psych impulse control disorders Flashcards
core qualities of impusive control disorders
repetitive engagement in behavior despite adverse outcome; little control over the neg behavior; anxiety or cravign prior to engagement in behavior; relief or satisfaction during or after completion of the behavior
intermittent explosive disorder
recurrent outbursts of aggression that result in assault against people or property, out of proportion to trigger; each episode remits spontaneously, leaving pt remorseful and distressed
treatment for intermittent explosive disorder
SSRIs, anticonvulsants, lithium, and propranolol; individual psychotheraoy is difficult and ineffective given the nature of the disease and lack of individual control; group therapy may be helpful
kleptomania
inability to resists uncontrollable urges to steal objects that are not needed for personal use or monetary reasons; pleasure or relief is experienced while stealing, but intense guilt and shame are reported by patients
epi of kleptomania
more common in women; sx often occure during stress; course of illness is usually chronic
treatment for kleptomania
insight-oriented psychotherapy, behavioral therapy and SSRIs; some anecdotal evidence for naltrexone
pathological gambling dsm criteria
five or more of: preoccup with gambling, need to gamble for pleasure; repeated attempts to cut down; restlessness and irritability when gambling; gambling done to escape problems; returnign to reclaim losses after gambling;
epi of pathological gambling
high in adolescents, lower rates in older adults; marked by periods of abstinence and relapse; one third will achieve recovery without treatment
treatment for pathologic gambling
Gamblers Anonymous is most effective; after 3 mos of abstinence from gambling, insight-oriented psychotherapy may be attempted
trichotillomania
recurrnet pulling out of one’s hair causing visible hairloss; tension before pulling, relief after pulling
tricho epi
more common in women; onset during childhood or adolescence; assoc with stressful event
increased incidence of what in tricho patients
OCD, OCPD, mood disorders, and borderline personality disorder
treatment for trichotillomania
SSRIs, antipsychotics, or lithium; behavioral interventions might have some benefit
pyromania
at least one episode of deliberate fire setting; purpose of fire setting is not for monetary gain, expression of anger or making a political statement, and not due to hallucination or delusion
epi of pyromania
equal prev in men and women; mean age of onset is late adolescence; prognosis is better in kids than adults; chronic if untreated
treatment of pyromania
behavioral therapy, supervision, and SSRIs
neurotransmitter involved in impulsiveness and aggression
low levels of seratonin
one fourth of patients with bulimia nervosa have comorbid kleptomania
right
pyromania
impulse to start fires to relieve tnsion, typically with feelings of gratification or relief afterward
