Impulse Control Disorders

A number of psychological disorders, such as bipolar disorder, sexual disorders & substance abuse, may be characterized by a tendency to gratify an immediate desire or impulse regardless of the consequences to one's self or to others, these disorders also usually involve other maladaptive thoughts and behaviours and the loss of control may only be a component of the wider problem.

Impulse control disorders are, however, defined primarily by a loss of control.

Impulse control disorder is a collection of disorders which include:

Intermittent explosive disorder (aggressive outbursts whilst stressed)
Kleptomania (theft)
Pyromania (Fire)
Pathological gambling
Trichotillomania (manipulation & pulling of hair)
Dermatillomania (skin picking)
Dermatophagia (compulsive skin biting)
Onychophagia (nail biting)
Rhinotillexomania (compulsive nose picking)
Compulsive shopping

The onset of these disorders usually occur between the ages of 7 and 15.

Impulse control disorders are considered to be part of the obsessive compulsive spectrum of disorders.

The significant feature of which is the seeming inability to resist the urge or impulse to act. The essential difference being, in addition to functioning as an anxiety release, the compulsive behaviour (in impulse control disorders) also results in a temporary feeling of gratification.

The essence of emotional self-regulation is the ability to control one's impulses in the service of goal.

Formulation

The Cognitive Behavioural Psychotherapist will collaborate with the patient and assess and identify all maintaining factors; including environmental & situational triggers, thoughts, behaviours, emotions and physical symptoms associated with the problem and develop a working formulation which will be utilised to guide the course of therapy.

Treatment

The treatment of choice is dependent on the idiosyncratic formulation and may include Habit reversal, stress & anger management strategies, identification & modification of dysfunctional beliefs and behaviour modification strategies. Encouragement is given to increase helpful and decrease unhelpful behaviours.

The vicious circle