First Aid: Impulse Control Disorders Flashcards
With impulse control disorders, what is experienced prior to the impulse?
anxiety
With impulse control disorders, what is experienced after the behavior is completed?
relief
What is 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
Do patients with intermittent explosive disorder usually feel remorse for their actions?
yes
What neurochemical change has been shown to be associated with impulsiveness and aggression?
low levels of serotonin
What is the gender difference in intermittent explosive disorder?
men > women
What is the age of onset for intermittent explosive disorder?
typically in late teens or twenties
What are common comorbidities for intermittent explosive disorder?
- H/o child abuse
- H/o head trauma
- H/o Seizures
What is the prognosis for intermittent explosive disorder?
may progress in severity til middle age
What is the treatment for intermittent explosive disorder?
SSRIs
Anticonvulsants
Lithium
Propranolol
What is the role of therapy in intermittent explosive disorder?
Individual psychotherapy is difficult and ineffective
What is the DSM-IV diagnostic 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 hallucination or delusion
What is the gender difference for kleptomania?
women > men
True or false: very few shoplifters have kleptomania?
true (under 5%)
What are some comorbidities of kleptomania?
- Mood disorders
- Eating disorders (25% of bulimics)
- OCD
What is the treatment for kleptomania?
- Insight-oriented psychotherapy
- Behavioral therapy (systematic desensitization and aversive conditioning)
- SSRIs
What is the DSM-IV criteria for pyromania?
- More than 1 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 is not for monetary gain, expression of anger, making a political statement and is not due to a hallucination or delusion
What gender is more likely to have pyromania?
men
What is a common comorbidity with pyromania?
mental retardation
What is the prognosis for pyromania?
better in children than adults (children usually have complete recovery)
What type of treatment is used for pyromania?
- Behavior therapy
- Supervision
- SSRIs
What is the DSM-IV criteria for pathological gambling?
Recurrent maladaptive gambling behavior, as shown by 5 or more of the following:
- Preoccupation with gambling
- Need to gamble with increasing amount of $ 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
- Chasing losses
- Lying to therapist or family members about gambling
- Jeopardizing relationships or job because of gambling
- Relying on others to financially support gambling
What is the most affective treatment for pathological gambling?
Gamblers Anonymous (12 step program)
What is the DSM-IV criteria for trichotillomania?
- Recurrent pulling out of one’s hair, resulting in visible hair loss
- Usually involves scalp but can involve eyebrows, eyelashes, and facial and pubic hair
- Tension present before the behavior and pleasure or relief resulting afterwards
- Causes significant distress or impairment in daily functioning
When does trichotillomania usually begin?
onset during childhood or adolescence (25% after stressful event)
What are some common comorbidities of trichotillomania?
OCD
OCPD
Borderline Personality Disorder
What is the treatment for trichotillomania?
- SSRIs, antipsychotics, lithium
- Hypnosis, relaxation techniques
- Behavioral therapy, substituting behaviors, positive reinforcement
