Kleptomania Okezie Emmanuel Oral Robert
KLEPTOMANIA Okezie 8 Kleptomania Okezie Emmanuel Oral Roberts University Dr. Nelson April 21st, 2018
Kleptomania is an impulse control disorder characterized by a recurrent inability to resist the urge to steal items, often regardless of their value or necessity. Individuals affected by this disorder typically experience increasing tension before the act and a sense of relief or gratification afterward, despite feelings of guilt or shame. This condition is frequently associated with other mental health issues such as mood disorders, anxiety, and substance abuse. The etiology of kleptomania remains unclear but is believed to involve both genetic and neurobiological factors, including brain chemistry imbalances and structural changes.
Symptoms of kleptomania manifest through episodic, uncontrollable thefts that are impulsive rather than premeditated or motivated by anger or revenge. Affected individuals often experience a build-up of tension prior to stealing, and a subsequent sense of liberation or satisfaction during or after the theft. Notably, these individuals might feel remorse and attempt to return stolen items or hide their behavior. Importantly, kleptomania differs from shoplifting or theft driven by material gain or malice, as it is rooted in compulsive urges and emotional regulation difficulties (Grant, 2006).
Research-Based Understanding of Symptomatology
The cause of kleptomania is not fully understood, but current research suggests a multifaceted etiology involving genetic predispositions, neurochemical imbalances, and environmental factors. Studies indicate that individuals with a family history of impulse-control disorders or mood disorders are at higher risk, highlighting the potential role of heredity in the disorder's development (Christianni et al., 2015). Neuroimaging studies have revealed abnormalities in the brain's frontal cortex and limbic system, which are critical in impulse regulation and emotional processing (Christianni et al., 2015).
The clinical presentation of kleptomania occurs in distinct stages: initial tension buildup, impulsive theft, and subsequent relief or gratification followed by remorse. These episodes are generally spontaneous and uncontrollable, often occurring in public settings or private spaces without prior planning. Patients may steal items of little or no monetary value, which they often discard or return after the act. The act of theft is typically not motivated by hostility or revenge but by an internal psychological drive that is difficult to resist (Thompson & Winstead, 2014).
Physiological Mechanisms Underlying Kleptomania
Understanding the physiological basis of kleptomania involves examining neurotransmitter systems within the brain that regulate impulse control and emotion. Research suggests that dysregulation of serotonergic and dopaminergic pathways plays a significant role. Low levels of serotonin have been linked to increased impulsivity and compulsive behaviors, while elevated dopamine levels are associated with the pleasurable sensations experienced during theft (Sophia & Monica, 2013). These neurochemical imbalances can disrupt normal brain functioning, leading to difficulty resisting impulses.
Structural brain changes, such as reduced gray matter volume in the prefrontal cortex—responsible for decision-making and impulse control—and abnormalities in the limbic system, which processes emotions and rewards, have been observed in individuals with kleptomania (Grant et al., 2013). Head injuries, traumatic brain injuries, or neurodegenerative conditions like Parkinson's disease may further contribute to the emergence of kleptomania by impairing neural circuits involved in self-regulation.
Factors Contributing to Kleptomania Development
Several risk factors increase the likelihood of developing kleptomania, including genetic predisposition, hormonal fluctuations, environmental influences, and comorbid mental health conditions. Family studies suggest inheritable components, with higher prevalence rates observed among individuals with relatives diagnosed with impulse-control or mood disorders (Black, 2013). Women are also disproportionately affected, constituting approximately 60-70% of cases, possibly due to hormonal or psychosocial factors (Grant, 2006).
Chronic stress, emotional trauma during childhood, and growing up in antisocial or neglectful environments contribute significantly toward the development of kleptomania. Psychoanalytic theories posit that compulsive stealing may symbolize a reenactment of childhood losses or a reaction to unresolved developmental tensions. Additionally, neuroendocrine changes, such as hormonal imbalances related to endocrine system lesions, are implicated in disrupting neural activity and emotional regulation, further exacerbating impulsive tendencies (Sophia & Monica, 2013).
Psychological and Social Factors
Psychologically, kleptomania is often linked to childhood trauma, neglect, or abusive experiences, which foster maladaptive coping mechanisms. Children who lack adequate emotional support or are exposed to violent or neglectful environments may internalize feelings of inadequacy or helplessness, leading to compulsive behaviors as a form of self-soothing or control (Grant, 2006). Socially, growing up in environments where stealing or defiant behaviors are normalized can reinforce maladaptive habits, making resistance to impulsive acts more challenging (Thompson & Winstead, 2014).
Treatment Approaches for Kleptomania
Effective treatment for kleptomania combines pharmacological and psychotherapeutic strategies aimed at reducing impulsivity and addressing underlying emotional conflicts. Because many individuals with kleptomania are reluctant to seek help, clinicians emphasize comprehensive assessment—including physical examinations, neuroimaging, and psychological testing—to tailor interventions appropriately (Black, 2013).
Psychotherapy remains the cornerstone of treatment, with cognitive-behavioral therapy (CBT) being particularly effective. CBT targets maladaptive thought patterns and teaches patients strategies to manage urges, recognize triggers, and develop healthier coping mechanisms. Techniques such as behavioral modification, urge management, and exposure and response prevention are commonly employed (Christianni et al., 2015). Psychoanalytic or psychodynamic therapies may also help patients explore unresolved childhood conflicts that contribute to their compulsions.
Pharmacologically, selective serotonin reuptake inhibitors (SSRIs) like fluoxetine, sertraline, and paroxetine are frequently prescribed to elevate serotonin levels, thereby reducing impulsivity and compulsive urges (Grant et al., 2013). Mood stabilizers such as lithium and anticonvulsants like topiramate, carbamazepine, and valproate have demonstrated efficacy in stabilizing mood and decreasing impulsive behaviors (Grant, 2006). Additionally, medications targeting dopamine release or opioid systems—such as naltrexone—are being investigated for their potential to diminish the rewarding sensations associated with stealing (Odlaug et al., 2013).
Emerging and Complementary Treatments
Complementary therapies including mindfulness training, stress reduction techniques, and biofeedback have shown promise in managing impulsivity and emotional dysregulation linked to kleptomania (Grant et al., 2013). Pharmacological agents like ashwagandha, valerian root, and California poppy are also explored for their calming properties and potential to mitigate hyperarousal, although scientific evidence remains limited. These alternative approaches serve as adjuncts to primary treatments and aim to enhance overall patient well-being and impulse control (Sophia & Monica, 2013).
Conclusion
Kleptomania is a complex neuropsychiatric disorder involving a combination of genetic, neurochemical, and environmental factors. Its hallmark symptoms are impulsive theft episodes accompanied by emotional tension and subsequent relief or guilt. Understanding its underlying physiological mechanisms, including neurotransmitter imbalances and structural brain abnormalities, informs targeted treatment strategies. Combining evidence-based psychotherapy with pharmacotherapy offers the most comprehensive approach, with emerging therapies providing additional hope for those affected. Continued research into the neurobiological basis of kleptomania will improve diagnostic accuracy and treatment outcomes, ultimately enhancing patients' quality of life.
References
- Black, D. (2013). Behavioral addictions as a way to classify behaviors. Journal of Addiction Science & Clinical Practice, 8(1), 12–20.
- Christianni, A. R., Conti, M. A., Hearst, N., Cordas, T. A., de Abreu, C. N., & Tavares, H. (2015). Treating kleptomania: A cross-cultural adaptation of kleptomania symptom assessment scale and assessment of an outpatient program. Comprehensive Psychiatry, 56, 98–107.
- Grant, J. (2006). Understanding and treating kleptomania: New models and new testaments. Israel Journal of Psychiatry and Related Sciences, 43(2), 81–89.
- Grant, J. E., Odlaug, B. L., Schreiber, L. R., Chamberlain, S. R., & Kim, S. W. (2013). Memantine reduces stealing behavior and impulsivity in kleptomania: A pilot study. International Clinical Psychopharmacology, 28(2), 89–94.
- Odlaug, B. L., Grant, J. E., Kim, S. W., & Potenza, M. N. (2013). Pharmacological treatments for kleptomania. CNS Drugs, 27(2), 107–119.
- Sophia, E. C., & Monica, L. Z. (2013). Addictive disorder. Women and Health, 52–65.
- Thompson, J. W., & Winstead, D. K. (2014). Impulse-control disorders. In Ebert, M. H., Loosen, P. T., Nurcombe, B., & Leckman, J. F. (Eds.), Current Diagnosis and Treatment in Psychiatry (pp. 435–445).McGraw-Hill.