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impulse-control disorders

Alternative Names 
severe social behaviour problems, severe acting out

Definition
Impulse control disorders are characterised by a person's failure to resist an impulse. The person is unable to prevent him or herself from performing an act that will be harmful to self or others.

What is going on in the body? 
Some research has supported the idea that impulse control problems are related to functions in specific parts of the brain, or to certain hormones. It is also thought that the symptoms are affected by abnormal transmission of nerve impulses.

What are the signs and symptoms of the condition? 
A person with an impulse control disorder cannot regulate or control the impulse to engage in a certain behaviour. This can be any behaviour, but the most common include:
  • pathological gambling, in a condition known as compulsive gambling disorder
  • pyromania or fire-setting
  • stealing
  • tricotillomania, or compulsively pulling out one's own hair
  • intermittent and isolated explosive episodes of aggression that cause bodily harm and/or property destruction. This disorder is known as intermittent explosive disorder.
Before committing the act, the person may feel increasingly tense. At the time of committing the act, he or she may experience pleasure, gratification, or release. Right after the act, he or she may or may not feel regret, self-reproach, or guilt.

What are the causes and risks of the condition? 
The causes of impulse control disorders are unknown. However, a person who has had a head injury may be at higher risk for developing this disorder. Someone with temporal lobe epilepsy is also at higher risk for developing an impulse control disorder.

What can be done to prevent the condition? 
There is no known way to prevent an impulse control disorder.

How is the condition diagnosed? 
Diagnosis of impulse control disorder is only made after all other medical and psychiatric disorders that might account for the symptoms have been ruled out. If no other disorder can account for the symptoms, then an impulse control disorder is considered.

What are the long-term effects of the condition? 
Impulse control disorders tend to result in social, occupational, and legal problems for the person. Since a person with this disorder often behaves in a socially inappropriate manner, her or she often has problems in all areas of life.

What are the risks to others? 
While an impulse control disorder is not contagious, others can be harmed by the impulsive behaviour of the affected individual.

What are the treatments for the condition? 
Counselling is aimed at helping a person with an impulse control disorder respond to appropriate social limits. Sometimes medication is used when a person is very aggressive. There are groups such as Gamblers Anonymous that can be helpful in some cases.

What are the side effects of the treatments? 
Side effects depend on the medication used, and may include drowsiness and allergic reactions.

What happens after treatment for the condition? 
An impulse control disorder can generally be controlled with medication. The person may need to continue the medication to help prevent the aggressive outbursts. Counselling may need to be continued for an extended period of time. A person may attend meetings to help prevent the specific behaviours, such as gambling.

How is the condition monitored? 
An impulse control disorder is monitored by the person affected and his or her family. The police may be involved when stealing or pyromania is involved.

Author: Ann Reyes, Ph.D.
Reviewer: eknowhow Medical Review Panel
Editor: Dr John Hearne
Last Updated: 19/06/2005
Contributors
Potential conflict of interest information for reviewers available on request
 


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