The Relationship Between Shoplifting and Borderline Personality Symptomatology Among Internal Medicine Outpatients

Dear Editor:

The lifetime prevalence of shoplifting in the United States is around 11 percent, and may be explained in various ways, including associations with psychiatric disorders.¹ However, few studies have examined relationships between shoplifting and borderline personality disorder (BPD), a disorder characterized by inherent impulsivity. While studies in eating disorder^2–4 and kleptomania⁵ samples indicate possible associations between BPD and shoplifting, a study by Saint-Martin and Chabrol⁶ did not report the same findings. In this study, we hypothesized a relationship between shoplifting and borderline personality symptomatology.

Participants were men and women being seen for nonemergent medical care at an outpatient internal medicine clinic staffed predominantly by resident providers. We excluded individuals with compromising medical (e.g., pain), intellectual (e.g., mental retardation), cognitive (e.g., dementia), or psychiatric symptoms (e.g., psychotic) that would preclude the candidate's ability to successfully complete a survey.

During clinic hours, one of the authors (Lam) approached consecutive patients in the lobby and informally assessed exclusion criteria. With potential candidates, the recruiter reviewed the focus of the project and then invited each to complete a five-page survey. Participants were asked to place the completed surveys into sealed envelopes and then into a collection box in the lobby.

The survey consisted of three core sections: 1) a demographic query, 2) a yes/no query about shoplifting (i.e., “Have you ever shoplifted?”), and 3) two assessments for borderline personality symptomatology—the borderline personality scale of the Personality Diagnostic Questionnaire-Revised⁷ and the Self-Harm Inventory.⁸ This project was approved by an institutional review board and completion of materials was assumed to be informed consent, which was clarified on the cover page.

Of the 471 individuals approached, 417 agreed to participate (participation rate of 88.5%). Of these, 379 completed relevant study measures. These 130 men and 249 women ranged in age from 19 to 97 years (mean 50.30, standard deviation 15.44). Most respondents (88.1%) were Caucasian, followed by African-American (7.9%), other (2.1%), Hispanic (1.1%), and Asian (0.8%). All but 6.4 percent of respondents reported having at least attained a high school diploma; 14.7 percent reported a bachelor's degree, and 14.1 percent a graduate or professional degree.

Ninety six (25.3%) indicated having shoplifted. Compared to those who denied ever having shoplifted (M=1.61, SD=1.95, n=279), those who indicated such behavior (M=3.44, SD=2.54, n=96) had statistically significantly higher PDQ-4 scores, F(1,373)=53.46, p<0.001. Similarly, compared to those who denied ever having shoplifted (M=1.33, SD=2.27, n=276), those who indicated such behavior (M=5.20, SD=4.64, n=96) had statistically significantly higher SHI scores, F(1,370)=113.92, p<0.001. In addition, a greater proportion of those who indicated having shoplifted (36.5%) exceeded the PDQ-4 cut-off score compared to the proportion of those who denied ever having shoplifted (10.8%), χ²=32.94, p< 0.001. Similarly, a greater proportion of those who indicated having shoplifted (49.0%) exceeded the SHI cut-off score compared to the proportion of those who denied having shoplifted (9.8%), χ²=68.60, p<0.001.

According to findings, there is an association between shoplifting and borderline personality symptomatology, likely affecting only a portion of individuals with this personality disorder. Viewed as an impulsive behavior, shoplifting is consistent with the construct of BPD.

This study has a number of potential limitations, including the self-report nature of all data and the tendency for self-report measures of BPD to be overinclusive. However, in this consecutive and reasonably sized sample, we examined a relationship that is rarely explored and found that shoplifting is a behavior that may be associated with BPD.

With regards,
Randy A. Sansone, MD;
Charlene Lam, MD, MPH; and
Michael W. Wiederman, PhD
Dr. Sansone is a Professor in Psychiatry and Internal Medicine at Wright State University School of Medicine in Dayton, Ohio, and Director of Psychiatry Education at Kettering Medical Center in Kettering, Ohio. Dr. Lam is a resident in the transition-year program at Kettering Medical Center in Kettering, Ohio. Dr. Wiederman is a Professor in Psychology in the Department of Human Relations at Columbia College in Columbia, South Carolina.