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Abstract
Although stealing among adolescents appears to be fairly common, an assessment of adolescent stealing and its relationship to other behaviors and health problems is incompletely understood. A large sample of high school students (n = 3,999) was examined by self-report survey with 153 questions concerning demographic characteristics, stealing behaviors, other health behaviors including substance use, and functioning variables, such as grades and violent behavior. The overall prevalence of stealing was 15.2 percent (95% confidence interval (CI), 14.8–17.0). Twenty-nine (0.72%) students endorsed symptoms consistent with a diagnosis of DSM-IV-TR kleptomania. Poor grades, alcohol and drug use, regular smoking, sadness and hopelessness, and other antisocial behaviors were all significantly (p < .05) associated with any stealing behavior. Stealing appears to be fairly common among high school students and is associated with a range of potentially addictive and antisocial behaviors. Significant distress and loss of control over this behavior suggest that stealing often has significant associated morbidity.
The lifetime prevalence of stealing appears fairly high. A recent, large epidemiological study of adults found that 11.3 percent of the general population admitted to having shoplifted in their lifetimes.1 This finding is consistent with estimates by the National Association of Shoplifting Prevention that 1 (9.1%) in 11 people has shoplifted during his lifetime.2 Stealing in adults has been associated with other antisocial behaviors, psychiatric comorbidity (e.g., substance use disorders, pathological gambling, and bipolar disorder), and impaired psychosocial functioning.1 Stealing appears to start generally in childhood or adolescence, with approximately 66 percent of individuals reporting lifetime stealing beginning before they were 15 years of age.1
Despite the early age at onset of stealing, as well as the significant adult morbidity associated with this behavior, stealing among adolescents has historically received relatively little attention from clinicians and researchers. Limited research suggests that adolescents who steal have impairments in problem-solving skills and a cognitive bias toward inappropriate solutions to problems.3 Other research suggests that parent-child difficulties, school failure, and negative peer influences underlie adolescent stealing.4
Although stealing may be fairly common, it is unclear how many adolescents who steal have kleptomania. Kleptomania, characterized by a diminished ability to resist recurrent impulses to steal objects that are not needed for their monetary or personal use, has been relatively understudied across the lifespan and particularly in adolescents with propensities for stealing.5 In the present study, we assessed a large sample of public high school students regarding stealing behavior. Although previous research suggests that stealing and antisocial behaviors are linked,1,6 no study has systematically examined the relationship of stealing with a range of behaviors and health functioning. Given the incomplete data on the co-occurrence of stealing and other variables among young people, the purpose of this study was to fill these gaps in knowledge. Specifically, we sought to examine the prevalence and sociodemographic correlates of different severity levels of stealing in adolescents, to investigate health correlates in high school students who steal, and to examine the different severity levels and clinical characteristics of stealing and determine differences in students whose stealing merits a diagnosis of kleptomania. Recognizing possible differences in stealing severity among adolescents may have clinical and health implications. It is also important to recognize associations between stealing and health variables, as identifying and treating the stealing behavior may significantly improve the prognosis of other behaviors.
Methods
Study Procedures and Sampling
The study procedure has been published in detail.7 In summary, the study team mailed invitation letters to all public four-year and nonvocational or special education high schools in the state of Connecticut. These letters were followed by phone calls to all principals of schools receiving a letter to assess the school’s interest in participating in the survey. To encourage participation, we offered all schools a report after data collection that outlined the prevalence of stealing and other health-related behaviors in that school. Schools that expressed an interest were contacted to begin the process of obtaining permission from school boards and/or school system superintendents, if approval was needed.
In addition, targeted contacts were made to schools that were in geographically underrepresented areas, to ensure that the sample was representative of the state. The final survey therefore contains schools from each geographical region of the state of Connecticut, and it contains schools from each of the three tiers of the state’s district reference groups (DRGs; i.e., groupings of schools based on the socioeconomic status of the families in the school district). Sampling from each of the three tiers of the DRGs was intended to create a more socioeconomically representative sample. Although this was not a random sample of public high school students in Connecticut, the sample obtained is similar in demographics to the sample of Connecticut residents enumerated in the 2000 census, ages 14 to 18.8
Once permission was obtained from the necessary parties in each school, letters were sent through the school to parents informing them about the study and outlining the procedure by which they could deny permission for their child to participate in the survey if they wished. In most cases, parents were instructed to call the main office of their child’s high school to deny permission for their child’s participation. From these phone calls, a list of students who were not eligible to participate was compiled for reference on the survey administration day. If no message was received from a parent, parental permission was assumed. These procedures were approved by all participating schools and by the Institutional Review Board of the Yale University School of Medicine.
In most cases, the entire student body was targeted for administration of the survey. Some schools conducted an assembly where surveys were administered, while others had students complete the survey in every health or English class throughout the day. In each case, the school was visited on a single day by members of the research staff who explained the study, distributed the surveys, answered questions, and collected the surveys.
Students were told that participation was voluntary and that they could refuse to complete the survey if they wished and were also reminded to keep the surveys anonymous by not writing their name or other identifying information anywhere on the survey. Each student was given a pen for participating. Students who were not eligible to participate because a parent had denied permission or who personally declined to participate were allowed to work on schoolwork while the other students completed the survey. The refusal rate was under one percent.
Measures
The survey consisted of 153 questions concerning demographic characteristics, stealing behavior, other health behaviors including substance use, and functioning variables such as grades and violent behavior.
Stealing behavior was assessed by asking how many times the person stole from stores or people in a typical week. Possible answers to this were: never, fewer than 7 times, 7 to 14 times, 15 to 20 times, and 21 or more times. Those who reported any stealing were then asked six additional questions:
Have you ever tried to cut back on stealing things?
Has a family member ever expressed concern about the amount of time you spend stealing things?
Have you ever missed school, work, or other important social activities because you were stealing?
Do you think you have a problem with excessive stealing?
Have you ever experienced an irresistible urge or uncontrollable need to steal things?
Have you ever experienced a growing tension or anxiety that can only be relieved by stealing?
Three of the questions are based on the Minnesota Impulse Disorders Interview, a valid and reliable screen for adolescent kleptomania,9 and reflect Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria for kleptomania. Trying to cut back on stealing and an irresistible urge to steal reflect Criterion A; growing tension or anxiety that is relieved only by stealing mirrors both Criteria B and C.5 Therefore, students who endorsed all three of these questions were placed in the kleptomania group, while other respondents who reported stealing but did not endorse all three symptoms were placed in the nonkleptomania stealing group.
Demographics included gender, race, Hispanic ethnicity, grade, and family structure (live with one or two parents or some other configuration). Health and functioning variables included grade average (A or B, C, and D or F); extracurricular activities (including employment); tobacco use (never, once or twice, occasionally but not regularly, regularly in the past, or regularly now); lifetime marijuana use (any use in the past 30 days); alcohol frequency (none, light (1–5 days), moderate (6–19 days), or heavy (20 days or more)); lifetime use of other drugs (any or none); current caffeine use (none, 1–2 drinks per day, 3 or more drinks per day); a two-week period of feeling sad or hopeless and losing interest in usual activities (assessing for depression symptomatology) in the past 12 months; a history in the past 12 months of getting into a fight requiring medical attention; and a report within the past 12 months of carrying a weapon of any kind to school.
Data Analysis
Data were double-entered from the paper surveys into an electronic database. Random spot checks of completed surveys and data-cleaning procedures were performed, to ensure that the data were accurate and not out of range.
Distribution characteristics of all variables were examined. Only participants with complete data on the dependent variable were included in the analyses. Baseline demographic data were evaluated for differences between those with complete data and those without complete data, using t tests for parametric data and Mann-Whitney U tests for nonparametric data. Participants were divided into three groups: no stealing, nonkleptomania stealing, and kleptomania. Differences between the three groups were examined using Pearson’s chi-square. All comparison tests were two-tailed.
Multivariate analyses were conducted by using multinomial logistic regression models with the three-group stealing variable as the dependent variable. The three groups were compared using odds ratios from these models, adjusting for demographic characteristics found to distinguish the three groups in bivariate analyses. Because all pairwise comparisons of three groups were performed, p values were corrected to .02 to allow for multiple comparisons.
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