Kleptomania: symptoms, causes and treatment

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 alteration based on the act of stealing, and which has place in people who know perfectly well that stealing is wrong, but who practically cannot be controlled.

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

• Related article: "How to control impulsivity? 8 tips that help"

Kleptomania as a disorder

Stealing is a crime that, as a general rule, is carried out voluntarily and fully consciously, and its purpose is to It is fundamental to obtain the good or product in order to use it or achieve some type of economic benefit with he.

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

people with kleptomania.

Kleptomania is a psychological disorder or psychiatric disorder, which is characterized by the existence of a strong urge to steal items that the subject is unable to resist. Or, rather, it is based on the impulse to take sales products and take them away without paying, since it is debatable that the attraction of this action is the fact of infringing on private property.

These impulses, which the subject cannot control, lead them to commit petty thefts on a regular basis, even though the object in question is not valuable to them and they cannot derive any benefit from it. The person in question experiences strong tension and anxiety before the criminal act, a feeling that he manages to pleasantly alleviate after committing the theft.

Symptoms

The robbery in It is not a premeditated or preplanned act, but arises as a reaction to stress or as an emotional discharge through which to calm their impulses. It is an almost automatic and partially involuntary act that arises out of necessity, in the here and now.

The motive for the theft is therefore not economic, and it is also not carried out with the aim of revenge or expressing anger. Nor is it a way to rebel against society and norms, as someone with antisocial disorder might do, nor is it a response to a delusion or hallucination. Likewise, it is not the product of an alteration of consciousness such as that which would be caused by drug use or the presence of a manic episode.

And it is that kleptomania It is one of the so-called impulse control disorders. (now destructive impulse control and behavior disorders), a group to which both this disorder and pyromania or intermittent explosive disorder, and that are characterized by the difficulty to control impulses, emotions and desires that appear suddenly and irresistibly, without the mediation of another cognitive or psychiatric alteration.

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

course and epidemiology

Kleptomania is a rare disorder and accounts for less than 5% of thefts that take place. This condition can appear at very different ages, including childhood or adolescence and in a few cases in adulthood. It is more common in young women. In some cases it remits on its own, although sometimes it reappears in response to stressful situations or persists for years (although with treatment the prognosis is very favourable).

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 disorders (that kleptomania and another disorder occur together). Among the most frequent are alcoholism, Obsessive-Compulsive Disorder, major depression or eating disorders.

Affectation in daily life

The kleptomaniac may feel guilty about his act, and is usually aware that he is committing theft, but is unable to resist taking the good in question. In fact, it is not uncommon for the item in question to be returned once stolen to the establishment or owner (usually discreetly, sometimes with apology notes), or are hidden or given away. It is not uncommon for symptoms such as shame and remorse to appear, which can alter the subject's day-to-day life.

Besides it it may be common for them to be caught in the act and have problems with the law, in such a way that they can be sentenced to prison. Likewise, this can lead to problems at a social level, to the point of having interpersonal conflicts and even being rejected by their environment, or having difficulties at a work level.

The lack of control over impulses can lead to the subject feeling a low sense of self-efficacy, which in turn Sometimes it can lead to a feeling of little control over your life and finally to the appearance of problems with your state of mind. cheer up. They can also generate hoarding behaviors for stolen objects.

Possible causes of its appearance

The exact causes of the appearance of kleptomania are not known, although There are different hypotheses that claim to offer an explanation. possible to the reason for said pathology (most of it 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 can use the act of stealing as a way to obtain pleasure through the performance of a prohibited act, as a defense of the ego against anxiety or as an act in which one unconsciously reacts to the lack of deprivation of affection in the childhood.

Have been observed as possible risk factors the presence of head trauma (which may have damaged the frontal and inhibition ability behavioral), alterations at the dopaminergic, serotonergic level or at the level of opioid neurotransmission endogenous. In addition to this, it is possible that there is some kind of biological predisposition or learned from parental models, since it has been observed that people with kleptomania tend to be statistically more likely to have a family history of the disorder obsessive.

In addition, it has also been observed that personality structures close to paranoid, schizoid and borderline personality disorders also imply a greater risk of appearance.

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

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

It has also been linked to OCD, in which the anxiety felt is temporarily alleviated by carrying out the criminal act but in turn is negatively reinforced by it in the long run. In fact, it has been suggested that it could be an impulsive variant that could be classified as an obsessive-compulsive spectrum disorder.

Treatment

Kleptomania is a condition that requires treatment. In this sense There are multiple types of therapy and interventions, both psychological and pharmacological (although usually a combination of both is used).

Among the different therapies at a psychological level we can find in the first place systematic desensitization, in which the subject is exposed to anxiety-producing situations in order to face them leading to carrying out behaviors incompatible with anxiety, or carrying out alternative behaviors to the heist. Another alternative is exposure with response prevention.

Psychoeducation is also useful for both the subject and his environment, given the little social understanding of this disorder. Procedures such as acceptance and commitment therapy have also been seen as effective.

At the pharmacological level they have been seen as effective antidepressant drugs such as SSRIs (which in turn are used in both depression and OCD), especially some such as fluoxetine or fluvoxamine. Although these are drugs of choice, also mood stabilizers, anticonvulsants or even drugs effective in alcoholism such as naltrexone have 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. Massón, 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.; Garcia, L.I.; Calderón, M.A.; Sanz, L.J.; de los Rios, P.; Left, S.; Roman, P.; Hernangomez, L.; Navas, E.; Thief, A; and Alvarez-Cienfuegos, L. (2012). Clinical psychology. CEDE PIR Preparation Manual, 02. YIELD. Madrid