ICD Flashcards
Characteristics of impulse control disorders and non-substance addictive disorder
P1 - definitions (Griffiths)
P2 - types : kleptomania, pyromania (Burton et al) + gambling disorder
P3 - measures: Kleptomania Symptom Assessment Scale (K-SAS)
Causes of impulse control disorders and non-substance addictive disorder
P1 - biochemical: dopamine
P2 - behavioural: positive reinforcement
P3 - cognitive: feeling-state theory (Miller)
Treating and managing ICDs and Non-substance addictive disorder
P1 - biochemical (Grant et al)
P2 - cognitive-behavioural: covert sensitisation (Glover)
imaginal desensitisation (Blaszczynski and Nower), impulse control therapy (Miller)
Definition (Griffiths) for ICD and non-substance addictive disorder
- salience (most important activity)
- mood modification (buzz)
- tolerance (increasing amount of activity)
- withdrawal (unpleasant when stopped/reduced)
- conflict + relapse (can’t stop, return back to)
What is Kleptomania?
- stealing objects not needed for personal use or monetary value
- tension before stealing, pleasure afterwards
- intrusive thoughts, urge to steal
- affect concentration
- not committed to express anger, not due to delusion/hallucination
What is pyromania?
- deliberately and intentionally set fires on more than one occasion
- feel tense/emotionally charged before the act and pleasure when setting fire or participating in their aftermath
What is gambling disorder?
- non-substance addictive disorder
- difficulty in controlling impulses
- stimulate brain’s reward centre —similar to substance abuse
- persistent + problematic gambling behaviour
- difficulty withdrawing
- impact family/individual/society
What is the feeling state theory (Miller)
- Cognitive theory, describes how intense, positive feelings can be linked with a behaviour
- Miller refers to this link as a state-dependent memory —> build over time through association, known as feeling-state
Explain the intense feeling in feeling state theory
- persist over time and different circumstances, early positive feeling states, affect later behaviour
- underlying negative thoughts/experiences —> most likely to create the feeling states that lead to ICDs
- e.g. the pyromaniac who has the feeling state ‘ I am powerful’ when setting a fire may have underlying negative beliefs about themselves, such as they are weak or unimportant
Describe the behavioural causes
- positive reinforcement, positive reinforcer
- The reward that the person gets from their action is positive reinforcement which makes the behaviour more likely to be repeated
Behaviourists claim that the reward can be external or internal
Skinner next investigated the effect of different frequencies and types of rewards and their effect on behaviour - schedules of reinforcement.
Variable-ratio schedule: when reward is delivered after an unpredictable number of responses. e.g. slot machine
Gambling Disorder (NSAD): external reinforcement=money internal reinforcement=dopamine reward pathway
Describe the biological causes
- dopamine reward pathway
- striatum
- reward deficiency syndrome
Normally, the ____striatum_____ is activated when we do something pleasurable. However, Da levels become ___lower_____ when behaviours are compulsive.
This part of the brain is responsible for ___reward_____ and behavioural control. Therefore, a deficiency in ____dopamine______ could lead to a cycle of compulsions and addictions.
As part of the striatum seems to be involved in feelings of _____pleasure____, together with other areas it is known as the ___dopamine reward pathway__.
Describe the biochemical treatment of ICD and NSADs (Grant et al)
- a group of drugs: OPIATES ANTAGONIST = successful in treating gambling disorders
- NALTREXONE (alcohol dependents) and NALMEFENE (both opiates antagonist)
A: examine how individuals responded to this biochemical treatment
P:
- double-blind experiment, 16 week course of the NALMEFENE
18 week course of NALTREXONE
- gambling severity assessed with Yale Brown Obsessive Compulsive Scale
R: overall opiate groups = significant reduction in symptoms
- family history of alcoholism + highest dose of opiates = greatest reduction in gambling disorder symptoms
—> suggest opiates may be even more effective in some gambling addicts than others
Describe the K-SAS
- psychometric
- 12 item questionnaire for kleptomania
- with 5 point likert scale (0=none, 4=extreme)
- higher score = more severe symptom
- e.g. if u had urges to steal last week, on average, how strong were your urges?
Describe Impulse Control Therapy (Miller)
Cognitive change:
Behavioural change:
Miller suggests that this therapy takes place over two sessions, with homework in between the session. The process has 12 stages
Why does impulse control therapy not simply eliminate the impulsive behaviour itself?
(impulse control therapy)
So the patient can still engage in that activity, e.g. shopping, but in a normal, healthy way (without stealing). Without long term sacrifices/changes.
