Impulse control Flashcards
define impulse control disorder
person feels a compulsion to carry out a certain behaviour, rather than take a substance
stages of impulsivity
- Impulse
- Tension
- Pleasure
- Relief
- Guilt/No guilt
common components which form a definition of addictive behaviours
salience, mood modification, tolerance, withddrawal, conflict, relapse
define salience
when an activity takes over as the most important activity in a person’s life
define mood modification
where the person experiences a ‘buzz’, ‘high’ or feelings of peace and escape
define tolerance
increasing amounts of the particular activity are required to sufficiently modify mood
define withdrawal
unpleasant feelings or physical effects that occur when the behaviour is reduced or stopped
define conflict
occurs between addict and those around them or internally
definition of kleptomania
inability to resist stealing objects not needed for personal use or monetary value
characteristics of kleptomania
intrusive thoughts and urges to steal, feel tension before stealing, feel pleasure or gratification afterwards.
what is the K-SAS
11-item self-rated scale which measures impulses, thoughts, feelings and behaviours related to stealing. The individual considers this in relation to the past seven days. Highest scores reflect greatest severity and duration of symptoms
example of K-SAS question
If you had urges to steal during the past week, on average, how strong were your urges? Please circle the most appropriate number: 0(mild) – 4(extreme)
evaluate K-SAS
scored well for retest reliability with GAFS, good concurrent validity. Self-report means response bias as people may feel ashamed of behaviour and under-report symptoms. Quantitative data. Helpful to monitor reduction in symptoms, allows patient to gain insight
definition of pyromania
impulse to start fire, intentionally set fires on more than one occasion, fascinated with fire
characteristics of pyromania
set off false fire alarms, watch explosions, severe distress after starting fires
description of pyromania by Burton et al
fire setting is a behaviour, arson is a subtype of fire setting but it is a criminal act willfully done with malicious intent, pyromania is a psychiatric diagnosis tat has individuals engage in intentional and pathological fire setting
definition of gambling disorder
non-substance addictive disorder in DSM-5 as its symptoms and behaviours are very similar to substance disorders
characteristics of gambling disorder
stimulate brain’s reward centre similar to substance abuse, persistent and problematic behaviour leads to compromised relationships
explain the biochemical cause
its release is triggered by rewarding stimuli so reward centres are stimulated and release dopamine, levels of dopamine in striatum (reward and behaviour control) are reduced when behaviour becomes compulsive so reward deficiency syndrome happens and you increasingly engage in impulsive behaviour
explain the behavioural cause
operant conditioning, enjoyment of activity becomes positive reinforcement, then schedules of reinforcement becomes addictive
explain the cognitive cause
impulse control disorders are caused because links form a state-dependent memory (feeling state) (intense and desirable), underlying negative thoughts most likely to create feeling-states that lead to impulse control disorders
feeling-state + triggering event = desired feeling + compulsive behaviour
explain biochemical treatment
Opioid receptor antagonists inhibit dopamine release in the nucleus accumbens and ventral pallidum through the disinhibition of GABA input to the dopamine neurons in the ventral tegmental area. opioid antagonists are though to decrease doopamine neurotransmission in the nucleus accumbens and the motivational neurocircuitry, thus dampening gambling-related excitement and cravings.
Grant et al
16 week course of nalmefene, 18 week course of naltrexone, placebo 284 participants, double-blind, Y-BOCS specifically modified for gambling disorder, 35% greater reduction in score for at least one month after. Family history of alcoholism and higher doses of opiates had greatest reduction
explain covert sensitisation
classical conditioning, form of behavioural therapy in which an undesirable behaviour is paired with an unpleasant image in order to eliminate that behaviour, so impulsive behaviour is paired with unpleasant images or experiences such as vomiting and bankrupcy, eventually learning to do it while gambling
Glover
case study of 56 year old woman seeking help for shoplifting, imagery of nausea and vomiting was used to create unpleasant association with stealing, four session at two-weekly intervals, muscle relaxation used for first two sessions, increasing nausea visualisation, practice outside formal sessions, last session had her imagine sickness going away after placing item back and walking out of the shop, after 19 months had decreased desire with single relapse
explain imaginal desensitisation
taught progressive muscle relaxation, visual situation where they feel the desire to carry out impulsive behaviour, contemplating acting on their urge but then leaving the situation without having acted upon their urge , which reduces arousal and anxiety
Blaszczynski & Nower
case study on Mary doe, gambling addiction, progressive muscle relaxation
1. initiate urge 2. plan to follow through urge 3. arriving at venue 4. generating arousal and excitement 5. having second thoughts about behaviour 6.decreasing attractiveness of behaviour
explain impulse control therapy
feeling-state theory suggests that these disorders are created when intense positive feelings become linked with specific behaviour
Impulse control disorder protocol:
1. identify aspect of behaviour that produces most intense feeling
2. measure intense positive feeling with Positive Feelings Scale
3. combine image of performing behaviour + positive feeling +physical sensations
4. eye movement desensitisation and reprocessing exercises performed
5. reflect and re-evaluate feeling state with PFS
Miller
case study, John depression and debt, compulsive gambler, identify feeling-state of gambling memory involved winning, reduction and less excitable feel for gambling, 3 months later can self-regulate
