impulse control disorder Flashcards
what is impulse control disorder?
it is characterized by the repeated inability to resist the impulse or urge to carry out a behavior.
the behavior will feel rewarding in short term but will have negative long term consequences such as HARM TO THEMSELVES OR OTHERS, DISTRESS ABOUT BEHAVIOR, SIGNIFICANT IMPAIRMENT TO ONE OR MORE AREAS OF LIFE
what is kleptomania ?
kleptomania is characterized by a powerful impulse to steal this impulse is very hard to resist, and the person will often steal things as a result
Before the theft occurs, there is an intense feeling of attention or effective arousal and immediately following the theft there are feelings of excitement, gratification, or relief
The stealing is not intended to achieve any motive such as monetary gain
what is pyromania ?
Pyromaniac characterized by a powerful impulse to set fires the impulse is very hard to resist which results in many act or attempts at setting fire to property or other objects
An increasing of tension occurs directly prior to the fire setting, and a sense of pleasure. Excitement and gratification is felt during or after the act.
Additionally, there’s a fascination with fire and related stimuli such as watching or building fires or firefighting equipment
There is no motive such as monetary gain sabotage or revenge
what is gambling disorder?
Gambling disorder involves a pattern of persistent or reoccurring, gambling behavior, either online or off-line
It is characterized by impaired control of gambling in terms of length of time spent gambling or how much money is spent
Gambling given priority over other activities, or interest
Gambling continuing or increasing despite negative consequences
The gambling result in significant distress or significant impairments to important of functioning such as family, life, friendship, or worklife
For diagnosis to be made, gambling behavior would be present for at least a year
what is the kelptomania assessment scale ?
Diagnosis of these disorders can be made within the clinician using an appropriate self report measure
One measure for the diagnosis of kleptomania is the kleptomania system assessment scale
this is an 11 item soft rated scale that measures impulses thoughts, feelings, and behaviors related to stealing
The individual taking assessment is asked to consider the question in relation to the past seven days
Each item is rated on point scale typically 0 to 4 or 0 to 5
With the highest score, reflecting the greatest severity in duration of symptoms
what is rhe behavioral explanation for ICD?
an alternative explanation for these disorders also relates to the idea of rewards
The behavior approach considers the action of the person involved in the compulsive behavior one behavioral theory that can account for these patterns of behavior is positive reinforcement
Positive reinforcement is one aspect of operant conditioning
Positive reinforcement occurs when someone’s learned behavior is a result of previous trials of behavior
An example is a person who has given a scratch card for their birthday and wins, which encourages them to buy more scratch cards, then enjoyment of winning act as a positive reinforcer
schedules of reinforcement . instead of constant positive reinforcement most betting games involve a lot of losing.
you do not receive a reward each time
this reduces a chance that the player will ever feel fully satisfied with their reward.
what is the cognitive explanation for ICD?
the feeling state theory. it replies on underlying thoughts about particular behaviors to explain obsessions.
intense positive feelings can become linked with specific behaviors such as gambling. miller proposed that impulse control disorders are caused by these links and they form a state dependent memory which he refers to as a feeling state.
the feeling state is all the sensations emotions or thoughts a person experiences in relation to a particular event.
it this the feeling state that leads to the impulse control problems
miller argues that an underlying negative thought or experience is most likely to create the feeling state that lead to ICD
example: a person with pyromania who has the feeling state i am powerful when setting fires will have underlying negative beliefs about themselves
what was the biological treatment
a successful treatment of gambling disorder is a group of drugs called opiate antagonists
explain the aim of GRANT et al
the research aimed to identify clinical variables associated with treatment outcome in PG subjects receiving opiate antagonists
what was the hypothesis of GRANT et al
the research hypothesized that a family history of alcoholism and stronger urges to gamble would be associated with positive outcomes for those treated with opiate antagonists
what was the sample for GRANT et al
two double blind placebo clinical trials
284 participants with PG who had gambled in the last two weeks
approximately equal number of men and women
All participants were from the USA
an independent group design was used
design of GRANT et al ?
participants in each trial were randomly assigned to one of 4 conditions. 1.placebo 2. nalmefene doses of 25 mg/day 50 mg/day 100 mg/day OR naltrexone doses of 50 mg/day 100 mg/day 150 mg/day
25% participants were given a placebo to act as a control
clinical administered scales and semi structured interviews were used to gather data
the PG YBOCS was the main measure hated
this is a clinican administrated scale to assesss gambling severity by assessing symptoms over the previous seven days.
other scales were also administered assessing the participants on psychological functioning anxiety and depressive disorder
semi structured interviews were used to gather family history especially in terms of alcoholism
what were the results for GRANT et al?
treatment response was defined as at least a 35% reduction in PG-YBOCS FOR AT LEAST ONE MONTH FOLLOWING TREATMENT
Results that the variable, most strongly associated with the positive response to opiates antagonist treatment was a family history of alcoholism
This combined with the knowledge that opiate antagonist can be effective treatment for alcohol dependence, suggest that there may be a genetic influence on their response to opiate antagonist treatment
For receiving a higher dose of opiate antagonist intensity of gambling urges were associated positive response to treatment
Receiving younger age associated with a positive response this may be due to the fact that gambling urges and behaviors were less ingrained than an old patient
those with less severe PG did not respond more positively to placebo
explain convert sensitization ?
The covert sensitization procedure involves conditioning in which an unpleasant stimulus, such as nausea is paired with an undesirable behavior in order to change that behavior
describe GLOVER et al
glover describes one case study using Covert sensitization to treat an instance of kleptomania
56 year-old woman with a 14 year history of daily shoplifting was seeking out for her behavior, took part in the therapy
Her behavior after her husband was convicted of embezzlement. The woman became isolated from her friends and became depressed.
Compulsive thought of shoplifting entered her head each morning, which were repulsive, but nonetheless impossible to resist
glover reports that the woman sought treatment for her disorder the treatment involved using the imagery of nausea and vomiting to create an unpleasant association with stealing the woman under four sessions at two weekly intervals
For the first two sessions, muscle relaxation was used, enhance her ability to immerse herself in the visualization
Increasing nausea visualization was used over each session
She imagined vomiting as she lifted the item to steal and attracting attention and discussed of those around her
She practiced visualizations outside of formal sessions as homework
During the last session, she imagine the sickness going away as she replaced the item and walked away without shoplifting
Participant associate pleasant sensation of vomiting with undesirable behavior
She had avoidance of stealing and a single relapse
