Disruptive, Impulse-Control and Conduct Disorders Flashcards
Intermittent explosive disorder NT
Dec serotonin and NE
Increased testosterone and dopamine
Decreased GABA and ACh
Intermittent expllosive disorder evaluation
Particular attention to seiures and CHI
Intermittent explosivie disorder diagnosis
Reucrrent outbursts representing a fialure ot ocntrol aggressive impulses by either
1) verbale or physican aggrsssion twoard property, animals, or others twice a week for 3 mos with no injury
2) 3 outburts of above but cuasing injury/destruction
NOT premeditated and no objective
At least 6 y/o
CSI
tx of intermittent explosive
Pick med with fewest LT side effects
Kleptomania
Reccurent failure to resist impulses to steal that are not needed
Increasing snese of tension before
Pleausre, grat, relief after commiiting
NOT in response ot anger/vengeance/delusion.halluciination
Kelptomania demo
More in females
Must consider whether stealing is an antisocial act with secondary gain rather than taking iterms not needed
Kelpto tx
Non pharm:
Systematic desensitization - guided relaxation and exposrue to stimuli previously causing stealing behaviors (most affective)
Aversive conditioning - noxious stmuli associated with unwanted behavior
Banning on shopping
Group therapy
Pharm - SSRIs, anticonvulsatns, ECT
Pyromania
First setting on more than one occassion
tension before, pleasure after
Not done for other reason
Pyromania demo
More in males…watch for suicide
Pyromania workup
EEG if looks like a seiures
Psychotic patients will almost always act alne…about 1/3 in resonse to hallucination and delusion
Tx should be individualized
Pyro tx
Aversion conditiong - best
Social skills training - imrpove the way individuals realte to tohers
Relapse prevention plan
Gambling disorder
12 month period
Need to gamble with increasing amounts of money
Restless or irritable when trying to stop
Tried to stop unsuccessfully
Preoccupied with ganbling
Chases losses
Lies to other
Not better account for by manic episode
Gambling course and etiology
Early adolesnce for males and later for females
Onset is insidious
Chronic
Low autonomic arousal
Gambling disorder comorbidities
Substance abuse
Dep, personalty (narc, borderline, histrionic)
Antisocial maybe?
Gambling tx
Lithium, SSRIs, maybe naltrexone
Group therapy
