Impulse Control Disorder refers to the inability to repeatedly resist certain urges or impulses that may be harmful to one's self or to others.
ICD can develop as early as age seven and continues throughout adulthood. Symptoms may go undiagnosed for several years by the pediatrician or by the clinical psychiatric practitioner unfamiliar with this new class of personality disorders. All too often it is the unsuspecting parents who are blamed for the child's misbehaving deeds.
Behavior Concerns in Children
Impulsive acts often display as symptoms similar to other behavior disorders such as Oppositional Defiant Disorder, Attention Deficit Hyperactivity Disorder, and Obsessive Compulsive Disorder.
Impulse Control Disorders in children often are misinterpreted as "bad behavior". Symptoms present as one or more annoying or frustrating habits:
- Scratching or picking at the skin
- Repeating words or phrases over and over
- Extreme defiance
- Aggressive behavior
- Destruction of belongings and/or others' property
- Stealing
- Eloping
- Demonstrating an irresistible obsession with elements such as fire or water
- Insomnia
As the child with ICD matures into adolescence and thus grows in size and strength, the disturbing behaviors grow into harmful, if not dangerous, uncontrollable impulses.
The Harmful Effects of Impulse Control Disorders
Six primary categories define ICD:
- Intermittent explosive disorder (Violent anger, with or without provocation, and usually out of proportion to the cause.)
- Pyromania (Repeated setting of fires.)
- Kleptomania (Stealing things that have little or no value to the client.)
- Obsessive Gambling (Inability to stop despite great loss.)
- Trichotillomania (Pulling one's own hair out from the scalp or body.)
- Not Otherwise Specified
Impulse Control Disorders include addictions to alcohol, drugs, substance abuse, eating disorders, pedophilia, and sexual promiscuity. Compulsive liars go to great lengths to deceive others and thus satisfy their uncontrollable urge.
Domestic violence and child abuse are categorized under intermittent explosive disorder. Stealing (kleptomania) often leads to shoplifting and repeated criminal activity. Compulsive gamblers lose not only their money, but also jeopardize their reputation, career, and family life.
Acts of self-mutilation, such as nail-biting, picking at sores, creating wounds, all bring a sense of pleasure and relief to the victim in spite of the unattractive results.
Cause(s) of Impulsive Behavior
The exact cause of Impulse Control Disorders is unknown. However, research suggests that ICD may develop as a side effect from other medical conditions, particularly traumatic head injury, genetic disposition (epilepsy), and abnormal neurological development during the prenatal period. It has been suggested that certain chemical imbalances in the brain may preclude ICD and that hormones such as testosterone may act as a contributor.
Stress and anxiety trigger acts of impulsive behavior. Impulsive actions are typically preceded by feelings of tension and excitement and are followed by a sense of relief and gratification. The client may or may not experience guilt or remorse, following an episode. Most clients find their impulsive urges highly distressing and feel a loss of control over their lives.
Diagnosing Impulse Control Disorders
Positive diagnosis is determined by ruling out other behavioral, psychiatric, and relative physical conditions. A thorough examination may include (but is not limited to) observing and recording exact behaviors on a daily basis for weeks at a time to determine a type and frequency pattern.
Treating Personality Disorders
While there is no specific cure for personality disorders, a variety of treatment methods are recognized in controlling impulsive behavior. Medication, behavior therapy, counseling, and behavior modification are but a few available choices. Support groups, Gamblers Anonymous, and Anger Management programs, all serve clients in need of help.
Whatever mode of therapy or mental health treatment is chosen, it is vital that the client be closely monitored to ensure beneficial and lasting results.
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