Kleptomania or klopemania is the inability to refrain from the urge to steal goods and is usually done for reasons other than personal use or financial gain. First described in 1816, kleptomania is classified in psychiatry as impulse control disorder. Some of the main characteristics of this disorder suggest that kleptomania may be a disorder of obsessive-compulsive disorder.
These disorders are often under-diagnosed and often associated with other psychiatric disorders, particularly anxiety and eating disorders, as well as alcohol and substance abuse. Patients with kleptomania are usually treated with therapy in other areas due to comorbid complaints rather than problems directly related to kleptomania.
Over the past 100 years, a change from psychotherapy to psychopharmacological intervention for kleptomania has occurred. Pharmacological treatments using selective serotonin reuptake inhibitors (SSRIs), mood stabilizers and opioid receptor antagonists, and other antidepressants along with cognitive behavioral therapy, have yielded positive results.
Video Kleptomania
Signs and symptoms
Some of the fundamental components of kleptomania include recurrent intrusive thoughts, impotence to resist the urge to engage in stealing, and release of pressure after action. These symptoms suggest that kleptomania may be considered an obsessive-compulsive disorder.
People diagnosed with kleptomania often have other types of disorders that involve mood, anxiety, eating, impulse control, and drug use. They also have tremendous levels of stress, guilt, and remorse, and the privacy issues that accompany the act of stealing. These signs are thought to cause or intensify common comorbid disorders. The behavioral characteristics associated with stealing can lead to other problems as well, which include social separation and substance abuse. The many other types of disorders that often occur together with kleptomania usually make clinical diagnosis uncertain.
There is a difference between ordinary theft and kleptomania: "ordinary theft (whether planned or impulsive) is deliberate and motivated by the usefulness of the object or its monetary value," whereas with kleptomania, there "is a recurrent failure to withstand an impulse to steal goods even though the goods are not required for personal use or for the value of their money. "
Maps Kleptomania
Cause
Psychoanalytic model
Many psychoanalytic theorists claim that kleptomania is one's attempt "to gain symbolic compensation for actual or anticipated harm", and feels that the key to understanding its etiology lies in the symbolic meaning of the stolen goods. Drive theory is used to suggest that the act of stealing is a defense mechanism that serves to modulate or keep unwanted feelings or emotions from being disclosed. Others suggest that kleptomaniac may just want the stuff they stole and the feelings they get from the theft itself.
Cognitive behavior model
The cognitive-behavioral model has replaced the psychoanalytic model in describing the development of kleptomania. Practitioners of cognitive behavior often conceptualize disorders as a result of operant conditioning, behavioral coupling, distorted cognition, and poor coping mechanisms. The cognitive-behavioral model shows that behavior is reinforced positively after people steal some items. If this individual experiences little or no negative consequences (punishment), then it is likely that the behavior will recur. As behaviors continue to occur, the precursor or strong cues become continuously related to it, in what ultimately becomes a strong chain of behavior. According to cognitive-behavioral theory (CBT), both antecedents and consequences can be in the environment or cognition. For example, Kohn and Antonuccio (2002) describe client antecedent cognition, which includes thoughts such as "I am smarter than others and get away with it"; "they deserve it"; "I want to prove to myself that I can do it"; and "my family deserves to have better things". These thoughts are a powerful gesture to steal behavior. All of these thoughts are precipitated by additional antecedents that are thoughts of family, finances, and work stress or feelings of depression. "Maintaining" cognition provides additional reinforcement for stealing behavior and includes a feeling of justification and pride, for example: "one for 'little guy' scores against big companies". Although these thoughts are often followed with feelings of regret, this comes too late in the order of the operand to serve as a worthy punishment. Ultimately, individuals with kleptomania become dependent on stealing as a way to cope with stressful situations and sad feelings, which serve to better maintain behavior and reduce the number of alternative coping strategies available.
Biological model
Biological models that explain the origin of kleptomania are based largely on pharmacotherapy treatment studies using selective serotonin reuptake inhibitors (SSRIs), mood stabilizers, and opioid receptor antagonists.
Several studies using SSRIs have observed that opioid antagonists appear to reduce the impulse to steal and kill the "rush" that is usually experienced immediately after stealing by some subjects suffering from kleptomania. This will show that poor regulation of serotonin, dopamine, and/or natural opioids in the brain is the cause of kleptomania, linking it with impulse control and affective disorder.
An alternative explanation is also based on opioid antagonist studies suggesting that kleptomania is similar to a "self-medication" model, in which stealing stimulates one's natural opioid system. "Opioid liberation 'soothes patients', cures their grief, or reduces their anxiety, so stealing is a mechanism for breaking free of chronic hyperarousal states, possibly generated by previous stressful or traumatic events, and thus modulating affective states.
Diagnosis
Disagreement surrounds the method in which kleptomania is considered and diagnosed. On the one hand, some researchers believe that kleptomania is merely the theft and refutation of suggestions that there is a psychological mechanism involved, while others observe kleptomania as part of a substance-related addiction. Yet others categorize kleptomania as a variation of impulse control disorders, such as obsessive-compulsive disorder or eating disorders.
According to the fourth edition of the Fourth edition (DSM IV-TR) Diagnostic and Statistical Manual (DSM IV-TR), a frequent and widely used guide to the diagnosis of mental illness, the following symptoms and characteristics are diagnostic criteria for kleptomania:
- the recurring incapacity to defend themselves from the urge to steal things that are unimportant for personal use or for their economic value;
- increase the sense of pressure immediately before committing theft;
- satisfaction, fulfillment, or rescue at the time of theft;
- theft is not done to convey antagonism or revenge, and not as a reaction to delusion or fantasy; and
- thieves are not better taken into account by behavioral disorders, episodes of mania, or antisocial personality disorder.
Skeptics have denounced kleptomania as an illegitimate psychiatric concept exploited in the legal defense of wealthy shoplifters. During the twentieth century, kleptomania was strongly associated with increased prevalence of department stores, and "department store kleptomaniacs" was a widely held social stereotype that had political implications.
Comorbidity
Kleptomania appears to be associated with other psychiatric disorders, particularly mood swings, anxiety, eating disorders, and alcohol and substance abuse. The occurrence of stealing as a behavior in conjunction with eating disorders, especially bulimia nervosa, is often taken as a sign of the severity of eating disorders.
Possible associations between depression and kleptomania were reported in early 1911. Since then many have been established in clinical observations and available case reports. Mood disorders may come first or occur simultaneously with the onset of kleptomania. In advanced cases, depression can result in self-inflicted injury and may even lead to suicide. Some people have reported relief from symptoms of depression or manic after theft.
It has been argued that since kleptomania is associated with strong compulsive and impulsive qualities, kleptomania may be seen as a variation of obsessive-compulsive spectrum disorder, along with pathological gambling, compulsive buying, pyromania, nailbiting and trichotillomania. This point achieves support from higher obsessive-compulsive disorder (OCD, see below) cases in close relatives of patients with kleptomania.
Substance abuse substance
Kleptomania and drug addiction seem to have the same central quality, including:
- repeated or compulsive participation in behavior despite unwanted penalties;
- weak control over disruptive behavior;
- a need or desire condition before taking part in problematic behavior; and
- positive pleasurable conditions in all acts of disturbing behavior.
Data from epidemiologic studies also suggest that there is an affiliation between kleptomania and the interruption of the use of substances along with high levels in the same direction. Phenomenological data maintain that there is a connection between kleptomania and drug addiction. A higher percentage of cases of kleptomania have been noted in adolescents and young adults, and fewer number of cases among older adults, which implies a natural history analogous to those seen in substance use disorders. Family history data also proposed a common genetic input that may be used for alcohol and kleptomania. Disturbance of substance use is more common in people with kleptomania than in the general population. Furthermore, pharmacological data (eg, possible efficacy of opioid antagonists, naltrexone, in the treatment of kleptomania disorders and substance use) may provide additional support for the combined association between kleptomania and substance use disorders. Based on the idea that kleptomania and substance use disorders may share some features of etiology, it can be concluded that kleptomania would react optimistically to the same treatment. As a matter of fact, certain nonmedical treatment methods that are successful in treating substance abuse also help in treating kleptomania.
Obsessive-compulsive disorder
Kleptomania is often regarded as part of obsessive-compulsive disorder (OCD), because unbearable and uncontrollable action is similar to OCD rituals that are often excessive, unnecessary, and undesirable. Some individuals with kleptomania show symptoms of accumulation that resemble those with OCD. The prevalence rate between the two disorders does not show a strong relationship. Studies that examined the comorbidity of OCD in subjects with kleptomania had inconsistent results, with some showing relatively high co-occurrences (45% -60%) while others showed low levels (0% -6.5%). Similarly, when kleptomania levels were examined in subjects with OCD, a relatively low co-occurrence was found (2.2% -5.9%).
Pyromania
Pyromania, another impulse disorder, has many bonds with kleptomania. Many pyromaniacs start fires along with small thefts that often appear similar to kleptomania.
Treatment
Although this disorder has been known by psychologists for a long time, the cause of kleptomania remains ambiguous. Therefore, various therapeutic approaches have been introduced for its treatment. These treatments include psychoanalytic-oriented psychotherapy, behavioral therapy, and pharmacotherapy.
Psychoanalytic and Psychodynamic Approach
Several explanations of the mechanism of kleptomania have been presented. The contemporary social approach proposes that kleptomania is the result of consumerism and a large number of commodities in society. Psychodynamic theory depends on multiple points of view in defining disorders. Psychoanalysts define conditions as indications of defense mechanisms stemming from an unconscious ego to anxiety, intuition or forbidden desire, unresolved struggle or forbidden sex drive, fear of castration, sexual pleasure, and sexual satisfaction and orgasm during the act of stealing. The psychoanalytic and psycho-dynamic approach to kleptomania provides a long-standing psychoanalytic or psycho-dynamic psychotherapy as a core treatment method for several years. Like most psychiatric conditions, kleptomania is observed in psycho-dynamic lenses rather than seen as bio-medical disorders. However, the prevalence of the psychoanalytic approach contributes to the growth of other approaches, especially in the biological domain.
Behavioral and cognitive interactions
Cognitive-behavioral therapy (CBT) primarily replaces psychoanalytic and dynamic approaches in the treatment of kleptomania. Various behavioral approaches have been recommended as helpful according to some of the cases stated in the literature. They include: hidden sensitization by unpleasant images of nausea and vomiting, reluctant therapy (eg, holding the breath to achieve a slight feeling of pain each time a desire to steal or action is conceivable), and systematic desensitization. In certain cases, the use of combining several methods such as hidden sensitization along with exposure and prevention of response is applied. Although the approach used in CBT requires more research and investigation in kleptomania, success in combining this method with the drug is illustrated in the use of drug treatment as a single method of treatment.
Drug treatments
The common phenomenological and biological common basics of kleptomania and OCD, pathological gambling and trichotillomania have led to the theory that similar drug groups can be used in all these conditions. As a result, the primary use of the selective serotonin reuptake inhibitor (SSRI) group, which is a form of antidepressant, has been used in kleptomania and other impulse control disorders such as binge eating and OCD. Electroconvulsive therapy (ECT), lithium and valproic acid (sodium valproate) have been used as well.
The use of SSRIs is due to the assumption that the biological dynamics of this condition stem from the low levels of serotonin in the brain synapses, and that the efficacy of this type of therapy would be relevant for kleptomania and other comorbid conditions.
Opioid receptor antagonists are considered practical in reducing symptoms associated with impulse, which is a central part of impulse control disorder; for this reason, they are used in the treatment of substance abuse. These qualities make them helpful in treating kleptomania and impulse control disorders in general. The most commonly used drug is naltrexone, a long-term competitive antagonist. Naltrexone acts mainly on the receptor-, but also the antagonist? - and? -receptors.
There has been no controlled study of the psycho-pharmacological treatment of kleptomania. This could be as a consequence of kleptomania becoming a rare phenomenon and difficulty in reaching a sizeable sample. The facts on this issue come largely from case reports or from pieces collected from a small number of closed cases in a series of groups.
History
In the nineteenth century, French psychiatrists began to observe kleptomaniac behavior, but were limited by their approach. In 1890, a large number of case materials on kleptomania have been developed. Hysteria, infertility, cerebral defects, and advanced menopause as a theory to explain this seemingly preposterous behavior, and many kleptomania are linked to immaturity, given the tendency of young children to take whatever they want. The French and German observations later became the center of the psychoanalytic explanation of kleptomania.
Etymology
The term kleptomania is derived from the Greek word ?????? (klepto) "to steal" and ????? (mania) "crazy desire, necessity". Its meaning is roughly according to the "necessity of stealing" or "stealing compulsively".
The first generation of psychoanalysis
At the beginning of the twentieth century, kleptomania was more a legal reason for self-bourgeois bourgeois women than valid psychiatric drugs by French psychiatrists.
Sigmund Freud, the creator of controversial psychoanalytic theory, believes that the underlying dynamics of human behavior associated with uncivilized savages - the impulse is restrained by barriers to social life. He does not believe human behavior to be rational. He created a large theoretical corpus that his students applied to psychological problems such as kleptomania. In 1924, one of his followers, Wilhelm Stekel, read the case of a kleptomaniac woman who was driven by a sex drive pushed to hold "something forbidden, secretly". Stekel concludes that kleptomania is "a suppressed and substituted sex drive done through a medium of symbol or symbolic action, every necessity in the psychic life brought about by emphasis."
Second generation of psychoanalysis
Fritz Wittels argues that kleptomaniacs are sexually underdeveloped people who feel the loss of love and have little experience with human sexual relationships; stealing is their sex life, giving them such a powerful sensation that they do not want to be healed. The kleptomaniacs man, in his view, is homosexual or always a sissy.
A well-known large-scale analysis of shoplifter in Britain laughs at Stekel's idea of ​​sexual symbolism and claims that one of the five shoplifters accused is a "psychiatrist."
New perspectives
Empirical-based conceptual articles argue that kleptomania is becoming more common than previously thought, and occurs more frequently among women than men. These ideas were new in recent history but echoed them in the mid to late nineteenth century.
Society and culture
Stealing is often an obsession. Although people know they can get caught and marked for life, they find it difficult to break the habit. The main symptoms include a decreased person resistance to steal unnecessary objects, feeling entitled to own them at any cost. If someone escapes by stealing they may have adrenaline and for some successful thefts, dopamine is produced by the brain that can affect heart rate and blood pressure.
See also
- Portrait of a Kleptomaniac
References
External links
Media related to Kleptomania on Wikimedia Commons
Source of the article : Wikipedia
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