Impulse Control Disorders Flashcards
Describe an impulse control disorder.
Failure to resist an impulse or drive to perform an act that is harmful to self or others
How do individuals feel when performing an impulse?
Before the action, they feel increasing tension and during the act, gratification. (after - bad consequences)
What is the difference between an impulse and a compulsion?
Impulse is a tension state that can exist without an action but compulsions always have an action component.
What are some causes of impulse control disorders?
- Primary cause: unknown, psychic trauma
- Incomplete sense of self: not receiving affirming responses from significant relationships & so self fragments
- Psychosocial: early life events - alcohol abuse, violence, parents with difficulty control impulses
What neurotransmitters are associated with being more impulsive?
Glutamate, norepi, dopamine
What neurotransmitters are associated with being less impulsive?
GABA, serotonin
What are the diagnostic features of intermittent explosive disorder? How is it treated?
Episodes of failure to resist aggressive impulses - assaultive acts or property destruction; treated with therapy + SSRIs & buspirone
What are the diagnostic features of pyromania? How is it treated?
Deliberate fire setting; feel tension/arousal prior to act and pleasure afterwards (not for monetary gain!); behavior therapy, visit burn unit
Fun facts: psychosocial symbol of sexuality; low CSF levels of serotonin metabolite
What are some features of pathological gambling? How is it treated?
Preoccupation with gambling; gamble to escape problems; unsuccessful efforts to cut down; do not see themselves as doing something wrong; Treatment: therapy, gamblers anonymous
What are some features of kleptomania? How is it treated?
Failure to resist impulses to steal objects that are not needed for personal/monetary value; history of dysfunctional childhood; Treatment: therapy + SSRIs
What is the difference between impulsive acts and OCD?
Impulsive acts - feel pleasure, gratification upon committing act
OCD - feel dissipation of tension upon committing act + other ritualistic behaviors
What are some features of trichotillomania? How is it treated?
Feeling gratified once they pull their hair; starts in childhood could be due to disturbance in mother-child relationship; overlaps with OCD; treated by psychiatrist & dermatologist - CBT (habit reversal), insight oriented therapy + poor results with medications
Risk of suicide decreases with compliance to which drug?
Lithium
