One of the characteristics of psychological disorders is that their existence does not depend on ethical codes: they exist independently of them. The case of kleptomania is an example of this: it is a behavioural alteration based on the act of stealing, and which takes place in people who know perfectly well that stealing is not right, but who can hardly control themselves.

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

Kleptomania as a disorder

Stealing is a crime that is generally carried out voluntarily and with full awareness, and its main purpose is to obtain the property or product in order to use it or to obtain some kind of economic benefit from it.

However, there are people who do not commit theft for this reason and 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 who suffer from kleptomania .

Kleptomania is a psychological disorder or psychiatric disorder, which is characterized by the existence of a strong urge to steal objects that the subject is unable to resist .

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

Symptoms

The theft in is not a premeditated or pre-planned act , but arises as a reaction to tension or as an emotional discharge through which to calm your 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, and furthermore it is not carried out with the aim of revenge or expressing anger. Nor is it a way of rebelling against society and norms, as someone with antisocial disorder might do, or a response to a delusional idea or hallucination. Nor is it a response to a delusional idea or a hallucination. Likewise, it is not the result of an alteration of consciousness such as would be caused by drug use or the presence of a manic episode.

Kleptomania is one of the so-called impulse control disorders (now destructive impulse control and behavioural disorders), a group to which both this disorder and pyromania or intermittent explosive disorder belong, and which is characterised by the difficulty in controlling impulses, emotions and desires that appear suddenly and irresistibly, without any further cognitive or psychiatric impairment.

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 are carried out. This condition can appear at very different ages , including childhood or adolescence and in a few cases in adulthood. It is more frequent in young women. In some cases it remits on its own, although sometimes it re-emerges in response to stressful situations or remains for years (although with treatment the prognosis is very favourable).

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

It is relevant to mention that although theft cannot be explained by other disorders, it is common for there to be comorbidity with other alterations (which occur jointly with kleptomania and another disorder). 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 a theft, but is unable to resist taking the property in question. In fact, it is not uncommon that once stolen the object in question is returned 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 day-to-day life.

In addition to this it can be common for them to be caught in the act and have problems with justice , so that they can be sentenced to prison. This can also lead to problems on a social level, to the point of having interpersonal conflicts and even being rejected by their environment, or having difficulties on a work level.

Lack of control over impulses can lead to the subject feeling little sense of self-efficacy, which in turn can lead to the feeling of little control over their life and eventually to the emergence of mood problems. It can also lead to behaviors of accumulation of stolen objects.

Possible causes of its appearance

The exact causes of the appearance of kleptomania are not known, although there are different hypotheses that attempt to offer a possible explanation for the reason of this pathology (most of which comes from the psychodynamic current).

Within the psychodynamic orientation, kleptomaniacal 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 forbidden 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 childhood.

Possible risk factors have been observed to include the presence of head injuries (which may have damaged the frontal lobe and the capacity for behavioural inhibition), alterations at the dopaminergic, serotonergic or neurotransmission level of endogenous opioids. In addition, 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 table is the presence of a high level of impulsivity . They tend to be people with a great intensity in their fantasies and desires, in some cases with less tolerance for delayed gratification and high sensitivity to reward 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 a possible involvement of the nucleus accumbens and the brain’s reward system has been suggested, influencing impulses and motivation. T

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

Treatment

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

Among the different therapies at a psychological level we can find in first place the systematic desensitization , in which the subject is exposed to anxious situations with the aim of confronting them by carrying out behaviours incompatible with anxiety, or the carrying out of alternative behaviours to theft. Another alternative is exposure with response prevention.

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

At the pharmacological level, antidepressant drugs such as the SSRIs (which are used in both depression and OCD) have been seen as effective, especially some such as fluoxetine or fluvoxamine. Although these are drugs of choice, mood stabilisers, 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 & Science 19(6):540-5.
  • Madden, G.J.; Bickel, W.K. (2010). Impulsivity: The Behavioral and Neurological Science of Discounting. Washington, DC: American Psychological Association.
  • 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). Clinical Psychology. Manual CEDE de Preparación PIR, 02. CEDE. Madrid