Impulse control disorders

Question 1

Conduct Disorder

Answer 1

A. A repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated, as manifested by the presence of at least three of the following 15 criteria in the past 12 months from any of the categories below, with at least one criterion present in the past 6 months:

Aggression to People and Animals

1. Often bullies, threatens, or intimidates others.
2. Often initiates physical fights.
3. Has used a weapon that can cause serious physical harm to others (e.g., a bat, brick, broken bottle, knife, gun).
4. Has been physically cruel to people.
5. Has been physically cruel to animals.
6. Has stolen while confronting a victim (e.g., mugging, purse snatching, extortion,armed robbery).
7. Has forced someone into sexual activity.

Destruction of Property

1. Has deliberately engaged in fire setting with the intention of causing serious damage.
2. Has deliberately destroyed others’ property (other than by fire setting).

Deceitfulness or Theft

1. Has broken into someone else’s house, building, or car.
2. Often lies to obtain goods or favors or to avoid obligations (i.e., “cons” others).
3. Has stolen items of nontrivial value without confronting a victim (e.g., shoplifting,
   but without breaking and entering: forgery).

Serious Violations of Rules

1. Often stays out at night despite parental prohibitions, beginning before age 13 years.
2. Has run away from home overnight at least twice while living in the parental or pa­rental surrogate home, or once without returning for a lengthy period.
3. Is often truant from school, beginning before age 13 years.

C. If the individual is age 18 years or older, criteria are not met for antisocial personality disorder.

Question 2

Intermittent Explosive Disorder

Answer 2

A. Recurrent behavioral outbursts representing a failure to control aggressive impulses as manifested by either of the following;

1. Verbal aggression (e.g., temper tantrums, tirades, verbal arguments or fights) or physical aggression toward property, animals, or other individuals, occurring twice weekly, on average, for a period of 3 months. The physical aggression does not result in damage or destruction of property and does not result in physical injury to animals or other individuals.
2. Three behavioral outbursts involving damage or destruction of property and/or physical assault involving physical injury against animals or other individuals occurring within a 12-month period.

B. The magnitude of aggressiveness expressed during the recurrent outbursts is grossly out of proportion to the provocation or to any precipitating psychosocial stressors.

C. The recurrent aggressive outbursts are not premeditated (i.e., they are impulsive and/
or anger-based) and are not committed to achieve some tangible objective (e.g.,
money, power, intimidation).

D. The recurrent aggressive outbursts cause either marked distress in the individual or
impairment in occupational or interpersonal functioning, or are associated with finan­cial or legal consequences.

E. Chronological Age Is At Least 6 Years(or equivalent developmental level).

Question 3

Oppositional Defiant Disorder

Answer 3

A. A pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least 6 months as evidenced by at least four symptoms from any of the following categories, and exhibited during interaction with at least one individual who is not a sibling.

Angry/Irritable Mood

1. Often loses temper.
2. Is often touchy or easily annoyed.
3. Is often angry and resentful.

Argumentative/Defiant Behavior

1. Often argues with authority figures or, for children and adolescents, with adults.
2. Often actively defies or refuses to comply with requests from authority figures or
   with rules.
3. Often deliberately annoys others.
4. Often blames others for his or her mistakes or misbehavior.

Vindictiveness
1. Has been spiteful or vindictive at least twice within the past 6 months.

Question 4

Kleptomania

Answer 4

A. Recurrent failure to resist impulses to steal objects that are not needed for personal use or for their monetary value.

B. Increasing sense of tension immediately before committing the theft.

C. Pleasure, gratification, or relief at the time of committing the theft.

D. The stealing is not committed to express anger or vengeance and is not in response to a delusion or a hallucination.

E. The stealing is not better explained by conduct disorder, a manic episode, or antisocial personality disorder.

Question 5

Pyromania

Answer 5

A. Deliberate and purposeful fire setting on more than one occasion.
B. Tension or affective arousal before the act.
C. Fascination with, interest in, curiosity about, or attraction to fire and its situational con­texts (e.g., paraphernalia, uses, consequences).
D. Pleasure, gratification, or relief when setting fires or when witnessing or participatingin their aftermath.
E. The fire setting is not done fo rmonetary gain, as an expression of sociopolitical ideol­ogy, to conceal criminal activity, to express anger or vengeance, to improve one’s living circumstances, in response to a delusion or hallucination, or as a result of impaired judgment (e.g., in major neurocognitive disorder, intellectual disability [intellectual de­ velopmental disorder], substance intoxication).
F. The fire setting is not better explained by conduct disorder, a manic episode, or anti­ social personality disorder.