Impulse Control Disorders Flashcards
Impulse control disorders are characterized by an inability to…
resist behaviors that may bring harm to oneself or to others
What is experienced prior to impulses in an impulse control disorder? After?
Prior: Anxiety or tension
After: Relief and satisfaction
What are the DSM-IV criteria for intermittent explosive disorder?
- Failure to resist aggressive impulses that result in assault or property destruction
- Level of aggressiveness is out of proportion to any triggering events
What is the usual onset of intermittent explosive disorder? What are the etiological factors?
Onset usually in late teens or twenties
Etiological factors: Genetic, perinatal, environmental and neurobiological factors
Patients often have history of child abuse, head trauma, or seizures
What is the treatment for intermittent explosive disorder?
SSRIs, anticonvulsants, lithium, and propanolol
Group therapy and/or family therapy may be useful
What are the DSM-IV criteria for Kleptomania?
- Failure to resist urges to steal objects that are not needed for personal or monetary reasons
- Pleasure or relief is experienced while stealing
- Purpose of stealing is not to express anger and is not due to a halucination or delusion
Kleptomania is more common in _____ (men/women)
Women
What percentage of shoplifter are kleptomaniacs?
What are some common comorbid disorders?
5% of shoplifters
Increased incidence of comorbid mood disorders, eating disorders, and OCD
What is the treatment for kleptomania?
Insight-oriented psychotherapy
Behavior therapy (systematic desensitization and aversive conditioning)
SSRIs
What are the DSM-IV criteria for pyromania?
- More than one episode of intentional fire setting
- Tension present before the act and pleasure or relief experienced afterwards
- Fascination with or attraction to fire and its uses and consequences
- Purpose of fire setting not for monetary gain, expression of anger, making a political statement, and is not due to a hallucination or delusions
Pyromania is more common in _____ (men/women)
Men
What is the treatment for pyromania?
Behavior therapy, supervision, and SSRIs
What are the DSM-IV criteria for Pathological Gambling? (10)
5 or more of the following
- Preoccupation with gambling
- Need to gamble with increasing amount of money to achieve pleasure
- Repeated and unsuccessful attempts to cut down on gambling
- Restlessness or irritability when attempting to stop gambling
- Gambling done to escape problems or relieve dysphoria
- Returning to reclaim losses after gambling
- Lying to therapist or family members to hide level of gambling
- Committing illegal acts to finance gambling
- Jeopardizing relationships or job because of gambling
- Relying on others to financially support gambling
What are some predisposing factors to pathological gambling?
- Loss of a parent during childhood
- inappropriate parental discipline during childhood
- ADHD
- Lack of family emphasis on budgeting or saving money
- Etiology may involve genetic, biological, environmental, and neurochemical factors
What are treatment options for pathological gambling?
Gamblers anonymous (12 step program) is most effective
After 3 months of abstinence from gambling, insight oriented psychotherapy may be attempted
Treat comorbid mood disorders
