Impulse Control Disorders
- ccording to the ICD-11, impulse control disorders are characterized by repeated
a
inability to resist the impulse or urge to carry out a behaviour
- this behaviour will feel rewarding to the person in short-term, but will have long-term
negative consequences such as significant impairment to some aspects of life
(family, school, friends or work life), harm to themselves and others and distress
about their behaviour
Kleptomania
- a disorder characterized by a powerful impulse to steal
- this impulse is very hard to resist and the person will often steal as a result
- the stealing is not intended to achieve any motive such as monetary gain + for a
diagnosis to be made there must not be another obvious explanation for the
behaviours such as any other behavioural or mental disorder and substance use
Pyromania
- a powerful impulse to set fires
- very hard to resist this impulse, resulting in many acts of setting fire to properties or
other objects
- increased sense of tension appears prior to fire-setting and a sense of pleasure,
excitement or gratification is felt during and immediately after the act
- there is also a fascination with related stimuli such as watching fires and firefighting
equipment
- no intelligible motive such as monetary gain, sabotage or revenge
Gambling Disorder
- pattern of persistent or recurring gambling behaviour either online or offline,
characterized by:
1. impaired control of the gambling in terms of: length of time spent gambling or how
much money is benign spent
2. gambling being given priority over other activities
3. gambling continuing to increase despite negative consequences
- sually, for a diagnosis, the gambling behaviour and other features must be present
u
for at least a year, but this can be for a shorter duration if all diagnostic requirements
are met and symptoms are severe
EASURES
M
Kleptomania Symptom Assessment Scale - K-SAS
, - this is an 11-item self-rated scale that measures impulses, thoughts, feelings and
behaviours related to stealing
- the individual taking the assessment is asked to consider the past 7 days
- each item is rated on a point-based scale, typically 0-4 or 0-5, with the highest scores
reflecting the greatest severity and duration of symptoms
EXPLANATIONS
BIOLOGICAL
Dopamine
- ‘happy chemical’ because its release is triggered by rewarding stimuli
- when someone with kleptomania steals something, their reward centers are
stimulated and release dopamine
- however, when these behaviours become compulsive, levels of dopamine in the
striatum are reduced
- striatum= area of the brain that is responsible for reward and behaviour control =>
deficiency in dopamine can lead to the continuation of compulsions and addictions
- this mechanism is known as‘reward deficiency syndrome’
PSYCHOLOGICAL
Behavioural- Positive Reinforcement
- PR is one aspect of operant conditioning that occurs when when someone’s learned
behaviour is a result of previous trials of behaviour
- increased likelihood of repeating a behaviour
- ‘schedules of reinforcement’- gamblers believe that the payout could happen if they
play just one more time and so on as gambling involves both losing and winning
Cognitive- Miller’s Feeling-State Theory
- Miller uses this cognitive approach to explain how intense, positive feelings can
become linked with specific behaviours such as gambling
- the feeling-state is all the sensations, emotions and thoughts a person experiences in
relation to a particular event + it is composed of the positive emotions and memory of
behaviour that leads to impulse control disorders
- if a person’s feeling-state about starting a fire is ‘I am a powerful human being’,
combined with the positive emotions, psychological arousal and memory of setting a
fire, then this could create a compulsion for fire-setting behaviour
- ccording to the ICD-11, impulse control disorders are characterized by repeated
a
inability to resist the impulse or urge to carry out a behaviour
- this behaviour will feel rewarding to the person in short-term, but will have long-term
negative consequences such as significant impairment to some aspects of life
(family, school, friends or work life), harm to themselves and others and distress
about their behaviour
Kleptomania
- a disorder characterized by a powerful impulse to steal
- this impulse is very hard to resist and the person will often steal as a result
- the stealing is not intended to achieve any motive such as monetary gain + for a
diagnosis to be made there must not be another obvious explanation for the
behaviours such as any other behavioural or mental disorder and substance use
Pyromania
- a powerful impulse to set fires
- very hard to resist this impulse, resulting in many acts of setting fire to properties or
other objects
- increased sense of tension appears prior to fire-setting and a sense of pleasure,
excitement or gratification is felt during and immediately after the act
- there is also a fascination with related stimuli such as watching fires and firefighting
equipment
- no intelligible motive such as monetary gain, sabotage or revenge
Gambling Disorder
- pattern of persistent or recurring gambling behaviour either online or offline,
characterized by:
1. impaired control of the gambling in terms of: length of time spent gambling or how
much money is benign spent
2. gambling being given priority over other activities
3. gambling continuing to increase despite negative consequences
- sually, for a diagnosis, the gambling behaviour and other features must be present
u
for at least a year, but this can be for a shorter duration if all diagnostic requirements
are met and symptoms are severe
EASURES
M
Kleptomania Symptom Assessment Scale - K-SAS
, - this is an 11-item self-rated scale that measures impulses, thoughts, feelings and
behaviours related to stealing
- the individual taking the assessment is asked to consider the past 7 days
- each item is rated on a point-based scale, typically 0-4 or 0-5, with the highest scores
reflecting the greatest severity and duration of symptoms
EXPLANATIONS
BIOLOGICAL
Dopamine
- ‘happy chemical’ because its release is triggered by rewarding stimuli
- when someone with kleptomania steals something, their reward centers are
stimulated and release dopamine
- however, when these behaviours become compulsive, levels of dopamine in the
striatum are reduced
- striatum= area of the brain that is responsible for reward and behaviour control =>
deficiency in dopamine can lead to the continuation of compulsions and addictions
- this mechanism is known as‘reward deficiency syndrome’
PSYCHOLOGICAL
Behavioural- Positive Reinforcement
- PR is one aspect of operant conditioning that occurs when when someone’s learned
behaviour is a result of previous trials of behaviour
- increased likelihood of repeating a behaviour
- ‘schedules of reinforcement’- gamblers believe that the payout could happen if they
play just one more time and so on as gambling involves both losing and winning
Cognitive- Miller’s Feeling-State Theory
- Miller uses this cognitive approach to explain how intense, positive feelings can
become linked with specific behaviours such as gambling
- the feeling-state is all the sensations, emotions and thoughts a person experiences in
relation to a particular event + it is composed of the positive emotions and memory of
behaviour that leads to impulse control disorders
- if a person’s feeling-state about starting a fire is ‘I am a powerful human being’,
combined with the positive emotions, psychological arousal and memory of setting a
fire, then this could create a compulsion for fire-setting behaviour
