Kleptomania
Kleptomania is classified as an impulse control disorder characterized by the uncontrollable urge to steal items that are not needed for personal use. It affects an estimated one to three percent of the global population, with a higher prevalence in women, though fewer than five percent of individuals who shoplift meet the criteria for this disorder. Kleptomania is often associated with other psychological issues such as depression and anxiety, and it lacks clearly defined causes and treatments. Historically, perceptions of such impulsive behaviors have evolved, with various theories proposed over time, from ancient beliefs about bodily humors to modern psychological frameworks.
Diagnosis of kleptomania involves specific criteria, including the experience of significant tension before theft and pleasure or relief during the act, without motivations such as revenge or material gain. Treatments can be challenging, as many individuals do not seek help due to shame or secrecy. Common approaches include behavioral therapy, medication (often antidepressants), and support groups, although responses to treatments may vary. Understanding the underlying emotional turmoil may be crucial for effective intervention, making therapy and self-help support vital components in managing the disorder.
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Subject Terms
Kleptomania
- TYPE OF PSYCHOLOGY: Cognition; psychopathology
- FIELDS OF STUDY: Aggression; anxiety disorders; aversive conditioning; behavioral therapies; depression; sexual disorders
SIGNIFICANCE:Kleptomania is an impulse control disorder wherein an individual is unable to resist the repetitive impulse to steal objects that the individual does not need. Although associated with depression and anxiety, kleptomania has no clear causes or treatments.
Introduction
Kleptomania is one of five impulse control disorders (ICDs) that also include pyromania (compulsively setting fires), pathological gambling, trichotillomania (pulling out one’s hair), and intermittent explosive disorder, which involves incidents of aggression toward other people. An estimated one to three percent of the world’s population suffers from one of these disorders; more women than men develop kleptomania, although fewer than five percent of individuals who shoplift meet the diagnostic criteria for kleptomania.
Perceptions of impulsive control disorders, or impulsive behaviors, and their origins have changed dramatically throughout history. The Greek doctor Hippocrates believed they were caused by an excess of yellow bile, a bodily fluid thought to produce impulsiveness. German Protestant Reformation leader Martin Luther exhorted his congregation to shun impulses presumed to be harmful, while the founder of modern psychology, Sigmund Freud, insisted that impulses are common to all individuals and, as such, are neither good nor bad. Most impulse control disorder research was carried out in the early twentieth century, and the third edition of the Diagnostic and Statistical Manual of Mental Disorders (1980, DSM-III), a record of all known mental and psychological disorders, began to list impulse control disorders among them.
The manual’s criteria for diagnosing kleptomania are specific
- individuals repeatedly fail to resist impulses to steal items for no material gain
- great irritation occurs before individuals begin the theft
- individuals feel pleasure, gratification, or relief as they commit the theft
- individuals do not steal to express anger or vengeance
- individuals who steal are not diagnosed with antisocial personality disorders
However, the causes of kleptomania are far less defined. Although early views of kleptomania generally held that those with the disorder were seemingly “normal” people with impulses to steal, more recent research indicates that kleptomania or any impulse control disorder is not a lone disorder. Women make up 80 percent of the total number of known kleptomaniacs, and many of their medical records document troubled histories of depression, self-loathing, and suicidal tendencies. Others show patterns of early pain, emotional loss, and identity confusion, although it is not known how these traumas connect with kleptomania.
In pursuing causes for kleptomania, attention is directed toward the brain's chemical makeup. The chemicals serotonin, norepinephrine, and dopamine are neurotransmitters that influence judgment and feelings, so any imbalance in the levels of these chemicals can produce impulsivity. Also, genetic research has determined that impulsivity tends to extend through an entire family.
Treatment
Treatment of kleptomania is difficult because most kleptomaniacs are never arrested or come forward for treatment. Families inhibit identification or treatment of the family member out of shame and efforts to maintain secrecy, and many victims who begin treatment often drop out before any real benefits are achieved. Also, because most kleptomaniacs or people with other impulse control disorders have additional psychological disorders, no single medication is available for the treatment of any impulse control disorder.
Because depression, anxiety, and mood swings usually accompany kleptomania, antidepressants are commonly prescribed to relieve the depression and self-loathing that prompts the act of stealing. Selective serotonin reuptake inhibitors (SSRIs), less harmful in the case of an overdose, are prescribed with increasing frequency in cases of impulse control disorders, as are mood stabilizers, which can have serious side effects. However, most medications have mixed results for kleptomania, with the best results attributed to a combination of therapies.
Behavioral therapy attempts to alter behavior by helping the patient learn to avoid participation in detrimental activity. As individuals are rewarded by positive behavior, they are punished by negative behavior. Aversive behavioral therapy pairs various forms of discomfort with the impulse to steal. For example, patients snap a rubber band against their wrists as thoughts of stealing increase. Covert sensitization, or the process of encouraging the patient at the time of impulse to think the situation through, including the possibilities of traumatic experiences like being arrested or spending time in jail, has been reported to be somewhat effective.
Painful or unpleasant consequences imagined by the victim frequently counter the theft impulses. Because other issues and conflicts beset most individuals with kleptomania, the most beneficial treatments are psychotherapy and self-help groups. In conversations with a trusted therapist, a patient may reveal a history of emotional turmoil that could provide some understanding of or key to the patient’s impulses.
Bibliography
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Gahan, Desmond. Compulsive Cravings: A Comprehensive Guide to Understanding Kleptomania. Sepharial, 2023.
Grant, Jon E. Impulse Control Disorders: A Clinician’s Guide to Understanding and Treating Behavioral Addictions. Norton, 2008.
Grant, Jon E., et al. Stop Me Because I Can’t Stop Myself: Taking Control of Impulsive Behavior. McGraw-Hill, 2004.
"Kleptomania." Cleveland Clinic, 15 June 2022, my.clevelandclinic.org/health/diseases/9878-kleptomania. Accessed 10 Oct. 2024.
McIntosh, Kenneth, and Phyllis Livingston. Youth and Impulse Control Disorders: On the Spur of the Moment. Mason Crest Books, 2007.
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Zhang, Zi-hao, et al. “Kleptomania: Recent Advances in Symptoms, Etiology and Treatment.” CurrentMedical Science, vol. 38, no. 5, 2018, pp. 937–40, doi.org/10.1007/s11596-018-1966-2.