Impulse Control Disorder Flashcards
1
Q
What is ICD?
A
- Characterised by the inability to resist the impulse or urge to carry out a behaviour, this behaviour will feel rewarding to the person in short term consequences but will have long term negative consequences.
2
Q
What are Griffiths 6 components of addiction?
A
- Salience: the single most important activity
- Mood modification: a buzz or a high
- Tolerance: increasing amount of activity required
- Withdrawal: unpleasant feeling when amount is reduced or suddenly discontinued.
- Conflict: between addict and people around them or addicts themselves
- Relapse: going back to their addictive behaviours after stopping for a while
3
Q
What is kleptomania? (4)
A
- Characterised by a recurring irresistible urge to steal items that are often neither wanted nor needed.
- Theft episodes are typically unplanned triggered by escalating tension and followed by momentary pleasure.
- Individuals with kleptomania often experience concurrent depression and anxiety due to guilt.
- Can develop at any age, with a higher prevalence in females.
4
Q
What is pyromania? (4)
A
- Individuals with pyromania exhibit a fascination with fire and fire related equipment and intentionally start fires repeatedly, often without intending to cause harm.
- Tension builds before fire-setting followed by relief and pleasure upon ignition.
- Typically starts during teenage years.
- Risk factors such as boredom, stress, feelings of inadequacy and conflicts at school or home.
5
Q
What is a gambling disorder? (5)
A
- Involves a tension build up relieved by placing bets.
- Regular gamblers may develop tolerance requiring longer or higher stake gambling for the same level of arousal.
- Withdrawal symptoms can be more severe than in substance addictions.
- Takes over essential daily activities, making it challenging despite negative consequences.
- Diagnosis requires 12 months of recurrent gambling behaviour.
6
Q
Describe the K-SAS (5)
A
- Kleptomania Symptom Assessment Scale
- An 11 item self-report scale based on the individuals thoughts, feelings and actions from the past week.
- Scale of 0-4.
- Provides a framework for classifying the severity of kleptomania symptoms.
- Can also asses changes in symptom severity overtime.
7
Q
What are some examples of the K-SAS items? (3)
A
- During the past week, how often have you experienced an irresistible urge to steal?
- Have you felt increasing tension or anxiety just before stealing something.
- To what extent have your stolen items been of no use or value to you?
8
Q
Explain the biological explanation of ICD. (5)
A
- Reward deficiency syndrome.
- When dopamine is deficient it leads to the continuation of compulsions and addictions.
- This deficiency results from a complex interplay of genetic factors and environmental influences.
- Individuals tend to find little pleasure in their daily life leading them to seek such activities that give a dopamine rush.
- When dopamine levels are reduced, these behaviours become compulsive.
9
Q
Explain the behavioural explanation of ICD. (4)
A
- Positive reinforcement is one aspect of operant conditioning.
- Rewarded behaviours are more likely to be repeated.
- Learnt behaviours are a result of previous trials of that behaviours.
- The enjoyment of winning acts as a positive reinforcer, increasing the likelihood of their repeating behaviours.
10
Q
Why do gamblers not stop playing when they lose? (3)
A
- Schedules of reinforcement
- Instead of constant positive reinforcement, most betting games involve a lot of losing.
- Involves partial positive reinforcement to reduce chances of the players ever feeling full satisfied meaning they are more likely to keep playing.
11
Q
Explain the cognitive explanation of ICD. (5)
A
- Miller states ICDs are caused due to the link between a positive feeling and specific behaviour, forming a state-dependent memory, feeling-state.
- The association between both positive or negative feeling states and the specific behaviour contributes to the development of habitual behaviour.
- Individual lacking these empowering feelings are more susceptible to ICDs because these emotions act as powerful motivators.
- Memories can be context-dependent meaning specific people, objects or event can trigger a feeling state.
- Initiating the compulsive behaviour results in relief and strengthens the associated memory making it a potent motivator for future actions.
12
Q
Explain the biological treatment for ICD.
A
- Medication: opioid antagonists.
- Works by preventing reward centre from receiving happy chemicals in the brain, reducing the response to the impulse.
- Effective to those with family history of alcoholism and strong gambling urges.
13
Q
Explain covert sensitisation.
A
- Involves classical conditioning in which an unpleasant stimulus such as nausea is paired with the undesirable behaviour in order to change the behaviour.
14
Q
What are the 4 processes of covert sensitisation?
A
- Negative associations: amplifying negative emotions linked to the problematic behaviour.
- Imagery: guided to mentally visualise disgusting scenes.
- Associations: unsettling images paired with thoughts related to the target behaviour.
- Outcome: if the connections are strong enough, these thoughts may trigger negative emotions, overpowering the urge to engage in the problematic behaviour.
15
Q
Explain Glover’s example study. (9)
A
- 56 year old, married woman who had been stealing for 14 years.
- Would wake everyday with compulsive thoughts about stealing.
- Would find it awful to resist thoughts.
- Would steal unnecessary items like baby shoes.
- Described her urges as overwhelming and wished she was chained to a wall to stop her from stealing.
- Treatment involved imagery of nausea to create unpleasant associations.
- Muscle relaxation medication was used.
- Advised to shop with a strict list and to leave the bag she previously used for stealing at home.
- At a 19 month checkup, her desires decreased and she reported improvements in her self-esteem and social life.
16
Q
What is imaginal desensitisation ?
A
- A form of treatment involving relaxation-based imagery to reduce the strength of these urges by reducing excitement and physiological arousal relating to the triggering stimulus.
- Empowers the client through developing coping skills and building a sense of self efficacy.
- Work by helping the individual imagine a full behavioural sequence in order to reduce urges, behaviour and the tension that reinforces the habit.
- Involves progressive muscle relaxation.
17
Q
Explain guided imagery. (4)
A
- Used to reverse physiological arousal to a point where the triggering stimulus no longer elicits an intense response.
- In the first session, the therapist asks open-ended questions to identify behavioural sequences associated with the onset of urges.
- Sequence of events are dissected into 4-6 scenes leading to the target behaviour.
- Therapist crafts a personalised guided imagery script, approximately 20 minutes long, used in face to face sessions then transformed to an audio recording for uses between sessions.
18
Q
Explain Blaszczynski and Nower’s case study
A
- Mary Doe; a 52 year old divorced mother of two.
- Developed a gambling interest in childhood by watching her grandmother.
- Began gambling for money in school and started daily casino visits.
- Therapist discussed life stressors triggering gambling and created a guided imagery script focusing on positive behavioural sequences.
19
Q
Explain Grant’s key study
( aim - hypotheses - methodology - sample - conditions - data collections - result)
A
- To investigate factors that predict the effectiveness of opiate antagonists in the treatment of gambling disorders.
- Effectiveness factors for opiate antagonists such as family history of alcoholism, strong urges of gambling and euphoric response to alcohol.
Placebo effect in individuals with milder gambling urges. - RCT characteristics; double blind raters, placebo controlled and independent measures design.
- 284 individuals from the US, 48% females, all diagnosed with PG and no prior experience with opiate antagonists.
- Nalmafene trial and naltrexone trial.
- Structured interviews, questionnaires, Y-BOCS, anxiety and depression assessments.
- 35% reduction is PG Y-BOCS scores, younger patients showed better response, less severe patients responded more positively to placebo.
