11. Impulse control d/o

Question 1

What are the 5 impulse control d/os?

Answer 1

1. Intermittent explosive disorder
2. Kleptomania
3. Pathological gambling
4. Trichotillomania
5. Pyromania

Question 2

What neurotransmitter change has been shown to be associated w/ impulsiveness and aggression?

Answer 2

Low levels of serotonin

Question 3

Tx of intermittent explosive d/o? (5)

Answer 3

SSRIs, anticonvulsants, lithium, propranolol, antipsychotics

Question 4

What comorbid psych illness is associated w/ kleptomania? (3)

Answer 4

mood disorders, eating disorders (bulimia nervosa), OCD

Question 5

% of shoplifters who are kleptomaniacs?

Answer 5

5%

Question 6

Tx of kleptomania? (3) [psychotherapy and pharmaco]

Answer 6

Insight-oriented psychotherapy, behavior therapy (ie. systematic desensitization and aversive conditioning)
- SSRIs

Question 7

Predisposing factors for pathological gambling? (4)

Answer 7

• loss of a parent during childhood
• inappropriate parental discipline during childhood
• ADHD
• lack of family emphasis on budgeting or saving money

Question 8

Prognosis of pathological gambling?

Answer 8

1/3 achieve recovery w/o tx

Question 9

Tx of pathological gambling?

Answer 9

• Gamblers anonymous = most effective tx

- after 3 months of abstinence from gambling, insight-oriented psychotherapy may be attempted

Question 10

What is thought to be the trigger for trichotillomania?

Answer 10

the texture of the hair

Question 11

Tx of trichotillomania?

Answer 11

• SSRIs, antipsychotics, lithium

- behavioral interventions (hypnosis, relaxation techniques, substituting another behavior)

Question 12

DSM criteria for pyromania?

Answer 12

• at least 1 episode of deliberate fire setting

- tension or arousal experienced before the act, and pleasure/gratification/relief experienced when setting fires

Question 13

Mean age of onset of pyromania?

Answer 13

late adolescence

Question 14

Tx of pyromania? (3)

Answer 14

behavior therapy, supervision, SSRIs