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Flashcards in Atypical Impulse Control Disorders Deck (27)
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1

essential features

failure to resist and impulse or drive or the temptation to perform an act that could be harmful to the person or others

2

Preoccupation

increasing sense of tension or arousal prior

3

Intoxication

pleasure, gratification, or relief duing

4

Wtihdrawal

regret, self-reproach, or guilt following

5

Intermittent Explosive Disorder

characterized by discrete episodes of failure to resist aggressive impulses resulting in serious assaults or destruction

6

Kleptomania-essential features

-recurrent failure to resist impulses to steal objects not need for personal use or monetary value

1. hoard or return objects
2. chances arrest-not likely to steal but will preplan to avoid arrest
3. tension increases if resist urge; tension relief upon act completion
4. no help from others

7

Kleptomania-associated features

1. impulse to steal is ego dystonic, conflict with the ego and one's self image
2. fears capture; fell depressed or guilty
3. may cause legal, family, career and personal difficulties
4. a possible variant of OCD

8

Kleptomania-DSM Diagnostic

-sense of tension before committing act
-pleasure, gratification or relief at time of committing act
-stealing is not committed to express anger and is not in response to a delusion or a hallucination

-not better accounted for by conduct disorder, a manic disorder, or antisocial personality disorder

9

Kleptomania- course

-can go on for years
1. sporadic
2. episodic
3. chronic
4. may appear in childhood and continue into adulthood

10

Kleptomania- relationship to shoplifting

1. shoplifters rate high on inner tension before and relief after stealing
2. similar descriptions of impulsivity in both groups

11

Kleptomania- underregulation: strength

-temporary weakness-anxiety or stress
-externally-mediated weakness deficit- goods displayed to attract interest

12

Kleptomania- misregulation

symptoms relief from anxiety or depression

13

Pyromania- essential features

presence of multiple episodes of deliberate and purposeful fire setting

14

Pyromania- associated features

1. advance preparation for starting fire
2. indifferent to consequences
3. lead to property damage, legal consequences, or injury/loss of life

15

Pyromania- DSM Diagnostic

A. deliberate and purposeful fire setting on more than one occasion
B. tension or affective arousal before the act
C. fascination with, interest in, curiosity about, or attraction to fire and its situational
D. pleasure, gratification, or relief when setting fires, or when witnessing or participating in their aftermath
E. done for monetary gain, as an expression of sociopolitical ideology, to conceal criminal activity, to express anger or vengeance, to improve one's living circumstances, in response to a delusion or hallucination or as a result of impaired judgment
F. not better accounted for by conduct disorder, a manic disorder, or antisocial personality disorder

16

Pyromania- course

1. episodic: fire setting incidents wax and wane in frequency
2. no typical age of onset

17

Trichotillmania- essential features

-disorder of compulsive hair pulling that ofter results in alopecia

1. pulling hair from scalp, eyebrows, eyelashes
2. itch-like sensation

18

Trichotillmania- associated features

1. Examining hair root, twirling it off, pulling strand between teeth, or eating the hairs (trichophagia)
2. hair-pulling does not occur in the presence of others
3. social situations avoided
4. individuals deny hair pulling and conceal hair loss
5. some have urges to pull hair from others
6. pull hair from pets, dolls, other
7. majority pull hair from more than one site

19

Trichotillmania- DSM Diagnostic

A. recurrent pulling out of one's hair resulting in noticeable hair loss
B. increasing sense of tension immediately before pulling out the hair or when attempting to resist the behavior
C. pleasure, gratification, or relief when pulling out of the hair
D. disturbance is not better accounted for by another mental disorder and is not due to a general medical condition
E. disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning

20

Trichotillmania- Types of hair pulling

1. Focused (similar to OCD rituals)
-associated with mounting tension prior; relief after
-attention focused on act of pulling, which distracts
-more elaborate rituals (hair pulling symmetry)

2. "automatic"
-not associated with prodromal urge or sensation
-occurs during sedentary activities

21

Trichotillmania- physical changes

1. no inflammation of follicle but evidence of damaged follicles; evidence of short/broken hairs

2. patterns of hair loss are highly variable
-areas of complete hair loss
-noticeably thinned hair density
-eyebrows and eyelashes completely absent
-scarring and infection

22

Trichotillmania- course

1. age of onset- 5-16 years
2. average- 13 years
3. many years or episodic

23

Trichotillmania- comorbidity

80%
1. mood and anxiety disorders most frequent
2. eating disorders and substance use less frequent
3. OCD rare

24

Trichotillmania- underregulation: strength

Temporary weakness
-causes significant shame and weakness
-stress causes vulnerability to relapes

25

Trichotillmania- underregulation: monitoring

-treatment involves self-monitoring and relaxation training
-transcendence failure

26

Trichotillmania- underregulation: inertia

- interruption of hair pulling causes extreme anxiety
- becomes automatic behavior similar to a habit

27

Comorbidities

mood disorder spectrum
-depression
-antidepressants

OCD spectrum
- compulsive nature
- SSRIs

Group therapy is most commonly recommended