impulse control disorders

Question 1

intermittent explosive do: dx

Answer 1

• recurrent outbursts of aggression –> assault against people or property
• out of proportion to triggering event/stressor
• episode often remits quickly and spontaneously

Question 2

IED: epidem

Answer 2

• men > women
• onset usually late teens
• genetic, perinatal, environmental, neurobiological factors

LOW SEROTONIN

Question 3

IED: tx

Answer 3

• SSRIs!
• anticonvulsants, lithium, propranolol
• group therapy or family therapy

Question 4

kleptomania: dx

Answer 4

• inability to resist uncontrollable urges to steal objects that are not needed
• pleasure or relief while stealing, intense guilt and shame often follow
• stolen objects often thrown/given away, returned, hoarded

Question 5

kleptomaina: epidem/etiology

Answer 5

• women > men
• sx often during stress
• 5% of shoplifters
• increased incidence of mood do, eating do, OCD
  (1/4 of bulimia pts have kleptomania)
• usually chornic

Question 6

kleptomania: tx

Answer 6

• insight-oriented psychotherapy, behavior therapy

- SSRIs

Question 7

pathological gambling: dx

Answer 7

5+ of:

• preoccupation with gambling
• need to gamble with increasing amt of $$
• repeated and unsuccessful attempts to cut down
• restlessness/irritability when trying to cut down
• gambling to escape problems or relieve dysphoria
• returning to reclaim losses
• lying to therapist/family members about level of gambling
• illegal acts to finance gambling
• jeopardizing relationships/jobs
• relying on others to financially support gambling

Question 8

pathological gambling: epidem

Answer 8

• 1-3% of US adults
• men&raquo_space; women
• high rates in adol and young adults
• increased incidence of mood dos, anxiety dos, OCD
• many predisposing factors
• 1/3 achieve recovery w/o tx

Question 9

pathological gambling: tx

Answer 9

• Gamblers anon
• psychotherapy after 3 months of abstinence
• treat comorbid dos

Question 10

trichotillomania: dx

Answer 10

• recurrent repetitive intentional pulling out of hair
• scalp most common
• tension before pulling, relief/pleasure afterwards
• significant distress/impairment

Question 11

trichotillomania: epidem

Answer 11

• 1-3% of pop
• women > men
• onset in childhood/adol, 25% assoc with stressful event
• hair texture thought to be trigger
• increased incidence of OCD, OCPD, mood do, BPD
• chronic or remitting course

Question 12

trichotillomania: tx

Answer 12

• SSRIs, antipsychotics, lithium

- behavioral interventions?

Question 13

pyromania: dx

Answer 13

• 1+ episode of deliberate fire setting
• tension or arousal before, pleasure/gratification/relief when setting fires/after
• fascination with, curiosity about, attraction to fire and consequences
• not for monetary gain, expression of anger, or making political statement

Question 14

pyromania: epidem

Answer 14

• men = women (?)
• onset late adol
• prognosis better in children than adults

Question 15

pyromania: tx

Answer 15

• behavior therapy
• supervision
• SSRIs