Kleptomania: a review of the research

Depression in university students: associations with impulse control disorders

OBJECTIVE

The purpose of this study was to assess the implications of depression in a sample of university students, particularly relating to impulse control disorders. While previous studies have shown high rates of depression among university students, no study to date has assessed whether levels of depression show associations with the incidence of impulse control disorders in this population.

METHODS

In all, 6000 students participated in the College Student Computer Use Survey. A total of 1717 students completed the scales of interest for this analysis. Participants were assigned to groups based on depression scores: severe (N = 75), mild/moderate (N = 647) and none (N = 995). The three groups were assessed using analysis of variance (ANOVA) or chi-square test. A multinomial logistic regression analysis was used to elucidate associations between depression and impulse control disorder diagnoses.

RESULTS

Groups differed across demographic, health and academic variables. The severe depression group reported higher rates of skin-picking disorder, compulsive sexual behaviour and compulsive buying.

CONCLUSION

Results suggest a significant association between depression and impulse control disorders. One possibility is that a facet of impulsivity contributes to both problems, which could be important information for clinicians. Future studies will need to clarify the exact nature of the relationship between depression and impulse control disorders.

Treatment of Kleptomania Using Cognitive and Behavioral Strategies

Little research exists examining the treatment of kleptomania, particularly in men. This case study illustrates the treatment of a male client with kleptomania in which depression, suicidal ideation, and potential legal complications were present. Strategies included covert sensitization, behavioral chaining, problem solving, cognitive restructuring, and use of homework. On completion of treatment, symptoms of depression and kleptomania had decreased significantly. At 16-weekfollo w-up, the client reported continued remission of kleptomania and depressive symptoms. Treatment complications are discussed, and recommendations to clinicians are made.

[Cognitive-behavioral treatment for impulse control disorders]

OBJECTIVES

This paper reviews the cognitive-behavioral treatment of kleptomania, compulsive buying, and pathological gambling.

METHOD

A review of the published literature was conducted.

RESULTS

Treatment research in all of these areas is limited. The cognitive-behavioral techniques used in the treatment of kleptomania encompass covert sensitization, imaginal desensitization, systematic desensitization, aversion therapy, relaxation training, and alternative sources of satisfaction. Regarding compulsive buying, no empirical support for treatment exists but common techniques examined were covert sensitization, exposure and response prevention, stimulus control, cognitive restructuring, and relapse prevention. Treatment of pathological gambling has been successful in both group and individual format using techniques such as aversive therapy, systematic desensitization, imaginal desensitization and multimodal behavior therapy (which have included in vivo exposure, stimulus control, and covert sensitization) along with cognitive techniques such as psychoeducation, cognitive-restructuring, and relapse prevention.

CONCLUSIONS

There is a general consensus in the literature that cognitive-behavioral therapies offer an effective model for intervention for all these disorders. An individualized case formulation is presented with a case study example. Clinical practice guidelines are suggested for each disorder.