Impulse Control Disorders Flashcards
What characterizes an impulse control disorder?
a predisposed inability to resist unplanned, rapid reactions toward internal or external stimuli without regard for the negative consequences
- repetitive or compulsive engagement in behavior despite adverse consequences
- little control over the negative behavior
- anxiety or craving experienced prior to engagement in impulsive behavior
- Relief or satisfaction during or after completion of the behavior
What are the diagnostic critieria for intermittent explosive disorder?
recurrent outburst of aggression that result in assault against people or property
outbursts and aggression are out of proportion to the triggering event or stressor.
not better explained by another psych diagnosis
each episode often remits quickly and spontaneously, often leaving patients feeling remorseful and distressed
When does intermittent explosive disorder typically present?
in the teenage years and worsen until middle age
What neurotransmitter has been associated with the impulsiveness and aggression of intermittent explosive disorder?
serotonin
What is the typical treatment for intermittent explosive disorder?
SSRIs, anticonvulsants, lithium or propranolol
individual psychotherapy is usually difficult and ineffective because of the lack of individual control
group therapy may be more useful
What are the diagnostic criteria for kleptomania?
inability to resist uncontrollable urges to steal objects that are not needed for personal use or monetary gain
pleasure or relief is experienced while stealing; however, intense guilt and shame are often reported
objects stolen are typically given or thrown away, returned or hoarded
Which gender is more affected by kleptomania?
women
What percentage of shoplifters are considered kleptomaniacs?
only 5%
Kleptomania is very common in patients with what eating disorder?
bulimia nervosa
What is the treatment for kleptomania?
insight-oriented psychotherapy
behavior therapy like systematic desensitization and aversive conditioning
SSRIs
anecdotal evidence for naltrexone (probably helps with the craving piece)
What are the diagnostic criteria for pathological gambling?
Persistent and recurrent maladaptive gamping behavior as evidenced by 5+ of:
- preoccupation w/ gambling
- need to gample with increasing amounts of money to achieve pleasure
- repeated and unsuccessful attempts to cut down
- restlessness or irritability when attempting to stop
- gambling done to escape problems or relieve dyshoria
- returning to reclaim losses after gambling
- lying to therapist or family to hide level of gambling
- committing illegal acts to finance it
- jeopardizing relationships or jobs
- relying on others to financially support the habit
Which gender has pathological gambling more often?
males (2/3 of cases)
What is the typical course and progression of pathological gambling?
usually starts in adolescence or young adulthood, marked by periods of abstinence and relapse
one-third will achieve recovery without treatment
What is the treatment for pathological gambling?
The Gamblers Anonymous 12-step program is the most effective
after three months of abstinence, insight-oriented psychotherapy can be attempted
What are the diagnostic criteria for trichotillomania?
recurrent, repetitive, intentional pulling out of one’s hair causing visible hair loss
usually involves the scalp, though can include eyebrows, eyelashes and facial or pubic hair
tension is experienced immediately before the pulling behavior with pleasure or relief occuring afterwards
