CLINICAL- Impulse Control Disorders Flashcards
Describe the diagnostic criteria for ICD
- Impulse control disorders are characterized by the repeated inability to resist the impulse/urge to carry out the behavior
- The behavior will feel rewarding to the person short term, but long term will lead to negative effects
All impulse disorders have 5 unique stages: - An impulse
- Growing tension
- Pleasure after impulse is done
- Guilt or lack of it
The 3 impulse disorders are:
- Kleptomania
- Pyromania
- Gambling disorder
Describe kleptomania
- The powerful impulse to steal
- These stolen objects are not needed for personal use or monetary value
- Intrusive thoughts, affective arousal and tension characterize it and the urge to steal affects the person’s ability to concentrate and the person will feel guilt or shame.
Describe Pyromania
- An impulse control disorder characterised by the impulse to start fires
- There is a strong fascination with fire. Excitement or gratification is usually felt during and immediately after the act
- For there to be a diagnosis, the individual must have deliberately set fire on more than one occasion. It also cannot be due to any other mental disorder
- There’s no real motive behind the fire such as monetary, sabotage or revenge
Describe a gambling disorder
- This involves a pattern of persistent gambling behaviour, either online or offline
It is characterized by: - Length of time spent on the activity and how much money is spent
- Gambling being given priority over other activities
- Gambling continuing despite negative consequences
The gambling will result in impairment in important areas of life such as family or work life
Describe the Kleptomania Symptoms Assessment Scale (K-SAS)
- An 11-item self-report questionnaire
- The respondent will relate these questions to the past seven days
- Each item is rated on a scale of 0-4 or 0-5
EXAMPLE QUESTION:
During the past week, how many times did you experience urges to steal? Please circle the most appropriate number
1. None — 5. Constant, near-constant
Evaluate the K-SAS
- Standardised procedures make it reliable
- quantitative data for comparison of severity/ Nomothetic approach collects large amounts of data
- Good concurrent validity compared to the Global Assessment of Functioning scale
- Social desirability bias
Describe the biological explanation
DOPAMINE EXPLANATION:
- This is known as the ‘happy’ chemical and is released as a trigger by reward stimuli
- The striatum is an area in the brain that is responsible for reward and behavioral control, so a deficiency in dopamine can lead to the continuation of compulsions and addiction
- e.g a kleptomaniac will steal something and their reward centers are stimulated and release dopamine, they will increase in stealing behaviour and this is known as “reward deficiency syndrome”
Evaluate the biological explanation
- Comings and Blum support the explanation using brain scans which are objective, increasing validity and reliability
- Nature is supported
- Reductionist
- Deterministic, no control over chemical pathways
What are the 2 psychological theories for ICD
- Behavioural: Positive reinforcement
- Cognitive: Miller’s feeling-state theory
Describe the behavioural explanation
Positive reinforcement: When a behaviour results from a reward being given and so, the behaviour repeats.
- for example, the enjoyment of winning at gambling acts as a positive reinforcer
- This is explained well by use of schedules of reinforcement
- This means that for gamblers, they ill not receive a reward every time and so they will keep playing in hopes of redeeming the money they have lost and so on.
evaluate the behavioural explanation
- Reductionist as it reduces several factors of rewards which could make them repeat Potenza, 2006), suggesting a neurobiological underpinning that behavioral theories overlook.
- Supports the situational side since it rewards the individual (Clark et al., 2009).
- Early experiments, such as Skinner’s work or unethical studies manipulating reinforcement in addictive behaviors, have been criticized for their artificial settings and potential harm to participants, questioning their validity and applicability to ICDs in real-life contexts.
- The behavioural model does not fit all types of addictions e.g Russian roulette which is a tactical game
Describe the cognitive explanation
Miller (2010) explains that these are intense positive feelings linked with specific behaviours such as gambling or stealing.
- These links form a “state-dependent memory”
- The person with negative thoughts about themselves will experience an intense feeling of euphoria and power when they indulge in their impulsive behavior to overcome
INTENSE DESIRE + INTENSE POSITIVE EXPERIENCE = FEELING-STATE
- The feeling- state refers to all sensations, emotions and thoughts a person will experience after a particular event.
-Miller stated that an underlying negative thought/ experience is most likely to create the feeling-state that leads to ICD
Evaluate the cognitive theory
- Supports both the individual and situational side. situational because the experiences reward the person. Individual because every feeling-state is different
- Holistic explanation as it considers many other aspects
- Applicable to everyday life which can be treatment
what is the biological treatment used
- A group of drugs called opiate antagonists
