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Impulse Control Disorders

Impulse control disorders are characterized by recurrent behaviors that violate the rights of others, lack of control over the behaviors, anxiety or tension prior to engaging in the behaviors, and relief after engaging in the behaviors. These disorders include intermittent explosive disorder, kleptomania, and pyromania. Treatment involves cognitive behavioral therapy and selective serotonin reuptake inhibitors or mood stabilizers.

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عبد الله الحربي
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125 views12 pages

Impulse Control Disorders

Impulse control disorders are characterized by recurrent behaviors that violate the rights of others, lack of control over the behaviors, anxiety or tension prior to engaging in the behaviors, and relief after engaging in the behaviors. These disorders include intermittent explosive disorder, kleptomania, and pyromania. Treatment involves cognitive behavioral therapy and selective serotonin reuptake inhibitors or mood stabilizers.

Uploaded by

عبد الله الحربي
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Impulse Control Disorders

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1
Impulse Control Disorders
Intermittent Explosive Kleptomania Pyromania
Disorder

2
Approach to Impulse Control
Disorders
1. Recurrent behavior which violates the rights of others
2. Lack of control
3. Anxiety or tension prior to engaging in the behavior
4. Relief after engaging in the behavior

• Verbal/Physical Outbursts • Stealing low value items • ≥2 episodes of fire-


• Not premeditated or for 2˚ gain • NOT due to psychosis setting
• Not for 2˚ gain

Intermittent Explosive Disorder Kleptomania Pyromania

• CBT
• SSRIs or Mood
Stabilizers

3
Impulse Control Disorders
• 1. Recurrent behavior which violates the rights of others
• 2. Lack of control
• 3. Anxiety or tension prior to engaging in the impulsive behavior
• 4. Relief after engaging in the behavior

4
Intermittent Explosive Disorder
• Presentation: Verbal and/or physical outbursts
• Out of proportion to the stressor
• Males

• Pathophysiology: ↓ 5-HT => ↓5-HIAA in the CSF


• Child abuse
• Seizures

Wikicommons – Jon Sullivan

5
Intermittent Explosive Disorder
• Dx: Recurrent verbal and/or physical outbursts against people or property
• If NO injury or damage => Outbursts ≥2x/week for 3 months
• If injury or damage => Outbursts ≥3x/year
• Out of proportion to the stressor

Additional criteria:
• NOT accounted for by another condition/substance
• NOT premeditated or for 2˚ gain (vs. Conduct/Antisocial Personality)

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Intermittent Explosive Disorder
• Mgmt: CBT
• SSRIs OR Mood Stabilizers

https://blausen.com/

7
Kleptomania
• Presentation: Female shoplifter
• Steals items of low value

• Pathophysiology: ↓ 5-HT => ↓5-HIAA in the CSF


• Associated w/ mood/anxiety/eating disorders
• Family Hx of OCD and substance use disorders

Wikicommons – Rakoon

8
Kleptomania
• Dx: Uncontrollable urges to steal objects
• ↑ tension immediately prior to stealing
• Release of tension upon stealing
• Stealing NOT in response to a delusion/hallucination

• Mgmt: CBT (Systematic Desensitization)


• SSRIs

https://blausen.com/

9
Pyromania
• Presentation: Multiple episodes of fire-setting
• Fascination with or attraction to fire
• Males

• Pathophysiology: ↓ 5-HT => ↓5-HIAA in the CSF


• Associated w/ mood, substance, and gambling disorders

Wikicommons – KoS

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Pyromania
• Dx: ≥2 episodes of fire-setting
• ↑ tension prior to fire-setting, w/ release of tension afterward
• NOT for 2˚ gain (e.g. money, crime, ideological expression)
• NOT in response to a hallucination/delusion

• Mgmt: CBT
• SSRIs or Mood Stabilizers

Wikicommons – Public Domain

11
Approach to Impulse Control
Disorders
1. Recurrent behavior which violates the rights of others
2. Lack of control
3. Anxiety or tension prior to engaging in the behavior
4. Relief after engaging in the behavior

• Verbal/Physical Outbursts • Stealing low value items • ≥2 episodes of fire-


• Not premeditated or for 2˚ gain • NOT due to psychosis setting
• Not for 2˚ gain

Intermittent Explosive Disorder Kleptomania Pyromania

• CBT
• SSRIs or Mood
Stabilizers

12

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