Exam 3 Impulse Control Dis

Question 1

Intermittent Explosive Disorder (IED) criteria?

Answer 1

1) Episodes of assault/destruction w/o adequate cause
2) Aggressiveness OOP to stressor

(sidenote) NO psychotic sxs

Question 2

IED tx: Meds? (5)

Answer 2

SSRI
Stabilizers
BZs
Anticonvuls
Antipsych

Question 3

IED tx: other?

Answer 3

Behavior mod

Question 4

Conduct Disorder (CD) criteria? (3)

Answer 4

(sidenote) 7+yo, ADHD-similar sxs

A) Violates rights of others/societal norms:
-aggression to people/animals
-destruction
-deceitful/theft
-rule violation
B) Significant impairment
C) if 18+ yo, does not meet criteria for anti-social personality

Question 5

CD tx: Meds? (4)

Other?

Answer 5

ADHD meds
Antidepress
Stabilizers
Antipsych

Pt/Parent therapy

Question 6

Oppositional Defiant Disorder (ODD) criteria? (4)

Answer 6

A) Negative/hostile/defiant > 6mo w/ 4+:
  1-Loses temper
  2-Argues w/ adults
  3-Defies requests/rules
  4-Deliberately annoys
  5-Blames
  6-Easliy annoyed
  7-Angry/resentful
  8-Spiteful/vindictive

B) Significant impairment

C) Behaviors not during psychotic or mood dis

D) Not CD, if 18+ not ASPD

Question 7

Kleptomania criteria? (5)

Answer 7

A) Recurrent impulse to steal unneeded items
B) Increased tension before theft
C) Pleasure/relief during theft
D) Not expression of anger or response to delusion/hallucination
E) Not from CD, mania or ASPD

(sidenote) can be w/ mood or addictive dis

Question 8

Kleptomania tx?

Answer 8

Behavior mod

Meds not indicated

Question 9

Pyromania criteria? (6)

Answer 9

A) Deliberate fire setting
B) Fascination w/ fire
C) Increased tension prior
D) Pleasure/Relief setting, watching and aftermath
E) Not for monetary gain
F) Not CD, mania, ASPD

Question 10

Pyromania tx?

Answer 10

Psych therapy (find cause)
Meds not indicated

Question 11

Pathologic Gambling criteria? (2)

Answer 11

A) Persistent/recurrent w/ 5+
  1-Preoccupation w/
  2-Excitement ↑ w/ ↑ money gambled
  3-Can't stop
  4-Restless/irritable w/ cutting back
  5-Escape from problems
  6-Chases losses (gambles more to get even w/ losses)
  7-Lies
  8-Illegal acts to fund gambling
  9-Jeopardized relationships
  10-Relies on others to bail him out of trouble
B) Not mania

Question 12

Pathologic Gambling tx? (5)

Answer 12

Psych therapy
Behavior mod
Cognitive behav therapy
Groups
P SSRI, anxiolytics, stabilizers

Question 13

Trichotillomania criteria? (4)

Answer 13

A) Noticeable pulling out of hair
B) Increase tension prior
C) Pleasure/relief while pulling
D) Causes significant distress

Question 14

Trichotillomania tx?

Answer 14

Behavior mod

P SSRI, anxiolytics, stabilizers

Question 15

Paraphilia is?

Answer 15

Deviation from “normal” sexual interests

Question 16

Paraphilia criteria? (3)

Answer 16

A) Recurrent, intense, sexually arousing fantasies/urges/behaviors involving:
1-Non-human objects
2-Suffering/humiliation of self or partner
3-Children/non-consensting partner

B) 6+ months

C) Significant distress/impairment

Question 17

Exhibitionism criteria?

Answer 17

Same as paraphilia specifically involving exposing genitalia to unsuspecting strangers

(sidenote) pleasure is in reaction of victim

Question 18

Voyeurism criteria?

Answer 18

Same as paraphilia specifically involving observing unsuspecting person naked/disrobing/sexual activity

(sidenote) U single males 20-30s, masturbate during

Question 19

Frotteurism criteria?

Answer 19

Same involving rubbing against/touching non-consenting person

Question 20

Fetishism criteria?

Answer 20

Same involving non-living objects

(sidenote) object used for masturbation

Question 21

Masochism criteria?

Answer 21

Same involving being humiliated, bound, suffering

Question 22

Sadism criteria?

Answer 22

Same involving excitement from suffering of victim

Question 23

Pedophilia criteria?

Answer 23

Same involving 13 yo or younger

Pt must be 16 yo and 5+ yrs older than child

Question 24

Paraphilia tx?

Answer 24

CBT: address rationalization/distorted thinking
Social skills
12-step/Group

SSRIs
Anti-androgens for victim-based (depo-provera, triptorelin)
Stablizers (val acid)
Antipsych for aggressive behavior

Question 25

Gender Identity Disorder criteria?

Answer 25

A) Strong/persistent cross-gender identification
B) Persistent discomfort w/ gender or sense of inappropriateness of gender role of their sex
C) Not concurrent w/ physical intersex condition
D) Impariment

(sidenote) NOT non-conformity to sex stereotypes

Question 26

Sexual Disorder NOS criteria (hypersexual behavior)?

Answer 26

Sexual disturbance not meeting criteria for other dysf, disorder, or paraphilia

(sidenote) based on loss of control, inability to stop and negative consequences

Question 27

Quick screen for sex disorder:

PATHOS

Answer 27

Preoccupied w/ sex
Ashamed of sex behavior
Treatment before
Hurt others (emotionally by behavior)
Out of control
Sad (depressed after)

Refer if 3+