Impulse control disorders

• Impulse control disorders (ICD)

  Characterised by the repeated inability to resist impulses or carry out behaviour that violates the rights of others or conflicts with societal norms or the law
• Impulse control disorders


  • Rewarding in the short term but has long term negative consequences
• For a diagnosis of an impulse control disorder to be made, there must not be any other obvious explanations such as other behavioural or mental disorders, substance use or intellectual impairment
• Types of impulse control disorders

  • Kleptomania
  • Pyromania
  • Gambling disorder
• Kleptomania


  A strong impulse to steal. The more difficult the challenge the more thrilling and addictive it becomes
• Kleptomania


  1. Before theft = feeling of tension + arousal

  2. After theft = feeling of excitement + relief
• 1. K-SAS(self assessment scale)

  • Self-report measure to assess kleptomania
  • 11 item rating scale
  • Measures thoughts, feelings and behaviours related to stealing
  • Covers the last 7 days
  • 0-4 or 0-5 point scale
• Biological explanation of kleptomania

  • Dopamine - known as 'happy' chemical and its release is triggered by rewarding stimuli
  • Reward deficiency syndrome - when someone with kleptomania steals, their reward centres are stimulated and release dopamine, but when these behaviours become compulsive, levels of dopamine in the striatum are reduced, leading to continuation of compulsions and addictions
  • Kleptomania can be a side effect of using synthetic dopamine
• Psychological explanation of kleptomania

  • Positive reinforcement - when a behaviour results in a reward such as money or attention, it is likely to be repeated again
  • Schedules of reinforcement - explains why gamblers don't stop when they start to lose, as gambling machines involve partial positive reinforcement
• Biological treatment for kleptomania


  • Opiate antagonists - group of drugs traditionally used to treat substance abuse, work by reducing the response of reward centres in the brain which reduces the urge to engage in addictive behaviours and extends the period of abstinence
• Cognitive treatment for kleptomania


  1. Covert sensitisation paired with muscle relaxation - involves conditioning in which an unpleasant stimulus (e.g. vomiting, being caught) is paired with the undesirable behaviour to change that behaviour

  2. Involves imagery about the undesired behaviour rather than actual behaviour
• Pyromania is a powerful impulse to set fires, with a sense of tension occurring directly prior to fire-setting and a sense of excitement and pleasure felt during or after
• Gambling disorder is a pattern of persistent or recurring gambling either online or offline, characterised by gambling being given priority over other activities or interests, gambling continuing despite negative consequences, and impaired control of the length of time spent gambling or how much money is being spent
• For a diagnosis of gambling disorder, the gambling behaviour needs to be present for at least a year
• Miller's feeling state


  Intense positive feelings can become linked with specific behaviours, forming a 'state dependent memory' or a feeling state. To get the same feeling, the person compulsively repeats the event. Underlying negative thoughts or feelings are likely to create feeling-states that lead to impulse control disorders.
• Imaginal desensitisation


  Therapist teaches muscle relaxation

  2. Clients visualise themselves being exposed to the situation that triggers the drive to carry out the impulse control disorder

  3. Clients then think about carrying out the behaviour but mentally leave the situation

  4. Helps to reduce impulses by reducing arousal associated with the disorders