Impulse-Control Disorders Not Elsewhere Classified

1
Impulse-Control Disorders Not Elsewhere Classified

• Assessment Diagnosis
• SW 593

2
Introduction

• There are a variety of situations in which a
  client fails to resist an impulse, drive, and/or
  temptation to engage in behaviors with a clear
  potential for negative effects.
• The clients actions are believed to be an
  attempt to relieve some growing sense of tension
  or arousal.
• The client experiences a sense of relief or
  gratification followed by feelings of regret or
  guilt.

3
Intermittent Explosive Disorder

• Key criterion
• Failure to resist aggressive impulses that result
  in actual assault and/or property destruction.
• The degree of aggressiveness involved is judged
  to exceed a reasonable response to the specific
  provocation.
• Must rule out a wide range of other mental
  disorders that could include outbursts.

4
Kleptomania

• Key criterion
• Cycles of growing internal discomfort and a sense
  of relief when performing the theft.
• Objects stolen are not needed for personal or
  monetary use or to express anger or revenge
  toward their owner.
• Other mental disorders should be ruled out before
  making this diagnosis.

5
Pyromania

• Key criterion
• Relates to the building and relieving tension.
• Client evidences a general fascination with fire.
• Fire setting is not motivated by receiving
  material gain, expressing some ideological
  viewpoint, or concealing other criminal activity.
• Rule out other mental disorders.

6
Trichotillomania

• Key criterion
• The individual pull out own hair in sufficient
  quantities to be noticeable.
• To relieve the building sense of tension and to
  achieve some sense of relief or gratification.
• No question of some alternative gain related to
  the behavior but rule outs should still be done.

7
Pathological Gambling

• Key criterion
• Persistent and recurrent pattern of gambling is
  continued despite negative consequences.
• Addictive-like behaviors are exhibited with
  preoccupation, need to escalate amounts of money,
  and an inability to control the behavior.
• Engages in behavior to feel better or solve
  problems.

8
Pathological Gambling

• The client often engages in lying to conceal the
  amount of gambling.
• Engages in illegal activities to fund the
  gambling.
• Becomes reliant on others for financial support.
• Jeopardizes a variety of important relationships
  or occupational opportunities.

9
Assessment

• Few specifically focused instruments have been
  developed.
• General personality profiles may be useful.
• In-depth interviewing regarding the problematic
  actions is commonly used.
• Interviews should focus particularly on the
  internal experiences of the client in the times
  prior to, during, and after action.

10
Cultural Considerations

• It appears that Intermittent Explosive Disorder
  and Pyromania occurs more frequently in males.
• Kleptomania seems to occur more frequently in
  females.
• With Trichotillomania the incidence is similar
  for both females and males.
• 3.5 of adult population and 8 of the adolescent
  population is affected by PG.