Impulse Control Disorders

12 step group and cognitive behavioral therapy in combination with medication

Treatment Summary: Impulse-Control Disorders (ICD) includes pathological gambling, kleptomania, compulsive buying, pyromania and aggression. The treatment which seems to work for all of these disorders is a 12-step program which is much the same as alcoholics anonymous and offers peer support. This program in combination with cognitive behavioral therapy and the use of selective reuptake inhibitors (SSRIs) seem to help curb the strong urges associated with the ICD's.

• Reference: : Schmitz, John M., (2005). The interface between impulse-control disorders and addictions: are pleasure pathway responses shared neurobiological substrates ? Sexual Addition & Compulsivity, 12(1), 149-168.
• Submitter: Sue Dolifka

Treatment Summary: The treatment of an impulse control disorder includes both therapeutic and medical interventions. The most prominent form of treatment would be cognitive behavior therapy (CBT). CBT is effective in treating impulse control disorders because the focus of the treatment exposes the relationship between thoughts and behaviors. The goal of CBT is to help clients with impulse control disorder to replace distorted thought processes with more positive and realistic thoughts that help clients to rationalize their thoughts to help in controlling their impulsive urges. An example would be an person whom has a gambling addiction once the person has a clear understanding of their distorted thinking, beliefs and attitudes towards gambling which is usually derived from cultural factors and values. The person can begin the process of restructuring their lifestyle to replace gambling behaviors with more productive ones. Group therapy or support groups such as gamblers anonymous allow people with the same condition a forum to explore the challenges and triumph involve in the treatment of the disorder. The groups members can support each other with can be instrumental in helping one to refrain from the undesired behavior. Interpersonal Therapy explores in-depth the emotional inside of the thoughts and feelings to a person with impulsive disorder and how that feeling is contributing to a behavior. The goal of interpersonal therapy would address the hidden emotional issues that ultimately contribute to an impulsive control behavior. When a client understands why they part take in the destructive behavior they will be less like to continue to engage in the act. Biofeedback is another intervention aimed at remedying impulse control behaviors. Biofeedback monitors normal body functions such as heart and breathing rate while the person practices relaxation techniques to help clients learn how to control the their body functions. The goal of treatment is to teach clients how to relax and minimize anxiety during impulsive triggers. Medications is another alternative treatment to control impulsive urges a the medication naltrexone is an opioid antagonists had been prescribed to patients with impulse control disorders. The medication in a preliminary study has shown the help significantly to reduce urges and by effective decrease impulsive behaviors.

• Reference: Okuda, M., Bal�n, I., Petry, N., Oquendo, M., & Blanco, C.. (2009). Cognitive-Behavioral Therapy for Pathological Gambling: Cultural Considerations. The American Journal of Psychiatry, 166(12), 1325-30. Retrieved March 29, 2010, from ProQuest Psychology Journals. (Document ID: 1910035701). Jeffrey L Geller. (2007). Clinical Manual of Impulse-Control Disorders :The American Journal of Psychiatry, 164(2), 352. Retrieved March 29, 2010, from ProQuest Psychology Journals. (Document ID: 1247738501). Jon E. Grant, J.D., M.D., M.P.H.; Suck Won Kim, M.D.; and Boyd K. Hartman, M.D. (2008). A Double-Blind, Placebo-Controlled Study of the Opiate Antagonist Naltrexone in the Treatment of Pathological Gambling Urges. Journal of Clinical Psychiatry, 69:783-789
• Submitter: N/A

Cognitive-Behavioral Therapy (CBT) and Fire Safety Education (FSE)

Treatment Summary: Kolko studied the effects of CBT and FSE in children with pyromania. He found that there was a significant improvement in the children who learned cognitive behavioral techniques emphasizing self-management and interpersonal behavior change as well as training in fire safety and prevention concepts as opposed to the children who only received a home visit by a fireman. The study suggests that children need to be educated on the effects of fire and what skills to implement instead of the fire play behavior.

• Reference: Kolko, D., (2001). Efficacy of cognitive-behavioral treatment and fire safety education for children who set fires: Initial and follow-up outcomes. Journal of Child Psychiatry and Psychology, 42(3),359-369.
• Submitter: Ilana Rivera