A structured environment approach for a case of repeated shoplifting following cerebral infarction

Abstract

  We encountered the case of a patient who exhibited timetable-like behavior and aphasia and who repeat edly shoplifted as a form of social behavioral impairment due to cognitive disorder following a cerebral in farction caused by left internal carotid artery occlusion. We assessed the shoplifted items and shoplifting factors by behavioral observation, by comparing and examining the responsible lesion with those in earlier studies. The shoplifting habit was eliminated by interventions including a system of multidisciplinary coop eration to (1) manage finances based on the specific grocery items that the patient shoplifted, store these grocery items, and create a checklist and (2) schedule the patientʼs shopping and eating behaviors by per ceiving his/her timetable-like behavior as a positive aspect. Our results demonstrated the potential of envi ronmental structuring to eliminate inappropriate behavior early in the case of a shoplifter who exhibited a stereotypical eating disorder due to a unilateral lesion without damage to the frontal lobe. This suggests that evaluating the cause of inappropriate behavior based on the lesion and behavioral observation of the patient and providing multidisciplinary intervention covering community life are effective against social behavioral impairment associated with antisocial behavior such as shoplifting.