ICD Flashcards
(18 cards)
What is the main characteristic of impulse control disorder?
repeated inability to RESIST the impulse or urge to carry out a behaviour
Describe the assessment tool for kleptomania
Kleptomania Symptom Assessment Scale (K-SAS)
11 items rated on a point-based scale, typically 0 to 4
Measures impulses, thoughts, feelings and behaviours related to stealing.
The greater the score, the greater the SEVERITY
AO3 of KSAS
+: practical
+: quant data
-: quant data
+: practical- 10 mins to complete diagnosis
+: quant data-> increasings objectvity in scoring
-: quant data- self-report also lowers validity
Describe the diagnostic criteria for kleptomania.
Characterised by a powerful impulse to steal.
This impulse is very hard to resist and the person will often steal things as a result.
Increasing tension before theft. Feelings of excitement after theft.
Not intended to achieve any motive such as monetary gain.
For diagnosis, there must not be another obvious explanation for the behaviours, such as any other behavioural or mental disorder, substance use or intellectual impairment.
Describe the biological explanation for impulse control disorder.
When someone with impulse control disorder gives in to their impulses, their reward centres are stimulated and release dopamine.
When these behaviours become compulsive, however, levels of dopamine in the striatum are reduced. This will lead to continuation of compulsions and addictions.
This mechanism is known as “reward deficiency syndrome”
Describe the behavioural explanation for impulse control disorder.
Positive reinforcement.
In the case of gambling, partial positive reinforcement is used as an explanation because people do not receive a reward everytime.
This reduces the chance the player will ever feel fully satisfied with their reward and they are more likely to keep playing in the mistaken belief that they will earn back more than they have lost.
Describe Miller’s feeling-state theory as an explanation for impulse control disorders.
All sensations, thoughts and emotions in relation to an event is called the feeling-state.
Intense positive feeling-states when carrying out a behaviour are what causes impulse control disorders.
Positive feeling states will only appear intense and very desirable when constrasted with negative feeling states. A person who feels powerful when setting fires may have underlying negative beliefs about themselves such as being weak or unimportant. Hence, the experience of setting fires is intensely gratifying for them.
Describe the aim of Grant et al. (2008).
investigating factors predicting effectiveness of opiate antagonists treating pathological gambling
Describe the hypothesis of Grant et al. (2008).
- Family history of alcoholism and stronger urges to gamble would be associated with stronger outcomes for those treated with opiate antagonists.
- People with less severe PG would be more likely to respond positively to a placebo than those with severe PG.
Describe the sample of Grant et al. (2008).
284 patients with PG who had gambled in the last two weeks. Diagnosed from DSM-5
From the USA. Outpatients from psychiatric centres
Approximately equal numbers of men and women.
Describe the procedure of Grant et al. (2008).
In one trial, participants were randomly assigned to placebo, nalmefene doses of 25, 50 or 100 mg/day.
In the another trial, participants were assigned to placebo, naltrexone doses of 50, 100 and 150 mg/day.
Both trials were double-blind.
Yale-Brown Obsessive Compulsive Scale Modified for Pathological Gambling (PG-YBOCS) was administered.
Semi-structured interview were used to gather family history.
Describe the results for Grant et al. (2008).
A family history of alcoholism and strong gambling urges seem to predict a positive response to opiate antagonists in treatment of PG.
(opiate group at least 35% reduction in YBOCS scores for 1 month post-treatment)
For those receiving a higher dose of opiate antagonists, intensity of gambling urges was associated with a positive response to treatment.
For those receiving placebo, younger age was associated with a more positive response; presumably because the behaviour is less ingrained than in older patients.
AO3: grant
+: double blind placebo
+: generalisability
-: ethics-deception
-: self report family history
+: double blind trial for placebo ELIMINATES RESEARCHER BIAS -> increases validity
+: generalisability- META-ANALYSIS- ppts recrtuied from 15 treatment centres-> representative
-: ethics deception- placebo ppts believe receiving real treatment->health risk as don’t get treated
+: objective quant data
-: self report of family history
Describe the study by Glover (1985).
covert sensitisation
case study
56 yr old woman with 14year history of daily shoplifting
4 sessions, 2 week intervals
muscle relaxation used to enhance ability to immerse herself in visualisation
imagery of nausea+vomiting paired with act of stealing. imagery episodes involving increasing nausea as she approached article in supermarket she intended to steal, vomiting as she lifted the article with other shopper’s attention drawn to her. vomiting+unpleasant sensations stopped as soon as she replaced the article, turned away+left
19 month check up, decreased desire of stealing with only 1 relapse. reported improvements in self-esteem+social life
Explain what is meant by a double-blind, placebo-controlled trial as used in Grant et al. (2008).
experimental procedure where neither the participant nor the researcher is aware of which condition the participant is in so a participant could be in the nalmefene, naltrexone or the placebo group and not know which group they are in.
Placebo-controlled is a control group where no test medication is actually received and the medication given has no actual effect, but the participant may think they are receiving the test medication so a participant could be in the nalmefene, naltrexone or the placebo group and not know which group they are in.
Suggest the effects if a double-blind trial had not been used in Grant et al. (2008).
Participant bias. If a participant knows they are in nalmefene, naltrexone or the placebo group, they might change their behaviour to support the aims of the study.
Experimenter bias. If an experimenter knows a participant is in nalmefene, naltrexone or the placebo group, they may bias their behaviour toward the participant to support the aims of the study.
Explain two strengths of conducting placebo-controlled trials in studies of gambling disorder.
It is a control so there is a baseline to which the results of the experimental group can be compared and the effectiveness of the nalmefene or naltrexone on gambling disorder can be revealed.
It is a placebo and so the participant will behave as if they are in the experimental group because they do not know whether they are in the nalmefene, naltrexone or the placebo group.
Describe the study by Blaszczynski and Nower (2003).
imaginal desensitisation
1st: therapist teaches progressive muscle relaxation procedure
clients visualise selves being exposed to trigger prompting impulsive behaviour
asked to think about acting on impulse, then mentally leaving situation
all steps done in continued relaxation
shown to reduce the levels of psychological and physiological arousal associated with these disorders
