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Kleptomania: Definition, Symptoms, Prevalence and Treatment

1. Introduction

There is the recent story of a well-to-do actress Winona Rider stealing mere merchandise just worth $5, 500 from Saks Fifth Avenue in Beverly Hills, California that puzzled many people (Plante, 2006). Many questions were asked why a well-groomed actress of means could steal some clothes that she was able to buy with a little easily. In response to such queries, it was later revealed that the actress was suffering from kleptomania, an impulse control disorder characterized by repetitive and difficult to resist urges to steal objects that have little or no monetary value (American Psychiatric Association, 2000). Kleptomania is considered a mental disorder because it causes clinically significant impairment in social, occupational or other important areas of functioning (DSM-IV-TR; APA, 2000).

2. Kleptomania: definition, symptoms and prevalence

-2.1. Definition

The American Psychiatric Association’s (2000) Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Text Revision (DSM-IV-TR) defines kleptomania as “recurrent failure to resist impulses to steal objects that are not needed for personal use or monetary value” (p. 581). DSM-IV further adds that the stealing must result in “clinically significant distress or impairment in social, occupational or other important areas of functioning” (p. 581). Furthermore, DSM -IV requires that “the symptoms are not due to another mental disorder (e.g., conduct disorder, antisocial personality disorder, borderline personality disorder, schizophrenia) and are not better accounted for by another Axis I diagnosis” (p. 581). Finally, according to DSM-IV the individual must be at least 18 years old to be diagnosed with kleptomania (p. 581). The definition of kleptomania provided by DSM-III-R is very similar to DSM -IV except that it does not require the presence of clinically significant distress or impairment and it does not specify an age limit for diagnosis (APA, 1987). The research criteria for kleptomania in DSM -III is even less specific and only requires that the individual has “recurrent episodes of stealing objects not needed for personal use or monetary value” (APA, 1980).

-2.2. Symptoms

The primary symptom of kleptomania is an irresistible urge to steal things even if the person does not need them and can afford to pay for them. The urge to steal is usually preceded by intense anxiety or tension which is relieved by the act of stealing. There may also be a sense of euphoria or pleasure after committing the act. However, this feeling is usually short-lived and is followed by feelings of guilt and shame. The individual may also have difficulty resisting the urge to steal in specific situations such as when they are bored or feeling down. In some cases, the individual may be aware that their behaviour is abnormal but feel powerless to stop it. Kleptomaniacs often go through periods of remission where they do not feel the urge to steal for long periods of time but the urges usually return at some point (APA, 2000).

-2.3. Prevalence

The prevalence of kleptomania is unknown but it is thought to be relatively rare. One study found that the lifetime prevalence of kleptomania was 0.6% ( black, 2001). Another study found that the point prevalence of kleptomania was 0.3% (Grant et al., 2005). The prevalence of kleptomania may be higher in clinical populations such as inpatient psychiatric units (FAdditional research is needed to determine the true prevalence of kleptomania.

3. Risk factors for developing kleptomania

-3.1. Biological

There is no known biological cause of kleptomania but there are some theories about possible causes. One theory is that kleptomania may be caused by a dysfunction in the brain’s serotonin system (Muller et al., 2006). This theory is based on the fact that medications that increase serotonin levels in the brain (e.g., SSRIs) are sometimes effective in treating kleptomania (Muller et al., 2006). Another theory is that kleptomania may be caused by a dysfunction in the brain’s dopamine system (Stein et al., 2005). This theory is based on the fact that medications that increase dopamine levels in the brain (e.g., amphetamines) can sometimes trigger episodes of kleptomania (Stein et al., 2005).

-3.2. Psychological

There are several psychological theories about the development of kleptomania. One theory is that kleptomania may be a form of self-destructive behaviour (Garrison, 1992). This theory suggests that individuals with kleptomania may steal to sabotage their own lives and relationships in order to unconsciously escape from their problems. Another theory is that kleptomania may be a form of rebellion against authority figures (Garrison, 1992). This theory suggests that individuals with kleptomania may steal to rebel against parents, teachers or other authority figures who they feel are limiting their freedom or oppressing them in some way.

-3.3. Social

There are also several social theories about the development of kleptomania. One theory is that kleptomania may be caused by a desire to fit in with a criminal subculture (Garrison, 1992). This theory suggests that individuals with kleptomania may start stealing because they want to be accepted by a group of friends or peers who are involved in criminal activity. Another theory is that kleptomania may be caused by feelings of Entitlement (Garrison, 1992). This theory suggests that individuals with kleptomania may feel entitled to take things that do not belong to them because they feel like they deserve them or because they are experiencing financial hardship.

4. Kleptomania: comorbidity and differential diagnosis

Klomorbidity refers to the presence of two or more disorders in an individual at the same time (American Psychiatric Association, 2000). Kleptomania often occurs comorbid with other mental disorders such as depression, anxiety disorders, substance abuse disorders and eating disorders (APA, 2000). It is important to note that kleptomania must be distinguished from other mental disorders such as conduct disorder, antisocial personality disorder, borderline personality disorder and schizophrenia (APA, 2000). Kleptomania must also be distinguished from other impulse control disorders such as pyromania (i.e., the urge to start fires), intermittent explosive disorder (i.e., the urge to lash out violently) and compulsive gambling (APA, 2000).

-4.1. Comorbidity

As mentioned above, kleptomania often occurs comorbid with other mental disorders such as depression, anxiety disorders, substance abuse disorders and eating disorders (APA, 2000). One study found that the comorbidity rate of kleptomania with other mental disorders was 43% (Grant et al., 2005). Another study found that the comorbidity rate of kleptomania with depression was 30% ( Black, 2001). The comorbidity rate of kleptomania with substance abuse disorders was 20% ( Black, 2001). The comorbidity rate of kleptomania with eating disorders was 15% ( Black, 2001).

-4.2. Differential diagnosis

As mentioned above, it is important to distinguish kleptomania from other mental disorders such as conduct disorder, antisocial personality disorder, borderline personality disorder and schizophrenia (APA, 2000). It is also important to distinguish kleptomania from other impulse control disorders such as pyromania (i.e., the urge to start fires), intermittent explosive disorder (i.e., the urge to lash out violently) and compulsive gambling (APA, 2000).

5. Treatment of kleptomania

The treatment of kleptomania typically involves a combination of psychotherapy and pharmacotherapy (APA, 2000). Psychotherapy is a type of counseling that helps individuals understand and change their thoughts, feelings and behaviours (APA, 2000). Pharmacotherapy is the use of medication to treat symptoms associated with mental disorders (APA, 2000).

-5.1. Psychotherapy

The most commonly used type of psychotherapy for treating kleptomania is cognitive-behavioural therapy (CBT; Grant et al., 2009). CBT is a type of therapy that helps individuals change their thoughts and behaviours by teaching them new skills and strategies for dealing with their problems (Grant et al., 2009). CBT for kleptomania typically involves helping the individual identify and resist the urges to steal (Grant et al., 2009). CBT may also involve helping the individual cope with guilt and shame after stealing (Grant et al., 2009). Other types of psychotherapy that have been used to treat kleptomania include interpersonal therapy and Gestalt therapy but there is less research on these approaches (Grant et al., 2009).

-5.2. Pharmacotherapy

Pharmacotherapy helps in the treatment of symptoms associated with kleptomania, hence its application as a supporting treatment for psychotherapy.

FAQ

Kleptomania is a mental disorder that compels an individual to steal items, even though they may not need or want the items.

The exact cause of Kleptomania is unknown, but it is believed to be caused by a combination of genetic and environmental factors.

There is no cure for Kleptomania, but there are treatments that can help lessen the symptoms, such as therapy and medication.

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