Impulse Control Disorders
Controlling our impulses or urges is a hallmark of our psychological maturity and helps distinguish us from other species. Loss of this control can result in a myriad of destructive behaviors, including kleptomania, pathological gambling, pyromania and intermittent explosive attacks of rage.
Some psychologists consider impulse control disorders a subset of other conditions such as Obsessive Compulsive Disorder (OCD). Medication used to treat depression and anxiety often help in the treatment of impulse control disorders.
Cause of Impulse Control Disorders
The exact cause of impulse control disorders is still unknown, but it’s believed to be a combination of physical, biological, emotional, cultural and societal factors. Complex and disruptive if left untreated, these behaviors can devastate the lives of everyone involved, including family, friends, and co-workers.
Recognizing Impulse Control Disorders
The hallmark of an impulse control disorder is the feeling of increased tension or arousal until the act is committed, resulting in feelings of pleasure, gratification and relief. Often, these feelings are replaced by those of guilt and regret. The acts may or may not be planned, but generally fulfill the immediate and conscious wish. Most people suffering from this disorder feel a loss of control over their lives and are highly distressed over their inability to control these urges.
Intermittent Explosive Disorder
Seen primarily in males, intermittent explosive disorder is characterized by a loss of control and aggressive behavior, often resulting in the assault of another, or property damage out of proportion to the trigger of the episode. Aggressors often blame the victim, a third party or the circumstances of their lives to avoid responsibility for their actions. Treatment includes cognitive and behavioral therapy, as well as anger management.
Kleptomania
Kleptomania has many features in common with obsessive compulsive disorder. Higher incidence rates occur in the female population than among males. Sufferers of kleptomania feel compelled to steal property not needed for monetary value.
Feelings of guilt and regret follow the release of tension, pleasure and gratification that accompany the act. Serotonin reuptake inhibitors have been shown to provide relief from the symptoms of kleptomania, indicating a dysfunctional serotoninergic mechanism.
Pathological Gambling
Pathological gambling is diagnosed in terms of the impact it has on the sufferer’s life, not by the amount of money won or lost. People who suffer from a pathological gambling problem usually experience disruption in their personal and family lives, and they develop severe financial problems as a result of their loss of control over this urge. The underlying problem is linked to depression, and treating depression with medication, participation in Gambler’s Anonymous and psychotherapy often offer relief.
Pyromania
Usually episodic and rare, pyromania is not the primary diagnosis when it occurs in conjunction with another disorder such as Conduct Disorder in children, Bipolar Disorder or Schizophrenia.
Marked by a significant fascination with fire, pyromania involves setting fires for pleasure, and is similar to other impulse control disorders in that the experience provides a temporary sense of release and gratification.
Trichotillamania
Tricholtillamania is the pulling of one's hair until it results in hair loss. Like other impulse control disorders, trichotillamania is marked with a sense of release and gratification.
Clinical distress or impairment of life function must be present for this diagnosis. Linked to OCD, compulsive hair pulling is repetitive and is usually treated when the impact on life functioning occurs. It is mainly seen in females.
Dermatillomania
Also linked to Obsessive Compulsive Disorder, dermatillomania, or "skin picking," can result in damage to the fingers, chest and face. Cognitive therapy has been effective in helping sufferers of this disorder, as well as medication prescribed for OCD.
People with dermatillomania often suffer from body dysmorphia (preoccupation over a real or imagined bodily defect) and it is very similar to tricholtillamania in causes and treatment.
Impulse control disorders are complex and are often diagnosed in conjunction with other psychological problems such as depression and OCD. While environmental factors can be a cause, scientists believe that these conditions have a physical or biological component.
Certain brain structures, including the limbic system, are linked to emotions and memory function. When the brain's function is compromised in certain ways, impulse control disorders can appear. Much success has been achieved with new treatment of impulse control disorders using cognitive therapy, behavioral therapy, psychotherapy and the use of serotonin reuptake inhibitors.
Resources
Lepkifker, E., Dannon, Z. R., Iancu, I., Horesh, N., & Kotler, M. (1999). The treatment of kleptomania with seretonin reuptake inhibitors. Retrieved April 21, 2008, from The Good Drug Web site: www.biopsychiatry.com/klepto.htm
Ploskin, D. (2007). Impulse control disorders. Retrieved April 21, 2008, from the Psych Central Web site: http://psychcentral.com/lib/2007/what-are-impulse-control-disorders/
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