How Kleptomania Works


Actress Winona Ryder was convicted of shoplifting in 2002, but she didn't attempt a kleptomania defense.
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Shoplifting in the United States costs retailers approximately $10 billion annually [source: Grant]. Professional thieves do some of the damage, but amateur shoplifters do the most. Most amateur shoplifters steal for personal use rather than resale, but a small percentage feels a compulsive need to steal. An addiction to stealing items not for personal use or monetary gain characterizes a behavior known as kleptomania.

While shoplifting has been a problem for centuries, kleptomania was first described as a psychological disorder in the early 1800s and has been only intermittently recognized by the American Psychiatric Article System Association as a type of mental illness since the 1950s. Psychiatrists continue to debate whether kleptomania is a distinct mental illness or a manifestation of some other psychological disorder. Although there has been little research on the neurobiology of kleptomania, some studies have provided biological clues, and some have attempted pharmacological treatment of this condition.

­There are many reasons for shoplifting: resale, supporting a drug habit, personal use and "just for the thrill of it." However, most of these reasons fit stealing, but not kleptomania. Kleptomania is characterized by an impulsive need to steal, and many kleptomaniacs are first discovered in the act of shoplifting. The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) has outlined the following criteria for a diagnosis:

  1. The individual repeatedly fails to resist the impulse to steal items that are not needed for personal use or monetary value.
  2. The individual experiences tension before stealing.
  3. The individual's tension is relieved or gratified by the act of the theft.
  4. The theft is not due to anger, revenge, delusions, hallucinations or impaired judgment (dementia, mental retardation, alcohol intoxication, drug intoxication).
  5. Other psychological disorders can't account for the individual's stealing behavior (like manic episodes and antisocial behaviors).

In this article, we'll examine what kleptomania is, how oft­en it occurs, who suffers from it, what might cause it and how it can be treated.

Kleptomania Characteristics

With the diagnosis criteria in mind, kleptomania as a true condition occurs in a rather small percentage of the population. While no true estimate of the general population is available, scientists estimate that kleptomania occurs in 5 to 10 percent of psychiatric patients [source: Grant].

Kleptomania tends to occur in women more than in men. However, there may be some gender bias in this finding because women who steal tend to get psychiatric evaluations, while men who steal tend to go to prison [source: Grant]. Similarly, there doesn't appear to be any one social group in which kleptomania is rampant

Kleptomania usually begins in the teens or 20s. By the time patients present themselves to psychiatrists, women are usually in their mid- to late 30s, while men are in their 50s. There have been reports of kleptomaniacs in their late 70s. We don't know if kleptomania has a genetic component, but some studies suggest that kleptomaniacs have parents or close relatives with substance abuse problems, obsessive-compulsive disorder and/or mood disorders.

Kleptomaniacs usually steal items that they could otherwise afford (like shampoo, clothing and sunglasses). They don't go into stores with the intent to steal, but they become tense with the prospect of theft and might not steal when there is a high probability of getting caught. The theft itself generally relieves the tension, but it leads to intense feelings of guilt, embarrassment, anxiety and remorse. Kleptomaniacs may hoard the stolen items, give them away, dispose of them or clandestinely return them.

Often, the stealing behavior of kleptomania occurs along with other psychological disorders, like obsessive-compulsive, personality and mood disorders. This observation has led some psychiatrists to question whether kleptomania is indeed a true psychological disorder or a manifestation of some other psychological disorder. Generally, kleptomania has been classed with other impulse control disorders, such as pathological gambling, pyromania and trichotillomania (chronic hair-pulling). Impulse control disorders are those where the individuals cannot resist the impulse to commit some behavior, criminal or otherwise. The addictive nature of kleptomania, as well as other impulse control disorders, has provided some insights for possible causes and treatments.

Kleptomania Causes and Treatment

Antidepressants can be used to treat kleptomania, but the results aren't consistent.
Antidepressants can be used to treat kleptomania, but the results aren't consistent.
Joe Raedle/Getty Images

There have been no rigorous or conclusive studies on the neurological basis of kleptomania. However, some have provided clues about its possible causes and locations within the nervous system. Here are some possible causes noted by psychiatrist Jon Grant of the University of Minnesota School of Medicine [source: Grant].

  • A defect in a molecule that transports the neurotransmitter serotonin (see How Antidepressants Work)
  • Head trauma: damage to circuits between the orbital and frontal lobes of the brain, or low blood flow to the temporal lobe
  • Decreases in the fine structure of white matter (axons and dendrites) in the frontal lobe. This could alter information flow between the frontal lobe and the thalamus/limbic system.

Taken together, these studies point toward the front of the brain, particularly connections involved in information exchange with the limbic system (which controls moods, emotions and desires).

Neuroscientists have implicated serotonin in addiction and depression. And impulse control disorders do resemble addictive behaviors. So, impulse control disorders may use the same neurotransmitter pathways -- and could possibly be treated by drugs that alter serotonin transport and reuptake.

Selective serotonin reuptake inhibitors (SSRI) like fluoxetine (Prozac), paroxetine (Paxil) and fluvoxamine (Luvox) have been used to treat kleptomania, but case reports of these treatments have demonstrated mixed results. Some have reported success in relieving kleptomania symptoms, while others have not indicated any effects at all [source: Grant].

Likewise, attempts to treat kleptomania with lithium (a mood stabilizer) or naltrexone (an opioid antagonist -- used to treat heroin and morphine addictions) have been inconclusive.

With the lack of clear neurobiology and pharmacological evidence for kleptomania, psychiatrists have used cognitive behavioral therapies [source: Grant].

  • Covert sensitization: When the patient feels the urge to steal, he must imagine negative consequences until the impulse goes away.
  • Aversion therapy: When the patient feels the urge to steal, he holds his breath until it is slightly painful. Eventually, he associates the unpleasant feelings with the urge, and the impulse to steal diminishes.
  • Systemic desensitization: The patient undergoes relaxation therapy and learns to substitute relaxing feelings for the urge to steal.

Like drug treatments, these cognitive behavioral therapies have achieved mixed results. Clearly, there needs to be more controlled behavioral, neurological and pharmacological studies for kleptomania, as well as other impulse control disorders. But a major problem is that many of these behaviors occur so rarely in the general population that getting enough subjects to obtain convincing scientific evidence may be difficult.

To learn more about kleptomania, take a look at the links on the next page.

Related Articles

More Great Links

Sources

  • ABC News Primetime. "Addicted to Stealing: Inside a Shoplifter's Mind." July 10, 2007. http://abcnews.go.com/Primetime/story?id=1190720&page=1
  • Adler, J. "The Thrill of Theft." Newsday, Feb. 25, 2002. http://www.diogenesllc.com/thrilltheft.pdf
  • BehaveNet clinical Capsule, DSM-IV Kleptomania. http://www.behavenet.com/capsules/disorders/kleptomaniadis.htm
  • Dell'Osso, B et al. "Epidemiologic and clinical updates on impulsecontrol disorders: a critical review." Eur Arch Psychiatry ClinNeurosci.256 (8), 464-475, 2006. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=16960655
  • Forensic Psychiatry. Kleptomania. http://www.forensicpsychiatry.ca/impulse/kleptomania.htm
  • Gazzinga, MS, and MS Steven. "Neuroscience and the Law." Scientific American Mind. April 15, 2005. http://www.sciam.com/article.cfm?id=neuroscience-and-the-law&print=true
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  • Grant, JE. "Co-occurrences of Personality Disorders in Persons with Kleptomania - a Preliminary Study." J Am Acad Psychiatry Law 32: 395-398, 2004. http://www.jaapl.org/cgi/reprint/32/4/395.pdf
  • Grant, JE. "Understanding and Treating Kleptomania: New Models and New Treatments." Isr J Psychiatry Relat Scie 43: 81-87, 2006.
  • Kohn, CS. "Conceptualization and Treatment of Kleptomania Behaviors Using Cognitive and Behavioral Strategies." Int J Behav Consult Therapy 2: 553-559, 2006. http://www.behavior-analyst-today.com/IJBCT-VOL-2/IJBCT-2-4.pdf
  • MayoClinic.com. Kleptomania. http://www.mayoclinic.com/health/kleptomania/DS01034
  • Menaster, M et al. "Psychiatric Illness Associated with Criminality." eMedicine, Sept. 14, 2006. http://www.emedicine.com/med/topic3485.htm
  • National Association of Shoplifting Prevention. http://www.shopliftingprevention.org/main.asp
  • Psychiacomp. "Impulse Control Disorders." http://www.psychiacomp.com/didactic/impulse-control.php
  • Psychology Today. Kleptomania. http://psychologytoday.com/conditions/klepto.html
  • Shoplifters Anonymous. http://www.shopliftersanonymous.com/
  • Washington Post. "Antidepressants Don't Help Kleptomaniacs." March 16, 2007.http://www.washingtonpost.com/wp-dyn/content/article/2007/03/16/AR2007031601175.html
  • Yagoda, B. "Addicted to Stealing." Self, February 1994. http://www.shopliftingprevention.org/WhatNASPOffers/NRC/ArticlesToRead/Addicted_To_Stealing.htm