hardkleptomaniaimpulse control disordersantisocial personality disorderdifferential diagnosisshoplifting
A 29-year-old woman presents for psychiatric evaluation after her third arrest for shoplifting in 2 years. She reports an increasing sense of tension before entering stores, followed by an irresistible urge to take items. She describes a feeling of pleasure and relief at the moment of taking the item, followed immediately by intense guilt and shame. She states that the stolen items are usually inexpensive and things she does not need, such as keychains, pens, or small figurines. She has thrown away most of the stolen items and has never attempted to sell them. She is employed as an accountant with a stable income and reports no financial difficulties. She has no prior criminal history aside from shoplifting, maintains stable relationships, and shows remorse during the interview. She denies any history of conduct disorder symptoms in childhood. Collateral from her spouse confirms her distress about the behavior and her repeated but unsuccessful attempts to stop. Which of the following is the most likely diagnosis?