Kleptomania: The sudden urge to steal

Stealing is an action we are taught to avoid from a young age. It is the basic foundation for right and wrong. In a certain population of people with Kleptomania, however, the spontaneous urge to steal cannot be resisted. Kleptomania is a psychological condition causing the sudden urge to steal. Read further to discover the psychological processes which underlie this bizarre impulse disorder.

What is Kleptomania?

Kleptomania is a psychological disorder of impulse control characterized by the urge to steal items that are of little monetary value. Individuals with the diagnosis struggle to resist the compulsion to steal. What separates kleptomania from shoplifting is that the act of stealing is unplanned. While shoplifting is typically strategized and provides relief from a situation such as the need for clothes and food, kleptomaniacs are driven to steal on a whim and without preparation beforehand. They have significant anxiety after experiencing brief feelings of relief.

An estimated 6 per 1000 people or 1.2 million American adults have this disorder. Founded in the 19th century by Mathey, women are more prone to the disorder than men. The onset arises in late adolescence but continues well into adulthood.

Signs and Symptoms of Kleptomania

People with this disorder present with a range of signs and symptoms defining episodes of theft. This includes:

• Recurrent impulse to steal—Stolen items are not for personal gain.
• Anxiety—Intense feelings of anxiety and tension precede the theft event.
• Relief and euphoria—During the theft, those with this disorder possess a sense of gratification by satisfying their urges to steal.
• Low self-esteem—Depression, guilt, remorse, and self-hatred come after the theft. These combined emotions result in low self-esteem.
• Stealing from friends and family—Theft from public locations like malls and stores are common, but the compulsion to steal is so strong that Kleptomaniacs also steal from their friends and family.
• Fear of arrest— People with it avoid seeking therapy out of fear they will be turned in and arrested by authorities.
• Giving away items—Stolen objects are items of no value to the individual. They are usually given to others, hidden, or eventually returned.

Kleptomania Diagnostic Criteria

Kleptomania is a difficult condition to diagnose. The signs and symptoms rely on self-reported, subjective traits that are difficult to confirm. Mental health professionals cannot easily measure the self-reports of theft, the reasons why the theft occurred, and whether the theft was planned or spontaneous. The Diagnostic and Statistical Manual of Mental Health Disorders (DSM) does offer a set of criteria to diagnose it:

• Compulsive, unplanned theft of items that are of little monetary value—the individual can pay for the stolen items themselves and find it hard to resist the urge to steal
• Increased tension before the theft
• Pleasure and relief when committing the crime of stealing
• The motives for stealing are not to express anger, nor are they related to a delusion or hallucination
• Another conduct disorder, manic episode, or psychological condition cannot better explain recurring theft

Causes of Kleptomania

The causes of kleptomania are not entirely known. Experts hypothesize that the condition is caused by changes in brain chemicals called neurotransmitters—specifically serotonin, dopamine, and an imbalance of the opioid system.

Serotonin is a neurotransmitter involved in numerous physiological functions throughout the body, but it is mainly recognized for regulating mood and emotion. Low levels of serotonin are connected to impulse disorders.

Similarly, dopamine is a neurotransmitter important for movement, attention, memory, and reward behavior. In those with this disorder, spontaneous theft provokes a surge of dopamine. The feel-good sensations derived from increased dopamine fuels their pleasure-seeking behavior.

Additionally, the brain’s opioid system is closely associated with the reward and pleasure-seeking behavior induced by the brain’s neurotransmitters. The opioid system controls urge. When the opioid system is compromised, people with kleptomania cannot repress the urge to steal.

Kleptomania and Other Psychiatric Disorders

There are certain risk factors leaving one prone to Kleptomania. Someone is more likely to be diagnosed if they have a first-degree relative who displays symptoms of it or a related psychological disorder. The chances of developing kleptomania are also higher if the individual has obsessive-compulsive disorder, anxiety, an eating disorder, or substance abuse disorder.

Kleptomania and Obsessive-Compulsive Disorder

Obsessive-compulsive disorder (OCD) is a psychological disorder characterized by excessive intrusive thoughts labeled as obsessions and repetitive compulsive behaviors to reduce anxiety. Studies reflect that the “repetitive [theft] behavior seen in kleptomania is suggestive of a compulsion” (Grant & Potenza, 2006). The excessive urge to steal is comparable to the ritualistic behaviors depicted in obsessive-compulsive disorder. The probability that those with kleptomania will have other compulsions is rather high due to the neurotransmitter imbalance prevalent in both disorders. Research correlates kleptomania with behaviors such as obsessive hand washing, hoarding, and trichotillomania (compulsive hair pulling).

Kleptomania and Anxiety

60 to 80% of kleptomaniacs have a comorbid anxiety disorder (Grant, Odlaug, & Kim, 2010). The disorder itself produces secondary anxiety stemming from the surrounding fear of getting caught, as well as the guilt, depression, and hopelessness from being unable to stop themselves from theft. However, individuals with kleptomania are susceptible to primary anxiety disorders that are only compounded by the anxiety from their urge to steal. Compulsive theft is seen as a way to reduce tension and worry.

Kleptomania and Eating Disorders

Eating disorders describe a group of illnesses which influence a person’s thoughts of food and eating behaviors. Restricting food, binge eating, and preoccupation with body-image are indicators of an eating disorder. Bulimia nervosa is a type of eating disorder that afflicts a great number of the population with kleptomania. Bulimia causes episodes of consuming unusually large amounts of food (binging) followed by behaviors to make up for overeating like forced vomiting (purging), fasting, or unhealthy exercise. Kleptomania co-occurring with various eating disorders is linked to the severity of the eating disorder. Food items are the objects sought when engaging in the uncontrollable urge for theft.

Kleptomania and Substance Abuse

Substance abuse disorder is commonly known as drug addiction. The inability to control the use of legal and illegal substances leads to problems in daily functioning. Substance abuse interferes with health, work or school, and relationships. Since addiction is rooted in impulse control, substance abuse disorder and kleptomania share qualities of a compulsive urge to participate in unwanted behavior.

Treatment for Kleptomania

The consequences of kleptomania are overwhelming. It is imperative those with kleptomania receive treatment immediately, as stealing is a crime. Ridding of the compulsion for theft is crucial to avoid future arrests and secondary psychological disorders. Managing kleptomania is possible with a combination of medications and therapies.

Medications

• Selective serotonin reuptake inhibitor (SSRIs)—Selective serotonin reuptake inhibitors are the drug class of choice for kleptomania. SSRIs block the reuptake of serotonin the brain. With reduced levels of serotonin in the disease process, SSRIs treat kleptomania by increasing the availability of neurotransmitters.
• Lithium— Some patients with kleptomania have shown improvements from lithium therapy. Lithium is prescribed for bipolar disorder because of its mood stabilization properties, but the effects on the central nervous system increase serotonin synthesis and have advantages in the impulse control mechanisms of kleptomania.
• Valproic acid— Valproic acid is an anti-seizure medication that calms the nervous system and reduces unwanted behavior.
• Opioid receptor antagonists—Opioid receptor antagonists are a group of medications that bind to the opioid receptors. They benefit impulse control disorders and lessen symptoms of compulsive urges and behaviors.

Psychoanalytic or Psychodynamic Therapy

A psychoanalytic approach to therapy has exhibited modest improvements in those with kleptomania. This therapy emphasizes that theft behaviors in kleptomania are symbolic of the individual’s unconscious desires. Psychoanalytic or psychodynamic therapy was the intervention of choice for many decades until replaced with new perspectives. The information learned has advanced the treatments for kleptomania today.

Cognitive Behavioral Therapy

Cognitive behavioral therapy is a form of psychotherapy, or talk-therapy, which focuses on how thinking patterns shape behavior. To treat kleptomania, the therapist works with the client to identify distorted thoughts, beliefs, and attitudes that contribute to the compulsive urge to steal. Cognitive behavioral techniques like covert sensitization—where the client imagines the negative consequences arising from theft—have the best outcomes. Exposure therapy is an alternative technique which exposes the client to situations where they are confronted and must resist the sudden urge to steal. Therapy alone is not as successful as combining cognitive behavioral therapy with pharmaceutical treatments.

Group Therapy

While individual therapy is necessary, group therapy can be an asset to kleptomania treatment. It provides support from others enduring similar conditions. Group therapy is optimal for treatment when kleptomania is controlled. The group support creates a judgment-free zone of encouragement in which to remain in remission yet share in the struggles of potential relapse and conflicting emotions from a history of compulsive theft. Any hardship is a little easier with a friend.

References

Grant, J. E., Odlaug, B. L., & Kim, S. W. (2010). Kleptomania: Clinical Characteristics and Relationship to Substance Use Disorders. American Journal of Drug & Alcohol Abuse, 36(5), 291–295. https://doi-org.ngu.idm.oclc.org/10.3109/00952991003721100

Grant, J. E., & Potenza, M. N. (2006). Compulsive aspects of impulse-control disorders. The Psychiatric clinics of North America, 29(2), 539–x. doi:10.1016/j.psc.2006.02.002

Cheyanne Perry

Cheyanne is currently studying psychology at North Greenville University. As an avid patient advocate living with Ehlers Danlos Syndrome, she is interested in the biological processes that connect physical illness and mental health. In her spare time, she enjoys immersing herself in a good book, creating for her Etsy shop, or writing for her own blog.