Impulse Control Disorders - CHI Health, Omaha, Nebraska (NE)
Personality Disorders
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The impulse control centers within our brains weigh the consequences of each urge and keep us from doing things that could cause harm to ourselves or somebody else. People with an impulse control disorder cannot resist the urge to perform a particular action which they know is obviously harmful to themselves or others.

The key difference between a normal impulse and impulse control disorder is the individual knowingly commits an act, even if it causes negative consequences.

Impulse control disorders occur in people who have trouble coping with situations or emotions. The impulse behavior develops in response to stress or tension and builds to excitement. They may not necessarily plan their behaviors, but acting on an urge fulfills their immediate, conscious wishes and gives them a release or gratification. After committing the impulsive act, most people feel remorse, self-loathing and out of control.

The most common of impulse control disorders are:

  • Intermittent Explosive Disorder–expressions of anger, often to the point of uncontrollable rage
  • Domestic Violence–Intermittent Explosive Disorder which is directed solely at a spouse or domestic partner
  • Kleptomania–the compulsive urge to steal items, either for no reason or for the thrill of doing so
  • Pyromania–the deliberate setting of fires for pleasure or stress relief, for which there is no monetary gain, political or vengeful expression or criminal concealment
  • Compulsive Gambling Disorder–the compulsive urge to keep gambling, regardless of consequences
  • Trichotillomania–the compulsive urge to pull out or eat one's own hair, resulting in noticeable hair loss
  • Onychophagia–compulsive nail biting

Other addictions that may be included in this category are compulsive shopping, sexual compulsion and internet addiction.

Causes

Scientists do not know exactly what causes impulse control disorder. Research suggests that genetics, brain function and chemistry, and hormones may play a role. There also may be environmental causes. Impulse control disorders may occur along with other mental disorders or physical conditions, such as anxiety, personality, mood and eating disorders, and traumatic brain injury. Substance abuse may worsen an impulse control disorder.

Diagnosis

After ruling out other mental or medical conditions that may cause similar symptoms have been ruled out, an individual usually is referred to a mental health provider with expertise in impulse control disorder for evaluation.

Treatment

Once a physical cause has been ruled out, individuals will be referred to a mental health professional who specializes in impulse control disorders.

Impulse control disorders are most often treated with a combination of psychotherapy, behavioral modification therapy and medications. In cognitive behavioral therapy, individuals are encouraged to identify their behavioral patterns and recognize the negative consequences associated with those behaviors. Behavioral modification therapy teaches avoidance techniques when impulses strike. Exposure therapy helps individuals gradually build up a tolerance to situations that may trigger a response while exercising self-control.

Medications may be useful for those who are experiencing depression along with their impulse control behaviors.