1- Impulse Control Disorders Flashcards
What is the premise behind CBT?
Thoughts influence feelings which alter behavior → changing the thought process will change the behavior
CBT includes what three elements?
Thought, behavior, emotion
CBT will provide the pt with what are a means to slowly change the behavior?
Homework, bibliotherapy, journaling assignments, etc..
Impulse control disorders are a continuum ranging from what to what?
Impulsivity to compulsivity
What disorder has the following cycle?
Preoccupation → Pleasure/satisfaction/relief → Binge/Intoxication → Withdrawal/negative affect → restarts
Addiction
Addiction, impulse control disorders, compulsive disorders are have reinforcement of a behavior through what?
Vicious behavioral cycles
What disorder has the following cycle?
Tension/arousal → impulsive acts → pleasure/relief/gratification → regret/guilt/self-reproach → restarts
Impulse control
What disorder has the following cycles?
Anxiety/stress → repetitive behaviors → relief of anxiety/stress →obsessions → restarts
Compulsive disorder
What are the DMS5 criteria for intermittent explosive disorder?
- Recurrent aggressive behavior or verbal aggression (< 30 min)
- Aggression is out of proportion to stressors
- No premeditated
- Cause distress/consequences
- ≥ 6 y.o (starts in late childhood)
- Behavior not accounted for by another mental disorder
Can an individual feel guilty for their actions if they have intermittent explosive disorder?
Yes
Trauma, genetics, serotonin disruption in limbic system and front/limbic cortex are RF for what disorder?
Intermittent explosive disorder
What is the tx for IED?
SSRIs, CBT + med, desensitization behavior modification
Conduct disorders are dx in children great than what age?
> 7 yo (one of the most common ped psych disorders)
Parental rejection/neglect, difficult infant temperament, harsh discipline, physical or sexual abuse, unstable family, familial psychopathology are RF for what disorder?
Conduct disorder
What is the DSM5 criteria for CD?
A. Major rights of others/societal norms are violated 3x in past 12 months
- aggression to people and animals
- destruction of property
- deceitfulness or theft
- violation of rules
B. Causes social, academic or occupational impairment
C. If pt 18+ yo, & does not meet criteria for Anti-social personality disorder
Lack of remorse.guilt, callous/lack of empathy, unconcerned about school performance, shallow or deficient affect are associated w/ what disorder?
Conduct disorder
What is the tx for CD?
Individual and group therapy, parental behavioral therapy, pharmacotherapy (ADHD meds, antidepressants, mood stabilizers, antipsychotics)
What disorder is classified as a recurrent pattern of negativistic, defiant, disobedient, and hostile behavior toward authority figures?
Oppositional Defiant disorder
It is normal for preschool children to be defiant. What is next step if symptoms increase?
Assessment for oppositional defiant disorder (usually starts before 8 y/o)
Are the sx of ODD or CD more severe?
CD (CD dx will take precedent over ODD)
What is the tx for ODD?
Behavioral modification, family therapy
What disorder is more common in disruptive households and can be associated w/ ADHD?
Oppositional defiant disorder
What is the DSM5 criteria for dx of Oppositional defiant disorder?
A. Negativistic, hostile, defiant behavior > 6 month w/ 4+ of the following:
- Often lose temper
- Argues w/ adults
- Defies adults requests/rules
- Deliberately annoys people
- Blames other for their behavior
- Easily annoyed
- Often angry/resentful
- Often spiteful or vindictive
B. Clinically significant impairment in social, academia or occupational functioning
C. Behavior do not occur during psychotic or mood disorder
D. Criteria is not met for CD & if > 18 y/o and criteria not met for ASPD
What disorder is defines are impulsive stealing of objects not needed for profit or personal use (often discarded after stolen)?
Kleptomania
