Kleptomania: causes, symptoms, treatment, psychotherapy

Pathological dependence, in which there is an obsession with small thefts - is kleptomania. Let's consider its features, signs, methods of correction and treatment.

Irrational compulsive and irresistible attraction to commit theft or kleptomania, carries no less danger than alcoholism, drug addiction or game addiction. According to the International Classification of Diseases of the Tenth Revision of the ICD-10, the disorder is classified as Category V Mental and Behavioral Disorders (F00-F99):

F60-F69 Disorders of personality and behavior in adulthood.

• F63 Disorders of habits and drives.
  • F63.2 Pathological attraction to theft (kleptomania).

The unconscious formula of kleptomania: "If you do not give it to me, I'll take it anyway." The disease is characterized by repeated unsuccessful attempts of the kleptomaniac to resist the desire to steal something that is not of value to him. In this case, stolen items can be spoiled, abandoned or hidden. The behavior of the patient is accompanied by a growing sense of tension before the theft and complete satisfaction at the time of its commission and after it.

For the first time this pathology was attributed to mental disorders in the 1960s in the USA. People with this diagnosis are protected by law. Perfect theft is a disorder of mental activity. The patient is forced to steal, although he knows about the possible criminal liability. The Kleptomaniac repents of perfect deeds, but after a while repeats everything again.

[1], [2]

Epidemiology

Medical statistics indicate that 0.1-0.6% of the total population is subject to an uncontrolled desire for theft. According to the research, about 5% of all thefts in stores are made by kleptomaniacs.

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

[3], [4], [5], [6], [7]

Causes of the kleptomania

The exact causes of kleptomania are not known until now. There are several theories about the origin of the disorder, consider them:

1. Structural changes in the brain. The disease can be associated with the transmitter of the nerve impulse, that is, the function of the neurotransmitter serotonin. It is involved in the regulation of emotions and mood. A low level of serotonin leads to uncontrolled behavior, and the release of dopamine gives a pleasant sensation. Because of this, dependence develops and there is a desire to experience "these feelings" again.
2. Head injuries. Other studies indicate that the disease can occur after accidents involving head trauma or organic brain damage. A fatal predilection arises with epilepsy, after the stroke, with progressive paralysis and senile dementia.
3. Family history. The risk of developing the disorder exists in people whose parents have had bipolar, obsessive-compulsive disorder, anxiety-phobic states, alcohol or drug addiction, bulimia nervosa or anorexia nervosa.
4. Hormonal changes - lesions of the endocrine system. This reason is based on established facts: most often seizures are determined in menopause, during pregnancy and before menstruation.
5. Postponed mental illness. These can be disorders of the sexual sphere or eating disorders. Hereditary predisposition is important.

In most cases, a kleptomaniac is a hysterical person. This characterological feature significantly reduces the ability to control one's behavior and manage drives. Hysterics can not withstand abnormal needs, so any pathological attraction very quickly progresses.

[8]

Risk factors

Kleptomania refers to the rare disorders of the psyche, which are most often manifested in adolescence or adulthood, in rare cases in 50-60 years. The risk factors for the disease consist of:

• Hereditary predisposition. The presence of a family history significantly increases the risk of the disease.
• Female. According to medical statistics, about 60-70% of patients are women.
• Frequent stress and chronic nervous tension. In this case, theft is perceived as a reward for the suffered failures, suffering. Similar is observed in schizophrenia, as a result of hallucinations or delusions.
• The disease can develop in people who have grown up in antisocial families. In this case, at the subconscious level, a statement is produced: stealing is normal. Theft provides moral satisfaction.

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

• Young children commit theft because of a lack of understanding of the fact of the ban on such actions.
• Deficiency of parental attention very often leads to the fact that the child appropriates parental money or things. This is a specific reunion with the parents.
• Lack of money for small expenses.
• Aspiration to assert itself when communicating with peers or children from more affluent families.

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

Pathogenesis

The mechanism of kleptomania development is similar to other pathological dependencies - alcoholic, game or narcotic. The pathogenesis of the disease, according to scientists, is associated with the protein TDP-43, which is in the brain and spinal cord. His mutations lead to improper cell growth. The disorder occurs when the hypothalamus and limbic system are disturbed. The pathogenesis of antisocial behavior depends on possible factors and the causes of its occurrence.

[9], [10], [11], [12], [13], [14], [15]

Symptoms of the kleptomania

Anyone can become a kleptomaniac, regardless of social status or financial situation. Symptoms of kleptomania are manifested in stages, consider them:

• An uncontrolled impulse to steal something that does not represent any benefit or value. Against this background, there is resistance to obsession
• The feeling of tension increases, like the anticipation of adrenaline before the theft.
• After the perfect deed there is a feeling of relief and satisfaction. Gradually appear self-incriminating thoughts, feelings of guilt and shame for what was done.
• Episodes arise without planning, that is, spontaneously. This can happen in a public place or away. The patient has no signs of schizophrenia.
• Kleptomanus commits theft himself. Stolen items can be returned to the site or discarded because of uselessness.

The process of theft is accompanied by a strong psycho-emotional burden on the body. There is a sense of moral satisfaction and buzz. The patient can commit theft permanently or observe certain time intervals. The degree of duration of theft depends on the level of development, that is, the neglect of the disease. A pathological condition can arise because of temporary life situations. For example, during menstruation or pregnancy. That is, because of the worsening perception of the world around us.

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

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

Stolen items can be returned or discarded, thefts do not have the nature of revenge.

Kleptomania in children

As a rule, kleptomania in children develops on the background of psychological distress, which is significantly burdened by inability to keep under control their desires. Consider the main symptoms of the disease in childhood:

• In the life of the baby there is something that badly affects his emotions.
• During the theft the child is tense and experiencing euphoria at the same time.
• Young kleptomaniacs commit theft themselves without devoting friends or relatives to their actions.
• Theft can be a method of expressing anger or anger.
• The child really realizes the perfect, that is, there are no indistinct explanations for the misconduct.
• The disease can grow because of an inferiority complex.
• A kleptomaniac can feel unnecessary or deprived, therefore he tries to have as many things as possible at his disposal.

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

• The appearance in the house of other people's things or money.
• The loss of valuable items.
• The small loss of money in the purse of parents.
• Oppressed and closed.
• Refusal to communicate with peers.
• Increased irritability, aggressiveness.
• Sharp mood swings.
• Insomnia and sleeping problems.
• Changes in appetite.

Despite the fact that the child is aware that stealing the property of others is bad, he can not resist uncontrollable impulses. As a rule, children try to find a logical explanation for their actions. Theft may be prompted by a desire to try something new or unusual.

The treatment of pediatric kleptomania is aimed at eliminating the factors that triggered the onset of addiction. As a rule, this is the creation of a favorable climate in the family and the provision of comfortable conditions for the child in the children's team. The treatment is conducted by a psychologist, while in therapy not only children but also parents need it. In especially severe cases, psychotherapy in combination with hypnosis sessions can be prescribed.

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

[16], [17], [18], [19]

Kleptomania in adolescents

Cases of kleptomania in adolescents occur more often than in children. As a rule, pathology develops at an early age. The patient is mentally unbalanced, but has no criminal thoughts. In this disease, girls are more likely than boys.

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

Consider the most common factors of kleptomania in adolescence:

• Deficiency of parents' attention - insufficient emotional contact or lack of it leads to the formation of a violation. The child tries to compensate for the lack of emotional response through unconscious craving for theft. At the same time the patient does not realize his actions and does not understand why he committed the theft. This factor is typical for children from wealthy families.
• An unsuccessful family - growing up in a pathological environment postpones a negative imprint on the child's psyche. Constant quarrels and scandals lead to the fact that the teenager unconsciously tries to neutralize the conflict atmosphere. This allows for a while to divert the attention of parents from quarrels and switch to the misdeeds of their offspring.
• Self-affirmation among peers - attempts to find their place in the children's team, one of the frequent causes of the disorder. Through antisocial behavior the child gains authority from peers and tries to establish strong social contacts. This is observed in children who consider themselves a "white crow" in the team, too hesitant or shy.
• The need to show their "adulthood" - adolescents can commit theft because of the desire to prove their adulthood and peculiar coolness. The desire to steal may be the only option to communicate with other adolescents and be accepted into the collective.

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

Another possible cause of mental disorder is the lack of moral principles and moral principles. In this case, the adolescent does not have a cliche that theft is a crime that involves punishment. The child believes that he does not steal, but simply takes other people's things. At the same time, the process of embezzlement gives pleasure and pacification, causes dependence on the emotional experiences received.

Parents should not turn a blind eye to frustration, as the pathological addiction will not disappear by itself. For treatment it is necessary to address to the psychologist who will help to overcome a pernicious inclination.

Stages

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

1. An obsession to steal a thing that is really unnecessary and does not represent value. The process of theft is accompanied by a pronounced feeling of tension, which is replaced by satisfaction because of the perfect action.
2. After a sense of relief, there comes a stage of self-flagellation and a sense of guilt for the perfect.
3. Attacks occur spontaneously. The desire to kidnap anything can overtake both in a public place and at home.

In this case, the more neglected the disease, the more often there are episodes. All thefts are committed on their own, and stolen items can be discarded and even returned to their place in time.

[20], [21], [22]

Forms

A mental disorder associated with an irresistible attraction to theft has several varieties. Consider the main types of kleptomania, depending on the cause of its origin:

1. Sexual perversion - the desire to commit theft is due to the desire to experience sexual arousal. This type of violation is based on sexual dissatisfaction.
2. Oral impulse is the condition of an adult who is stuck in childhood. Stopping on the oral stage of psychosexual development indicates a neurotic regression. That is, the theft is still committed by a "small child", in the body of an adult.
3. A neurotic desire to possess something, any way. In this case it can be not only things, but also a physical condition, for example, a slender figure. Proceeding from this, anorexia relates in part 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 completely depends on the causal mechanism of pathology.

[23], [24], [25]

Complications and consequences

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

The patient feels powerless and can not 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 dependencies (play, alcohol, narcotic).
• Social isolation.
• Suicidal behavior and thoughts.

A mental disorder can have a direct sexual significance. In some cases, theft is the only way to meet the frigidity or low libido.

[26], [27], [28], [29], [30]

Diagnostics of the kleptomania

Uncontrolled attraction to theft is identified 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. Suspicion of the disorder is possible if there are such factors:

• Repeated with a certain frequency of gusts to steal something a person does not need, and that is of no value to him.
• Stress and anticipation of joy before the theft, a sense of satisfaction and relief after it.
• Theft is committed in solitude, without irritation, vengeance or anger. The patient does not have schizophrenia or delirium.

Another diagnostic feature of kleptomania is a certain periodicity of seizures. That is, the theft does not occur on a daily basis, since it is too much stress on the psyche. During the period of remission, that is, when the patient found ways to compensate for the theft, seizures are single with long time intervals.

Test for kleptomania

The main factor that makes it possible to diagnose kleptomania is the unintentional committing of theft. That is, the theft occurred because of a mental disorder, and does not represent material gain or intent. It is not a sign of an antisocial personality disorder or bipolar disorder. To confirm that the episode is caused by obsessive mania, the patient is sent to a forensic psychiatric examination.

Consider the main criteria for diagnostic testing:

1. You can not resist the desire to steal an object unnecessary for you.
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 with sexual satisfaction.
4. Attacks are not associated with selfish motives, drug use, medication or the desire to take revenge.

The test for kleptomania should meet the criteria of DSM, that is, the diagnostic statistical manual on mental disorders.

[31], [32], [33], [34], [35]

Differential diagnosis

If there is a suspicion of kleptomania, the patient is expected to have comprehensive examinations. Differential diagnostics makes it possible to separate obsessive-compulsive disorder from similar abnormalities.

Obsessive attraction to theft is differentiated with such pathologies:

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

In addition to the above syndromes, kleptomania is compared with violations of impulsive control and other mental illnesses.

Kleptomania or theft

Forensic psychiatric examination is necessary to determine what caused the crime - kleptomania or theft. A diagnosis like kleptomania is made if the theft occurs when an unsuccessful attempt to resist a detrimental impulse occurs. Stolen items are of no value.

Kleptomaniac makes an act for the very process of theft and pleasure at the time it was committed. His actions are careless and spontaneous, and stolen things are not expensive, because the patient has no purpose to enrich himself. The whole process takes place alone.

The thief plans his actions, and the abducted things are necessary for the person for profit. Very often petty thieves pretend to be frustrated in order to avoid punishment. Theft can be committed in a team with accomplices, with the invention of sophisticated plans to assign someone else's property.

Treatment of the kleptomania

People with antisocial behavior with uncontrolled urges to steal, very rarely seek help themselves. The treatment of kleptomania is aimed at normalizing the patient's condition and eliminating obsessive thoughts. Typically, therapy consists of psychiatric care and medication.

Psychotherapy of kleptomania

It is conducted to identify the true causes of pathological dependence. This method has several varieties, consider them:

1. Behavioral psychotherapy - separates unhealthy beliefs and behavior, replacing them with positive and healthy ones.
2. Disgust therapy - the psychologist models a situation that causes the patient to steal. At this point, the patient holds his breath to discomfort and lack of oxygen. This method has a moderate pain, but with regular training causes unpleasant, uncomfortable associations if you want something to steal.
3. Group psychotherapy - the patient gets to know people with the same problem. Anonymity and complete trust in the group allow us to determine the causes of the disease and find ways to correct it.

Regardless of the type of psychotherapy, the patient must be prepared for such treatment. It should be written down all the symptoms that arise at the time of theft. This will establish what affects the pernicious desire. It also requires an anamnesis of life and the identification of traumatic and stressful situations.

It will not be superfluous to make a list of questions for the psychiatrist, which will help to learn more about the disease: why there was a pathology, what methods of treatment are effective and can help, how often sessions and other things are needed. In turn, a psychiatrist will also ask a number of questions. The main of them: at what age there was a fatal attraction, how often there are seizures, what feelings arise at the time of the crime.

Medication

The doctor selects the drugs or makes certain pharmacological combinations that stop the disastrous urge. It is the doctor who chooses the dosage and duration of therapy, individually for each patient. Most often kleptomaniacs are prescribed such medicines:

• Antidepressants - selective inhibitors of serotonin reuptake have pronounced therapeutic properties. Prozac and Paroxetine are widely used.
• Stabilizers of mood - are necessary for alignment of mood and control of desires for theft. One of the popular stabilizers Lithium.
• Normotimiki - reduce the level of excitement in the brain and reduce the urge to commit crimes. Such drugs are used to treat epilepsy: Topiramate, Carbamazepine, Tegretol.

In addition to drugs for the treatment of kleptomania attacks, phytotherapy can be used: ashwaganda grass (stabilizes the functions of adrenaline), valerian root, St. John's Wort, Californian poppy and other plants.

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

How to get rid of kleptomania?

The question of how to get rid of kleptomania is of interest not only to the sick, but also to their relatives, who also suffer from a disorder of loved ones. To date, there are no specific medications or methods that can quickly and permanently cure the pernicious predilection of stealing. Only an integrated approach - psychotherapy and taking medications, reduce or eliminate the symptoms of the disease.

Psychotherapy is a psychoanalysis and criticism that is aimed at motivating the patient to change behavior. Behavioral therapy consists of systematic desensitization, restoration of disturbed social and family ties, aversive conditioning. Medicinal preparations stabilize the production of adrenaline, improve the mood and condition of the patient.

Prevention

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

• Taking medications prescribed by a doctor.
• Regular sessions of psychotherapy.
• Elimination of factors provoking frustration.
• Avoid situations, thoughts and feelings that cause the urge to steal.
• Refusal of alcohol and other bad habits.
• The study of relaxation techniques (yoga, meditation) to combat growing stress.

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

The support of relatives is of special importance in the prevention process. Relatives and friends should understand that the recovery of the patient is a lengthy process in which they are involved. Close people should help and assess the actions of the kleptomaniac, but without conviction and addiction. Particular attention should be paid to family psychotherapy.

[36], [37], [38], [39]

Forecast

Obsessive-compulsive disorder with an irresistible desire to steal things that are not of value, has a chronic course. The disease is characterized by periodic impairments and improvements in the condition. The forecast depends on a number of factors. First of all, this is the age of the patient, the causes that cause dependence and the prescribed methods of treatment.

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