Impulse Control Disorders
WHAT ARE IMPULSE CONTROL DISORDERS?
Impulse control disorders are a group of five behavior disorders characterized by losing control of one’s behavior in certain situations. People with these disorders feel tension that builds to a high level before they engage in the behavior. Afterward, they feel a sense of release or perhaps pleasure. Some people experience guilt or shame afterward. The loss of control over one’s behavior may be part of a larger pattern of behavior that includes substance abuse or sexual disorders.
Impulse control disorders include the following specific disorders:
- Excessive anger (intermittent explosive disorder, or IED)
- Compulsive stealing (kleptomania)
- Compulsive fire setting (pyromania)
- Compulsive pulling out of hair (trichotillomania)
- Pathological gambling
WHAT ARE THE SYMPTOMS OF IMPULSE CONTROL DISORDERS?
Excessive Anger (IED)
A person with this disorder engages in extreme, unwarranted angry outbursts. These angry explosions are out of proportion with the situation and result in physical assaults onto others or in acts that cause significant damage to property. To be considered IED, the behavior must not be the result of substance abuse or a medical condition. People with IED are often charged with domestic violence or assault and have legal problems as a result. Rarely do they take responsibility for their behavior; instead, they usually blame the victim.
Compulsive Stealing (Kleptomania)
People with kleptomania steal for the thrill of the experience. They usually do not need the items they steal and may even put them back after stealing them. They do not have a secret wish to be caught and do not steal because they need the items or seek revenge. Like other impulse control disorders, people with kleptomania experience a feeling of tension before they engage in the behavior and feel relief or pleasure afterward. More women than men have this relatively rare disorder.
Compulsive Fire Setting (Pyromania)
People with pyromania experience the same buildup of tension before the act and sense of relief afterward. In this case, the behavior is setting fires. This disorder is more compulsive than impulsive compared to the other impulse control disorders, because it requires a bit more People with these disorders feel tension that builds to a high level before they engage in the behavior. Afterward, they feel a sense of release or perhaps pleasure. planning. People with this disorder do not set fires to benefit from insurance money or to seek revenge. They are usually fascinated by fire. Pyromania is rare, and people who have it set fires only infrequently.
Compulsive Pulling Out of Hair (Trichotillomania)
Like the other impulse control disorders, trichotillomania involves a buildup of tension before the behavior and relief and pleasure afterward. This disorder is uncommon but less rare than pyromania and kleptomania. People with trichotillomania may pull hair from any part of the body; the hair on the head (including eyebrows and eyelashes) is the most common target. People with this disorder generally feel very distressed about it. It may result in a significant amount of hair loss, along with infection and inflammation of the areas from which the hair is removed. This disorder seems to be most common among women.
Pathological Gambling
A serious problem, pathological gambling affects as many as 3 percent of the population in the United States. People with this disorder are preoccupied with gambling and gradually increase the amounts of money with which they gamble so that they achieve a feeling of gratification or excitement. Most gamblers try to reduce their gambling behavior but feel irritable or restless when they are not gambling. They eventually give in and gamble to escape from the feelings of irritability or restlessness.
Pathological gambling often becomes so severe that it can cost a person not only money but relationships and jobs. It can also lead to stealing or other illegal behavior to support the gambling behavior, as well as to lying about it to one’s family and employer. Pathological gambling is different from recreational gambling in that it seriously disrupts the person’s life. Most pathological gamblers are men; however, many are women, in whom the disorder tends to develop later in life than it does in men.
"People with impulse control disorders should seek the help of a licensed mental health professional. These disorders are serious and can cause problems in many areas of a person’s life."
WHAT IS THE TREATMENT FOR IMPULSE CONTROL DISORDERS?
People with impulse control disorders should seek the help of a licensed mental health professional with special training and experience. Each of the five types of impulse control disorders responds best to certain treatments.
Treatment for IED.
Treatment may include counseling, training in anger management techniques, or medication. A combination of all is often recommended. Cognitive behavioral counseling often focuses on self-control methods, stress management, and therapy to identify and change irrational beliefs. Since many people with this disorder find their way into the criminal justice system, they are often seen as criminals, not as people with emotional problems.
Treatment for Kleptomania.
Treatment may involve behavior modification that helps the patient learn to eliminate the stealing behaviors.
Treatment for Pyromania.
Treatment, similar to that for kleptomania, usually includes behavior modification to help the patient learn to eliminate the fire-setting behavior. When pyromania is treated in childhood, the outcome is often positive; however, adults who are not treated generally don’t improve.
Treatment for Trichotillomania.
Treatment generally has a cognitive behavioral focus. The therapist may also help the patient explore unconscious issues that underlie the hair-pulling behavior.
Treatment for Pathological Gambling.
Treatment includes joining Gamblers Anonymous, a 12-step program similar to Alcoholics Anonymous. Recovery is also maximized when a patient seeks individual and family counseling.
WHERE CAN I GO FOR MORE INFORMATION?
Impulse Control Disorders (General)
Horvath, Thomas, and Hester, Reid. Sex, Drugs, Gambling, and Chocolate: A Workbook for Overcoming Addictions. San Luis Obispo, CA: Impact Publishers, 1998.
Intermittent Explosive Disorder.
Lerner, Harriet. The Dance of Anger: A Woman’s Guide to Changing the Patterns of Intimate Relationships. New York: HarperCollins, 1997.
Potter-Efron, Ron, and Potter-Efron, Pat. Letting Go of Anger: The 10 Most Common Anger Styles and What to Do about Them. Oakland, CA: New Harbinger Publications, 1995.
Kleptomania
Shplifters Anonymous (www.shopliftersanonymous.com) Now known as Cleptomaniacs and Shoplifters Anonymous (CASA).
Pyromania
Sakheim, George, and Osborn, Elizabeth. Fire setting Children: Risk Assessment and Treatment. Washington, DC: Child Welfare League of America, 1994.
Trichotillomania
Golomb, Ruth, and Vavrichek, Sherrie. The Hair Pulling "Habit" and You: How to Solve the Trichotillomania Puzzle (revised ed.). Silver Spring, MD: Writers’ Cooperative of Greater Washington, 2000.
Pathological Gambling
Gamblers Anonymous International Service Office (gamblersanonymous.org).
Heineman, Mary. Losing Your Shirt: Recovery for Compulsive Gamblers and Their Families. Minneapolis: Compcare Publications, 1996.