According to the DSM-5, Kleptomania disease uses the code 312.32 (F63.2) from the updated ICD-9-CM which facilitates any activities involving insurance claims and any other public-health functions. DSM-5 classifies Kleptomania as a disruptive, an impulse controlled conduct disease that exists in page 225 (APA, 2014).
Body section
Kleptomania is a disease, which a person is unable to control the impulse to steal. In many cases, the persons suffering from the Kleptomania disease take objects that are never needed and do not have significant value to them. Grant (81) identify some of the Kleptomania characteristics as the repeated incapability to resist the desire to steal materials with little or no monetary gains. Typically, the goods or the objects the Kleptomaniacs steal tend to have little value because they can afford them and in many occasions, they give away those objects after robbing them. The kleptomaniacs experience increasing tension or fear immediately before committing the stealing acts. These individuals tend to experience pleasure and satisfaction during the process of executing the stealing action. Nevertheless, the kleptomaniacs never commit the illegal acts for vengeance purposes or as an expression of their hallucination or delusions. According to APA (2014), the patterns of stealing among the Kleptomaniacs vary on the episode of stealing and the period of remission.
According to Grant " Potenza (336), the real cause of Kleptomania is not apparent, but there is a close relationship between the neurotransmitter pathways and behavioral obsession. The lack of balance of chemicals in the brain especially those related to depression such as dopamine is likely to affect the brain functioning and especially in controlling the impulses. Grant, (81) explains that many individuals suffering from Kleptomania have other coexisting mental diseases, which may be the cause of the disease. Kleptomania mainly occurs during adolescence and in few cases during adulthood and childhood. Kleptomania is a rare disorder that is treated in, 0.3-0.6 percent of the population with many women suffering from the disorder. Kleptomania is a disorder that is addressed in conjunction with other disorders such as eating, anxiety, personality and bipolar diseases (Grant " Kim 379).
Case report
A case report by Suraweera, Divadithya "de Silva (2014) is essential to the study of Kleptomania because it shows the importance of exposure and response preventive techniques of the urge to steal among the kleptomaniac. In the report, a 23-year-old woman reports the acts of stealing which she began in her fifteens. The woman stole money whenever she got an opportunity in which she never premeditated before she took the money. The woman explained that her urge to steal begun immediately she saw money which is followed by increased tension and then accompanied by relief and the sense of pleasure after she picks the money. The woman stole little amounts of money in which she felt some degree of guilt and shame after taking. The woman was discovered stealing at the workplace where she had to leave the job.
The woman developed persistent sadness, with poor sleep, lack of food appetite that led the family members to ask for the psychiatrist help. When she was caught the woman felt a lot of guilty especially for the several theft actions she had committed in the past that made her feel worthless and the shame.
The female was an introvert with no record on the cases of physical and the sexual harassment and with no conflicts and violent at their home. The woman received SSRI, fluoxetine, and benzodiazepine that helped curb her insomnia. The woman together with her family was taught about exposure and response prevention before she got exposed to cash placed in random areas at their home without any prior know-how. (Suraweera, et al. 2014), case report shows that the woman was unable to resist the urge to steal money at first, but after the repeated contact with money, she gained control over the urge. Reviewing her case after six months after treatment depicts a woman with no symptoms of kleptomania.
Case study 2
Research by Grant and Potenza (2008) on the gender-related differences among the people suffering from kleptomania is vital because it helps to understand the differences in disease presentation among women and men that have a clinical advantage. The research took place from the year 2001-2007, which included 95 people. People participating in the study were recruited through advertisements, and they took part in the pharmacological education. Individuals in the research were undergoing the primary treatment for kleptomania, aged eighteen and above and they could readily undergo interviews. The study aimed to tests whether kleptomania is associated with clinical impairment among both men and women. Grant and Potenza (2008), confirm that there is a significant impairment among both men and women. For example, the average scores among the individuals suffering from kleptomania were three times greater than the counts in pathological gambling. More so, the living standards among the individuals suffering from kleptomania were low compared to the individuals suffering from substance use disorder.
The case study shows a difference in the onset of shoplifting behaviors among men and women. According to Grant " Potenza (2008), men begin shoplifting at a younger age than women do. Shoplifting behaviors such as gambling require early attention in adolescents through holding educational programs in school or at home, which can help to curb the problem in the study. More so, the research confirms that environmental conditions and the genetic make-up of an individual influence the risky behaviors among the males. Women are addicted faster in the acts of shoplifting compared to the men. Other differences among males and females suffering from kleptomania exist in the areas the shoplifting activities take place. The women tend to steal household objects while the men steal from electronic stores with more expensive objects hence in a tighter security area. Therefore, the research by Grant and Potenza is fundamental because it highlights the sex differences among the individuals suffering from Kleptomania.
Case study 3
Research by Grant " Kim (2002) is essential in the study of kleptomania because it provides information on the demographic data, family history and the treatment response of individuals suffering from Kleptomania. Twenty-two individuals from the outpatient group with the uncontrollable desire to steal are involved in a case study. In the results from the interviews, the age of the onset of kleptomania was 16 years with the symptom duration of twenty-one years. Seventy-three percent of the patients explained particular triggers for their shoplifting behavior. Among the twenty-one individuals in the research, seventeen persons were suffering from other disorders rather than kleptomania either from anxiety, personality. More so, many patients explained severe symptoms while fifteen individuals testified the feeling of extreme shame and guilt following the stealing behavior. From the research, it is clear that kleptomania is a disorder that distresses and disables individuals and it is related to high rates of comorbidity.
Perspective section
The behavioral approach
According to Kohn (554), human behavior can be learned or unlearned. Behaviorism is an approach that is majorly concerned with the observable and the quantifiable aspects of an individual’s behavior. According to the behavioral theory, people can be conditioned to react differently to a particular stimulus. For example, in the case of kleptomania disorder, an individual tend to have the urge to steal because of the rewards that accompany the behavior hence causing a change in a person's mind. Kohn (554) explains kleptomania as a combination of all undesirable behaviors which result from the operant and the individual respondent shaping, chaining, improvised coping abilities, and conditioning. The behavioral approach is perfect in the development of the kleptomania actions and their maintenance. For instance, when an individual steals an object that has a lot of importance according to it pairings in the past such as through advertisements and reading from books, their act of stealing is reinforced by accessing that object, feeling a sense of gratitude and all other positive emotions. However, the stealing behavior is also accompanied by the negative reinforcement whenever an individual feels anxious and guilty.
Individuals suffering from kleptomania are likely to repeat the stealing behaviors in cases where the individuals experience little or no negative reinforcement such as punishment. A behavioral chain is established through the repeated action, which then creates solid cues. Kohn (555) explains that more bold and daring stealing acts result from the positive reinforcements and the lack of any form of punishment. Individuals suffering from Kleptomania are likely to rely on the shoplifting acts to alleviate the distressing feelings they experience and as a way of coping with the stressing situations serving to maintain both the positive and the negative reinforcement hence minimizing any other form of coping plan. Therefore, from the behavioral approach, the kleptomaniacs tend to repeat the occurrence of the stealing behaviors because of the positive reinforcements associated with the actions.
Humanistic perspective
The humanist perspective is a development to curb the limitations of the behavioral and psychodynamic approaches. The humanism is an approach that tries to study each person uniquely and wholly. The humanistic theory does not agree with the behavioral assumption that mainly emphasizes the reinforcement of behavior and primarily utilize the use of human research. According to Kohn (554), human beings are free entities with the authority of whatever they do hence responsible for the consequences of their actions. The humanistic approach believes in everyone's worth, active and creative human nature. According to Kohn (556), the humanism approach tries to focus on the ability of an individual to overcome all pain, despair, and hardships in their life.
The humanistic approach emphasizes the features that are shared by all humans some of which include; grief, care, love and people’s self-worth. Kohn (557) explains that the humanistic perspective concerns itself with the experiences, the instinctual urges, responses and many other aspects of people. The humanistic perspective reveals that the stealing behavior among the kleptomaniac individuals do not result from barely the innate urge to steal and the past success in the process as explained by the behaviorist's approach. The humanistic approach majorly considers the conscious actions of an individual to their internal needs and desires, current situation that helps shape a person's behavior. According to Kohn (557), the objective reality of an individual is less significant than the subject perception and knowledge of the world. Therefore, the humanistic approach tries to understand the kleptomaniac's behavior through the subject's personal experience.
Treatment section
Treating kleptomania requires a combination of several cognitive behavior therapies and pharmacology that mainly stress on recognizing and helping cope with the urges and the desires of stealing among the kleptomaniacs. According to Grant " Odlaug (81), the anti-epileptics, opioid antagonists and lithium, are useful in helping to control the desire and the urge by the kleptomaniacs to steal. More so, the use of antidepressants eases the feelings of guilt, shame and the lack of self-worth that accompany the acts of stealing. Some kleptomania sub-types resemble the obsessive-compulsive disease hence they tend to react well to SSRIs. More so, the sub-groups of kleptomania that are similar to the mood disorders and other forms of addiction tend to respond well to lithium, which is a mood stabilizer (Grant 82). Therefore, it is clear that understanding the sub-types of kleptomania is necessary especially in the treatment process of the kleptomaniacs.
The relationship of kleptomania disorder to other addictive diseases has helped in the examination of the efficiency of the opioid antagonists. Grant (82) explain the importance of naltrexone, which is an opioid antagonist that is used in the management of alcohol as an effective treatment in the reduction of K-YBOCS scores and the desires to steal among the kleptomaniacs. The opioid antagonists according to Grant, (85) can alleviate the symptoms of kleptomania because it acts on dopamine hence able to lessen the urges and pleasures experienced by these individuals. In a case study, involving two outpatients who responded to naltrexone in the treatment of kleptomania is very important in this study. In one patient 50mg of naltrexone were utilized in a day, and in the other patient, 100mg were used. In three weekstime the two patients confirmed the remission of the urges to steal.
Psychological counseling is often adopted together with different types of medication to help in minimizing the psychological problems underlying the stealing behaviors behind kleptomaniacs. Some form of therapies includes behavior modification, psychodynamic family and cognitive behavioral therapy. In cognitive behavioral therapy, the counselor teaches the kleptomaniac better coping skills in dealing with the urges to steal. The process involves imagery where one images the process of stealing hence faces the consequences of their behavior. Other forms of treating kleptomania include the use of psychoanalytic and the use of cognitive behavioral therapies. Grant " Kim (383), explains that cognitive behavioral therapy such as aversion therapy is helpful to kleptomania patients.
Personal insights section
The study of kleptomania is critical to me as a student because it helps to understand the disorder itself and the many ways of treating the disease. According to Grant " Potenza (239), the kleptomania disease is prevalent in our surrounding, and it causes distress and legal consequences to the individuals with the kleptomaniac's behavior. The knowledge on the condition is useful because it can help to pinpoint specific characteristics exhibited by a family member and therefore help with treating and supporting them. More so, the study helps to understand the importance of catering for the young ones, to avoid the development of the kleptomaniac’s behaviors that may result as a compensation for their lack during childhood.
The study of the disorder has helped in understanding the importance of having a warm and a supportive family, which helps in providing a conducive family environment for a person to grow well without any forms of complications. The research has contributed to the understanding that no one deserves to be judged before they are given a chance to explain themselves, especially when caught shoplifting because the individuals exercising the behaviors could be in urgent need of help and medication. Therefore, the research is necessary because it encourages everyone to be careful and ready to help whenever help is needed especially among patients of kleptomania.
Bibliography
American Psychiatric Association. (2014). Desk reference to the diagnostic criteria from DSM-5®. American Psychiatric Pub. Retrieved from http://dsm.psychiatryonline.org/DSM5CodingSupplement
Grant, J. E. (2006). Understanding and treating kleptomania: new models and new treatments. Israel Journal of Psychiatry and Related Sciences, 43(2), 81.-87
Grant, J. E., " Kim, S. W. (2002). Clinical characteristics and associated psychopathology of 22 patients with kleptomania. Comprehensive Psychiatry, 43(5), 378-384.
Grant, J. E., " Potenza, M. N. (2008). Gender-related differences in individuals seeking treatment for kleptomania. CNS Spectrums, 13(3), 235-245.
Kohn, C. S. (2006). Conceptualization and treatment of kleptomania behaviors using cognitive and behavioral strategies. International Journal of Behavioral Consultation and Therapy, 2(4), 553.
Suraweera, C., Devadithya, M., " de Silva, V. (2014). Kleptomania: a case report from Sri Lanka. Sri Lanka Journal of Psychiatry, 5(1).
