Kleptomania: causes, symptoms, treatment, psychotherapy

Pathological addiction, in which an obsession with petty thefts arises, is kleptomania. Let's consider its features, signs, methods of correction and treatment.

Irrational obsessive and irresistible urge to commit theft or kleptomania, is no less dangerous than alcoholism, drug addiction or gambling addiction. According to the International Classification of Diseases of the Tenth Revision ICD-10, the disorder belongs to Category V Mental and Behavioral Disorders (F00-F99):

F60-F69 Personality and behavior disorders of adulthood.

• F63 Disorders of habits and drives.
  • F63.2 Pathological compulsion to steal (kleptomania).

The unconscious formula of kleptomania: "If you don't give it to me, I'll take it anyway." The disease is characterized by repeated unsuccessful attempts by the kleptomaniac to resist the desire to steal something that is of no value to him. In this case, the stolen items may be damaged, given away or hidden. The patient's behavior is accompanied by a growing feeling of tension before the theft and complete satisfaction at the time of its commission and after it.

This pathology was first classified as a mental disorder in the 1960s in the United States. People with this diagnosis are protected by law. Theft is a mental disorder. The patient is forced to steal, although he knows about possible criminal liability. The kleptomaniac repents of the actions he has committed, but after a while he repeats everything again.

Epidemiology

Medical statistics indicate that 0.1-0.6% of the entire population is subject to an uncontrollable desire to steal. According to studies, about 5% of all shoplifting is committed by kleptomaniacs.

In most cases, the disease is diagnosed at 30-40 years of age, the average age of onset is 20 years. The pathology is more often diagnosed in women than in men. The development of obsessive-compulsive disorder is associated with social factors and family history.

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Causes kleptomania

The exact causes of kleptomania are still unknown. There are several theories about the origin of the disorder, let's consider them:

1. Structural changes in the brain. The disease may be associated with the transmitter of a nerve impulse, i.e. the function of the neurotransmitter serotonin. It is involved in the regulation of emotions and mood. Low levels of serotonin lead to uncontrollable behavior, and the release of dopamine gives pleasant sensations. Because of this, addiction develops and a desire to experience "those feelings" again arises.
2. Head injuries. Other studies indicate that the disease may occur after accidents involving head injuries or organic brain damage. The destructive addiction occurs in epilepsy, after strokes, progressive paralysis and senile dementia.
3. Family history. People whose parents had bipolar disorder, obsessive-compulsive disorder, anxiety-phobic conditions, alcohol or drug addiction, nervous bulimia or anorexia are at risk of developing the disorder.
4. Hormonal changes – endocrine system damage. This reason is based on established facts: most often attacks are determined in the climacteric period, during pregnancy and before menstruation.
5. Past mental illnesses. These may include sexual disorders or eating disorders. Hereditary predisposition is important.

In most cases, a kleptomaniac is a hysterical personality. This characterological feature significantly reduces the ability to control one's behavior and manage desires. A hysteric is unable to resist abnormal needs, so any pathological desire progresses very quickly.

Risk factors

Kleptomania is a rare mental disorder that most often manifests itself in adolescence or adulthood, in rare cases at 50-60 years of age. Risk factors for the disease include:

• Hereditary predisposition. Having a family history significantly increases the risk of the disease.
• Female gender. According to medical statistics, about 60-70% of patients are women.
• Frequent stress and chronic nervous tension. In this case, stealing is perceived as a reward for past failures and suffering. This is observed in schizophrenia, as a result of hallucinations or delirium.
• The disease can develop in people who grew up in antisocial families. In this case, a statement is developed at a subconscious level: stealing is normal. Stealing gives moral satisfaction.

The risk of developing the disease in childhood is most often associated with the following factors:

• Young children commit thefts because they do not understand the fact that such actions are prohibited.
• Lack of parental attention very often leads to the child taking over parents' money or things. This is a specific reunification with parents.
• Lack of money for small expenses.
• The desire to assert oneself when communicating with peers or children from wealthier families.

In addition to the above risk factors, an uncontrollable addiction to theft can develop in people who have experienced serious personal drama.

Pathogenesis

The mechanism of kleptomania development is similar to other pathological addictions – alcohol, gambling or drugs. According to scientists, the pathogenesis of the disease is associated with the TDP-43 protein, which is present in the brain and spinal cord. Its mutations lead to abnormal cell growth. The disorder occurs when the hypothalamus and limbic system are dysfunctional. The pathogenesis of antisocial behavior depends on the possible factors and causes of its occurrence.

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Symptoms kleptomania

Anyone can become a kleptomaniac, regardless of social status or financial situation. Symptoms of kleptomania appear in stages, let's consider them:

• An uncontrollable urge to steal something that has no benefit or value. This leads to resistance to the obsessive desire
• The feeling of tension increases, as does the adrenaline rush before the theft.
• After the deed is done, there is a feeling of relief and satisfaction. Self-blaming thoughts, guilt and shame for what was done gradually appear.
• Episodes occur without planning, that is, spontaneously. This can happen in a public place or at a party. The patient does not show signs of schizophrenia.
• A kleptomaniac commits thefts independently. Stolen items may be returned to their place or thrown away because they are no longer needed.

The process of stealing is accompanied by a strong psycho-emotional load on the body. A feeling of moral satisfaction and pleasure arises. The patient can commit thefts constantly or observe certain time intervals. The degree of duration of thefts depends on the level of development, that is, the neglect of the disease. The pathological condition can arise due to temporary life situations. For example, during menstruation or pregnancy. That is, due to the aggravation of the perception of the surrounding world.

Obsessive-compulsive disorder has certain symptoms. The first signs of the pathological condition depend on the patient's age and the cause of the disorder. Let's consider the symptoms of kleptomania:

• Spontaneous occurrence of episodes of the disease. Attacks occur at the most unexpected moments and in the most inappropriate places.
• The desire to steal is so strong that it is impossible to resist.
• Theft is accompanied by tension, which quickly gives way to satisfaction and guilt.

Stolen items may be returned or thrown away; thefts are not intended to be revenge.

Kleptomania in children

As a rule, kleptomania in children develops against the background of psychological distress, which is significantly aggravated by the inability to control one's desires. Let's consider the main symptoms of the disease in childhood:

• There are things in a child's life that have a negative effect on his emotions.
• During the theft, the child is tense and experiences euphoria at the same time.
• Young kleptomaniacs commit thefts on their own, without informing their friends or family of their actions.
• Stealing can be a method of expressing anger or spite.
• The child truly understands what has been done, that is, there are no vague explanations for the offense.
• The disease can grow out of an inferiority complex.
• A kleptomaniac may feel unwanted or deprived, so he tries to have as many things at his disposal as possible.

Even if a child tries to hide his pathological addiction, the presence of kleptomania does not go unnoticed by others. Parents should closely monitor any changes in the child's behavior and, at the first symptoms of the disease, contact a child psychologist. The following signs indicate the development of pathology:

• The appearance of other people's things or money in the house.
• Loss of valuable items.
• Minor loss of money from parents' wallet.
• Depressed state and isolation.
• Refusal to communicate with peers.
• Increased irritability, aggressiveness.
• Sharp mood swings.
• Insomnia and sleep problems.
• Changes in appetite.

Even though the child knows that stealing other people's property is wrong, he or she cannot resist uncontrollable impulses. As a rule, children try to find a logical explanation for their actions. The desire to try something new or unusual may prompt theft.

Treatment of childhood kleptomania is aimed at eliminating the factors that provoked the onset of addiction. As a rule, this is the creation of a favorable climate in the family and providing comfortable conditions for the child in a children's group. Treatment is carried out by a psychologist, and not only children but also parents need therapy. In particularly severe cases, psychotherapy may be prescribed in combination with hypnosis sessions.

In most cases, pharmacological agents are not used to treat children. But if a serious mental disorder or organic disease is detected, then medication is indicated. These may be antidepressants or drugs that improve cerebral circulation and brain activity, calming and improving sleep. Particular attention is paid to the prevention of the disorder. Parents need to be interested in their children's lives and take an active part in them.

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Kleptomania in adolescents

Cases of kleptomania in adolescents occur more often than in children. As a rule, the pathology develops at an early age. The patient is mentally unstable, but does not have criminal thoughts. Girls are more susceptible to the disease than boys.

Obsessive-compulsive disorder in adolescents has the same causes as in adults. That is, it is associated with biochemical disturbances in the brain, emotional shocks, or other mental illnesses.

Let's look at the most common factors of kleptomania in adolescence:

• Parental attention deficit – insufficient emotional contact or its absence leads to the formation of the disorder. The child tries to compensate for the lack of emotional response through an unconscious craving for theft. At the same time, the patient is not aware of his actions and does not understand why he committed theft. This factor is typical for children from wealthy families.
• Dysfunctional family – growing up in a pathological environment leaves a negative imprint on the child’s psyche. Constant quarrels and scandals lead to the teenager unconsciously trying to neutralize the conflict atmosphere. This allows parents to temporarily distract their attention from quarrels and switch to their child’s misdeeds.
• Self-affirmation among peers – attempts to find one’s place in a group of children, one of the common causes of the disorder. Through antisocial behavior, a child gains authority among peers and tries to establish strong social contacts. This is observed in children who consider themselves “black sheep” in a group, who are too indecisive or shy.
• The need to show their "adulthood" - teenagers may commit thefts because of the desire to prove their adulthood and a certain coolness. The desire to steal may be the only option for communicating with other teenagers and being accepted into the group.

In addition to the above reasons, certain factors are identified that increase the risk of developing the disorder: oligophrenia, endocrinological spectrum diseases, organic lesions of the central nervous system and brain. The risk of developing kleptomania exists in people with an anxious or choleric temperament.

Another possible cause of mental disorder is the lack of moral principles and ethical values. In this case, the teenager does not have the idea that stealing is a crime that requires punishment. The child believes that he is not stealing, but simply taking other people's things. At the same time, the process of stealing brings pleasure and peace, causing dependence on the resulting emotional experiences.

Parents should not turn a blind eye to the disorder, as the pathological addiction will not disappear on its own. For treatment, you should contact a psychologist who will help you overcome the harmful attraction.

Stages

During the development process, kleptomania goes through several stages. The stages of the disease are determined by its symptoms, let's consider them:

1. An obsessive desire to steal something that is actually unnecessary and of no value. The process of stealing is accompanied by a strong feeling of tension, which is replaced by satisfaction due to the action performed.
2. After the feeling of relief comes the stage of self-flagellation and guilt for what was done.
3. Attacks occur spontaneously. The desire to steal something can overtake both in a public place and at home.

Moreover, the more advanced the disease, the more frequent the episodes. All thefts are committed independently, and the stolen items can be thrown away over time and even returned to their place.

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Forms

Mental disorder associated with an irresistible urge to steal has several varieties. Let's consider the main types of kleptomania depending on the cause of its origin:

1. Sexual perversion – the desire to commit theft is caused by the desire to experience sexual arousal. This type of disorder is based on sexual dissatisfaction.
2. The oral impulse is the state of an adult stuck in childhood. Stopping at the oral stage of psychosexual development indicates neurotic regression. That is, thefts are still committed by a "little child" in an adult's body.
3. A neurotic desire to possess something, by any means. In this case, it may not only be things, but also a physical condition, for example, a slim figure. Based on this, anorexia is partly related to kleptomania.

All three types of antisocial behavior are sexually oriented. According to the intermediate classification, the disease is characterized by sexual deviations and deviation. Treatment depends entirely on the causal mechanism of the pathology.

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Complications and consequences

Without timely and proper treatment, obsessive-compulsive disorder causes certain consequences and complications. Most often, patients face internal conflicts between the mental system of the ego and superego. That is, the patient tries to convince himself that he has every right to steal, since he has not received enough love or attention. Such self-hypnosis is unsuccessful in most cases. The kleptomaniac experiences a feeling of guilt and tries to overcome it by stealing even more and creating a vicious circle.

The patient feels powerless and cannot stop his addiction. Immoral behavior gradually destroys the psyche. Without treatment, kleptomania can lead not only to psychological and emotional problems, but also to legal and financial ones:

• Depressive state.
• Arrest, that is, deprivation of liberty.
• Eating disorders.
• Restless.
• Pathological addictions (gambling, alcohol, drugs).
• Social isolation.
• Suicidal behavior and thoughts.

Mental disorder can have a direct sexual meaning. In some cases, committing theft is the only way to satisfy frigidity or low libido.

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Diagnostics kleptomania

Uncontrollable attraction to theft is revealed with the help of a special examination. Diagnosis of kleptomania is carried out with the help of psychological testing, magnetic resonance and computed tomography, EEG.

Some signs of the disease are visible to the naked eye. The disorder can be suspected if the following factors are present:

• A recurring urge to steal something that a person does not need and that has no value for him.
• Tension and anticipation of joy before the theft, a feeling of satisfaction and relief after it.
• The theft is committed alone, without irritation, revenge or anger. The patient does not have schizophrenia or a state of delirium.

Another diagnostic feature of kleptomania is a certain periodicity of attacks. That is, thefts do not occur daily, as this is too much of a burden on the psyche. During the period of remission, that is, when the patient has found ways to compensate for theft, attacks are isolated with long time intervals.

Kleptomania test

The main factor that allows diagnosing kleptomania is the unintentional commission of theft. That is, the theft occurred due to a mental disorder and does not represent material gain or intent. It is not a sign of antisocial personality disorder or bipolar disorder. To confirm that the episode is caused by obsessive mania, the patient is sent for a forensic psychiatric examination.

Let's consider the main criteria for diagnostic testing:

1. You are unable to resist the urge to steal something you don't need.
2. The feeling of tension and anticipated pleasure makes one commit a crime.
3. After the theft, there is a feeling of euphoria, which can be compared to sexual satisfaction.
4. The attacks are not associated with selfish motives, drug use, medication, or a desire for revenge.

The test for kleptomania must meet the criteria of the DSM, or Diagnostic and Statistical Manual of Mental Disorders.

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Differential diagnosis

If kleptomania is suspected, the patient will undergo comprehensive examinations. Differential diagnostics allows us to separate obsessive-compulsive disorder from disorders with similar symptoms.

Obsessive urge to steal is differentiated from the following pathologies:

• Personality disorders caused by organic brain damage.
• Mood disorders.
• Antisocial personality disorder.
• Mental retardation.
• Schizophrenia.
• Dementia.
• Pathologies associated with the use of psychoactive substances.
• Delirium.
• Temporal lobe epilepsy.
• Artificially demonstrated violations.

In addition to the above syndromes, kleptomania has been compared to impulse control disorders and other mental illnesses.

Kleptomania or theft

A forensic psychiatric examination is necessary to determine what caused the crime – kleptomania or theft. A diagnosis such as kleptomania is made if the theft occurs during an unsuccessful attempt to resist a harmful impulse. The stolen items are of no value.

A kleptomaniac commits an act for the sake of the process of theft and the pleasure of the moment of its commission. His actions are careless and spontaneous, and the stolen things are not expensive, since the patient does not have the goal of getting rich. The entire process is carried out alone.

The thief plans his actions, and the stolen items are needed by the subject for profit. Very often, petty thieves feign frustration to avoid punishment. Thefts can be committed in a team with accomplices, inventing sophisticated plans to appropriate someone else's property.

Treatment kleptomania

People with antisocial behavior with uncontrollable urges to steal very rarely seek help on their own. Treatment of kleptomania is aimed at normalizing the patient's condition and eliminating obsessive thoughts. As a rule, therapy consists of psychiatric care and medication.

Psychotherapy for kleptomania

It is carried out to identify the true causes of pathological addiction. This method has several varieties, let's consider them:

1. Behavioural psychotherapy – separates unhealthy beliefs and behaviours, replacing them with positive and healthy ones.
2. Aversion therapy - a psychologist models a situation that causes the patient to want to steal. At this point, the patient holds his breath until discomfort and lack of oxygen. This method is moderately painful, but with regular training it causes unpleasant, uncomfortable associations when wanting to steal something.
3. Group psychotherapy – the patient meets people with the same problem. Anonymity and complete trust in the group allow to determine the causes of the disease and find ways to correct it.

Regardless of the type of psychotherapy, the patient must prepare for such treatment. All symptoms that occur at the time of theft should be recorded. This will help to determine what influences the harmful desire. Anamnesis of life and identification of traumatic and stressful situations are also necessary.

It would not be superfluous to make a list of questions for the psychiatrist, which will allow you to learn more about the disease: why the pathology arose, what treatment methods are effective and can help, how often sessions are needed, etc. In turn, the psychiatrist will also ask a number of questions. The main ones are: at what age did the pernicious desire arise, how often do attacks occur, what sensations arise at the time of the crime.

Drug treatment

The doctor selects medications or makes up certain pharmacological combinations that suppress the harmful urges. It is the doctor who selects the dosage and duration of therapy, individually for each patient. Most often, kleptomaniacs are prescribed the following medications:

• Antidepressants – selective serotonin reuptake inhibitors have pronounced therapeutic properties. Prozac and Paroxetine are widely used.
• Mood stabilizers – needed to balance mood and control urges to steal. One of the popular stabilizers is Lithium.
• Normotimics – reduce the level of excitation in the brain and reduce the urge to commit crimes. Such drugs are used to treat epilepsy: Topiramate, Carbamazepine, Tegretol.

In addition to medications, herbal medicine can be used to treat attacks of kleptomania: ashwagandha herb (stabilizes adrenaline functions), valerian root, St. John's wort, California poppy and other plants.

Before treatment, the patient's physical and psychological condition is assessed. Physical examinations (laboratory tests, MRI, CT) are necessary to identify changes or damage to the brain, metabolic disorders. Mental examinations consist of special tests and questionnaires, the results of which are taken into account when making a final diagnosis.

How to get rid of kleptomania?

The question of how to get rid of kleptomania is of interest not only to patients, but also to their relatives, who also suffer from the disorder of loved ones. Today, there are no specific medications or methods that can quickly and permanently cure the destructive addiction to steal. Only a comprehensive approach - psychotherapy and taking medications, reduce or eliminate the symptoms of the disease.

Psychotherapy is psychoanalysis and criticism, which are aimed at motivating the patient to change behavior. Behavioral therapy consists of systematic desensitization, restoration of damaged social and family ties, aversive conditioning. Medicines stabilize the production of adrenaline, improve the mood and condition of the patient.

Prevention

According to medical statistics, about 10% of people have committed theft at least once. In most cases, this is petty theft, which under certain circumstances can develop into an uncontrollable pathology. Prevention of kleptomania and prevention of relapses of the disease consists of:

• Taking medications prescribed by your doctor.
• Regular psychotherapy sessions.
• Elimination of factors that provoke the disorder.
• Avoiding situations, thoughts and feelings that trigger urges to steal.
• Giving up alcohol and other bad habits.
• Learning relaxation techniques (yoga, meditation) to combat increasing stress.

For successful recovery, the patient needs to focus on the goal of recovery and adhere to the chosen motivation.

Support from loved ones is of particular importance in the prevention process. Relatives and friends should understand that the patient's recovery is a long process in which they are involved. Relatives should help and evaluate the actions of the kleptomaniac, but without condemnation and bias. Particular attention should be paid to family psychotherapy.

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Forecast

Obsessive-compulsive disorder with an irresistible desire to steal things of no value, has a chronic course. The disease is characterized by periodic deterioration and improvement of the condition. The prognosis depends on a number of factors. First of all, this is the patient's age, the reasons causing the addiction and the prescribed treatment methods.

Kleptomania, with timely and correct therapy, has a favorable prognosis. After treatment, the patient is normally restored to society and can carry out professional activities. But only a small number of patients seek help. If the disorder is left unattended, it can lead to a number of serious consequences and complications, the most common of which is arrest, that is, imprisonment due to a crime committed.