Impulse control

Question 1

define impulse control disorder

Answer 1

person feels a compulsion to carry out a certain behaviour, rather than take a substance

Question 2

stages of impulsivity

Answer 2

1. Impulse
2. Tension
3. Pleasure
4. Relief
5. Guilt/No guilt

Question 3

common components which form a definition of addictive behaviours

Answer 3

salience, mood modification, tolerance, withddrawal, conflict, relapse

Question 4

define salience

Answer 4

when an activity takes over as the most important activity in a person’s life

Question 5

define mood modification

Answer 5

where the person experiences a ‘buzz’, ‘high’ or feelings of peace and escape

Question 6

define tolerance

Answer 6

increasing amounts of the particular activity are required to sufficiently modify mood

Question 7

define withdrawal

Answer 7

unpleasant feelings or physical effects that occur when the behaviour is reduced or stopped

Question 8

define conflict

Answer 8

occurs between addict and those around them or internally

Question 9

definition of kleptomania

Answer 9

inability to resist stealing objects not needed for personal use or monetary value

Question 10

characteristics of kleptomania

Answer 10

intrusive thoughts and urges to steal, feel tension before stealing, feel pleasure or gratification afterwards.

Question 11

what is the K-SAS

Answer 11

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

Question 12

example of K-SAS question

Answer 12

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)

Question 13

evaluate K-SAS

Answer 13

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

Question 14

definition of pyromania

Answer 14

impulse to start fire, intentionally set fires on more than one occasion, fascinated with fire

Question 15

characteristics of pyromania

Answer 15

set off false fire alarms, watch explosions, severe distress after starting fires

Question 16

description of pyromania by Burton et al

Answer 16

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

Question 17

definition of gambling disorder

Answer 17

non-substance addictive disorder in DSM-5 as its symptoms and behaviours are very similar to substance disorders

Question 18

characteristics of gambling disorder

Answer 18

stimulate brain’s reward centre similar to substance abuse, persistent and problematic behaviour leads to compromised relationships

Question 19

explain the biochemical cause

Answer 19

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

Question 20

explain the behavioural cause

Answer 20

operant conditioning, enjoyment of activity becomes positive reinforcement, then schedules of reinforcement becomes addictive

Question 21

explain the cognitive cause

Answer 21

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

Question 22

explain biochemical treatment

Answer 22

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.

Question 23

Grant et al

Answer 23

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

Question 24

explain covert sensitisation

Answer 24

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

Question 25

Glover

Answer 25

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

Question 26

explain imaginal desensitisation

Answer 26

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

Question 27

Blaszczynski & Nower

Answer 27

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

Question 28

explain impulse control therapy

Answer 28

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

Question 29

Miller

Answer 29

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