Impulse Control Disorders come in several forms.
Intermittent Explosive Disorder – There is often an underlying personality disorder that accompanies a disorder called Intermittent Explosive Disorder which is, itself, considered a disorder of impulse. Such individuals are prone to aggressive outbursts when under stress. They may perceive the stress as threat, frustration, insult, vulnerability or any combination of the above. Some of these individual have unusual EEG (brain) wave patterns or changes in brain chemistry. There may also be “soft” neurological findings, but the disorder is considered to arise from poor control of impulse when needs or demands are not met. As the individual accumulates a series of experiences in which such behaviors are tolerated, often beginning early in life, the behavior continues. The threat to individuals and property can be substantial. There are those for which this pattern of behavior suddenly emerges. The person is often upset, guilt-laden and remorseful after the rage filled episode even though there may be a sense of relief after the aggresive outburst.
Kleptomania is a disorder of impulse control. The individual feels that he/she cannot resist the impulse to steal objects that are not needed for personal use or are stolen for their monetary value. The patient will describe tension prior to stealing the object and a sense of relief and gratification after the theft has been perpetrated. This is not to be confused with those who steal out of anger and vengence or who do so due to delusional (false) beliefs.
Pyromania is an impulse control disorder in which the individual purposefully and recurrently sets fire for the pleasure derived from the fire itself, not for the monetary gain or social protest. The individual experiences tension or emotional arousal before setting the fire and relief after the act is completed. They are fascinated with fire, show appreciable curiosity and interest (will read, discuss, collect items, etc). Such individuals often will participate in the aftermath of the fire started such as assisting firefighters, assisting victims or attracted to watching the impact of what they have done.
Pathological Gambling is an impulse control disorder in which the individual is preoccupied with wagering, and the amount of the wager increases in order that the person achieve a greater sense of excitement. When the individual attempts to refrain from gambling, he/she becomes irritable even when attempting to reduce the amount of the gambling. The gambling becomes a means of escaping from negative moods (e.g., anxiety, depression, etc), and following loss, the individual feels driven to pursue catching up with the losses. Such individuals lie to their families, their employers and their treating psychologist. They may engage in illegal acts such as embezzlement and fraud to maintain their gambling, and they will not only rely upon others to help them financially but will exploit others and ruin relationships.
Trichotillomania is defined as increased state of tension prior to pulling ones hair and sense of relief when pulling out the hair. The person derives satisfaction or gratification even though they may express that they wish there were not performing the act. The individual may derive pleasure from extracting hair on any or all areas of the body. Inflammation, infection and areas of hair depletion are the most common findings. And while it is equally common among males and females in childhood, it appears to be more common in females in adulthood. Some of the commonly used treatments for obsessive-compulsive behaviors, and, indeed, some clinics appear to deal very well with this disorder, and often the patient is motivated to find a means not to engage in the behavior.
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