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Exposure and response prevention therapy augmented with naltrexone in kleptomania: a controlled case study using galvanic skin response for monitoring

Published online by Cambridge University Press:  21 March 2019

Sebastian Olbrich Open the ORCID record for Sebastian Olbrich [Opens in a new window] ,
Ina Jahn  and
Katarina Stengler
Sebastian Olbrich*
Affiliation:
Department for Psychiatry, Psychotherapy and Psychosomatics, University Zurich, Switzerland
Ina Jahn
Affiliation:
Department for Psychiatry and Psychotherapy, University Leipzig, Germany Department for Psychiatry, Psychotherapy and Psychosomatics, Helios Park Hospital Leipzig, Germany
Katarina Stengler
Affiliation:
Department for Psychiatry and Psychotherapy, University Leipzig, Germany Department for Psychiatry, Psychotherapy and Psychosomatics, Helios Park Hospital Leipzig, Germany
*
*Corresponding author. Email: [email protected]
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Abstract

Background:

Kleptomania is a disease that shares features with obsessive compulsive spectrum disorders (OCD) and with substance abuse disorders (SAD). This is underlined by therapeutic approaches in kleptomania ranging from cognitive behavioural therapy and selective serotonin reuptake inhibitors that are effective in OCD, and opioid antagonists that are currently being used in SAD. However, almost no literature exists about exposure and response prevention (ERP) therapy in kleptomania. Furthermore, there is a clear lack of objective markers that would allow a therapeutic monitoring.

Aim:

To show the effectiveness of ERP therapy in kleptomania in a single case report.

Method:

An ERP therapy under real-world conditions and later augmentation with the opioid antagonist naltrexone is described. Continuous measurements of galvanic skin response (GSR) before, during and after therapy sessions are reported in association with changes of the Kleptomania Symptom Assessment Scale (KSAS) self-questionnaire.

Results:

While KSAS scores showed a clear treatment response to ERP sessions, the GSR was significantly lower during ERP treatment in comparison with baseline measures. However, during augmentation with naltrexone, GSR measures increased again and clinical severity did not further improve.

Conclusions:

This case shows the possible usefulness of ERP-like approaches and therapy monitoring using electrophysiological markers of arousal for individualized treatment in kleptomania.

Keywords

CBTgalvanic skin responseexposure and response preventionkleptomania
Type
Brief Clinical Report
Information
Behavioural and Cognitive Psychotherapy , Volume 47 , Issue 5 , September 2019 , pp. 622 - 627
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2019 

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References

Abramowitz, J. S. (2006). The psychological treatment of obsessive-compulsive disorder. Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie, 51, 407–416.10.1177/070674370605100702CrossRefGoogle ScholarPubMed
Armstrong, R. A., Eperjesi, F. and Gilmartin, B. (2002). The application of analysis of variance (ANOVA) to different experimental designs in optometry. Ophthalmic and Physiological Optics, 22, 248–256. doi: 10.1046/j.1475-1313.2002.00020.x CrossRefGoogle ScholarPubMed
Arns, M., Bruder, G. E., Hegerl, U., Spooner, C., Palmer, D. M., Etkin, A., et al. (2015). EEG alpha asymmetry as a gender-specific predictor of outcome to acute treatment with different antidepressant medications in the randomized iSPOT-D study. Clinical Neurophysiology, 127, 509–519.10.1016/j.clinph.2015.05.032CrossRefGoogle ScholarPubMed
Behnoush, B., Memarian, A. and Teimoory, M. (2013). Naltrexone induced serotonin syndrome. International Journal of Medical Toxicology and Forensic Medicine, 3, 64–66. doi: 10.22037/ijmtfm.v3i2(Spring).3991 Google Scholar
Breitenstein, B., Brückl, T. M., Ising, M., Müller-Myhsok, B., Holsboer, F. and Czamara, D. (2015). ABCB1 gene variants and antidepressant treatment outcome: A meta-analysis. American Journal of Medical Genetics. Part B, Neuropsychiatric Genetics: The Official Publication of the International Society of Psychiatric Genetics, 168B, 274–283. doi: 10.1002/ajmg.b.32309 CrossRefGoogle ScholarPubMed
Christianini, A. R., Conti, M. A., Hearst, N., Cordás, T. A., de Abreu, C. N. and Tavares, H. (2015). Treating kleptomania: cross-cultural adaptation of the Kleptomania Symptom Assessment Scale and assessment of an outpatient program. Comprehensive Psychiatry, 56, 289–294. doi: 10.1016/j.comppsych.2014.09.013 CrossRefGoogle ScholarPubMed
Crawford, J. R. and Garthwaite, P. H. (2012). Single-case research in neuropsychology: a comparison of five forms of t-test for comparing a case to controls. Cortex; a Journal Devoted to the Study of the Nervous System and Behavior, 48, 1009–1016. doi: 10.1016/j.cortex.2011.06.021 CrossRefGoogle ScholarPubMed
Fraguas, D., Díaz-Caneja, C. M., Rodríguez-Quiroga, A. and Arango, C. (2017). Oxidative stress and inflammation in early onset first episode psychosis: a systematic review and meta-analysis. International Journal of Neuropsychopharmacology, 20, 435–444. doi: 10.1093/ijnp/pyx015 CrossRefGoogle ScholarPubMed
Gentile, J. R., Roden, A. H. and Klein, R. D. (1972). An analysis-of-variance model for the intrasubject replication design. Journal of Applied Behavior Analysis, 5, 193. doi: 10.1901/jaba.1972.5-193 CrossRefGoogle ScholarPubMed
Giesbrecht, T., Merckelbach, H., van Oorsouw, K. and Simeon, D. (2010). Skin conductance and memory fragmentation after exposure to an emotional film clip in depersonalization disorder. Psychiatry Research, 177, 342–349. doi: 10.1016/j.psychres.2010.03.010 CrossRefGoogle Scholar
Grant, J. E. (2006). Kleptomania. In Hollander, E. and Stein, D. J. (eds), Clinical Manual of Impulse-Control Disorders (pp. 175–201). Arlington, VA, USA: American Psychiatric Publishing, Inc.Google ScholarPubMed
Grant, J. E. and Chamberlain, S. R. (2018). Symptom severity and its clinical correlates in kleptomania. Annals of Clinical Psychiatry: Official Journal of the American Academy of Clinical Psychiatrists, 30, 97–101.Google ScholarPubMed
Grant, Jon E., Kim, S. W. and Odlaug, B. L. (2009). A double-blind, placebo-controlled study of the opiate antagonist, naltrexone, in the treatment of kleptomania. Biological Psychiatry, 65, 600–606. doi: 10.1016/j.biopsych.2008.11.022 CrossRefGoogle ScholarPubMed
Grant, J. E., Odlaug, B. L., Schreiber, L. R. N. and Kim, S. W. (2014). The opiate antagonist, naltrexone, in the treatment of trichotillomania: results of a double-blind, placebo-controlled study. Journal of Clinical Psychopharmacology, 34, 134–138. doi: 10.1097/JCP.0000000000000037 CrossRefGoogle ScholarPubMed
Hollander, E., Kwon, J. H., Stein, D. J., Broatch, J., Rowland, C. T. and Himelein, C. A. (1996). Obsessive-compulsive and spectrum disorders: overview and quality of life issues. Journal of Clinical Psychiatry, 57 (suppl 8), 3–6.Google ScholarPubMed
Lepkifker, E., Dannon, P. N., Ziv, R., Iancu, I., Horesh, N. and Kotler, M. (1999). The treatment of kleptomania with serotonin reuptake inhibitors. Clinical Neuropharmacology, 22, 40–43.CrossRefGoogle ScholarPubMed
Mouaffak, F., Leite, C., Hamzaoui, S., Benyamina, A., Laqueille, X. and Kebir, O. (2017). Naltrexone in the treatment of broadly defined behavioral addictions: a review and meta-analysis of randomized controlled trials. European Addiction Research, 23, 204–210. doi: 10.1159/000480539 CrossRefGoogle ScholarPubMed
Olbrich, S., Tränkner, A., Surova, G., Gevirtz, R., Gordon, E., Hegerl, U. and Arns, M. (2016). CNS- and ANS-arousal predict response to antidepressant medication: findings from the randomized iSPOT-D study. Journal of Psychiatric Research, 73, 108–115. doi: 10.1016/j.jpsychires.2015.12.001 CrossRefGoogle ScholarPubMed
Pizzagalli, D. A., Webb, C. A., Dillon, D. G., Tenke, C. E., Kayser, J., Goer, F., et al. (2018). Pretreatment rostral anterior cingulate cortex theta activity in relation to symptom improvement in depression: a randomized clinical trial. JAMA Psychiatry, 75, 547–554. doi: 10.1001/jamapsychiatry.2018.0252 CrossRefGoogle ScholarPubMed
Rudel, A., Hubert, C., Juckel, G. and Edel, M.-A. (2009). [Combination of dialectic and behavioral therapy (DBT) and duloxetin in kleptomania]. Psychiatrische Praxis, 36, 293–296. doi: 10.1055/s-2008-1067564 CrossRefGoogle ScholarPubMed
Shine, L. C. and Bower, S. M. (1971). A one-way analysis of variance for single-subject designs. Educational and Psychological Measurement, 31, 105–113. doi: 10.1177/001316447103100108 CrossRefGoogle Scholar
Toothaker, L. E., Banz, M., Noble, C., Camp, J. and Davis, D. (1983). N = 1 designs: the failure of ANOVA-based tests. Journal of Educational Statistics, 8, 289–309. doi: 10.3102/10769986008004289 CrossRefGoogle Scholar
Venkatasubramanian, G. and Keshavan, M. S. (2016). Biomarkers in psychiatry – a critique. Annals of Neurosciences, 23, 3–5. doi: 10.1159/000443549 CrossRefGoogle ScholarPubMed
Xia, C. H., Ma, Z., Ciric, R., Gu, S., Betzel, R. F., Kaczkurkin, A. N., et al. (2018). Linked dimensions of psychopathology and connectivity in functional brain networks. Nature Communications, 9, 3003. doi: 10.1038/s41467-018-05317-y CrossRefGoogle ScholarPubMed
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