Impulse Control Disorders

A2 level Clinical Psycholoy

ICD

• Failure to resist an impulse that is rewarding in the short term and harmful in the long run

• before committing action there is tension; relief from committing act

• afterward may either be guilty or not guilty

Types of ICD

kleptomania, pyromania, and gambling disorder

What are 3 diagnostic criteria of kleptomania?

• Recurrent failure to resist urges to steal

• feeling increased tension before theft

• and feelings of relief or gratification after the theft

• not intoxicated

What was the case study used to study kleptomania?

• Glover et al

• 56 year old woman who had been stealing for 14 years after her husband was convicted of embezzlement; shoplifted unnecessary goods

• isolated - low status job

what type of therapy was used in Glover?

covert sensitisation; making someone sensitive to stimuli; previously not sensitive to

How was covert sensitisation used?

• paired nausea and vomiting with act of stealing

• 4 sessions with 2 week intervals

• first 2: muscle relaxation medication; help visualise

• final session: continued to feel more nauseous

How effective was treatment?

• reported reduction in shoplifting thoughts

• did relapse twice but after 3 months found it easier to shop alone

Glover's conclusion

covert sensitisation helped he woman overcome kleptomania

Gambling Disorder diagnostic criteria

• gambling behaviour lasts more than 1 year

• impaired control

• continuation of gambling despite negative consequences

Gambling Case Study

Miller (2010)

Miller aim

EFFECTIVENESS OF ICDP treatment on gambling

Miller sample

• John, 35 year old gambling adding poker  hoursof playict

• for 10 years; lost more than $1m playing POKER

• deep in debt, lost his marriage

• increasing hours of playing poker

Effects of treatment in Miller

number of hours decreased; 40 or moreper week to less than 8

nolonger chased losing hands

What was the diagnostic criteria (ICD-11) of pyromania?

• recurrent failure to resist strong impulse to set fire

• fascination with fire and its situational contexts

• fire setting NOT DONE for monetary gain, vengeance or sociopolitical ideology

What does BUrton (2012) explain?

• difference between fire setting, pyromania and arson

• fire setting; accidental/ purposeful behaviour of setting fires

• arson: crime; usually not because of pyromania

• pyromania; clinical disorder

what is a measure of kleptomania?

KSAS (Kleptomania Symptoms Assessment Scale

KSAS

• 11 ITEMS

• each statement rated from 0-4

• item 4 and 7; reverse scale

• severity and impact of symptoms

• 21-30: moderate

• 31-44: severe (44 max)

5 ISSUES AND DEBATES FOR DIAGNOSTIC CRITERIA ICD

• IDIO V NOMO

• SELF REPORT-qs

• objective v subjective data

• quanti v quali

• case study