Impulse Control Disorders

An impulse control disorder is a reoccurring failure to resist impulses to do things that are harmful to self or to others.¹

For example:

A person with an impulse control disorder (pyromania) might experience an urge to set a fire, be unable to resist that urge and actually set a fire – with the likely consequence of harm to self or others.

A person with an impulse control disorder (trichotillomania) might experience urges to pull hair from the scalp, be unable to resist these urges (if even aware of them) and be left with embarrassing patches of baldness.

The Types of Impulse Control Disorders

Intermittent Explosive Disorder

– Characterized by a reoccurring failure to resist angry impulses and aggressive outbursts that result in violence or damage to property. These aggressive outbursts are far out of proportion to the situation and the behaviors are not better explained by another mental health condition (schizophrenia for example) or another medical condition (Alzheimer’s for example).

Kleptomania

– Characterized by recurring impulses to steal things that you do not need or even necessarily want and that have no great monetary value. People with kleptomania often feel rising anxiety prior to an act of theft that is relieved by stealing something. Immediately after the act, people with the disorder may feel relief or excitement for a while, but this is typically soon replaced by feelings of guilt or distress. To meet a diagnosis of kleptomania, you must not steal for financial reasons or out a desire for revenge or out of anger. Your thefts cannot occur as a result of a hallucination and no other medical or psychiatric condition may better explain your actions.

Pyromania

– Characterized by a fascination with watching and lighting fires and recurring fire setting - a recurring need to light fires and a feeling of tension or anxiety before fire-lighting that is relieved by the act. To meet a diagnosis of pyromania, you must not set fires for financial gain, as an act of violence or revenge, as an act of war, to hide a crime, as a result of substance impaired judgment or as a result of a hallucination. No other mental health disorder may better explain the behaviors. Although some arsonists are pyromaniacs, many are not.

Pathological Gambling

– Characterized by an obsession with gambling, an inability to control gambling behaviors despite legitimate attempts to stop or slow down, feeling irritable when unable to gamble, using gambling as a way to escape from negative feelings, committing crimes to raise gambling funds, losing a job or important relationship due to gambling, needing to bet ever large amounts of money to experience the same feelings of excitement, chasing losses with more gambling, lying to others about your gambling and asking for or borrowing money from those around you to help cover gambling debts. People with a pathological gambling disorder must display 5 of the above symptoms and their behaviors must not be better explained by a manic episode.

Trichotillomania

– Characterized be recurring urges that lead you to pull out your hair. This hair pulling is preceded by feelings of tension or anxiety and these feelings are relieved by the act of pulling hair. To meet a diagnosis of trichotillomania, your hair pulling must also cause you significant distress or social or occupational impairment and you may not have another mental health disorder that better explains your behaviors.

Impulse Control Disorders Not Otherwise Specified

– This is an umbrella term that can be used by clinicians to describe a disorder that is not explained by any of the above conditions but that occurs as a result of a failure to control impulses. Some examples may include compulsive sexual behaviors or exhibitionism, compulsive shopping or buying or compulsive self mutilation behaviors. ²