychodynamic
inquiry. Am J Psychother. 1988;42:574-584.
54. Lawrence, L. The psychodynamics of the compulsive female shopper.
Am J Psychoanal. 1990;50:67-70.
55. Winestine, MC. Compulsive shopping as a derivative of childhood
seduction. Psychoanal Q. 1985;54:70-72.
184
Jeu pathologique et achat compulsif :
font-ils partie du spectre des troubles
obsessionnels-compulsifs ?
Certains auteurs ont proposé d’intégrer l’achat
compulsif (AC) et le jeu pathologique (JP) dans le
spectre des troubles obsessionnels-compulsifs
(TOC), concept émergeant au début des années 90,
et qui a reçu un soutien important en dépit d’un
manque de preuves empiriques. L’intérêt pour
cette hypothèse est devenu très important en rai-
son de la recommandation de certains experts de
créer une nouvelle catégorie incluant ces troubles
dans le DSM-5 actuellement en rédaction. Dans cet
article, les auteurs décrivent l’origine des troubles
obsessionnels-compulsifs (TOC) et de leurs bases
théoriques, analysent le JP et l’AC et examinent les
arguments pour et contre leur appartenance au
spectre des TOC. Les deux pathologies sont décrites
en termes d’historique, de définition, de classifica-
tion, de phénoménologie, d’antécédents familiaux,
de physiopathologie et de prise en charge clinique.
Les auteurs concluent que : (i) le JP et l’AC ne sont
probablement pas liés aux TOC et que les preuves
sont insuffisantes pour les placer dans le cadre OC
du DSM-V ; (ii) le JP devrait rester au sein des
troubles du contrôle de l’impulsion (TCI) ; et (iii)
une nouvelle définition de l’AC devrait être créée
pour le classer également dans les TCI.
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 NEUROETHICS OF NEUROMARKETING

While&consumer&neuroscience&and&neuromarketing&has&many&proponents,&others&are&also&
concerned&that&the&use&of&neuroscience&in&business&will&allow&unprecedented&access&to&
consumers’&minds,&opening&the&floodgates&to&pure&manipulation&of&consumers.

As&always,&there&are&two&sides&of&a&coin.&Neuromarketing&both&has&its&promises&and&uses,&but&
also&its&perils&and&problems.&To&get&to&a&valid&use&of&neuroscience&in&marketing&and&consumer&
insights,&we&need&to&face&these&challenges&and&accommodate&the&practices&accordingly.&While&
academic&researchers&are&(or&should&be)&well&versed&in&ethics&codes&of&conduct,&this&is&often&not&
the&case&for&commercial&uses&of&neuroscience.&

But&as&with&most&technologies,&it&is&not&the&technology&but&the&use&of&it&that&can&challenge&
ethical&uses.&Two&initial&reservations&can&be&stated&for&the&direct&link&between&unethical&
conduct&and&neuromarketing:&

1) Companies&are&very&aware&of&ethical&issues,&and&the&aspect&of&Corporate&Social&
Responsibility&is&an&important&aspect&that&makes&many&companies&put&strong&
demands&on&the&actual&conduct&of&neuromarketing&or&any&other&marketing&study
2) Neuromarketing,&despite&it’s&many&advantages,&does&not&in&any&way&provide&a&direct&
link&to&customers’&“buy&button”.&While&it&is&an&important&leg&to&stand&on&for&customer&
insights,&in&no&way&does&it&make&customers&like&purchasing&zombies.
Journal of Consumer Behaviour
J. Consumer Behav. 7: 293–302 (2008)
Published online in Wiley InterScience
(www.interscience.wiley.com) DOI: 10.1002/cb.252

Neuroethics of neuromarketing
Emily R. Murphy 1,2y, Judy Illes 1z and Peter B. Reiner 1*
1
National Core for Neuroethics, University of British Columbia, Vancouver, BC, Canada
2
Center for Law and the Biosciences, Stanford Law School, Stanford, CA, USA

! Neuromarketing is upon us. Companies are springing up to offer their clients brain-based
information about consumer preferences, purporting to bypass focus groups and other
marketing research techniques on the premise that directly peering into a consumer’s
brain while viewing products or brands is a much better predictor of consumer behavior.
These technologies raise a range of ethical issues, which fall into two major categories:
(1) protection of various parties who may be harmed or exploited by the research,
marketing, and deployment of neuromarketing and (2) protection of consumer auto-
nomy if neuromarketing reaches a critical level of effectiveness. The former is straightfor-
ward. The latter may or may not be problematic depending upon whether the technology
can be considered to so effectively manipulate consumer behavior such that consumers
are not able to be aware of the subversion. We call this phenomenon stealth neuromar-
keting. Academics and companies using neuromarketing techniques should adopt a code
of ethics, which we propose here, to ensure beneficent and non-harmful use of the
technology in consideration of both categories of ethics concerns.
Copyright # 2008 John Wiley & Sons, Ltd.

Introduction Nation called it ‘‘the most alarming invention

In 1957, the marketing executive James Vicary
announced that he had increased sales of food
and drink at a movie theater by secretly
flashing subliminal messages with the words
‘‘Drink Coca Cola’’ and ‘‘Eat Popcorn’’. The
study was never published and may have even
been a hoax (Karremans et al., 2006), but the
episode illustrates the public’s strong reaction
to covert manipulation. An article in The
*Correspondence to: Peter B. Reiner, Professor, National
Core for Neuroethics, University of British Columbia,
2211 Wesbrook Mall, S121 Vancouver, BC V6T 2B5,
Canada.
E-mail: peter.reiner@ubc.ca
y
Fellow
z
Canada Research Chair in Neuroethics and Professor of
Neurology
since Mr. Gatling invented his gun’’ and The
New Yorker stated that ‘‘minds had been
entered and broken’’ (Moore, 1982). With
growing public understanding that the brain is
the mediator of behavior, the public’s reaction
to neuromarketing intrusions into their brains
may prove to be equally vigorous.
The term ‘‘neuromarketing’’ identifies a new
field of research championed by both aca-
demics and self-labeled companies using
advances in neuroscience that permit power-
ful insights into the human brain’s responses to
marketing stimuli (Renvoisé and Morin, 2007;
Senior et al., 2007). The goals of neuromarket-
ing studies are to obtain objective information
about the inner workings of the brains of
consumers without resorting to the subjective

Copyright # 2008 John Wiley & Sons, Ltd. Journal of Consumer Behaviour, July–October 2008
DOI: 10.1002/cb
294
reports that have long been the mainstay of
marketing studies. Thus, neuromarketing pur-
ports to provide qualitatively different infor-
mation, ostensibly superior to that obtained by
traditional means, about the economically
valuable topic of consumer preferences.
There is, of course, nothing inherently
problematic about the use of scientific tech-
nology to advance commercial interests (Eaton
and Illes, 2007). But the use of technology that
probes the inner workings of the human
brain, especially beyond what one might
divulge in traditional behavioral testing,
raises substantial ethical issues. These concerns
fall into two major categories: (1) protection of
various parties who may be harmed or
exploited by neuromarketing and (2) protection
of consumer autonomy. The public outcry
in response to Vicary’s subliminal imagery
reflects a clear ethical boundary – the autonomy
violation produced intrinsic discomfort with
consumers having their preferences manipu-
lated when they did not and could not know as
much. A similar boundary can be drawn for
contemporary marketing, particularly when
informed by information gleaned from novel
neurotechnologies. Neuroethics, in proactively
dealing with ethical issues unique to knowledge
about and manipulation of the human brain, is
well-positioned to offer guidance for beneficent
and non-harmful deployment of neuromarket-
ing techniques.
We will first briefly review the state of the art
and state of the market in neuromarketing.
The second section tackles current ethical
issues in neuromarketing, which apply irre-
spective of the technological capabilities. We
focus our discussion on potential harms
to research subjects, exploitation of vulner-
able niche populations, and the integrity of
business relationships, public trust, and con-
sumer confidence. The third section will
thoroughly explore the most substantial neu-
roethical concern associated with neuromar-
keting: the incursion on autonomy made by
neuromarketing if it achieves a level of
effectiveness that amounts to consumer coer-
cion. We conclude with pragmatic recommen-
dations: an ethical code to be adopted by the
Copyright # 2008 John Wiley & Sons, Ltd.
Emily R. Murphy et al.
neuromarketing industry to prevent harms and
preserve business integrity and consumer
trust.
The market for neuromarketing
Although the electroencephalography (EEG)
has been in use for the study of marketing
preferences for over 35 years (Krugman,
1971), there is little doubt that we have
entered a new age of neuromarketing in which
advanced technology is being used in unpre-
cedented ways to probe consumer prefer-
ences. A raft of peer-reviewed papers and
books have appeared in recent years in which
positron emission tomography (PET), func-
tional magnetic resonance imaging (fMRI) and
quantitative EEG analyses have been used to
assess consumer behavior (Smith et al., 2002;
Dickhaut et al., 2003; McClure et al., 2004;
Mast and Zaltman, 2005; Ahlert et al., 2006;
Knutson et al., 2007; Koenigs and Tranel,
2008; Plassmann et al., 2007; Renvoisé and
Morin, 2007; Schaefer and Rotte, 2007a, b). It
has already been anticipated that other
neuroimaging technologies such as magne-
toencephalography and cortical manipulation
with transcranial magnetic stimulation, as well
as combinations of modalities will be adopted
by ‘‘market researchers who wish to deploy a
specialized neuromarketing profile’’ (Senior
et al., 2007). We refer the reader interested in
details of each technology to the recent
overview by Senior et al. (2007) as well as
other papers in this Special Issue; different
neuroimaging techniques have strengths and
weaknesses in temporal and spatial resolution.
The choice of modality by neuromarketers will
no doubt be informed by a priori hypotheses
and pilot research about relevant brain areas
and activation patterns useful for predicting
actual consumer behavior.
The convergence of increased power in the
form of technology and advances in our
understanding of cognitive function has
emboldened some to make sweeping con-
clusions about the power of neuromarketing.
Indeed, at least ten commercial enterprises
have been established with the explicit
Journal of Consumer Behaviour, July–October 2008
DOI: 10.1002/cb
Neuroethics of neuromarketing
objective of using these advanced technologies
to provide neuromarketing (Emsense, FKF
Applied Research, Lucid Systems, Neurofocus,
Neuroco, Neurosense Limited, OTOInsights,
Sales Brain, Sands Research, and Thought
Sciences) and at least one US patent has been
issued on the topic (Zaltman and Kosslyn,
2000). Neuromarketing studies have garnered
a great deal of attention from the public, with
extensive coverage in both the mainstream
press (Kelly, 2002; Roston, 2004; Greene,
2007; Haq, 2007; Park, 2007; Saletan, 2007;
Baker, 2008; Brainard, 2008) and internet
weblogs (Dooley, 2007). One study has even
cautioned against a ‘‘neurorealism’’ created by
press coverage of novel technologies and their
real or potential applications in society (Racine
et al., 2005).
Protection of vulnerable parties
in research, selling, and
representation of neuromarketing
We first consider a set of issues that merit
ethical analysis irrespective of whether the
most speculative claims of neuromarketing
hold up to rigorous scientific analysis. Ethical
development of neuromarketing requires
protection of the research subjects, respon-
sible business-to-business advertising, and
accurate representation of the state of the
art of the technology to the public. Each of
these duties can be ensconced in an industry-
wide code of ethics that we propose be
adopted by all researchers and vendors of
neuromarketing and enforced by a discerning
marketplace of neuromarketing consumers
doing business with companies voluntarily
adhering to the code of ethics. Not only would
adoption of a code of ethics be justified on
moral grounds, but it would also serve to
insulate this young and dynamic industry from
accusations of irresponsible behavior.
Human subjects’ protection
It is well established that federally funded
scientists working in academic, government,
Copyright # 2008 John Wiley & Sons, Ltd. Journal of Consumer Behaviour, July–October 2008
295
and commercial settings have both ethical and
legal responsibilities to obtain informed con-
sent and protect the privacy of research
subjects whose brain function is probed with
imaging technologies, as per the Common Rule
(DHHS, 1991). The legal framework for such
privacy protection in the United States is
covered under PRIVACY RULE of the Department
of Health and Human Services (DHHS, 2005);
while this applies in some instances, it is
notable that such protections are apparently
absent when the subject is participating in a
study being carried out for marketing purposes
(Tovino, 2005). Thus standards for protecting
the privacy of individuals participating in
neuromarketing studies in the United States
are at the very least considerably comprom-
ised. In academic and medical research
centers, subjects volunteering to participate
in neuroimaging-based studies are protected
by Institutional Review Board guidelines,
which can include strict experimental guide-
lines because most imaging technologies
are considered to be FDA-regulated medical
devices (FDA, 1998). However, when moved
into commercialized and private enterprise,
such subject protections may not be present,
and the particularly loose restrictions sur-
rounding studies for marketing purposes are
especially worrying. Moreover, if new tech-
nologies are developed that fall outside the
purview of regulatory authorities, even these
protections may be lost. A key initiative for
neuroethics in neuromarketing is to develop
published codes of subject protections equal
to those required by academic and medical
research centers. fMRI, the most prevalent of
the neuromarketing imaging modalities, is
arguably a low-risk technology; nonetheless,
risks of various sorts are inherent in all brain-
imaging research and all subjects regardless of
the purpose of the study are deserving of
adequate protection and appropriate informed
consent procedures.
Even thornier than the issue of subject
protection is the notion that advanced tech-
nology in the neurosciences, in particular
fMRI, might allow invasion of the inner
sanctum of private thought. It bears repeating
DOI: 10.1002/cb
296
that such a breach is not possible today and
may or may not be technically achieved in the
future. Nonetheless, a vigorous discussion has
emerged regarding this possibility (Kulynych,
2002; Illes and Racine, 2005; Tovino, 2005;
Greely, 2006; Alpert, 2007; Appelbaum, 2007;
Illes, 2007; Tovino, 2007) and it is certainly
worth considering how society might manage
such information if it became technically
feasible.
Preventing exploitation of niche
populations
Special ethics review should be a minimum
standard for neuromarketing research that
either involves or targets vulnerable popu-
lations. Among the individuals that would fall
under this umbrella are persons (or family
members of persons) with neurological disease
or psychological disorders, children, and other
members of legally protected groups (Civil
Right Act (2008) 42 U.S.C.A. xx 2000e et seq.;
Coenen, 2007). While such ‘‘segmentation’’
and ‘‘target marketing’’ is standard business
practice in the marketing industry, there is a
fine line between target marketing and exploi-
tation (Sims, 1997). Our neuroethical concern is
about potential harms to vulnerable persons
as: (1) subjects in unregulated neuromarketing
research (introduced above), (2) targeted
populations who may be especially sensitive
to trumped-up claims of product effectiveness
based on information derived from advanced
neuroscience technologies, and (3) people
particularly exposed to ‘‘stealth neuromarket-
ing’’ techniques that such research and devel-
opment may produce (see below). Fortunately,
the prevention of such harms to vulnerable
persons aligns with profit motive, for as Sims
(1997) points out, when targeting a particular
market ‘‘maligns those it tries to serve,’’ it
undercuts its own business interests.
Responsible business-to-business
advertising and public representation
It is perhaps not surprising that neuromarketing
oversells its wares – an occupational hazard of
Copyright # 2008 John Wiley & Sons, Ltd. Journal of Consumer Behaviour, July–October 2008
Emily R. Murphy et al.
sorts. Independent critics have openly and quite
rightly condemned neuromarketing efforts that
overstate the benefits of the approach. The
editors of the high-impact journal Nature
Neuroscience succinctly reviewed the dangers
of over interpretation of neuromarketing results,
noting that the traditional skeptical approach of
scientific inquiry is being displaced by a wave of
media hype which suggests that fMRI ‘‘is on the
verge of creating advertising campaigns that we
will be unable to resist’’ (Editorial, 2004). In this
sense, neuromarketing represents just one
example of a more general problem in neuroi-
maging research – the question of the degree to
which results which are certainly fascinating
and worthy of continued attention can be used
to derive bona fide insights about the working
of the human brain (Illes and Racine, 2005), and,
with particular relevance to the claims of
neuromarketing, the accurate prediction of
human behavior. Business consumers of neuro-
marketing may find their advertising dollars
misspent if the technology does not live up to its
claims and pass the real-world test of accurate
prediction of actual consumer behavior. How-
ever, we are not overly concerned here with
business-to-business relationships; harms there
are primarily the potential for financial loss,
but are not inherently unethical (though they
may not meet industry standards of ‘‘truth-in-
advertising’’) (Frazier, 2007). However, poten-
tial for actual harm exists if such ‘‘neurohype’’
around the perceived capabilities of neuromar-
keting create fear, anxiety, or mistrust in the
general public.
Scientists working in the field of neurobiol-
ogy recognize the considerable challenge
involved in the translation of the brain’s
extraordinary connectivity – the human brain
is arguably the most complex biological organ
in the known universe, with tens of billions of
cells, each of which make thousands of
connections with other cells (Purves et al.,
2008) – into the complex repertoire of
behavior exhibited by humans. At the same
time, the general public finds color-coded
images of brains in action accompanied by
neuroscientific explanations to be particularly
persuasive (Dumit, 2003; McCabe and Castel,
DOI: 10.1002/cb
Neuroethics of neuromarketing
2007; Weisberg et al., 2008). This tension leads
to a situation where highly sophisticated
scientists, subject to both public adulation
and profit motive, are tempted to provide
simplistic answers to what in reality are highly
nuanced questions.
The neuromarketing field has already seen
egregious abuse of such information. In an op-
ed piece in the New York Times, a group of
academics and neuromarketers presented a
small body of unpublished data on the
results of an fMRI study of political preferences
of so-called ‘swing voters’ (Iacaboni et al.,
2007). The results were presented essentially
as de facto probes into the minds of their
subjects in one of the most widely read
newspapers in the world; for several days
after its publication, the article topped the
rankings of those most frequently emailed by
readers of the online version of the New York
Times. Given widespread concerns about
over-interpretation of fMRI data (Illes et al.,
2006b), it was notable that the op-ed piece
contained none of the qualifications that
would normally accompany a scholarly article
in a peer-reviewed journal. Academic col-
leagues responded with considerable outrage
in letters to the editor (Aron et al., 2007) and
most visibly in a scathing editorial in Nature
(Editorial, 2007). Incidents such as this draw
attention to the absence of a code of ethics for
responsible media – if not academic –
representation in the field of neuromarketing.
Such misrepresentation can do considerable
damage to the public trust of science and may
even generalize in public perception to create
anxieties about the perceived motivations of
neuroscientists conducting human neuroima-
ging research. In the current climate of
tightening public funds for basic research,
any such anxiety threatens the future of the
field, with potential harms to public health.
Academic and private sectors of neuroscience
research need to maintain close partnerships
and work together to promote public trust and
investment in neuroscience research. That
trust can be earned with forthright communi-
cation and full disclosure of risks, benefits, and
limitations of research findings.
Copyright # 2008 John Wiley & Sons, Ltd. Journal of Consumer Behaviour, July–October 2008
297
Stealth neuromarketing
In our view, the most vexing of the issues
raised by neuromarketing is in the realm of
autonomy. One could argue that the essential
objective of marketing as a discipline is to
manipulate consumer behavior – effectively, a
‘‘soft’’ attack on autonomy. Moreover, many of
the traditional tools of marketing such as focus
groups and polls rely upon nuanced interpret-
ations of human psychology to draw con-
clusions about consumer behavior and then
use that information to inform marketing
decisions. The implicit question in the present
discussion is whether the new tools of
neuromarketing will provide sufficient insight
into human neural function to allow manip-
ulation of the brain such that the consumer
cannot detect the subterfuge and that such
manipulations result in the desired behavior in
at least some exposed persons. Such stealth
neuromarketing is not possible with current
technology, but if developed would represent
a major incursion on individual autonomy. In
this analysis, we deliberately consider a set of
issues that will only arise with developments in
technology that are yet to be realized and may
never come to fruition. Nonetheless, it is in the
best interest of all parties involved in the
discussion that these issues are considered
today rather than at some unspecified time-
point in the future, possibly in response to an
adverse event. To appreciate how stealth
neuromarketing may come to pass, we present
a short discourse on phenomena in which
decision-making and motivation occur without
explicit conscious awareness.
It is well established that cognition is not a
monolithic process but rather one with various
submodalities carrying out a variety of func-
tions, some of which have been reasonably
well delineated. Of relevance to the present
discussion are two well-studied phenomena in
cognitive neuroscience. The first is blindsight
(Weiskrantz, 1990), in which individuals with
damage to portions of their visual cortex
declare themselves unable to see objects
placed in the damaged portion of their visual
field, but when asked to guess are easily able to
DOI: 10.1002/cb
298
identify the object. These experiments unequi-
vocally demonstrate that there is a distinction
between perception and conscious awareness.
The second phenomenon is implicit learning
(Reber, 1993), in which normal subjects are
presented with seemingly random strings of
letters and asked to memorize them. Unknown
to the individuals is the fact that there is a set of
rules being employed, but their attention is
directed towards memorization in the first part
of the experiment. Later they are asked to
describe the rules, and after protesting that
they did not know there were any rules, they
are asked to guess. Remarkably, subjects
correctly identify the rules over 70% of the
time. A recent brief report in Science (Aarts
et al., 2008) takes these phenomena one step
further and demonstrates how subliminal
priming effects can actually motivate and
mobilize people to respond more quickly
and spend extra effort on a simple motor task.
The simple but elegant study provides evi-
dence for the ‘‘human capacity to rely on
mental processes in preparing and motivating
behavior outside of awareness’’ (Aarts et al.,
2008). As the authors note, such responses are
of considerable utility insofar as they prepare
individuals to react quickly as circumstances
necessitate; at the same time, subliminal
priming represents an additional step towards
realization of stealth neuromarketing.
If it is possible to carry out highly sophisti-
cated cognitive tasks such as visual perception
or understanding grammatical rules, as well as
to enhance motivation and mobilization of
voluntary action without the relevant neural
computation arising to the level of perceptual
awareness, then it follows that at some point in
the future insights from advanced technology in
the neurosciences might allow corporations,
governments and others to influence decisions
and actions regarding brand preference without
the individual being aware of the subterfuge.
We would propose such an eventuality as the
sensible point at which the erosion of personal
autonomy becomes so substantial that one
might consider regulatory control, voluntary or
otherwise, to protect the citizenry from
unwanted intrusions on individual agency.
Copyright # 2008 John Wiley & Sons, Ltd.
Emily R. Murphy et al.
Recommendations
We conclude with a preliminary version of a
code of ethics that we recommend be adopted
by the neuromarketing industry. The over-
arching goal of this code of ethics is to promote
research and development, entrepreneurship,
and profitable enterprise alongside beneficent
and non-harmful use of neuroimaging techno-
logy at all stages of development, deployment,
and dissemination. These codes should be
discussed within the neuromarketing com-
munity with the advice of independent aca-
demic researchers working in the area of
neural correlates of decision-making, social
behavior, and consumer preferences, as well as
neuroethicists and professionals in marketing
industry ethics. Proactive development of such
guidelines within the professional community
will provide credibility and garner greater
acceptance than those that may be imposed
upon the field by regulatory bodies, especially
if they arise in response to adverse events (Illes
et al., 2003). Timeliness in this effort is critical
given the rapid pace of advancements in the
field.
! Protection of research subjects. Policies for
responsibly managing clinical findings,
including provision of sufficient subject pro-
tections, procedures for informed consent,
and explicit protocols for dealing with inci-
dental findings (Illes et al., 2006a) are a
requirement for any entity involved in brain
research. Furthermore, private companies
offering financial incentives for participation
in research studies significantly greater than
those offered in academic settings should be
cautious of undue influence of such incen-
tives, which may cross over into indirect
coercion. While most technologies used
by neuromarketing may be considered mini-
mal risk, subjects should be advised and
reminded of their right to withdraw from
any study for any reason, including minor
discomfort.
! Protection of vulnerable niche populations
from marketing exploitation. Policies for
research subjects’ protection should include
Journal of Consumer Behaviour, July–October 2008
DOI: 10.1002/cb
Neuroethics of neuromarketing
additional ethics review for research done on
protected or potentially vulnerable subject
populations. In addition, neuromarketing-
influenced advertising targeted at specific
protected consumer groups should aim to
beneficently serve the special needs of the
population without marginalizing, malign-
ing, or otherwise causing harm, whether
psychosocial or financial in nature.
! Full disclosure of goals, risks, and benefits.
Disclosure can be achieved through the
publication of ethics principles that have
been adopted to protect the privacy and
autonomy of human subjects and consu-
mers. Publication infers all aspects of the
process from consent documents to report-
ing and advertising and applies to both writ-
ten and verbal communication.
! Accurate media and marketing representa-
tion. Neuromarketing companies bear the
burden of accurately representing their
wares in media and business-to-business
marketing materials. At a minimum, this
standard encompasses full disclosure of
scientific methods and measures of validity
in mass media formats such as invited
opinions, editorials, and news reports.
Adherence to a code of responsible com-
munication and truth-in-advertising will help
maintain a positive and trusting public per-
ception of brain science research as well as
promote development of effective technol-
ogies.
! Internal and external validity. Eaton and
Illes (2007) have outlined the challenges in
initial and sustained product validity in the
commercialization of any neurotechnology.
We extend their recommendations here
to any marketing product influenced by
neuromarketing research with particular
attention to the point that the validity ques-
tions ‘‘arise most acutely for neurotechnol-
ogy that can be deployed without a
regulatory gatekeeper, such as the FDA’’
(Eaton and Illes, 2007). At a minimum,
internal validity checks should ensure a suf-
ficiently comprehensive research database
to provide meaningful and effective results
to neuromarketing consumers. External and
Copyright # 2008 John Wiley & Sons, Ltd. Journal of Consumer Behaviour, July–October 2008
299
sustained validity will require neuromark-
eters to align their product with changing
technologies and expanding neuroscience
knowledge. Maintenance of safety and effi-
cacy verification in any research, develop-
ment, and deployment of neuromarketing is
absolutely required.
These recommendations form the basis for
immediate and short-term action in the neuro-
marketing community and longer-term empiri-
cal research. Multidisciplinary collaboration
will enable efficient and positive progress
along this continuum.
In the 50 years since Vicary’s subliminal
imagery marketing stunt, interest in the possib-
ility that neuroscience might be used in the
service of a marketing agenda has remained
robust, with the current resurgence of interest
and proliferation of companies in the new
neuromarketing being noteworthy. It should
be emphasized that there is no evidence that at
the present time that any advanced neurotech-
nology permits the types of insights and sub-
sequent manipulation that Vicary envisaged
(Illes and Racine, 2005; Illes, 2007). However,
the fact that one must insert qualifiers such as
‘‘at the present time’’ provides ample reason to
carefully consider the implications that such a
development might have and the means by
which it might be sensibly managed. In the
meantime, there are a host of ethical issues in
the research, marketing, and deployment of
neuromarketing on the table right now. Such
proactive conduct is at the heart of the neu-
roethical agenda.
Acknowledgements
This study was supported by grants from the
Canadian Institutes of Health Research (Insti-
tute for Neuroscience, Mental Health and
Addiction and the Ethics Office of CIHR), the
Canadian Foundation for Innovation, the
British Columbia Knowledge Development
Fund, the Dana Foundation, the Greenwall
Foundation, and the MacArthur Foundation-
funded Law and Neuroscience Project.
DOI: 10.1002/cb
300
Biographical notes
Emily R. Murphy is a research fellow at the
Stanford Law School Center for Law and
the Biosciences, a research fellow on the
MacArthur Foundation-funded Law and Neuro-
science Project, and a visiting fellow at the
National Core for Neuroethics, UBC. Dr Mur-
phy received her Ph.D. in behavioral neuro-
science from the University of Cambridge,
where her work focused on neural and neuro-
chemical correlates of behavioral inhibition
and behavioral flexibility. Her current research
interests are at the intersection of law and
neuroscience, particularly in the areas of neu-
roimaging as evidence, and the neuroscience
of decision-making and drug addiction.
Judy Illes is the Director of the National Core
for Neuroethics at UBC and a pioneer in the
field with deep interests in ethical, social, and
policy challenges at the intersection of the
neurosciences and biomedical ethics. Dr Illes
has written numerous books, edited volumes
and articles. Her latest book, Neuroethics:
Defining the Issues in Theory, Practice and
Policy, was published by Oxford University
Press in 2006. Dr Illes is a member of the
Internal Advisory Board for the Institute of
Neurosciences, Mental Health and Addiction
(INMHA) of the Canadian Institutes of Health
Research (CIHR), the Institute of Medicine,
Forum on Neuroscience on Neurological
Disorders, the Dana Alliance for Brain Initiat-
ives, and co-Chair of the Committee on Women
in Neuroscience for the Society for Neuro-
science.
Peter B. Reiner is a Professor in the National
Core for Neuroethics at the University of Brit-
ish Columbia. Following a distinguished career
as a research scientist studying the neurobiol-
ogy of behavioral states and the molecular
underpinnings of neurodegenerative disease,
Dr Reiner became President & CEO of Active
Pass Pharmaceuticals, a drug discovery com-
pany that he founded to tackle the scourge of
Alzheimer’s disease. Upon returning to aca-
demic life, Dr Reiner refocused his scholarly
work in the area of neuroethics, focusing upon
the ethical issues associated with commercia-
Copyright # 2008 John Wiley & Sons, Ltd. Journal of Consumer Behaviour, July–October 2008
Emily R. Murphy et al.
lization of neuroscience, with a particular
interest in the emerging debate over cognitive
enhancers.
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Author Manuscript
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Published in final edited form as:
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J Cogn Neurosci. 2008 March ; 20(3): 470–477. doi:10.1162/jocn.2008.20040.

The Seductive Allure of Neuroscience Explanations

Deena Skolnick Weisberg, Frank C. Keil, Joshua Goodstein, Elizabeth Rawson, and Jeremy
R. Gray
Yale University

Abstract
Explanations of psychological phenomena seem to generate more public interest when they contain
neuroscientific information. Even irrelevant neuroscience information in an explanation of a
psychological phenomenon may interfere with people’s abilities to critically consider the underlying
logic of this explanation. We tested this hypothesis by giving naïve adults, students in a neuroscience
course, and neuroscience experts brief descriptions of psychological phenomena followed by one of
four types of explanation, according to a 2 (good explanation vs. bad explanation) × 2 (without
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neuroscience vs. with neuroscience) design. Crucially, the neuroscience information was irrelevant
to the logic of the explanation, as confirmed by the expert subjects. Subjects in all three groups judged
good explanations as more satisfying than bad ones. But subjects in the two nonexpert groups
additionally judged that explanations with logically irrelevant neuroscience information were more
satisfying than explanations without. The neuroscience information had a particularly striking effect
on nonexperts’ judgments of bad explanations, masking otherwise salient problems in these
explanations.

INTRODUCTION
Although it is hardly mysterious that members of the public should find psychological research
fascinating, this fascination seems particularly acute for findings that were obtained using a
neuropsychological measure. Indeed, one can hardly open a newspaper’s science section
without seeing a report on a neuroscience discovery or on a new application of neuroscience
findings to economics, politics, or law. Research on nonneural cognitive psychology does not
seem to pique the public’s interest in the same way, even though the two fields are concerned
with similar questions.
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The current study investigates one possible reason why members of the public find cognitive
neuroscience so particularly alluring. To do so, we rely on one of the functions of neuroscience
information in the field of psychology: providing explanations. Because articles in both the
popular press and scientific journals often focus on how neuroscientific findings can help to
explain human behavior, people’s fascination with cognitive neuroscience can be redescribed
as people’s fascination with explanations involving a neuropsychological component.

However, previous research has shown that people have difficulty reasoning about
explanations (for reviews, see Keil, 2006; Lombrozo, 2006). For instance, people can be
swayed by teleological explanations when these are not warranted, as in cases where a
nonteleological process, such as natural selection or erosion, is actually implicated (Lombrozo
& Carey, 2006; Kelemen, 1999). People also tend to rate longer explanations as more similar

© 2008 Massachusetts Institute of Technology

Reprint requests should be sent to Deena Skolnick Weisberg, Department of Psychology, Yale University, P. O. Box 208205, New Haven,
CT 06520-8205, or via e-mail: deena.weisberg@yale.edu.
 Weisberg et al. Page 2

to experts’ explanations (Kikas, 2003), fail to recognize circularity (Rips, 2002), and are quite
unaware of the limits of their own abilities to explain a variety of phenomena (Rozenblit &
Keil, 2002). In general, people often believe explanations because they find them intuitively
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satisfying, not because they are accurate (Trout, 2002).

In line with this body of research, we propose that people often find neuroscience information
alluring because it interferes with their abilities to judge the quality of the psychological
explanations that contain this information. The presence of neuroscience information may be
seen as a strong marker of a good explanation, regardless of the actual status of that information
within the explanation. That is, something about seeing neuroscience information may
encourage people to believe they have received a scientific explanation when they have not.
People may therefore uncritically accept any explanation containing neuroscience information,
even in cases when the neuroscience information is irrelevant to the logic of the explanation.

To test this hypothesis, we examined people’s judgments of explanations that either do or do

not contain neuroscience information, but that otherwise do not differ in content or logic. All
three studies reported here used a 2 (explanation type: good vs. bad) × 2 (neuroscience: without
vs. with) design. This allowed us to see both people’s baseline abilities to distinguish good
psychological explanations from bad psychological explanations as well as any influence of
neuroscience information on this ability. If logically irrelevant neuroscience information
affects people’s judgments of explanations, this would suggest that people’s fascination with
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neuropsychological explanations may stem from an inability or unwillingness to critically

consider the role that neuroscience information plays in these explanations.

EXPERIMENT 1
Methods
Subjects—There were 81 participants in the study (42 women, 37 men, 2 unreported; mean
age = 20.1 years, SD = 4.2 years, range = 18–48 years, based on 71 reported ages). We randomly
assigned 40 subjects to the Without Neuroscience condition and 41 to the With Neuroscience
condition. Subjects thus saw explanations that either always did or always did not contain
neuroscience information. We used this between-subjects design to prevent subjects from
directly comparing explanations that did and did not contain neuroscience, providing a stronger
test of our hypothesis.

Materials—We wrote descriptions of 18 psychological phenomena (e.g., mutual exclusivity,

attentional blink) that were meant to be accessible to a reader untrained in psychology or
neuroscience. For each of these items, we created two types of explanations, good and bad,
neither of which contained neuroscience. The good explanations in most cases were the genuine
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explanations that the researchers gave for each phenomenon. The bad explanations were
circular restatements of the phenomenon, hence, not explanatory (see Table 1 for a sample
item).

For the With Neuroscience conditions, we added neuroscience information to the good and
bad explanations from the Without Neuroscience conditions. The added neuroscience
information had three important features: (1) It always specified that the area of activation seen
in the study was an area already known to be involved in tasks of this type, circumventing the
interpretation that the neuroscience information added value to the explanation by localizing
the phenomenon. (2) It was always identical or nearly identical in the good explanation and
the bad explanation for a given phenomenon. Any general effect of neuroscience information
on judgment should thus be seen equally for good explanations and bad explanations.
Additionally, any differences that may occur between the good explanation and bad
explanation conditions would be highly unlikely to be due to any details of the neuroscience

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information itself. (3) Most importantly, in no case did the neuroscience information alter the
underlying logic of the explanation itself. This allowed us to test the effect of neuroscience
information on the task of evaluating explanations, independent of any value added by such
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information.1 Before the study began, three experienced cognitive neuroscientists confirmed
that the neuroscience information did not add value to the explanations.

Procedure—Subjects were told that they would be rating explanations of scientific

phenomena, that the studies they would read about were considered solid, replicable research,
and that the explanations they would read were not necessarily the real explanations for the
phenomena. For each of the 18 stimuli, subjects read a one-paragraph description of the
phenomenon followed by an explanation of that phenomenon. They rated how satisfying they
found the explanation on a 7-point scale from −3 (very unsatisfying) to +3 (very satisfying)
with 0 as the neutral midpoint.

Results and Discussion

Preliminary analyses revealed no differences in performance based on sex or level of education,
so ratings were collapsed across these variables for the analyses. Additionally, subjects tended
to respond similarly to all 18 items (Cronbach’s α = .79); the set of items had acceptable
psychometric reliability as a measure of the construct of interest.

Our primary goal in this study was to discover what effect, if any, the addition of neuroscience
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information would have on subjects’ ratings of how satisfying they found good and bad
explanations. We analyzed the ratings using a 2 (good explanation vs. bad explanation) × 2
(without neuroscience vs. with neuroscience) repeated measures analysis of variance
(ANOVA; see Figure 1).

There was a significant main effect of explanation type [F(1, 79) = 144.8, p < .01], showing
that good explanations (M = 0.88, SE = 0.10) are rated as significantly more satisfying than
bad explanations (M = −0.28, SE = 0.12). That is, subjects were accurate in their assessments
of explanations in general, finding good explanations to be better than bad ones.

There was also a significant main effect of neuroscience [F(1, 79) = 6.5, p < .05]. Explanations
with neuroscience information (M = 0.53, SE = 0.13) were rated as significantly more satisfying
than explanations that did not include neuroscience information (M = 0.06, SE = 0.13). Adding
irrelevant neuroscience information thus somehow impairs people’s baseline ability to make
judgments about explanations.

We also found a significant interaction between explanation type and neuroscience information
[F(1, 79) = 18.8, p < .01]. Post hoc tests revealed that although the ratings for good explanations
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were not different without neuroscience (M = 0.86, SE = 0.11) than with neuroscience (M =
0.90, SE = 0.16), ratings for bad explanations were significantly lower for explanations without
neuroscience (M = −0.73, SE = 0.14) than explanations with neuroscience (M = 0.16, SE =
0.16). Note that this difference is not due to a ceiling effect; ratings of good explanations are
still significantly below the top of the scale [t(80) = −21.38, p < .01]. This interaction indicates
that it is not the mere presence of verbiage about neuroscience that encourages people to think
more favorably of an explanation. Rather, neuroscience information seems to have the specific

1Because we constructed the stimuli in the With neuroscience conditions by modifying the explanations from the Without Neuroscience
conditions, both the good and the bad explanations in the With Neuroscience conditions appear less elegant and less parsimonious than
their without-neuroscience counterparts, as can be seen in Table 1. But this design provides an especially stringent test of our hypothesis:
We expect that explanations with neuroscience will be judged as more satisfying than explanations without, despite cosmetic and logical
flaws.

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effect of making bad explanations look significantly more satisfying than they would without
neuroscience.
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This puzzling differential effect of neuroscience information on the bad explanations may occur
because participants gave the explanations a more generous interpretation than we had
expected. Our instructions encouraged participants to think of the explanations as being
provided by knowledgeable researchers, so they may have considered the explanations less
critically than we would have liked. If participants were using somewhat relaxed standards of
judgment, then a group of subjects that is specifically trained to be more critical of judging
explanations should not fall prey to the effect of added neuroscience information, or at least
not as much.

Experiment 2 addresses this issue by testing a group of subjects trained to be critical in their
judgments: students in an intermediate-level cognitive neuroscience class. These students were
receiving instruction on the basic logic of cognitive neuroscience experiments and on the types
of information that are relevant to drawing conclusions from neuroscience studies. We
predicted that this instruction, together with their classroom experience of carefully analyzing
neuroscience experiments, would eliminate or dampen the impact of the extraneous
neuroscience information.

EXPERIMENT 2
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Methods
Subjects and Procedure—Twenty-two students (10 women; mean age = 20.7 years, SD
= 2.6 years, range = 18–31 years) were recruited from an introductory cognitive neuroscience
class and received no compensation for their participation. They were informed that although
participation was required for the course, the results of the experiment would have no impact
on their class performance and would not be known by their professor until after their grades
had been posted. They were additionally allowed to choose whether their data could be used
in the published research study, and all students elected to have their data included.

Subjects were tested both at the beginning of the semester and at the end of the semester, prior
to the final exam.

The stimuli and task were identical to Experiment 1, with one exception: Both main variables
of explanation type and presence of neuroscience were within-subject due to the small number
of participants.

Results and Discussion

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Preliminary analyses showed no differences in performance based on class year, so this variable
is not considered in the main analyses. There was one significant interaction with sex that is
discussed shortly. Responses to the items were again acceptably consistent (Cronbach’s α = .
74).

As with the novices in Experiment 1, we tested whether the addition of neuroscience

information affects judgments of good and bad explanations. For the students in this study, we
additionally tested the effect of training on evaluations of neuroscience explanations. We thus
analyzed the students’ ratings of explanatory satisfaction using a 2 (good explanation vs. bad
explanation) × 2 (without neuroscience vs. with neuroscience) × 2 (preclass test vs. postclass
test) repeated measures ANOVA (see Figure 2).

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We found a significant main effect of explanation type [F(1, 21) = 50.9, p < .01], confirming
that the students judged good explanations (M = 0.37, SE = 0.14) to be more satisfying than
bad explanations (M = −0.43, SE = 0.19).
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Although Experiment 1 found a strong effect of the presence of neuroscience information in

explanations, we had hypothesized that students in a neuroscience course, who were learning
to be critical consumers of neuroscience information, would not show this effect. However,
the data failed to confirm this hypothesis; there was a significant main effect of neuroscience
[F(1, 21) = 47.1, p < .01]. Students, like novices, judged that explanations with neuroscience
information (M = 0.43, SE = 0.17) were more satisfying than those without neuroscience
information (M = −0.49, SE = 0.16).

There was additionally an interaction effect between explanation type and presence of
neuroscience [F(1, 21) = 8.7, p < .01], as in Experiment 1. Post hoc analyses indicate that this
interaction happens for the same reason as in Experiment 1: Ratings of bad explanations
increased reliably more with the addition of neuroscience than did good explanations. Unlike
the novices, the students judged that both good explanations and bad explanations were
significantly more satisfying when they contained neuroscience, but the bad explanations were
judged to have improved more dramatically, based on a comparison of the differences in ratings
between explanations with and without neuroscience [t(21) = 2.98, p < .01]. Specialized
training thus did not discourage the students from judging that irrelevant neuroscience
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information somehow contributed positively to both types of explanation.

Additionally, our analyses found no main effect of time, showing that classroom training did
not affect the students’ performance. Ratings before taking the class and after completing the
class were not significantly different [F(1, 21) = 0.13, p > .10], and there were no interactions
between time and explanation type [F(1, 21) = 0.75, p > .10] or between time and presence of
neuroscience [F(1, 21) = 0.0, p > .10], and there was no three-way interaction among these
variables [F(1, 21) = 0.31, p > .10]. The only difference between the preclass data and the
postclass data was a significant interaction between sex and neuroscience information in the
pre-class data [F(1, 20) = 8.5, p < .01], such that the difference between women’s preclass
satisfaction ratings for the Without Neuroscience and the With Neuroscience conditions was
significantly larger than this difference in the men’s ratings. This effect did not hold in the
postclass test, however. These analyses strongly indicate that whatever training subjects
received in the neuroscience class did not affect their performance in the task.

These two studies indicate that logically irrelevant neuroscience information has a reliably
positive impact on both novices’ and students’ ratings of explanations, particularly bad
explanations, that contain this information. One concern with this conclusion is our assumption
that the added neuroscience information really was irrelevant to the explanation. Although we
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had checked our items with cognitive neuroscientists beforehand, it is still possible that subjects
interpreted some aspect of the neuroscience information as logically relevant or content-rich,
which would justify their giving higher ratings to the items with neuroscience information.
The subjects’ differential performance with good and bad explanations speaks against this
interpretation, but perhaps something about the neuroscience information genuinely did
improve the bad explanations.

Experiment 3 thus tests experts in neuroscience, who would presumably be able to tell if adding
neuroscience information should indeed make these explanations more satisfying. Are experts
immune to the effects of neuroscience information because their expertise makes them more
accurate judges? Or are experts also somewhat seduced by the allure of neuroscience
information?

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EXPERIMENT 3
Methods
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Subjects and Procedure—Forty-eight neuroscience experts participated in the study (29

women, 19 men; mean age = 27.5 years, SD = 5.3 years, range = 21–45 years). There were 28
subjects in the Without Neuroscience condition and 20 subjects in the With Neuroscience
condition.

We defined our expert population as individuals who are about to pursue, are currently
pursuing, or have completed advanced degrees in cognitive neuroscience, cognitive
psychology, or strongly related fields. Our participant group contained 6 participants who had
completed college, 29 who were currently in graduate school, and 13 who had completed
graduate school.

The materials and procedure in this experiment were identical to Experiment 1, with the
addition of four demographic questions in order to confirm the expertise of our subjects. We
asked whether they had ever participated in a neuroscience study, designed a neuroscience
study, designed a psychological study that did not necessarily include a neuroscience
component, and studied neuroscience formally as part of a course or lab group. The average
score on these four items was 2.9 (SD = 0.9), indicating a high level of expertise among our
participants.
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Results and Discussion

Preliminary analyses revealed no differences in performance based on sex or level of education,
so all subsequent analyses do not consider these variables. We additionally found acceptably
consistent responding to the 18 items (Cronbach’s α = .71).

We analyzed subjects’ ratings of explanatory satisfaction in a 2 (good explanation vs. bad

explanation) × 2 (without neuroscience vs. with neuroscience) repeated measures ANOVA
(see Figure 3).

We found a main effect of explanation type [F(1, 46) = 54.9, p < .01]. Just like the novices and
students, the experts rated good explanations (M = 0.19, SE = 0.11) as significantly more
satisfying than bad ones (M = 0.99, SE = 0.14).

Unlike the data from the other two groups, the experts’ data showed no main effect of
neuroscience, indicating that subjects rated explanations in the same way regardless of the
presence of neuroscience information [F(1, 46) = 1.3, p > .10].
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This lack of a main effect must be interpreted in light of a significant interaction between
explanation type and presence of neuroscience [F(1, 46) = 8.9, p < .01]. Post hoc analyses
reveal that this interaction is due to a differential effect of neuroscience on the good
explanations: Good explanations with neuroscience (M = −0.22, SE = 0.21) were rated as
significantly less satisfying than good explanations without neuroscience [M = 0.41, SE = 0.13;
F(1, 46) = 8.5, p < .01]. There was no change in ratings for the bad explanations (without
neuroscience M = −1.07, SE = 0.19; with neuroscience M = −0.87, SE = 0.21). This indicates
that experts are so attuned to proper uses of neuroscience that they recognized the insufficiency
of the neuroscience information in the With Neuroscience condition. This recognition likely
led to the drop in satisfaction ratings for the good explanations, whereas bad explanations could
not possibly have been improved by what the experts knew to be an improper application of
neuroscience information. Informal post hoc questioning of several participants in this study
indicated that they were indeed sensitive to the awkwardness and irrelevance of the
neuroscience information in the explanations.

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These results from expert subjects confirm that the neuroscience information in the With
Neuroscience conditions should not be seen as adding value to the explanations. The results
from the two nonexpert groups are thus due to these subjects’ misinterpretations of the
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neuroscience information, not the information itself.

GENERAL DISCUSSION
Summary of Results
The three experiments reported here explored the impact of adding scientific-sounding but
empirically and conceptually uninformative neuroscience information to both good and bad
psychological explanations. Three groups of subjects (novices, neuroscience class students,
and neuroscience experts) read brief descriptions of psychological phenomena followed by a
good or bad explanation that did or did not contain logically irrelevant neuroscience
information. Although real neuropsychological data certainly can provide insight into behavior
and into psychological mechanisms, we specifically wanted to investigate the possible effects
of the presence of neuroscience information, regardless of the role that this information plays
in an explanation. The neuroscience information in the With Neuroscience condition thus did
not affect the logic or content of the psychological explanations, allowing us to see whether
the mere mention of a neural process can affect subjects’ judgments of explanations.

We analyzed subjects’ ratings of how satisfying they found the explanations in the four
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conditions. We found that subjects in all groups could tell the difference between good
explanations and bad explanations, regardless of the presence of neuroscience. Reasoning
about these types of explanations thus does not seem to be difficult in general because even
the participants in our novice group showed a robust ability to differentiate between good and
bad explanations.

Our most important finding concerns the effect that explanatorily irrelevant neuroscience
information has on subject’s judgments of the explanations. For novices and students, the
addition of such neuroscience information encouraged them to judge the explanations more
favorably, particularly the bad explanations. That is, extraneous neuroscience information
makes explanations look more satisfying than they actually are, or at least more satisfying than
they otherwise would be judged to be. The students in the cognitive neuroscience class showed
no benefit of training, demonstrating that only a semester’s worth of instruction is not enough
to dispel the effect of neuroscience information on judgments of explanations. Many people
thus systematically misunderstand the role that neuroscience should and should not play in
psychological explanations, revealing that logically irrelevant neuroscience information can
be seductive—it can have much more of an impact on participants’ judgments than it ought to.
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However, the impact of superfluous neuroscience information is not unlimited. Although

novices and students rated bad explanations as more satisfying when they contained
neuroscience information, experts did not. In fact, subjects in the expert group tended to rate
good explanations with neuroscience information as worse than good explanations without
neuroscience, indicating their understanding that the added neuroscience information was
inappropriate for the phenomenon being described. There is thus some noticeable benefit of
extended and specific training on the judgment of explanations.

Why are Nonexperts Fooled?

Nonexperts judge explanations with neuroscience information as more satisfying than
explanations without neuroscience, especially bad explanations. One might be tempted to
conclude from these results that neuroscience information in explanations is a powerful clue
to the goodness of explanations; nonexperts who see neuroscience information automatically

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judge explanations containing it more favorably. This conclusion suggests that these two
groups of subjects fell prey to a reasoning heuristic (e.g., Shafir, Smith, & Osherson, 1990;
Tversky & Kahneman, 1974, 1981). A plausible heuristic might state that explanations
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involving more technical language are better, perhaps because they look more “scientific.” The
presence of such a heuristic would predict that subjects should judge all explanations containing
neuroscience information as more satisfying than all explanations without neuroscience,
because neuroscience is itself a cue to the goodness of an explanation.

However, this was not the case in our data. Both novices and students showed a differential
impact of neuroscience information on their judgments such that the ratings for bad
explanations increased much more markedly than ratings for good explanations with the
addition of neuroscience information. This interaction effect suggests that an across-the-board
reasoning heuristic is probably not responsible for the nonexpert subjects’ judgments.

We see a closer affinity between our work and the so-called seductive details effect (Harp &
Mayer, 1998; Garner, Alexander, Gillingham, Kulikowich, & Brown, 1991; Garner,
Gillingham, & White, 1989). Seductive details, related but logically irrelevant details presented
as part of an argument, tend to make it more difficult for subjects to encode and later recall the
main argument of a text. Subjects’ attention is diverted from important generalizations in the
text toward these interesting but irrelevant details, such that they perform worse on a memory
test and have a harder time extracting the most important points in the text.
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Despite the strength of this seductive details effect in this previous work and in our current
work, it is not immediately clear why nonexpert participants in our study judged that seductive
details, in the form of neuroscience information, made the explanations we presented more
satisfying. Future investigations into this effect could answer this question by including
qualitative measures to determine precisely how subjects view the differences among the
explanations. In the absence of such data, we can question whether something about
neuroscience information in particular did the work of fooling our subjects. We suspect not—
other kinds of information besides neuroscience could have similar effects. We focused the
current experiments on neuroscience because it provides a particularly fertile testing ground,
due to its current stature both in psychological research and in the popular press. However, we
believe that our results are not necessarily limited to neuroscience or even to psychology.
Rather, people may be responding to some more general property of the neuroscience
information that encouraged them to find the explanations in the With Neuroscience condition
more satisfying.

To speculate about the nature of this property, people seeking explanations may be biased to
look for a simple reductionist structure. That is, people often hear explanations of “higher-
level” or macroscopic phenomena that appeal to “lower-level” or microscopic phenomena.
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Because the neuroscience explanations in the current study shared this general format of
reducing psychological phenomena to their lower-level neuroscientific counterparts,
participants may have jumped to the conclusion that the neuroscience information provided
them with a physical explanation for a behavioral phenomenon. The mere mention of a lower
level of analysis may have made the bad behavioral explanations seem connected to a larger
explanatory system, and hence more insightful. If this is the case, other types of logically
irrelevant information that tap into a general reductionist framework could encourage people
to judge a wide variety of poor explanations as satisfying.

There are certainly other possible mechanisms by which neuroscience information may affect
judgments of explanations. For instance, neuroscience may illustrate a connection between the
mind and the brain that people implicitly believe not to exist, or not to exist in such a strong
way (see Bloom, 2004a). Additionally, neuroscience is associated with powerful visual

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 Weisberg et al. Page 9

imagery, which may merely attract attention to neuroscience studies but which is also known
to interfere with subjects’ abilities to explain the workings of physical systems (Hayes, Huleatt,
& Keil, in preparation) and to render scientific claims more convincing (McCabe & Castel, in
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press). Indeed, it is possible that “pictures of blobs on brains seduce one into thinking that we
can now directly observe psychological processes” (Henson, 2005, p. 228). However, the
mechanism by which irrelevant neuroscience information affects judgment may also be far
simpler: Any meaningless terminology, not necessarily scientific jargon, can change behavior.
Previous studies have found that providing subjects with “placebic” information (e.g., “May I
use the Xerox machine; I have to make copies?”) increases compliance with a request over and
above a condition in which the researcher simply makes the request (e.g., “May I use the Xerox
machine?”) (Langer, Blank, & Chanowitz, 1978).

These characteristics of neuroscience information may singly or jointly explain why subjects
judged explanations containing neuroscience information as generally more satisfying than
those that did not. But the most important point about the current study is not that neuroscience
information itself causes subjects to lose their grip on their normally well-functioning judgment
processes. Rather, neuroscience information happens to represent the intersection of a variety
of properties that can conspire together to impair judgment. Future research should aim to tease
apart which properties are most important in this impairment, and indeed, we are planning to
follow up on the current study by examining comparable effects in other special sciences. We
predict that any of these properties alone would be sufficient for our effect, but that they are
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more powerful in combination, hence especially powerful for the case of neuroscience, which
represents the intersection of all four.

Regardless of the breadth of our effect or the mechanism by which it occurs, the mere fact that
irrelevant information can interfere with people’s judgments of explanations has implications
for how neuroscience information in particular, and scientific information in general, is viewed
and used outside of the laboratory. Neuroscience research has the potential to change our views
of personal responsibility, legal regulation, education, and even the nature of the self (Farah,
2005; Bloom, 2004b). To take a recent example, some legal scholars have suggested that
neuroimaging technology could be used in jury selection, to ensure that jurors are free of bias,
or in questioning suspects, to ensure that they are not lying (Rosen, 2007). Given the results
reported here, such evidence presented in a courtroom, a classroom, or a political debate,
regardless of the scientific status or relevance of this evidence, could strongly sway opinion,
beyond what the evidence can support (see Feigenson, 2006). We have shown that people seem
all too ready to accept explanations that allude to neuroscience, even if they are not accurate
reflections of the scientific data, and even if they would otherwise be seen as far less satisfying.
Because it is unlikely that the popularity of neuroscience findings in the public sphere will
wane any time soon, we see in the current results more reasons for caution when applying
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neuroscientific findings to social issues. Even if expert practitioners can easily distinguish good
neuroscience explanations from bad, they must not assume that those outside the discipline
will be as discriminating.

Acknowledgments
We thank Paul Bloom, Martha Farah, Michael Weisberg, two anonymous reviewers, and all the members of the
Cognition and Development Lab for their conversations about this work. Special thanks is also due to Marvin Chun,
Marcia Johnson, Christy Marshuetz, Carol Raye, and all the members of their labs for their assistance with our
neuroscience items. We acknowledge support from NIH Grant R-37-HD023922 to F. C. K.

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Farah MJ. Neuroethics: The practical and the philosophical. Trends in Cognitive Sciences 2005;9:34–
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Hayes BK, Huleatt LA, Keil F. Mechanisms underlying the illusion of explanatory depth. (in preparation)
Henson R. What can functional neuroimaging tell the experimental psychologist? Quarterly Journal of
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McCabe DP, Castel AD. Seeing is believing: The effect of brain images as judgments of scientific
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Rosen J. The brain on the stand. The New York Times Magazine 2007 March 11;:49.
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Trout JD. Scientific explanation and the sense of understanding. Philosophy of Science 2002;69:212–
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Tversky A, Kahneman D. Judgment under uncertainty: Heuristics and biases. Science 1974;185:1124–
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 Weisberg et al. Page 11
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Figure 1.
Novice group. Mean ratings of how satisfying subjects found the explanations. Error bars
indicate standard error of the mean.
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 Weisberg et al. Page 12
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Figure 2.
Student group. Mean ratings of how satisfying subjects found the explanations. Error bars
indicate standard error of the mean.
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 Weisberg et al. Page 13
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Figure 3.
Expert group. Mean ratings of how satisfying subjects found the explanations. Error bars
indicate standard error of the mean.
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 Weisberg et al. Page 14

Table 1
Sample Item

Good Explanation Bad Explanation

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Without Neuroscience The researchers claim that this “curse” happens
because subjects have trouble switching their
point of view to consider what someone else
might know, mistakenly projecting their own
knowledge onto others.
With Neuroscience Brain scans indicate that this “curse” happens
because of the frontal lobe brain circuitry
known to be involved in self-knowledge.
Subjects have trouble switching their point of
view to consider what someone else might
know, mistakenly projecting their own
knowledge onto others.
The researchers claim that this “curse” happens
because subjects make more mistakes when
they have to judge the knowledge of others.
People are much better at judging what they
themselves know.
Brain scans indicate that this “curse” happens
because of the frontal lobe brain circuitry
known to be involved in self-knowledge.
Subjects make more mistakes when they have
to judge the knowledge of others. People are
much better at judging what they themselves
know.

Researchers created a list of facts that about 50% of people knew. Subjects in this experiment read the list of facts and had to say which ones they knew.
They then had to judge what percentage of other people would know those facts. Researchers found that the subjects responded differently about other
people’s knowledge of a fact when the subjects themselves knew that fact. If the subjects did know a fact, they said that an inaccurately large percentage
of others would know it, too. For example, if a subject already knew that Hartford was the capital of Connecticut, that subject might say that 80% of people
would know this, even though the correct answer is 50%. The researchers call this finding “the curse of knowledge.”

The neuroscience information is highlighted here, but subjects did not see such marking.
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FALL 2008 VOLUME 42, NUMBER 3 389

R. MARK WILSON, JEANNIE GAINES, AND RONALD PAUL HILL

Neuromarketing and Consumer Free Will
This article examines the impact of discoveries and methods of neuro-
science on marketing practices as they relate to the exercise of individ-
ual free will. Thus, our focus centers on ethical questions involving
consumers’ awareness, consent, and understanding to what may be
viewed as invasion of their privacy rights. After a brief introduction,
the article turns to scientific literature on the brain, followed by discus-
sion of marketing persuasion models. Ethical dilemmas within the free
will paradigm and Rawlsian justice developed in moral philosophy are
delineated next. The article closes with policy implications and a revised
consideration of consumer privacy.

Marketers seek to influence the intricate processes of evaluation and

selection by consumers, sometimes reverting to tactics and technologies
that redirect decision makers without their explicit permission. Examples
include product placements in videogames, movies, and television pro-
grams (see LeGresley, Muggli, and Hurt 2006). Others make use of inter-
personal influences in the marketplace (McGrath and Otnes 1995;
Pechmann et al. 2005). For example, marketing professionals may pay
females to order specific liquors in bars or have neighbors praise particular
brands of condiments or sneakers at parties (Heilbrunn 2005).
Relevant issues for our discussion are whether and to what extent mar-
keters are willing to engage in activities that lack transparency. Few aca-
demic studies have tackled this difficult subject, providing only anecdotal
evidence that the practice is more widespread than one might suspect. To
address this deficit, Zinkhan, Bisessi, and Saxton (1989) asked a sample of
MBA students about their willingness to deceive in a number of marketing
contexts and found a broad readiness to do so in order to ensure cooperation
by consumers. While the generalizability of their findings is limited, such
behaviors suggest that some marketers seek to limit our understanding of
their true intentions (Jeurissen and van de Ven 2006).

R. Mark Wilson is dean of the College of Business Administration at Niagara University, Niagara,
NY (mwilson@niagara.edu). Jeannie Gaines is an associate professor of management at the University
of South Florida St Petersburg, St Petersburg, FL (drjeanniegaines@yahoo.com). Ronald Paul Hill is
the Robert J. and Barbara Naclerio Chairholder in Business and senior associate dean of Intellectual
Strategy at the Villanova School of Business, Philadelphia, PA (ronald.hill@villanova.edu).

The Journal of Consumer Affairs, Vol. 42, No. 3, 2008

ISSN 0022-0078
Copyright 2008 by The American Council on Consumer Interests
390 THE JOURNAL OF CONSUMER AFFAIRS

For better or for worse, opportunities to influence consumers without

their full awareness may increase significantly as a result of research on
brain activity. Almost twenty years ago, consumer scholars recommended
using brain wave measures to study the impact of promotions on buyer
behavior (see Young 2002). This perspective was controversial, especially
given limitations and difficulties interpreting data from electroencephalo-
grams (Stewart 1984, 1985). However, over this period, the disciplines of
neuroscience and cognitive psychology advanced and joined forces to pro-
vide an entirely new paradigm for understanding ways consumers develop,
store, retrieve, and use information (Gordon 2002). Neuroscience method-
ologies, especially noninvasive neuroimaging technology, now enable
researchers to probe brain activity at the basic neural level of functioning
(Shiv et al. 2005).
The use of data obtained from brain imaging poses ethical dilemmas for
marketers. Potential moral issues emerging from neuroscience applications
include awareness, consent, and understanding of individual consumers.
The next section explores scientific literature on the brain, followed by a dis-
cussion of neuromarketing within models of marketing persuasion. The
article then describes ethical dilemmas involving the free will paradigm
argued historically in moral philosophy along with Rawlsian justice. Antic-
ipating our results, we find that the new technology may spawn difficult
ethical situations, and we offer policy implications for the future, with
the intent of incorporating advantages of neuroscience within the bound-
aries of ethical marketing.

NEUROMARKETING AND NEUROIMAGING

The term ‘‘neuromarketing’’ (NM) is a recently invented moniker. The

Economist (2004) credits Jerry Zaltman with initially proposing a union of
brain-imaging technology with marketing in the late 1990s, and when the
Atlanta marketing firm, BrightHouse, opened a neuromarketing division in
2001, the synthesis of neuroscience and marketing began to attract attention
in science, business, and journalism. Neuromarketing has been described as
‘‘applying the methods of the neurology lab to the questions of the adver-
tising world’’ (Thompson 2003, 53). Recently, the International Journal of
Psychophysiology called neuromarketing ‘‘the application of neuroscien-
tific methods to analyze and understand human behavior in relation to mar-
kets and marketing exchanges’’ (Lee, Broderick, and Chamberlain 2007,
200). Indeed, improvements in neuroimaging technologies have and will
continue to advance our knowledge of how people make decisions and
how marketers can influence those decisions.
FALL 2008 VOLUME 42, NUMBER 3 391

The use of one noninvasive neuroimaging technology, functional mag-

netic resonance imaging (fMRI), has experienced especially rapid growth.
fMRI enables researchers to isolate systems of neurons associated with
functions of the brain. For example, when a person looks at a print adver-
tisement, light activates some of the 125 million visual neural receptors,
rods and cones, in each eye. Nerve signals travel to the midbrain, which
focuses the pupils and coordinates eye movement over the advertisement.
Other signals from the rods and cones pass through the optic nerve fibers,
some of which cross-over to the other side of the brain so that the left half of
the advertisement is perceived in the right hemisphere of the brain and the
right half in the left hemisphere (Carey 2005; Dubuc 2007).
The information is processed for shape, color, and spatial location as the
signals pass through the lateral geniculate nuclei on their way to assembly
in the visual cortices located at the back of the brain. Memories triggered by
an advertisement are stored throughout the cerebral cortex and recalled
through the hippocampus located deep in each brain hemisphere; the stored
emotional memories and valences are processed by the amygdala, another
nerve bundle located near the base of each hemisphere (Carey 2005
Dalgleish 2004; Davidson 2003; Dubuc 2007; Kandel, Schwartz, and
Jessell 2000). Using fMRI, researchers are able to image the neural activity
associated with vision as well as with the cognitive and affective responses
to print advertisements.
Isolating neural systems formed by the one hundred billion neurons in
the human brain is a complex task. fMRI is able to locate active systems by
comparing images taken of a brain performing a specific function to those
of the brain when not performing that function. In an active neural system,
signals travel from one neuron to another by transmitting chemical com-
pounds, called neurotransmitters, across synapses to receptors on the
receiving cell. Neurotransmitters attaching to the receptors can either facil-
itate or inhibit a process that will result in the firing of electrical impulses
that stimulates release of neurotransmitters into synapses to the receptors of
the next cell (Carey 2005; Kandel, Schwartz, and Jessell 2000). Synaptic
activity of the activated network of neurons causes blood to flow to the
region (Logothetis 2003; Raichle and Mintun 2006). The additional blood
brings more oxygen and hydrogen to the area than is needed to replenish the
system of neurons, which increases the magnetic field during a scan by
a small but detectable amount (Gore 2003; Matthews and Jezzard 2004).
Improvements in hardware and software technologies continue to
increase the spatial and temporal resolutions of the images, that is, the clar-
ity of each image and the accuracy of tracking changes in brain activity over
time based on these small changes in magnetic field. Current magnetic
392 THE JOURNAL OF CONSUMER AFFAIRS

resonance imaging machines generate a 1.5-T strong magnetic force

(30,000 times the force of gravity). The protons in the nuclei of hydrogen
atoms in the brain, primarily located in the blood, align their axes with this
strong magnetic force. A radio wave pulse of appropriate frequency is
applied at an angle to the aligned axes causing the oscillating protons to
absorb energy and tip their axes away from alignment with the strong force.
When the pulse ends, the particles release the absorbed energy as they
return to alignment with the magnetic force. This released energy is the
measured magnetic resonance signal. The information in these signals is
then converted via computer software into an image of a slice of the brain.
The resulting image is different from a photograph or an X-ray; it is a rep-
resentation of contrasts among different tissues based on the density of the
hydrogen protons and the nature of the tissue containing the protons (Detre
and Wang 2002; Gore 2003; Heuttel, Song, and McCarthy 2004; Kandel,
Schwartz, and Jessell 2000; Patz 2007).
During an fMRI experiment, researchers scan the individual’s brain while
it is not performing the function of interest, referred to as a resting brain
(Raichle and Mintun 2006). Then, they perform an experiment designed
to activate specific brain functions of interest while researchers quickly scan,
often repeatedly, to capture changes in the signal during activity. Research-
ers adjust data for a myriad of factors, including the time delay between the
neuronal activity and the arrival of the blood supply to the area, head move-
ments, heartbeats, and breathing. Like a fingerprint, each brain is unique, so
in studies involving more than one person, researchers ‘‘warp’’ each partic-
ipant’s brain images onto a template so that brain locations can be compared
across individuals. A software program tests whether specific localities in
the brain are activated during the experiment. The program colors the image
of a resting brain in the locations of significant increases in blood flow,
highlighting relevant networks of neurons (Brown and Semelka 1999; Gore
2003; Heuttel and McCarthy 2000; Heuttel, Song, and McCarthy 2004).

Neuroimaging and Persuasion

Researchers have applied fMRI techniques and technology to investigate

the nature of decision making and persuasion. For example, Knutson et al.
(2005) found the neural activity associated with calculation of expected
value. They measured the brain activities of participants who were provided
an informational cue about the probability and magnitude of gain or loss at
the beginning of an experiment. The task was to push a button within a time
limit that varied with the probability of receiving the reward. After learning
the cues and the rules of this reward system, subjects entered the MRI
FALL 2008 VOLUME 42, NUMBER 3 393

machine and performed 288 trials. The authors found that activation of the
subcortical nucleus accumbens in the forebrain is related to magnitude of
payoff but not probability of gain, while activation of the mesial prefrontal
cortex is correlated with magnitude and probability of gain. These findings
demonstrate that such evaluations involve both affective and cognitive neu-
ral systems.
The neuroscience literature on expected value is expanding (Breiter et al.
2001; Elliot et al. 2003), as is the larger neuroscience literature on decision
making (Braeutigam 2005; Glimcher 2003; Knutson et al. 2007; Sanfey et al.
2006; Shiv et al. 2005; Zak 2004). Camerer, Lowenstein, and Prelec (2005)
describe the roles of affective and cognitive processes, acting either together
or separately, during decision making. The mind tags almost every concept
and object with a valence that is automatically brought to mind when pro-
voked by an appropriate symbol. Even if consumers are made aware of the
affective response, it is very difficult for them to override the affective influ-
ence with cognitive reasoning. The authors speculate that cognitive pro-
cesses may not be able to finalize a decision without a ‘‘go/no go’’
message from an affective function of the brain. Conclusions of these studies
about the importance of affect in decision making parallel those of psychol-
ogy and marketing (Johar, Maheswaran, and Peracchio 2006; Zajonc 1998).
Three recent articles (Braeutigam 2005; Fugate 2007; Lee, Broderick,
and Chamberlain 2007) and a review of the neuroscience/marketing liter-
ature suggest that synergy between these two disciplines produced new
insights into the impact of affect or emotion on the memory of visual stimuli
(Ambler and Burne 1999; Ambler, Ioannides, and Rose 2000; Erk, Martin,
and Walter 2005; Erk et al. 2003); antecedents of trust behavior (Ioannides
et al. 2000; Fehr, Fischbacher, and Kosfeld 2005; Kosfeld et al. 2005;
Zak et al. 2005); factors influencing brand selection and brand equity
(Ambler et al. 2004; Braeutigam et al. 2001, 2004; du Plessis 2005;
Plassmann et al. 2007); viewing time for images to enter memory (Rossiter
et al. 2001; Silberstein et al. 2000); reward centers in the brain (Berns et al.
2001; Erk et al. 2002; Senior 2003); differences between evaluation of per-
sonalities and products (Yoon et al. 2006); and ‘‘branding moments’’ in
advertisements (Young 2002). A highly publicized Coke/Pepsi fMRI study
by researchers at Emory University found a significant effect of brand knowl-
edge on brain response and expressed preference (McClure et al. 2004).
In addition to scholarly research, a number of university neuroscience
programs, including those at Emory, Cal Tech, and UCLA are teaming up
with private consulting firms to do applied research for large organizations
such as Viacom, Kimberly-Clark, and Daimler-Chrysler (Tiltman 2005).
More than 90 private neuromarketing consulting firms currently operate
394 THE JOURNAL OF CONSUMER AFFAIRS

in the United States as well as in an increasing number of other countries

(Reid 2006). The media has sensationalized many of these investigations,
alleging that marketers found the ‘‘buy button in your brain’’ (Dias 2006)
and that the population is about to be ‘‘brain scammed’’ (Brain Scam?
2004). As a result, use of neuroscience in marketing has both advocates
and critics. Advocates (Erk, Martin, and Walter 2005; Singer 2004;
Thompson 2005) propose that the combination will allow consumers
and marketers to better understand what products are desired—a win/
win for both parties. Critics (Herman 2005; Huang 1998; Lovel 2003;
Thompson 2003) warn that consumers’ ability to make logical, informed
decisions about purchases will be compromised. Whether an advocate or
a critic, many believe that neuroimaging methods will bring significant
changes to marketing persuasion. Just as forty years ago when a single
computer filled an entire room and its users hoped the reader would
not chew up the punch cards, today’s MRI machines are large, expensive,
and noisy, but it is easy to envision them, and other neuroimaging tech-
nologies developing rapidly into powerful, portable machines.
Similarly, at this point in time, conclusions drawn from the correlations
between brain functions and blood flow should be viewed with caution.
Their interpretation requires connecting a cognitive or affective response
to neural activity, and then neural activity to a significant blood response to
a region of the brain. Although neuroscientists have made significant
advances in connecting neural activity to blood response, much remains
to be learned about the relationship between a task-related thought or emo-
tion and neuronal activity (Heuttel, Song and McCarthy 2004, Raichle and
Mintun 2006). Nevertheless, it seems likely the new technologies will
enable neuroscience and marketing researchers to better understand the role
of emotions in decision making, to develop more effective methods of trig-
gering those emotions, to build greater trust and brand loyalty, to measure
intensity of an individual’s likes and dislikes, and, in general, to be more
persuasive marketers. The models of marketing persuasion in the next sec-
tion provide a framework for thinking about the changes that advanced neu-
roimaging technologies may bring.

CONSUMER PERSUASION MODELS

Traditional Consumer Persuasion Model

The Traditional Consumer Persuasion Model (Figure 1) exemplifies the

way marketers have typically created more effective promotions. During
the screening phase, a group of relevant individuals is presented with a
FALL 2008 VOLUME 42, NUMBER 3 395

FIGURE 1
Traditional Consumer Persuasion Model
SCREENING PHASE INTERVENTION PHASE OUTCOMES

ATTITUDES INDIVIDUAL
TOWARD CONSEQUENCES
PROMOTION
COGNITIVE NEURAL & PRODUCT
PROCESSES
PERSUASION REACTION OF REFINED
ATTEMPT TEST GROUP PERSUASION PURCHASE BEHAVIOR
WITH TEST GROUP SURVEYS ATTEMPT
INTERVIEWS
AFFECTIVE NEURAL
PROCESSES BEHAVIORAL
INTENTIONS
TO BUY
SOCIETAL
CONSEQUENCES

marketing stimulus, and feedback on its effectiveness is collected so that

a general persuasion attempt can be refined. Intervention occurs when
potential consumers are targeted with the resulting promotion, their cog-
nitive and affective processes are activated, and attitudes and behavioral
intentions are formed. The outcome phase is when a purchase occurs
(or does not occur) and includes the ensuing consequences to both the indi-
vidual and the larger society that can be described as positive or negative.
For example, the consumer may experience satisfaction, or even delight,
with the purchase or may regret the purchase and the possible financial
burden. Potential societal impacts include a boost to the overall economy
or a drain if the consumer cannot pay for the item in a timely fashion. If
a purchase is not made, the individual may experience regret or relief and
the economy is perhaps impacted negatively in a marginal way. This model
is generally accepted as an appropriate method to pursue customers and
increase sales. The screening group is aware and has consented to providing
feedback on various marketing stimuli. Additionally, most consumers and
societal members accept this process as standard practice that does not seek
to invade the private thinking and feeling of targeted consumers.

Revealed Preferences Consumer Persuasion Model

A more invasive strategy currently used by many retailers provides a sec-

ond model of persuasion development based on consumer data collected at
the individual level (Figure 2). For example, Tesco, Britain’s largest
retailer and private employer, uses a loyalty card program to record the
purchasing behavior in Tesco stores of approximately 12 million UK cus-
tomers and many more worldwide through Internet sales. Consumers will-
ingly disclose personal information required for the Clubcard because
396 THE JOURNAL OF CONSUMER AFFAIRS

FIGURE 2
Revealed Preferences Consumer Persuasion Model
SCREENING PHASE INTERVENTION PHASE OUTCOMES

ATTITUDES INDIVIDUAL
TOWARD CONSEQUENCES
PROMOTION
REFINED COGNITIVE NEURAL & PRODUCT
PERSUASION PROCESSES
LOYALTY CARD DATA ATTEMPT
TO INDIVIDUAL PURCHASE BEHAVIOR
SIGN-UP FOR COLLECTION
RE PURCHASES CUSTOMERS
CLUBCARD
COUPON
EMAILS
AFFECTIVE NEURAL
PROCESSES BEHAVIORAL
INTENTIONS
TO BUY
SOCIETAL
CONSEQUENCES

‘‘points’’ based on the cardholder’s total purchases can be redeemed for

discounts on future purchases or for air miles in frequent-flier programs.
Dunnhumby, a marketing research firm owned primarily by Tesco, ana-
lyzes customer data by correlating characteristics of products that an indi-
vidual buys with those of other people with similar, but not identical,
purchases and shopping habits. Tesco marketers are then able to design
promotions that cater to specific clusters of individuals such as targeted
e-mails and quarterly mailings. These communications include coupons
for items the individual typically buys as well as for items she/he is likely
to buy based on data analyses.
Tesco and others have been remarkably successful using customer infor-
mation to increase their own sales and by selling information about pur-
chasing behavior from the dataset to other retailers (Humby, Hunt, and
Phillips 2007; Rigby 2006; Rohwedder 2006). In the Revealed Preferences
Consumer Persuasion Model, the screening phase consists of signing cus-
tomers up for the Clubcard as well as collecting and analyzing data on each
purchase. In the intervention phase, the refined persuasion attempt is
crafted through specific e-mails, coupons based on consumer preferences,
and in the future via grocery carts with small LCD screens containing
advertisements targeted to the individual shopper. Cognitive and affective
responses, attitude formation and behavioral intentions, and purchase deci-
sions unfold consistent with outcomes of the former model.
Information about purchasing decisions is fed back to marketers to refine
succeeding persuasion attempts. As with the Traditional Model, engaged
individuals are aware and consent to what might be deemed under other
circumstances as an invasion of their privacy, at least during the screening
phase. However, it is doubtful that the majority understands the extent
of the statistical manipulations of their personal data that inform the
FALL 2008 VOLUME 42, NUMBER 3 397

intervention phase, even though it is recounted in a recent book titled

Scoring Points (Humby, Hunt, and Phillips 2007). The major difference
between the Revealed Preferences Model and the Traditional Model is that
customer preference data are collected and used to target the individual as
well as others ‘‘like’’ him or her. The feedback obtained through purchases
is also much more specific and accurate. Tesco’s stated marketing goal is to
give people what they want, and they have been creative in the use of data to
determine preferences.

Collective Neuromarketing Persuasion Model

The Collective Neuromarketing Persuasion Model (Figure 3) differs

from the first two models only in the screening phase. As opposed to study
groups or loyalty cards, this model introduces neuroimaging techniques
into the consumer behavior paradigm. Here, a subset of consumers agrees
to neuroimaging measurement while observing various marketing stimuli.
The new measurement methods record important nonconscious affective
influences, and the results are then used to design future persuasion
attempts.
During the intervention phase, the refined persuasion attempt is based on
brain scan data of the test group and is presented to future potential buyers
in relevant settings. The stimulus is processed by consumers, through cog-
nitive and affective mechanisms, to form an attitude toward the brand or
product. If neuromarketers are successful triggering affective areas of the
brain associated with rewards or pleasure, the consumer develops a positive
attitude toward the product, forms a behavioral intention to buy, and ulti-
mately purchases the item in question (outcome phase). The purchase
behavior forms a feedback loop to the screening phase where persuasion

FIGURE 3
Collective Neuromarketing Consumer Persuasion Model
SCREENING PHASE INTERVENTION PHASE OUTCOMES

ATTITUDES INDIVIDUAL
TOWARD CONSEQUENCES
PROMOTION
COGNITIVE NEURAL & PRODUCT
NEUROIMAGING
REFINED PROCESSES
OF TEST
PERSUASION PERSUASION
GROUPS’
ATTEMPT ATTEMPT PURCHASE BEHAVIOR
COGNITIVE &
WITH TEST GROUP FOR MASS
AFFECTIVE
AUDIENCES AFFECTIVE NEURAL
PROCESSES
PROCESSES BEHAVIORAL
INTENTIONS
TO BUY
SOCIETAL
CONSEQUENCES
398 THE JOURNAL OF CONSUMER AFFAIRS

attempts are continuously refined. This process allows for constant revision
of marketing stimuli based on a combination of brain imaging in tandem
with actual consumer behavior. As in the two previous models, the screen-
ing phase is conducted with participants’ awareness and consent, with the
major difference being the invasiveness of data collection on consumer
reactions to promotions through brain scans and their subsequent usages.

Individual Neuromarketing Persuasion Model

The Individual Neuromarketing Model (Figure 4) is a look at the pos-

sibilities that may exist in the coming years. As with the collective neuro-
marketing model, the screening phase consists of neuroimaging used with
a test group of consumers. However, the intervention phase in this model is
directed only at individuals as opposed to an undifferentiated mass of con-
sumers. For instance, consider a buyer who enters a marketplace such as
a department store or mall where she/he typically is bombarded with mar-
keting stimuli. In order to better understand its impact, retailers may neuro-
screen potential customers upon entering, registering reactions to what they
see, hear, feel, touch, taste, and/or smell, and combining these measure-
ments and outcomes with previous readings based on earlier visits.
As a consequence, marketing attempts could be targeted directly to con-
sumers based upon their brain scans. For example, if neuroimaging data
suggest a positive response to the touching of jewelry, the consumer
may experience a personalized discount prominently displayed in their
sightline in order to provide encouragement for purchase. While subjected
to these specific persuasion attempts, the individual’s brain is continuously
monitored to determine if the stimuli are having the desired effects. When
the transaction is or is not completed, the results might be fed back and

FIGURE 4
Individual Neuromarketing Consumer Persuasion Model
SCREENING PHASE INTERVENTION PHASE OUTCOMES

CONSUMER ATTITUDES INDIVIDUAL

ENTERS TOWARD CONSEQUENCES
MARKETPLACE PROMOTION
EXPERIENCES NEUROIMAGING OF
& PRODUCT
NEUROIMAGING MULTIPLE INDIVIDUAL’S
PERSUASION OF TEST PRODUCT TARGETED COGNITIVE NEURAL
ATTEMPT GROUPS’ STIMULI PERSUASION PROCESSES
COGNITIVE & PURCHASE BEHAVIOR
WITH NEUROIMAGING ATTEMPT TO
TEST GROUP AFFECTIVE CONSUMER NEUROIMAGING OF
OF CONSUMER’S
PROCESSES INDIVIDUAL’S
COGNITIVE & BEHAVIORAL
AFFECTIVE NEURAL
AFFECTIVE INTENTIONS
PROCESSES
PROCESSES TO BUY
SOCIETAL
CONSEQUENCES
FALL 2008 VOLUME 42, NUMBER 3 399

recorded to create an increasingly more sophisticated picture of the

consumer.
The Individual Neuromarketing Model suggests the greatest concerns
about personal awareness and consent, barring some form of voluntary
or government-mandated disclosures like the ones occurring now on genet-
ically modified foods. Additionally, while marketer use of neuroimaging
technology will allow consumers to experience exceptionally accurate
and effective marketing stimuli, concerns exist about how individuals’ pri-
vacy will be maintained, who ultimately owns brain scans, whether scans
can be sold to other persons or institutions, and what happens to extraneous
information, such as health problems, revealed by the scans. Such issues are
indicative of both possibilities and dilemmas that lie ahead at the intersec-
tion of marketing and neuroscience.
Together, persuasion models suggest new forms of consumer miscom-
prehension that may lead to additional privacy concerns. While a burgeon-
ing literature is developing on topics such as neuroethics, its primary focus
is on applications outside the marketing domain. The next section attempts
to fill this void by bringing a unique perspective to neuroethics within a
consumer-driven context that is organized around the concept of free will.
This philosophical premise is described briefly, and the resulting argument
frames the ethical implications caused by neuroscience thinking and prac-
tice. Models are evaluated by uniform criteria, followed by closing remarks
that signal the broader policy implications that may become important as
our understanding and training advances.

NEUROSCIENCE, FREE WILL, AND PERSUASION ATTEMPTS

Earlier discussion of neuroscience shows that our biology has an over-

whelming impact on decision making and action, suggesting that even
morality may be outside our purview (see Fukuyama 2002 for an excellent
discussion). Implicit to this belief is that knowing what portions of our
brains are stimulated may reveal the nature of resulting behaviors. Also
noted previously, technology necessary to create visual and dynamic rep-
resentations of such processes is developing rapidly, and machinery that is
both portable and unobtrusive may soon be available for use by researchers
and marketers. Such equipment could allow monitoring of consumers with
or without their awareness, permission, or understanding.
This ‘‘brave new world’’ (Huxley 1932) begs the question as to appro-
priate responsibilities between consumers and those parties that seek to
influence their beliefs, feelings, and behaviors. Among philosophers there
are differences of opinion on the nature and primacy of human beings that
400 THE JOURNAL OF CONSUMER AFFAIRS

may inform this debate (see Klemke 2000). At one end of the spectrum are
scholars who believe that all living creatures are similar, with some having
a few distinctive features but still operating by instinct (Flanagan 2002).
Other researchers who cross the boundaries between science and ethics rec-
ognize these genetic predilections yet believe in our ability to rise above
biology. (Once again see the review by Fukuyama 2002.) Part of this dis-
tinction is based on the long-standing debate concerning free will and its
role in our transcendence beyond nature (Baggini 2005).
The concept of the freedom of the will moved front and center during the
Age of Enlightenment in eighteenth-century Europe, when philosophers
argued about our capacity to use rational judgments to determine both truth
and moral behavior (Wallerstein 1997). Succeeding generations of scholars
examined various aspects of this construct, often suggesting that our cul-
pability in situations is dependent upon making conscious choices among
the variety of options available and acting voluntarily (Hospers 1953;
Spence 1996). A term coined to represent this context is uncaused causer
(Greene and Cohen 2004), which recognizes that current behavior is not
perceived to be controlled by anyone or anything external to the decision
maker (Levy 2003). As a consequence, free will provides a basis upon
which people have sought to differentiate themselves from each other
and exert that their lives have real importance. Modern approaches eschew
beliefs in externally imposed meaning in favor of internally generated
yearning (Baggini 2005).
Applied ethics scholars have used such theories in business/marketing
contexts to provide a normative structure whereby actions and outcomes in
exchange relationships can be judged (see Murphy, Laczniak, and Wood
2007). A complementary approach to free will is contractualism, and the
work of Rawls (1971) is at the centerpiece of its applications (see Brock
1998; Toenjes 2002). His frame provides legitimate standards by which the
distribution of rights and responsibilities can be determined to the consen-
sual agreement of exchange partners. These agreements are based on indi-
vidual dignity that social arrangements should not violate.
Inherent to this perspective is the division between inequities that result
from poor decision making and inequalities that are due to conditions
beyond one’s control (Tan 2001). For example, differences in relative
power, resources, or information based on dissimilarities in effort or con-
tribution to exchange relationships are morally acceptable (Cohen 1997).
However, inequities due to discrimination, selfishness, or other forms of
unjustifiable external constraints clearly are immoral. As a whole, Rawlsian
justice suggests that social actors must find ways to interact that satisfy
these conditions and produce solutions that are acceptable to all parties
FALL 2008 VOLUME 42, NUMBER 3 401

(Zanetti 2001). In the final analysis, Rawls (1971) believes that rational
people will establish systems of exchange that avoid downside risks asso-
ciated with poor starting positions and allow for fair allocations.
Our contention is that neuroscience findings and methods hold the poten-
tial for marketing practices that threaten consumers’ abilities to follow pref-
erences and dictates according to free will (Greene 2003) and contradict
Rawlsian justice. This context suggests that external constraints on decision
making imposed by applications of neural manipulation are possible vio-
lations. Transgressions are particularly troublesome when manipulation
occurs without explicit awareness, consent, and understanding. The next
subsections examine the ethical issues that arise in company-to-customer
communications. Potential dilemmas are delineated using the models
described previously as the frame of reference, and disruption of the will
advances as representations move from the traditional to neuromarketing
models. Concerns related to screening, intervention, and outcome phases
are presented using language involving the exercise of choice.

Ethical Issues for Traditional and Revealed Preference Models

The Traditional Model follows the more conventional path in the devel-
opment and dissemination of marketing communications for mass audien-
ces. Advertisements or other persuasion attempts are assessed using
a variety of techniques, including paper and pencil or baseline physiolog-
ical measures. While potential ethical conflicts may arise, the primary prac-
tice is that test consumers are aware of and consent to these assessments
prior to and during exposure to marketing stimuli in the screening phase.
Lack of transparency may occur, for example, in the use of one-way mirrors
or other forms of unobtrusive observation of reactions, but such procedures
typically involve behaviors in a more public setting and therefore may not
necessarily be viewed as violating individual privacy rights.
The same perspective may be true of the Revealed Preferences Model
whereby consumers willingly disclose a host of private information about
themselves in what they believe to be reciprocal relationships with firms.
These data often are used in subsequent persuasion attempts that are tar-
geted directly at individual consumers. Since these persons have agreed to
this arrangement by virtue of their participation, it can be assumed that they
willingly acknowledge and accept use of their profiles in ways that expand
opportunities for them to do business with focal retailers or other involved
marketers.
Nonetheless, the free will frame presented earlier suggests possible eth-
ical violations that are a function of the lack of true awareness and consent
402 THE JOURNAL OF CONSUMER AFFAIRS

on the part of subjects and targeted consumers. Even under the Traditional
Model, it is unlikely that participants in development of various marketing
stimuli fully understand the uses of information gleaned during the screen-
ing phase and how they might be used during future persuasion attempts.
Additionally, while the responses provided are typically applied in sum-
mary form only, the rights to use this information pass to the agency or
firm without an informed assessment of potential consequences by test con-
sumers. The outcomes of data manipulation and usage are considerably
greater for the Revealed Preferences Model since information is more likely
to be of a sensitive nature, sold to third-party marketers, and used to profile
specific consumers without even cursory awareness.

Ethical Issues for the Collective Neuromarketing Persuasion Model

The Collective Neuromarketing Model also follows the traditional path

involved in the creation of marketing communications for targeted consum-
ers. The primary difference is that neuroimaging technology is used during
screening of persuasion attempts, which represents a quantum change in
marketers’ ability to judge the impact of communications relative to meas-
ures discussed under the previous models. Not only does neuroimaging
allow researchers to ‘‘read the minds’’ of test subjects more accurately,
it also permits them to delineate which stimuli trigger excitement, trust,
pleasure, i.e., the emotions that lead people to buy. To the extent these stim-
uli are unrelated to product characteristics, the result is an attempt to manip-
ulate the consumer’s purchase decision.
Another area of concern is the degree to which test subjects understand
fully the personal nature of brain scans that are now property of a marketing
group or organization. If the research protocol leaves the test subjects
unaware of potential privacy issues, such lack of transparency may jeop-
ardize intimate neurological data.
After screening is finished, marketing managers begin a controlled
release of stimuli into the marketplace designed to influence cognitive
and affective neural processes of consumers. Once again, a quick inspec-
tion of these procedures suggests similarity with current marketing prac-
tices. However, the underlying intent is to trigger emotions that
encourage purchase rather than to provide consumers with accurate infor-
mation on which to make beneficial decisions.
The free will frame presented earlier suggests that the primary ethical
violation is a function of the lack of awareness, consent, and understanding
on the part of targeted consumers. Given these conditions, potential cus-
tomers are unable to make informed decisions about the extent to which
FALL 2008 VOLUME 42, NUMBER 3 403

they would choose to be influenced by such marketing stimuli. Some schol-

ars may contend that this problem exists with all persuasion attempts since
they often are placed in our sensory path without tacit permission and the
strategic intentions of their developers remain unknown. Nonetheless,
a fundamental distinction between other marketing and collective neuro-
marketing tactics is that the former attempts to change beliefs, attitudes,
and behaviors through well-recognized means, while the latter are expert
attempts to trigger buying emotions in consumers.

Ethical Issues for the Individual Neuromarketing Persuasion Model

The Individual Neuromarketing Model mirrors the possible ethical

issues associated with the screening phase of the previous models; how-
ever, the similarities end there. Once the range of possible neural reactions
are explored fully, potential customers are exposed to marketing stimuli
with the intent of creating an individual profile for the purpose of manip-
ulation using a running series of fine-tuned persuasion attempts that are
continuously monitored and recorded. The first ethical dilemma that arises
within the intervention phase concerns whether consumers are aware of and
consent to omnipresent scrutiny and to targeted/personal exposure to mar-
keting stimuli. The worst case scenario involves the use of neuroimaging
technology in public contexts where consumers would be oblivious to its
employ and/or its resulting effects on brain functioning and decision mak-
ing. Such a context limits consumer free will and violates Rawlsian ethics
since a rational person would never select to be so manipulated.
The next logical scenario allows for awareness of monitoring and devel-
opment of personalized marketing tactics using neuroscientific methods
and technologies without true consent. While this combination may seem
unlikely, the possibility exists that consumers will agree to enter a public
shopping environment where they undergo screening in order to maintain
access to marketplace activities that are not easily found elsewhere. Thus,
their perceived or real consumption restrictions may cause potential cus-
tomers to subject themselves to unwanted invasion of private mental pro-
cesses and to bombardment of their personal space with intrusive marketing
stimuli. These concerns also exist with the previous scenario, but awareness
may reduce the possibility of manipulation, leaving ethical violations asso-
ciated with obligatory consent rather than ignorance of intent.
The final scenario applicable to this model includes situations where
consumers are aware of and consent to scrutiny and persuasion attempts.
This situation eliminates many of the dilemmas noted with the two previous
scenarios, but a few issues remain. First, agreement does not ensure a
404 THE JOURNAL OF CONSUMER AFFAIRS

complete understanding of how personalized targeting will impact buyer

behavior, likely necessitating warning systems and social marketing pro-
grams that are currently used for addictive or complex products such as
tobacco and alcohol or financial services and healthcare. A second problem
becomes one of relative quality of consumption of persons without these
opportunities. Given the inequities in our material world, some consumers
are likely to experience vulnerability because of their lack of access to such
technologies. The third issue involves how beneficial a resulting purchase is
to the consumer. When a consumer purchases a product based on a decision
in which marketing stimuli unrelated to product characteristics cause affec-
tive neural systems to override cognitive processes, the final purchase out-
come may not always be in the best interest of the consumer.

CLOSING REMARKS

This investigation brings disparate literature and secondary research

together in order to explore the complex persuasion environment for mar-
keters and consumers of their goods and services resulting from neuro-
scientific discoveries. Ethical dilemmas are exacerbated by use of
neuromarketing methods and data, and center on issues of consumer free
will and privacy. The ability to exercise free will in purchasing decisions is
informed by Preston’s (2002) discussion of problematic ‘‘antifactual’’
advertising content consisting of puffery, obvious false claims, and lifestyle
claims. While not technically considered ‘‘deceptive advertising,’’ by the
Federal Trade Commission, they clearly fail to inform consumers about
products—ostensibly the basis of rational purchasing decisions. Neurotech-
nology enables marketers to refine persuasion attempts using noninforma-
tive or misinformative content, with the potential to trigger very positive
affective responses in consumers. While some may argue that this tech-
nique only encourages consumers to buy what they really want, Rotfeld
(2007) questions the whole premise of selling people only what they want.
He suggests that marketing should be ‘‘going beyond giving consumers
what they like,’’ but rather ‘‘helping more people understand what they
really should want’’ (p. 384) or need. This stance speaks to the importance
of marketplace education so consumers can exercise free will around pur-
chasing decisions based on accurate information.
Issues of awareness, consent, and understanding form a cohesive set of
moral questions that are addressed, in part, by free will and Rawlsian jus-
tice. For example, behind a ‘‘veil of ignorance’’ where one fails to know
whether she/he is the marketer or consumer, would she/he select to be
oblivious, ignorant, or restricted? The answer is a clear ‘‘no’’ from the
FALL 2008 VOLUME 42, NUMBER 3 405

perspective of any individual looking out for her/his best interest, and for
whom the ability to exercise free will is a high priority.
Unfortunately, self-regulation and public policy lag behind current prac-
tice and future opportunities. Just as copyright and varied intellectual prop-
erty laws established prior to the Internet fail to serve existing legal needs,
so our thinking about lack of transparency surrounding promotional activ-
ities should be updated to include neuromarketing methods. Many within
the academic and practitioner communities may suggest that the natural
skepticism of consumers developed over centuries of dealings in the mar-
ketplace will provide a natural barrier to potential harm. Nonetheless, dis-
trust is only activated in ways that are relevant to accumulated experiences,
and this ‘‘brave new world’’ portends new transparency concerns that may
have insidious effects as well as unknown consequences.
Regardless, the potential restriction of free will and privacy invasive-
ness enabled by neuroimaging technology requires attention by govern-
mental and academic constituencies. The rapid collection, assessment,
and deployment of brain scanning data anticipated by the latter models
reveal new terrain for researchers and legislators interested in the protec-
tion of consumer rights. Questions as to who owns such information, how
it may be combined with other databases in order to develop more sophis-
ticated and targeted marketing efforts, and under what conditions it may
be sold or traded with others represent areas that will require attention.
The Federal Trade Commission standards, as articulated in their Fair
Information Practice Principles, are a good starting point and are
designed to acknowledge the rights of consumers (www.ftc.gov/reports/
privacy3/fairinfo.shtm).
These principles are built around five core ideals. The first is notice/
awareness and is central to the remaining standards. Under this guiding
principle, consumers should be told who is collecting data, its possible uses,
and any potential recipients. The second is choice/consent, which is con-
sistent with our previous discussion on neuromarketing. Consumers are
given the opportunity to opt-in or opt-out of the collection of information
and also have the ability to tailor the nature of their data and its uses. The
third is access/participation, which is concerned with the consumer’s capac-
ity to view, verify, and contest the completeness and accuracy of informa-
tion about them in a timely and efficient way. The fourth is integrity/
security and requires that marketers, and their firms ensure that data are
up to date and protected against unauthorized access or manipulation.
The fifth principle involves enforcement/redress. Given our free will
premise, marketing practitioners should be expected to communicate the
uses and outcomes of neuroimaging technology prior to consumer
406 THE JOURNAL OF CONSUMER AFFAIRS

exposure, to allow individuals to opt-out of any or all aspects of the col-

lection process without penalty, to provide easily accessible and under-
standable feedback on personal information, and to ensure that
appropriate safeguards are in place to prevent unwanted third-party expo-
sure. The first line of defense is self-regulation and would require a cross-
disciplinary group of scholars and practitioners to come together to develop
standards, assessment mechanisms, and sanctions. If this fails to resolve the
most serious problems, private remedies through the court system may
establish the criteria upon which neuromarketing activities will be judged
and constrained, leading to legislative solutions and lawmaker control.
In conclusion, the issues of freedom of will, privacy rights, and the
development and dissemination of advertisements by business operations
are broadened significantly by the inclusion of neuroscience methods and
findings. The conjoining of marketing and neuroscience clearly is in its
infancy, and only the Collective Neuromarketing Model is in use by a grow-
ing assortment of scholars and practitioners. Yet, adoption of the Individual
Neuromarketing Model is more than musings in postmodern novels. It rep-
resents possibilities that will need a combination of voluntary compliance
and regulatory oversight in order to avoid some of the dilemmas noted here.
A critical role for policy makers and consumer scholars is to inform this
debate by monitoring the latest neuroscientific findings and evaluating their
implications for ethical marketing practice.

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 !
!
ABOUT)THIS)COMPENDIUM)
!
!
The$original$purpose$of$this$compendium$has$been$for$the$use$in$my$own$lectures$in$consumer$
neuroscience$and$neuromarketing$at$the$Copenhagen$Business$School.$However,$I$also$
recognise$that$this$volume$can$also$be$a$potentially$valuable$resource$for$both$newcomers$as$
well$as$experienced$people$within$this$discipline.$Neuromarketing$is$today$very$much$a$
conglomerate$of$divergent$solutions;$hyped$up$talks;$and$a$mixture$of$true$science$and$pop$
science$gone$terribly$wrong.$This$collection$of$papers$represent$my$own$take$on$what$the$
basics$should$entail$
!
This$book$is$also$intended$as$a$supplement$to$my$book$“Introduction$to$Neuromarketing$&$
Consumer$Neuroscience”,$which$you$can$read$more$about$here:$http://neuronsinc.com/
publications/introductionPtoPneuromarketingPconsumerPneuroscience/$(also$see$next$page).$
!
The$selection$of$texts$are$not$intended$to$be$an$exhaustive$listing$of$all$relevant$articles.$I$have$
worked$from$two$basic$premises:$1)$that$the$article$is$available$freely$on$the$web;$and$2)$that$
the$article$represents$some$of$the$leading$thoughts$(and$scholars)$in$this$field.$$
!
If$you$have$suggestions$or$comments,$please$send$me$an$email$at$tzramsoy@gmail.com$$
!
!
DISCLAIMER)
!
All$materials$in$this$compendium$–$texts$and$images$–$have$either$been$collected$from$freely$
available$resources,$or$written$by$myself.$I$claim$no$ownership$or$rights$over$these$materials.$
All$materials$in$this$compendium$–$except$my$own$freely$distributed$materials$–$can$be$
collected$and$compiled$by$any$individual.$Please$note$that$there$may$be$restrictions$on$
materials$in$this$compendium$for$sharing,$distributing$or$selling.$$
!
If$you$find$that$this$compendium$contains$materials$that$are$not$permitted$for$sharing,$please$
send$me$an$email$at$tzramsoy@gmail.com$and$I$will$adjust$accordingly.$
!
!
!
Happy$reading!$
!
!
All$the$best,$
$
!
!
!
!
!
!
!
v"2.0"–"August"2014

 WHO)MADE)THIS?)
!
$
Thomas"Zoëga"Ramsøy,"b."1973"in"Oslo,"Norway"
!
Thomas$is$considered$one$of$the$leading$experts$on$
neuromarketing$and$consumer$neuroscience,$and$he$is$an$
innovator$by$heart.$With$a$background$in$economics$and$
neuropsychology,$he$holds$a$PhD$in$neurobiology$from$the$
University$of$Copenhagen.$$
!
Thomas$has$published$extensively$on$the$application$of$
neuroimaging$and$neurophysiology$to$consumer$behaviour$and$
decision$making.$He$is$the$Director$of$the$Center$for$Decision$
Neuroscience,$where$his$research$team$uses$an$eclectic$mix$of$
technologies$and$the$sciences$of$economics,$$psychology$and$
neuroscience.$Beyond$this,$Thomas$is$the$CEO$of$Neurons$Inc,$
where$he$consults$companies$around$the$globe$on$the$use$of$
science$and$technology$in$business.$
!
!
!
More$information$about$Thomas$can$be$found$on$the$following$resources:$
!
Professional)pages)
DNRG$CBS$–$http://cbs.dk/DNRG$$
DNRG$HH$–$http://drcmr.dk/research/DecisionNeuroscience$$
Neurons$Inc$–$http://neuronsinc.com$$
!
Social)media)
Twitter$–$https://twitter.com/NeuronsInc$$
Neurons$Inc$–$http://NeuronsInc.com$$
BrainEthics$–$http://brainethics.org$
!
Societies)
Neuromarketing$Science$&$Business$Association$–$http://www.neuromarketingPassociation.com$$
Society$for$Mind$Brain$Sciences$–$http://mbscience.org/$
!
Publications)
ResearchGate$–$https://www.researchgate.net/profile/Thomas_Z_Ramsoy/$$
!
!
!
!