Impulse-Control Impulse-Control Disorders Not Disorders Not Elsewhere ClassifiedElsewhere ClassifiedAssessment & DiagnosisAssessment & Diagnosis

SW 593SW 593

Introduction Introduction

There are a variety of situations in which a There are a variety of situations in which a client fails to resist an impulse, drive, and/or client fails to resist an impulse, drive, and/or temptation to engage in behaviors with a clear temptation to engage in behaviors with a clear potential for negative effects.potential for negative effects.

The client’s actions are believed to be an The client’s actions are believed to be an attempt to relieve some growing sense of attempt to relieve some growing sense of tension or arousal.tension or arousal.

The client experiences a sense of relief or The client experiences a sense of relief or gratification followed by feelings of regret or gratification followed by feelings of regret or guilt.guilt.

Intermittent Explosive Intermittent Explosive DisorderDisorder

Key criterion:Key criterion: Failure to resist aggressive impulses that Failure to resist aggressive impulses that

result in actual assault and/or property result in actual assault and/or property destruction.destruction.

The degree of aggressiveness involved is The degree of aggressiveness involved is judged to exceed a reasonable response to judged to exceed a reasonable response to the specific provocation.the specific provocation.

Must rule out a wide range of other mental Must rule out a wide range of other mental disorders that could include outbursts.disorders that could include outbursts.

Kleptomania Kleptomania

Key criterion:Key criterion: Cycles of growing internal discomfort and a Cycles of growing internal discomfort and a

sense of relief when performing the theft.sense of relief when performing the theft. Objects stolen are not needed for personal Objects stolen are not needed for personal

or monetary use or to express anger or or monetary use or to express anger or revenge toward their owner.revenge toward their owner.

Other mental disorders should be ruled out Other mental disorders should be ruled out before making this diagnosis.before making this diagnosis.

Pyromania Pyromania

Key criterion:Key criterion: Relates to the building and relieving tension.Relates to the building and relieving tension. Client evidences a general fascination with Client evidences a general fascination with

fire.fire. Fire setting is not motivated by receiving Fire setting is not motivated by receiving

material gain, expressing some ideological material gain, expressing some ideological viewpoint, or concealing other criminal viewpoint, or concealing other criminal activity.activity.

Rule out other mental disorders.Rule out other mental disorders.

Trichotillomania Trichotillomania

Key criterion:Key criterion: The individual pull out own hair in sufficient The individual pull out own hair in sufficient

quantities to be noticeable.quantities to be noticeable. To relieve the building sense of tension and To relieve the building sense of tension and

to achieve some sense of relief or to achieve some sense of relief or gratification.gratification.

No question of some alternative gain related No question of some alternative gain related to the behavior but rule outs should still be to the behavior but rule outs should still be done.done.

Pathological GamblingPathological Gambling

Key criterion:Key criterion: Persistent and recurrent pattern of gambling is Persistent and recurrent pattern of gambling is

continued despite negative consequences.continued despite negative consequences. Addictive-like behaviors are exhibited with Addictive-like behaviors are exhibited with

preoccupation, need to escalate amounts of money, preoccupation, need to escalate amounts of money, and an inability to control the behavior.and an inability to control the behavior.

Engages in behavior to “feel better” or “solve Engages in behavior to “feel better” or “solve problems”.problems”.

Pathological GamblingPathological Gambling

The client often engages in lying to conceal the The client often engages in lying to conceal the amount of gambling.amount of gambling.

Engages in illegal activities to fund the Engages in illegal activities to fund the gambling.gambling.

Becomes reliant on others for financial support.Becomes reliant on others for financial support. Jeopardizes a variety of important relationships Jeopardizes a variety of important relationships

or occupational opportunities.or occupational opportunities.

Assessment Assessment

Few specifically focused instruments have Few specifically focused instruments have been developed.been developed.

General personality profiles may be useful.General personality profiles may be useful. In-depth interviewing regarding the problematic In-depth interviewing regarding the problematic

actions is commonly used.actions is commonly used. Interviews should focus particularly on the Interviews should focus particularly on the

internal experiences of the client in the times internal experiences of the client in the times prior to, during, and after action.prior to, during, and after action.

Cultural Considerations Cultural Considerations

It appears that Intermittent Explosive Disorder It appears that Intermittent Explosive Disorder and Pyromania occurs more frequently in and Pyromania occurs more frequently in males.males.

Kleptomania seems to occur more frequently in Kleptomania seems to occur more frequently in females.females.

With Trichotillomania the incidence is similar With Trichotillomania the incidence is similar for both females and males.for both females and males.

3.5% of adult population and 8% of the 3.5% of adult population and 8% of the adolescent population is affected by PG.adolescent population is affected by PG.