Academic journal article The International Journal of Behavioral Consultation and Therapy

Conceptualization and Treatment of Kleptomania Behaviors Using Cognitive and Behavioral Strategies

Academic journal article The International Journal of Behavioral Consultation and Therapy

Conceptualization and Treatment of Kleptomania Behaviors Using Cognitive and Behavioral Strategies

Article excerpt

Abstract

Kleptomania is a serious disorder that affects a small percent of the general population and a larger percent of the clinical population. It is frequently accompanied by other co-occurring problems, including depression, anxiety, obsessive-compulsive disorder, and substance abuse. Currently, little research on effective treatments exists; although behavioral and cognitive-behavioral treatments show great promise. Methods of behavioral assessments and intervention, as well future direction for research, are discussed.

Keywords: kleptomania, cognitive behavior therapy

Background

The DSM-IV-TR (American Psychological Association, 2000) classifies kleptomania as an impulse control disorder in which the essential feature is a recurring failure to resist impulses to steal items, even though those items are not needed for personal use or their monetary value (Criterion A). The individual experiences an increasing sense of tension just prior to the theft (Criterion B) and feels pleasure, gratification, or relief when committing the theft (Criterion C). The stealing is not committed in order to express anger or vengeance, is not done in response to a delusion or hallucination (Criterion D), and is not better accounted for by conduct disorder, a manic episode, or antisocial personality disorder (Criterion E). Historically, kleptomania has been considered a disorder seen mainly in white, upper- and upper middle-class women (Abelson, 1989; Goldman, 1991; Grant & Kim, 2002a, 2002b; McElroy, Hudson, Pope, & Keck, 1991; Sarasalo, Bergman, & Toth, 1996). With few exceptions (Kohn & Antonuccio, 2002; Wiedemann, 1998), comparatively little is known about males or individuals of ethnic minority or lower economic statuses. Given that, Criterion A may be an artifact of studying mainly upper-class, white females, because it presumes that only individuals who can otherwise afford the stolen items should be considered to be exhibiting kleptomania behaviors; recent research belies this notion (Kohn & Antonuccio, 2002; McElroy, Pope, Hudson, Keck, & White, 1991).

Prevalence & Diagnosis

A consensus about the origins and development of kleptomania has remained elusive to the field of psychology. Although this is due in part to the usual theoretical differences in perspective, it is exacerbated by a paucity of research into the disorder and because kleptomania appears to be a relatively rare problem, with an estimated prevalence rate ranging from 0.6 to 0.8% (Dannon, 2002; Goldman, 1992; Lepkifker, Dannon, Ziv, Iancu, Horesh, & Kotler, 1999). However, rates as high as 7.8% have been found when clinical populations are examined (Grant, 2006a). Different researchers have concluded that from none to a quarter of all shoplifters may suffer from kleptomania (Bradford & Balmaceda, 1983; Goldman, 1991; McElroy, Hudson, Pope, et al., 1991). Others suggest that kleptomania may be more common than previously thought, but is under-diagnosed due to secrecy, bias, or constricted diagnostic criteria (Abelson, 1989; Kohn & Antonuccio, 2002; McElroy, Pope, et al., 1991; McElroy, Keck, & Phillips, 1995; Murray, 1992). Some researchers have likened kleptomania to theft and refute the notion that there are psychological components involved (Bresser, 1979 as cited in Wiedemann, 1998). Others view kleptomania as part of an affective spectrum disorder (McElroy, Hudson, et al., 1991), and still others tend to classify kleptomania as more of an obsessive-compulsive disorder (Grant, 2006a; Tynes, White, & Steketee, 1990). Finally, some researchers view kleptomania as an addiction spectrum disorder (Wiedemann, 1998), along the lines of pathological gambling. Because kleptomania is often diagnosed in conjunction with many of these other disorders, it is unclear whether it is a symptom of these other disorders or a separate but co-morbid problem. What is clear, however, is that symptoms of kleptomania rarely occur in isolation, and frequently occur in conjunction with other mental health problems. …

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