Kleptomania Causes and Treatment
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 below.
More Great Links
- 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
- Grant, JE and BL Odlaug. "Kleptomania: Clinical Characteristics and Treatment." Rev Bras Psyquiatr, 2007. http://www.scielo.br/pdf/rbp/nahead/art02.pdf
- Grant, JE et al. "The Neurobiology of Substance and Behavioral Addictions, CNS Spectrums (CME course)." http://www.cnsspectrums.com/aspx/articledetail.aspx?articleid=912
- Grant, JE et al. "White Matter Integrity in Kleptomania: a Pilot Study." Psychiatry Res 147 (2-3): 233-237, 2006. http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1810346
- 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