Impulse control disorder

What is impulse control disorder? 

Impulse control disorders are conditions where individuals repeatedly fail to resist an impulse or urge to perform an act that is rewarding, in the short-term, despite damaging consequences in the long term. This may include severe distress or harm to themselves or others, significant life disruption and legal and financial difficulties. Impulse control disorder can be experienced as an isolated condition or accompanied by other psychiatric diagnoses. These disorders are often extremely disruptive for individuals, their families, and the community.

What are the different types of impulse control disorders?

Impulse control disorders are relatively common psychiatric conditions, poorly understood by clinicians, the public and the person who suffers from them. ICD involves various specific behaviours, including fire-setting, stealing, sexual behaviour, and explosive outbursts.

Here below is a short description of the most common of these disorders.

Sexual compulsion: an increased urge in sexual thoughts and behaviour. This increases exposure to Sexually Transmitted Infections (STIs), personal and safety issues, and social stigma. Internet addiction: excessive internet use, social media platforms, gambling, or porn sites, among others. Possible consequences of internet addiction are depression, anxiety, social isolation, psychosis, Insomnia, impulse control disorder, abuse of alcohol, prescription and illegal drugs, and suicidal thoughts. People who are addicted to the Internet may also become malnourished due to poor eating habits Compulsive shopping: the irresistible urge to shop beyond one’s economic means resulting in marked distress, financial problems and significant impacts on the individual’s social life and occupational functioning. Pyromania: the uncontrollable urge to start fires, often at the risk of the safety of oneself, others, and property. Intermittent explosive disorder (IED): repeated and disproportionate explosive outbursts of aggression. Kleptomania: the uncontrollable impulse to steal for pleasure. Trichotillomania: the irresistible urge to pull out hair from the scalp, eyebrows, and lashes. A related condition can be skin picking, where the sufferer picks at their skin to the point of self-harm.

What are the symptoms of these conditions?

The signs and symptoms of impulse control disorders vary based on the sufferer's age, the type of impulse control, how the environment reacts and whether the individual is male or female.

Despite these variations, all ICD appear to show the following pattern:

Uncontrollable urge Growing tension Pleasure upon acting Relief  Guilt (may or may not be present)

What causes impulse control disorders?

Although the specific causes underlying ICD are still unknown, many types of these behaviours are thought to stem from underlying neurological vulnerabilities coupled with genetic and environmental predisposing factors, including child abuse or neglect. The disorder often peaks in mid-adolescence. Often, other psychological conditions like  ADHD, OCD, depression, and anxiety accompany impulse control disorders. 

How can impulse control disorders be managed?

ICD is a highly debilitating condition that needs the help of an experienced clinician who can provide a treatment designed to address the individual’s specific needs and circumstances.

What is the treatment for impulse control disorders?

Treatment of impulse control disorders varies depending on the severity of the symptoms and the type of disorder.

The recommended treatment for impulse control disorders is Cognitive Behavioural Therapy, or CBT, which focuses on psychoeducation, cognitive restructuring, and relapse prevention. CBT teaches the individual to cope with the intrusive thoughts and emotional patterns underpinning the problematic behaviour and to develop skills to focus attention, regulate emotions and delay the urge for immediate gratification.

In most cases of ICD, medication for depression and anxiety, the antidepressants known as serotonin reuptake inhibitors or SSRIs have also proved effective in managing these conditions.