Impulse Control Disorders

Question 1

What characterizes an impulse control disorder?

Answer 1

a predisposed inability to resist unplanned, rapid reactions toward internal or external stimuli without regard for the negative consequences

1. repetitive or compulsive engagement in behavior despite adverse consequences
2. little control over the negative behavior
3. anxiety or craving experienced prior to engagement in impulsive behavior
4. Relief or satisfaction during or after completion of the behavior

Question 2

What are the diagnostic critieria for intermittent explosive disorder?

Answer 2

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

Question 3

When does intermittent explosive disorder typically present?

Answer 3

in the teenage years and worsen until middle age

Question 4

What neurotransmitter has been associated with the impulsiveness and aggression of intermittent explosive disorder?

Answer 4

serotonin

Question 5

What is the typical treatment for intermittent explosive disorder?

Answer 5

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

Question 6

What are the diagnostic criteria for kleptomania?

Answer 6

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

Question 7

Which gender is more affected by kleptomania?

Answer 7

women

Question 8

What percentage of shoplifters are considered kleptomaniacs?

Answer 8

only 5%

Question 9

Kleptomania is very common in patients with what eating disorder?

Answer 9

bulimia nervosa

Question 10

What is the treatment for kleptomania?

Answer 10

insight-oriented psychotherapy
behavior therapy like systematic desensitization and aversive conditioning
SSRIs
anecdotal evidence for naltrexone (probably helps with the craving piece)

Question 11

What are the diagnostic criteria for pathological gambling?

Answer 11

Persistent and recurrent maladaptive gamping behavior as evidenced by 5+ of:

1. preoccupation w/ gambling
2. need to gample with increasing amounts of money to achieve pleasure
3. repeated and unsuccessful attempts to cut down
4. restlessness or irritability when attempting to stop
5. gambling done to escape problems or relieve dyshoria
6. returning to reclaim losses after gambling
7. lying to therapist or family to hide level of gambling
8. committing illegal acts to finance it
9. jeopardizing relationships or jobs
10. relying on others to financially support the habit

Question 12

Which gender has pathological gambling more often?

Answer 12

males (2/3 of cases)

Question 13

What is the typical course and progression of pathological gambling?

Answer 13

usually starts in adolescence or young adulthood, marked by periods of abstinence and relapse

one-third will achieve recovery without treatment

Question 14

What is the treatment for pathological gambling?

Answer 14

The Gamblers Anonymous 12-step program is the most effective

after three months of abstinence, insight-oriented psychotherapy can be attempted

Question 15

What are the diagnostic criteria for trichotillomania?

Answer 15

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

Question 16

Which gender gets trichotillomania more often?

Answer 16

females

Question 17

when does trichotillomania usually start?

Answer 17

in childhood or adolescence, associated with stressful events in 25% of patients

Question 18

What are some mental health conditions that are commonly comorbid with trichotillomania?

Answer 18

OCD
OCPD
mood disorders
borderline personality disorder

Question 19

What are some treatments for trichotillomania?

Answer 19

SSRIs, antispychotics or lithium

behavioral interventions like hypnosis, relaxation techniques, etc.

Question 20

What are the diagnostic criteria for pyromania?

Answer 20

1. at least 1 episode of deliberate fire setting
2. tension or arousal experience before the act and pleasure/relief when setting the fires and subsequence consequences
3. fascination with, interest in, or attraction to fire or the consequences
4. purpose of setting the first is not for monetary gain, expression of anger, political statements or hallucinations/delusions