IMPULSE CONTROL DISORDERS 
By Ronnell D. Dela Rosa,DNM 
Common Characteristics
Disorders in this category include the
failure or extreme difficulty in controlling
impulses despite the negative
consequences.  This includes the failure to
stop gambling even if you realize that losing
would result in significant negative
consequences.  This failure to control
impulses also refers to the impulse to
engage in violent behavior (e.g., road
rage), sexual behavior, fire starting,
stealing, and self-abusive behaviors.
 
Disorders in this Category
1. Intermittent Explosive Disorder
2. Kleptomania
3. Pathological Gambling
4. Pyromania
5.Trichotillomania
 
1. INTERMITTENT EXPLOSIVE
DISORDER
  
Etiology
This disorder is apparently rare, with the
majority of cases occurring when the
individual is between late adolescence
and late twenties. There is some evidence
of that the neurotransmitter serotonin may
play a role in this disorder.
 
Symptoms
This disorder is characterized by frequent
and often unpredictable episodes of
extreme anger or physical outbursts.
Between episodes, there is typically no
evidence of violence or physical threat.
Treatment
Treatment could involve medication or
behavior therapy, with the best prognosis
utilizing a combination of the two.
 
Prognosis
Prognosis is fair.
2. KLEPTOMANIA
  
Etiology
Kleptomania appears to be much more
common in females, but little is understood
about the etiology. There is also some
association with other disorders such as
depression and anxiety.
 
Symptoms
Kleptomania involves the failure to resist
impulses to steal things that are not
needed for either personal use or for their
monetary value. There is typically anxiety
prior to the act of theft and relief or
gratification afterward. If the theft is related
to vengeance or psychosis, kleptomania
should not be diagnosed. (Kleptomania is
quite rare, where common shoplifting is
not).
 
Treatment
Treatment typically involves behavior
modification. Other treatment approaches
involve seeing the theft as an unconscious
process and analyzing it as such may assist
in gaining insight and eventually
extinguishing the behavior.
 
Prognosis
Prognosis is fair, but can increase with a
positive therapeutic relationship and a
strong motivation to change the behavior.
Kleptomania often goes untreated and
results in legal difficulties.
 
3. PATHOLOGICAL GAMBLING
Etiology
There is an association with risk in
pathological gambling, more so than
financial gain for most individuals.
Individuals diagnosed with this disorder are
frequently highly competitive, overly
concerned with approval from others and
prone to other ‘addictive’ type disorders.

Symptoms
Persistent and maladaptive pattern of
gambling which causes difficulties with
interpersonal, financial, and vocational
functioning.
 
Treatment
The most effective treatment has developed
through adaptation of the Alcoholics
Anonymous model to treat alcohol and drug
addictions.
Prognosis
Prognosis varies depending on the
individual. Some argue that there is no cure
for this disorder (much like alcoholism), but
that prolonged or continual abstinence is
possible.
 
4. PYROMANIA
 
Etiology
Little is known about the etiology of
pyromania, although there is research
supporting an environmental component
from early childhood.
Symptoms
Pyromania involves deliberate and
purposeful fire setting on at lease two
occasions. There is typically tension or
heightened arousal prior to the act and
gratification or relief afterward. The fire
setting is not done for monetary gain or an
expression of anger, vengeance,
personal gain, or psychosis.
 
Treatment
Treatment typically involves behavior
modification. Other treatment approaches
involve seeing the action as an unconscious
process and analyzing it as such may assist
in gaining insight and eventually
extinguishing the behavior.
Prognosis
Prognosis is fair to poor, but can increase
with a positive therapeutic relationship and
a strong motivation to change the behavior.
Pyromania often goes untreated and results
in legal difficulties and has a strong
connection with adult antisocial behavior.
 
5. TRICHOTILLOMANIA
 
Etiology
Typically occurring before adulthood, it has
been demonstrated that between one to two
percent of college samples have this
disorder or have had it in the past.
 
Symptoms
The primary feature of this disorder is the
recurrent pulling out of one’s own hair
which results in significant hair loss.
Treatment
Behavior modification may be the
treatment of choice, with the possibility of
exploring unconscious issues related to the
behavior.
 
Prognosis
Little treatment data is available and studies
show that the act of pulling out one’s own
hair can disperse for months, and even
years without any psychological
intervention.
 
ADJUSTMENT DISORDERS
Common Characteristics
All of the disorders in this category relate to a
significantly more difficult adjustment to a
life situation than would normally be expected
considering the circumstances.  While it is
common to need months and perhaps even
years to feel normal again after the loss of a
long time spouse, for instance, when this
adjustment causes significant problems for an
abnormal length of time, it may be considered
an adjustment disorder.   
The disorders in this category can present
themselves quite differently.  The key to
diagnosing is to look at (1) the issue that is
causing the adjustment disorder and (2) the
primary symptoms associated with the
disorder.
 
Disorders in this Category
  Adjustment Disorder Unspecified
  Adjustment Disorder with Anxiety
  Adjustment Disorder with Depressed Mood
  Adjustment Disorder with Disturbance of
Conduct
  Adjustment Disorder with Mixed Anxiety and
Depressed Mood
  Adjustment Disorder with Mixed Disturbance of
Emotions and Conduct