kaplan conduct

What are the five conditions that comprise the category of disruptive, impulse-control, and conduct disorders?

Oppositional defiant disorder, conduct disorder, intermittent explosive disorder, kleptomania, and pyromania

Which two disruptive, impulse-control, and conduct disorders are associated with childhood?

Oppositional defiant disorder and conduct disorder

Each disorder in this category is characterized by the inability to resist what?

An intense impulse, drive, or temptation to perform a particular act that is obviously harmful to self or others, or both

Before the event, the individual usually experiences what?

Mounting tension and arousal, sometimes—but not consistently—mingled with conscious anticipatory pleasure

Completing the action brings what?

Immediate gratification and relief

Within a variable time afterward, the individual experiences what?

A conflation of remorse, guilt, self-reproach, and dread

Shameful secretiveness about the repeated impulsive activity frequently expands to what?

Pervade the individual's entire life, often significantly delaying treatment

What factors all play an important role in impulse-control disorders?

Psychodynamic, psychosocial, and biological factors

What can lower a person's resistance to control impulses?

Fatigue, incessant stimulation, and psychic trauma

According to August Aichhorn, impulsive behavior was related to what?

A weak superego and weak ego structures associated with psychic trauma produced by childhood deprivation

Who linked impulsive behavior to attempts to master anxiety, guilt, depression, and other painful affects by means of action?

Otto Fenichel

Heinz Kohut considered many forms of impulse-control problems to be related to what?

An incomplete sense of self

Donald Winnicott saw impulsive or deviant behavior in children as a way for them to try to do what?

Recapture a primitive maternal relationship

Psychosocial factors implicated causally in impulse-control disorders are related to what?

Early life events

What have experiments shown impulsive and violent activity is associated with?

Specific brain regions, such as the limbic system

Low cerebrospinal fluid levels of what are associated with impulsive aggression?

5-hydroxyindoleacetic acid (5-HIAA)

What hormone has been associated with violent and aggressive behavior?

Testosterone

Considerable evidence indicates that what neurotransmitter system mediates symptoms evident in impulse-control disorders?

The serotonin neurotransmitter system

Intermittent explosive disorder manifests as what?

Discrete episodes of losing control of aggressive impulses

The aggressiveness expressed in intermittent explosive disorder is grossly out of proportion to what?

Any stressors that may have helped elicit the episodes

After each episode of intermittent explosive disorder, patients usually show what?

Genuine regret or self-reproach

What term has been used to convey the seizure-like quality of the characteristic outbursts in intermittent explosive disorder?

Epileptoid personality

What associated features suggest the possibility of an epileptoid state?

The presence of auras; postictal-like changes in the sensorium, including partial or spotty amnesia; and hypersensitivity to photic, aural, or auditory stimuli

In one study, about what percent of all persons admitted to a university hospital psychiatric service had disorders diagnosed as intermittent explosive disorder?

2 percent

In that study, what percent were men?

80 percent

What is the essential feature of kleptomania?

A recurrent failure to resist impulses to steal objects not needed for personal use or for monetary value

What is the estimated prevalence of kleptomania?

About 0.6 percent

What is the male-to-female ratio in clinical samples for kleptomania?

1:3

What is the essential feature of pyromania?

The recurrent, deliberate, and purposeful setting of fires

What is the male-to-female ratio for pyromania?

Approximately 8:1

What percent of arrested arsonists are younger than 18 years of age?

More than 40 percent

What did Freud see fire as a symbol of?

Sexuality

What did Freud believe the warmth radiated by fire evokes?

The same sensation that accompanies a state of sexual excitation

What did Freud believe a flame's shape and movements suggest?

A phallus in activity

Significantly low CSF levels of what have been found in fire setters?

5-HIAA and 3-methoxy-4-hydroxyphenylglycol (MHPG)

What is the difference between pyromania and arson?

Arson is done for financial gain, revenge, or other reasons and is planned beforehand

What class of medications has long been used, with mixed results, in treating explosive patients?

Anticonvulsants

What medication has been reported useful in generally lessening aggressive behavior?

Lithium (Eskalith)

What medications have been reported helpful in treating explosive patients?

Carbamazepine, valproate (Depakene) or divalproex (Depakote), and phenytoin (Dilantin)

What is a goal of therapy for intermittent explosive disorder?

To have the patient recognize and verbalize the thoughts or feelings that precede the explosive outbursts instead of acting them out

What treatment was included in the case of the 36-year-old real estate agent?

Carbamazepine (Tegretol) and a combination of supportive and cognitive-behavioral psychotherapy

What is the ACE model that promotes the Internet as a focus of psychopathology?

Anonymity, convenience, and escape

Online surveys find that what percent of users meet criteria for Internet addiction?

4 to 10 percent

The addicted averaged how many hours per week on a computer?

38.5 hours per week

What percent of addicted individuals got less than 4 hours of sleep per night because of Internet use?

Forty percent

What is the proposed DSM-5 diagnosis for persons who repeatedly damage their bodies but do not wish to die?

Non-suicidal self injury

What is the postulated mechanism by which cutting the skin or inflicting bodily pain may alleviate depressed states?

Cutting the skin or inflicting bodily pain may release endorphins or raise dopamine levels in the brain

What distinguishes an impulse from a compulsion?

An impulse is a tension state that can exist without an action; a compulsion is a tension state that always has an action component

What is the typical age of onset of kleptomania?

Late adolescence