Understanding Impulse Control Disorders

What is impulse control disorder?

There are several psychological problems that are characterized by a loss of control or a lack of control in specific situations. This lack of control is part of a behavioral pattern that also involves other maladaptive thoughts and actions like substance abuse or sexual disorders.

These are called Impulse Control Disorders. Impulsitivity, the key feature of these disorders, can be thought of as seeking a small, short-term gain with little or no resistance at the expense of a large, long-term loss. Affected individuals often feel anxiety or tension in considering these behaviors, and this is relieved or diminished once the action is performed.

Impulse control disorders are considered to be part of the Obsessive-Compulsive Disorder spectrum and a relatively new class of personality disorders. Some examples of these problems include the following.

Intermittent explosive disorder

It is a personality disorder in which an individual is prone to sporadic aggressive outbursts during which he or she causes bodily harm or destroys property.

These explosive episodes are unprovoked or seem to be out of proportion to the event that precedes them. It is more common among men.

This problem results in legal difficulties because the individual is often charged with assault or domestic violence. Loss of control is an essential feature of this disorder.

Typically, these individuals will not take responsibility for their loss of control and instead blaming the victim, other circumstances in their life, or some third party who may have told them something or said something that "caused" their uncontrolled anger. This denial also prevents the individual from making any changes.

Controlling this problem involves both behavioral and cognitive interventions. For instance, anger management techniques are needed as well as discovering a way to deflect the anger so that it can be controlled.

Domestic violence

Oftentimes, individuals involved in domestic violence only lose control within the context of a close, interpersonal relationship. However, many of these individuals have a generalized anger management problem, but can control it better outside their own home.

The criteria for a diagnosis of intermittent explosive disorders are almost always similar in domestic violence situations, except that violence occurs only in conjunction with substance abuse or intoxication.

The individual may choose to become intoxicated before a confrontation, may be because of an inability to confront others while sober. However, perpetrators of domestic violence rarely receive enough psychological treatment because they are viewed as criminals rather than people with psychological problems.

Treatment, however, consists of behavioral self-control techniques, stress management, and cognitive therapy to change the irrational belief system that triggers the violent behavior.

Kleptomania

This involves compulsive stealing of items not needed for their monetary value. The stolen items are usually to express anger or vengeance. There is usually a feeling of tension before stealing and a sense of pleasure at the time of the theft.

Unlike common belief, kleptomania is not a disease of professional thieves, as it is usually not preplanned. It is relatively rare problem, although more common in women than in men, and it is also out of character. The person does not want to steal, and feels guilty about the behavior.

Pyromania

This primarily involves setting fires for pleasure and experiencing a sense of relief or gratification from it. It is more common among men. This does not include fires set for monetary gain, to hide criminal activity, or to express anger, as a pyromaniac usually has a significant fascination with fire.

Additionally, pyromania is not diagnosed when the fire-setting activity is part of another psychological problem. This is a very rare problem and usually occurs infrequently.

Pathological gambling

This consists in persistent maladaptive gambling that creates serious life problems. This is different from recreational gambling, and is diagnosed by the impact it has on the person’s life and by the lack of control despite heavy monetary losses.

Pathological gamblers usually allow the habit to disrupt their personal lives and sometimes their work as well. They may gamble to relieve depression, and may commit illegal acts to hide their losses.

These losses actually act as a motivating factor in continuing gambling in order to recoup some of what was lost. They may endanger their job or their family relationships because of this problem, and would probably lie about the extent of their gambling.

Trichotillomania

This involves pulling out your own hair from the scalp, face, or body, habitually, to the point of seeing noticeable hair loss, and experiencing pleasure or tension relief from the behavior.

These cases are more common among women and it often begins in childhood. There are even some cases where affected individuals would even eat their own hair. This does not include hair loss as a result of medical conditions, and the disorder must result in clinical distress or impairment in life functioning.