Kleptomania: symptoms, causes and treatment

This type of impulse control disorder generates the urge to steal.

One of the characteristics of psychological disorders is that their existence does not depend on ethical codes: they exist independently of these.

The case of kleptomania is an example of this: it is a behavioral disorder based on the act of stealing, which occurs in people who know perfectly well that stealing is not right, but who are practically unable to control themselves.

In this article we will see what is kleptomania and what are the characteristics of this disorder of impulse regulation, how it affects people's lives, its symptoms and possible treatments.

Kleptomania as a disorder

Stealing is a crime that as a general rule is carried out voluntarily and fully consciously, and its main purpose is to get hold of the good or product in order to use it or achieve some kind of economic benefit with it.

However, there are people who do not commit theft for this reason and who may even end up returning what they have stolen, since what leads them to theft is the need to relieve tension and a loss of control of their impulses. These are people suffering from kleptomania.

Kleptomania is a psychological disorder or psychiatric alteration, which is characterized by the existence of a strong impulse to steal objects that the subject is unable to resist.. Or, rather, it is based on the impulse to take products for sale and take them without paying, since it is arguable that the attraction of this action is the fact of breaking private property.

These impulses, which the subject cannot control, lead him/her to commit petty theft on a regular basis, even though the object in question is not valuable to him/her and he/she cannot make any profit from it. The person in question experiences strong tension and anxiety before the criminal act, a sensation that is pleasantly relieved after the theft has been successfully committed.

Symptoms

Theft in is not a premeditated or preplanned act.It arises as a reaction to tension or as an emotional discharge through which to calm his impulses. It is an almost automatic and partially involuntary act that arises from necessity, in the here and now.

The motive for the theft is therefore not economic, nor is it carried out for the purpose of revenge or to express anger. Nor is it a form of rebellion against society and norms, as someone with antisocial disorder might do, or a response to a delusional idea or hallucination. Likewise, it is not the product of an alteration of consciousness such as would be caused by drug use or the presence of a manic episode.

And the fact is that kleptomania is one of the so-called impulse control disorders (now destructive impulse control disorders). (now destructive impulse control and behavioral disorders), a group to which this disorder, pyromania and intermittent explosive disorder, among others, belong, and which are characterized by difficulty in controlling impulses, emotions and desires that appear suddenly and irresistibly, without any other cognitive or psychiatric disorder.

The theft becomes a compulsive act, acquiring addictive characteristics and resembling obsessive disorders in its functioning.

Course and epidemiology

Kleptomania is a rare disorder and accounts for less than 5% of the thefts that take place. This condition can appear at very different agesincluding childhood or adolescence and in few cases in adulthood. It is more frequent in young women. In some cases it remits by itself, although sometimes it resurfaces in response to stressful situations or remains for years (although with treatment the prognosis is very favorable).

Some diagnostic classifications such as the ICD indicate that at least two or three episodes must have occurred in order to diagnose it.

It is relevant to mention that although the theft is not explainable by other disorders, it is common for there to be comorbidity with other alterations (kleptomania and another disorder occur together). Among the most frequent are alcoholism, obsessive-compulsive disorder, major depression or eating disorders.

Affect on daily life

The kleptomaniac may feel guilty about his act, and is usually aware that he is committing theft, but finds himself unable to resist taking the property in question. In fact, it is not uncommon for a it is not uncommon that once the object in question is stolen, it is returned to the to the establishment or person who owns it (usually discreetly, sometimes with notes of apology), or it is hidden or given away. It is not uncommon for symptoms such as shame and remorse to appear, which can alter the subject's daily life.

In addition to this it can be common for them to be caught in the act and to have problems with the law, so that they can end up in trouble with the courts.They may even be sentenced to prison. This can also lead to social problems, to the point of having interpersonal conflicts and even being rejected by their environment, or having difficulties at work.

The lack of control over impulses can lead the subject to feel little sense of self-efficacy, which in turn can lead to the feeling of little control over his life and finally to the emergence of mood problems. They can also lead to hoarding behaviors of stolen objects.

Possible causes of its occurrence

The exact causes of the onset of kleptomania are not known, although there are several There are different hypotheses that try to offer a possible explanation possible explanation to the reason of this pathology (most of them coming from the psychodynamic current).

Within the psychodynamic orientation, kleptomaniac theft has been interpreted as a symptom of an intrapsychic conflict, in which the subject may use the act of stealing as a way of obtaining pleasure through the performance of a forbidden act, as an ego defense against anxiety, or as an act in which he/she unconsciously reacts to the lack of affection deprivation in childhood.

It has been observed as possible risk factors the presence of cranioencephalic trauma (which may have damaged the frontal and the capacity of behavioral inhibition), alterations at dopaminergic, serotoninergic or endogenous opioid neurotransmission level. In addition to this, it is possible that there is some kind of Biological or learned predisposition from parental models, since it has been observed that people with kleptomania tend to have a statistically higher probability of having a family history of obsessive disorders.

In addition, it has also been observed that personality structures close to paranoid, schizoid and borderline personality disorder also imply an increased risk of occurrence.

The most relevant personality characteristic of this picture is found in the presence of high impulsivity. They are usually people with a great intensity in their fantasies and desires, in some cases with less tolerance to delay of gratification and high sensitivity to reward and anxiety. There is also usually a link with mood disorders.

In addition, it could be suggested that in this disorder a system similar to that occurring in addictions appears, and a possible involvement of the nucleus accumbens and the brain reward system, influencing impulses and motivation, has been suggested. T

t has also been linked to OCD, in which the anxiety felt is temporarily relieved by the commission of the criminal act but is in turn negatively reinforced by it in the long run. In fact, it has been suggested that this could be an impulsive variant that could be could be classified within the obsessive-compulsive spectrum disorders..

Treatment

Kleptomania is a condition that requires treatment. In this sense there are multiple types of therapy and existing intervention, as much at psychological level as pharmacological (although usually a combination of both is used).

Among the different therapies at the psychological level we can find in the first place systematic desensitizationin which the subject is exposed to anxiogenic situations in order to face them by carrying out behaviors incompatible with anxiety, or by performing alternative behaviors to the theft. Another alternative is exposure with response prevention.

Psychoeducation is also useful for both the subject and his or her environment, given the lack of social understanding of this disorder. Procedures such as acceptance and commitment therapy have also been found to be effective.

At the pharmacological level, the following have been found to be effective antidepressant drugs such as the SSRIs (which in turn are used in both depression and OCD), especially some such as fluoxetine or fluvoxamine. Although these are drugs of choice, mood stabilizers, anticonvulsants or even drugs effective in alcoholism such as naltrexone have also been used to treat kleptomania and have shown some success.

Bibliographic references:

• American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders. Fifth edition. DSM-5. Masson, Barcelona.
• Dannon, P. and Berman, G. (2013) Kleptomania: an impulse control disorder or addictive behavior. Health i Science 19(6):540-5.
• Fontenelle, L.F.; Mendlowicz, M.V.; Versiani, M. (2005). "Impulse control disorders in patients with obsessive-compulsive disorder". Psychiatry and Clinical Neurosciences. 59 (1): 30-37.
• Madden, G.J.; Bickel, W.K. (2010). Impulsivity: The Behavioral and Neurological Science of Discounting. Washington, DC: American Psychological Association.
• Grant, J.E.; Kim, S.W. (2002). "Clinical characteristics and associated psychopathology of 22 patients with kleptomania". Comprehensive Psychiatry. 43 (5): 378-84.
• Santos, J.L.; García, L.I.; Calderón, M.A.; Sanz, L.J.; de los Ríos, P.; Izquierdo, S.; Román, P.; Hernangómez, L.; Navas, E.; Ladrón, A; and Álvarez-Cienfuegos, L. (2012). Psicología Clínica. Manual CEDE de Preparación PIR, 02. CEDE. Madrid