Impulsive Control Disorders

Question 1

Key point of Impulsive Control Disorders

Answer 1

failure to resist drive or temptation

Intense arousal before act, followed by relief and euphoria after the act is performed

Question 2

What is the biological difference between impulse and compulsion?

Answer 2

Impulse connect to dopamine path, induces pleasurable response (endorphins)

Compulsion – relieve anxiety

Question 3

This disorder is not about the anger, it’s about liking to punch

Answer 3

Explosive Disorder

Question 4

What key elements are needed to diagnosis explosive disorder?

Answer 4

Action is grossly out of proportion of a stressor/situation, or is without provocation

Frequent occurrences

Make sure to rule out everything (conduct disorder, substance abuse, etc)

Question 5

What workup needs to be done in patients with possible explosive disorder?

Answer 5

Work patient up for brain lesions: rule out TBI and epilepsy – can cause the behavior

Question 6

This disorder is hair pulling that results in noticeable hair loss

Can be see in anxious situations or in leisure activities

Answer 6

Trichitillomania

Question 7

What conditions do you need to rule out in Trichitillomania?

Answer 7

Derm issues

OCD, anxiety, stress (especially if other compulsions are present)

Question 8

This disorder is a need to steal for the act of stealing (the rush - pleasure/relief afterwards)

Not stealing for secondary gains!

Not done due to delusions or other psych disorder

Answer 8

Kleptomania

Question 9

This disorder is deliberate and intentional setting of fires

May be people who work with fire 🡪 have fascination (Ex: firefighters)

Fire not done for anger, response to delusion, cover crime, etc

Not impaired judgement!

Answer 9

Pyromania

Question 10

This disorder the gambling act is rewarding

Disrupts family or other pursuits

May do this to improve decreased mood

Answer 10

Pathological Gambling