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Having a sudden urge, desire, or impulse to do something is a characteristic shared by the majority of people. Still, those of us with impulse control disorders find it very hard or impossible to control our urges or impulses.

These impulse control issues can significantly affect an individual’s health and overall quality of life, but they are treatable.

This article talks about the different types of impulse control disorders, their symptoms, causes, treatments, and how to help someone who has one.

The ability to regulate our urges or impulses as humans distinguish us from other creatures and demonstrate our psychological development. Most of us take for granted our capacity to think before acting. However, this is difficult for those who struggle to control their desires.

Impulse-control disorder (ICD) is a category of mental conditions defined by impulsivity – the inability to resist an urge, a temptation, or an impulse; or the inability to refrain from speaking up about a thought. Impulsivity is a sign of many mental disorders, like behavioral addictions, substance-related disorders, attention deficit hyperactivity disorder, antisocial personality disorder, fetal alcohol spectrum disorders, conduct disorder, borderline personality disorder, and certain mood disorders.

People with an impulse control disorder can’t stop the urge to hurt themselves or others. Alcohol or drug addictions, eating disorders, paraphilias sexual fantasies, compulsive gambling, acts involving suffering, non-human objects, humiliation or children, obsessive hair pulling, fire setting, stealing, and occasional explosive rage attacks are impulse control disorder examples.

Some of these disorders, including intermittent explosive disorder, pyromania, kleptomania, trichotillomania, and compulsive gambling have similar onset and progression patterns. Typically, a person experiences rising stress or excitement before completing the symptomatic behavior. During the act, the individual will likely experience pleasure, fulfillment, or relief. Afterward, the individual may experience self-blame, regret, or guilt.

The actions of these individuals may or may not be premeditated, but they typically satisfy their immediate, aware desires. However, the majority of people find their conditions extremely unpleasant and experience a lack of control over their life.

Scientists are unaware of the etiology of these disorders. Numerous factors, including biological or physical, psychological or emotional, cultural or societal, likely have a role. Scientists hypothesize that specific brain structures, notably the limbic system, which is associated with memory and emotional functions, and the frontal lobe, which is associated with planning activities and impulse control, contribute to the illness.

Hormones associated with aggression and violence, like testosterone, may also contribute to the diseases. For instance, researchers have hypothesized that women may be prone to less violent forms of impulse control disorders, like trichotillomania or kleptomania, while men may be inclined to more violent and aggressive forms, like intermittent explosive disorder and pyromania.

Additionally, research has demonstrated links between specific seizure diseases and violent impulsive actions. In addition, research has indicated that relatives of individuals with impulse control difficulties have a higher incidence of mood disorders and addiction.

Consequently, there is no one etiology for impulse control disorders. Temperamental, environmental, physiological, and hereditary variables may contribute to the development of a condition.

Intermittent explosive disorder risk factors and causes include a history of physical and mental trauma, serotonin imbalances in the limbic and orbitofrontal cortex, and relatives with IED.

Possible causes and risk factors of the oppositional defiant disorder include problems with emotional control; inconsistent, harsh, and neglectful parenting; lower basal cortisol response; and structural or functional anomalies in the amygdala and prefrontal cortex.

Conduct disorder—difficult disposition as an infant; below-average intellectual ability; inconsistent or abusive parenting; relatives with conduct disorder, exposure to violence; alcohol abuse, depression, bipolar disorder, ADHD or schizophrenia; and structural and functional differences in the ventromedial amygdala and prefrontal cortex.

Relatives with substance use disorders and obsessive-compulsive disorder may pose a risk for kleptomania.

Impulse control issues might vary from individual to individual, but a common thread is that the urges are extreme and hard to control.

Sometimes ICDs do not manifest until adulthood, however, most symptoms appear during adolescence.

These are among the most prevalent symptoms across all age groups:

  • Lying
  • Kleptomania or stealing
  • Destroying property
  • Demonstrating intense rage
  • Having sudden verbal and physical outbursts
  • Causing harm to others and animals
  • Trichotillomania; the pulling out of one’s hair, brows, and lashes.
  • Excessive or compulsive eating

Symptoms of impulse control disorder in adults

  • Adults with impulse control issues may also display the following:
  • Unregulated gambling
  • Addiction to shopping
  • Igniting fires purposefully, or pyromania
  • Internet addiction or excessive usage
  • Hyper-sexuality

Symptoms of impulse control disorder in children

Children with impulse control problems may have more academic and social challenges at school.

They may be more likely to act out in class, not do their homework, and fight with their peers.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) lists five formal disorders that meet the criteria for an impulse control disorder.

Oppositional defiant disorder

Frequently, oppositional defiant disorder (ODD) is a childhood behavior disorder. It is difficult for anyone with this disorder to manage their emotions or conduct. This condition affects 2–11 percent of children in the U.S., and it is more prevalent in males than females.

People with ODD typically develop symptoms between the ages of five and ten, and symptoms may diminish with age.

Intermittent explosive disorder

Intermittent explosive disorder (IED) is typically diagnosed in late childhood or adolescence. This condition is characterized by brief outbursts of rage and aggressiveness that look disproportionate to the event. The reason may not be apparent to anyone except the individual with IED.

Conduct disorder

Conduct disorder (CD) is a condition of impulse control that typically manifests in childhood or early adolescence.

This condition is characterized by rebelliousness, disobedience, and aggression.

This problem affects 2–10 percent of children and teens in the United States. Boys are more likely to get it than girls. The prevalence of mood disorders, attention deficit hyperactivity disorder (ADHD), and developmental disorders are also increased in those with this condition.

Kleptomania

People with kleptomania are compelled to steal items that do not belong to them. The illness can manifest at any age and affects females more frequently than males.

Pyromania

Pyromania is a rare disorder of impulse control in which a person becomes obsessed with fire and everything that has to do with it. They frequently feel compelled to set things ablaze. Pyromania is more common in teens and adults, and men are more likely to have it than women.

There is a correlation between pyromania and mental health problems and learning difficulties.

If a person has trouble controlling their impulses and doesn’t get help for it, they could face a number of problems. The safety, health, and well-being of an individual may be affected if the symptoms of these diseases are not treated. The following are examples of such impacts and consequences:

  • The emergence of another mental disorder
  • Substance abuse, dependency, or addiction
  • Physical harm is caused by engaging in dangerous actions.
  • Interactions with law enforcement and imprisonment
  • Disciplinary measures in schools
  • Academic failure
  • Getting kicked out of school
  • Lack of capacity to get or retain a job
  • Lack of ability to establish and sustain healthy relationships

There are two therapy options for impulse-control disorders: psychological and pharmacological. The treatment approach is influenced by the presence of coexisting conditions.

Medication

Along with fluvoxamine, clomipramine has been shown to be an effective treatment for impulsive gambling disorder, reducing pathological gambling problems by up to 90 percent. While clomipramine is useful in treating trichotillomania, fluoxetine has not provided consistently favorable results. 

Fluoxetine has demonstrated positive outcomes in the management of pathologic impulsive skin-picking conditions, although additional study is required to confirm these findings. Fluoxetine has also been looked at as a treatment for IED. In a randomized, double-blind, 14-week study of 100 people, the frequency and severity of impulsive aggression and irritability decreased significantly.

Despite a significant reduction in impulsive aggression from baseline, only 44 percent of fluoxetine responders and 29 percent of all fluoxetine participants were deemed to be in full remission after the research. 

Paroxetine has demonstrated modest efficacy, albeit with uneven results. Escitalopram is another medicine that has been shown to help people with anxiety who are addicted to gambling. Even though SSRIs have been shown to be helpful in treating pathological gambling, the different results of using SSRIs show that neurobiologically, impulse-control disorders are not all the same.

Psychosocial

Cognitive behavioral therapy (CBT), which is effective in the treatment of compulsive gambling and sexual addiction, is a component of the psychosocial treatment strategy of ICDs. A consensus exists that cognitive-behavioral therapies provide an effective therapeutic model.

Pathological, impulsive, or compulsive gambling

Pathological gambling has been shown to be helped by aversive therapy, systematic desensitization, imaginal desensitization, covert sensitization, and stimulus control. In addition, cognitive approaches like cognitive restructuring, psychoeducation, and relapse prevention are successful in treating such situations.

Pyromania

Pyromania is more difficult to manage in adults because of a lack of cooperation, but CBT is an effective treatment for pyromaniac children.

Intermittent explosive disorder

Cognitive-behavioral therapy has proven to be useful in the treatment of Intermittent explosive disorder, along with several other techniques. Cognitive Relaxation and Coping Skills Therapy (CRCST) comprises  12 sessions, beginning with relaxation training, then cognitive restructuring, and concluding with exposure therapy. Later, the emphasis shifts to avoiding aggressive tendencies and taking further preventive steps.

Kleptomania

Covert sensitization, systematic desensitization, imaginal desensitization, relaxation training, aversion therapy, and “alternative sources of gratification” are cognitive behavior approaches used to treat kleptomania.

Compulsive buying

Even though compulsive buying is classified as Impulse-control disorder – Not Otherwise Specified in the DSM-IV-TR, certain researchers have hypothesized that it exhibits core characteristics of impulse-control disorders, such as preceding tension, inability to resist urges, and pleasure or relief after action. The efficacy of cognitive behavior therapy for compulsive buying has not been determined conclusively; nonetheless, exposure and response prevention, cognitive restructuring, covert sensitization, relapse prevention, and stimulus control are frequent treatment strategies.

If you care for someone with an impulse control condition, you may question how to assist them. Understanding impulse control disorder in adults and children is the first step in learning how to assist someone with ICD. Once you have an understanding of impulse control issues, you may find particular approaches to assist your friend or family member.

It can be hard to understand dysfunctional impulse control. It may be challenging for you to understand that someone cannot control their urges and impulses if you do not have one of the many forms of impulse control disorders, but it is more prevalent than you might believe.

If you know someone with an impulsive disorder, you may be curious as to what impulse control disorders are and what causes impulse control disorder. There are a variety of impulse control issues. 

The impulse control disorders examples include hair-pulling, obsessive stealing (kleptomania), and eating disorders. All of these behavioral addictions can be classified as impulse control disorders. When someone has a disorder of impulse control, they experience stress before engaging in hazardous action. They feel a feeling of satisfaction or relaxation upon completion. After doing the act, the individual will likely experience guilt or regret.

The details of symptoms, causes, and types of impulse control disorders have already been discussed in the article. So if you have read the article this far, you have taken the 1st step in helping others with impulse control disorders.

In addition to knowing the indicators of impulse control disorder, you can assist someone with this condition in the following ways:

  • Be a social support system for your friend or loved one if and when they are ready to chat.
  • Do not take an individual’s aggressiveness or actions personally.
  • Encourage them to get into therapy and seek proper treatment; treatment for impulse disorders can be successful and might include medication and counseling.
  • Assist your friend or loved one in locating a support group; there are numerous groups for various impulse control issues. You might even be invited to a meeting with them.
  • Consider activities to distract your friend from their cravings, like going on a walk or joining a fitness class.

Having issues with impulse control do not necessarily indicate pathology in a child.

Problems with impulse control can be frequent among children as they progress through various phases of development. Impulse control difficulties may also be a symptom of conditions such as attention deficit hyperactivity disorder (ADHD).

The following are some suggestions for assisting children with impulse control:

  • Teach children to recognize and label their emotions. Assisting children in comprehending their emotions might offer them a foundation for better managing their emotions and impulsivity.
  • After you offer instructions, ask your kid to repeat them.
  • Teach your child how to solve problems. Before taking action, encourage them to discuss their strategies for resolving a problem.
  • Children who have difficulty with impulse control can benefit from structure and consistency. Create and maintain a routine so that your child understands what to anticipate and how to respond to situations throughout the day.
  • Certain games are intended to help children develop impulse control. Simple games like Green Light, and Red Light, teach impulse control, therefore push your child to participate in these activities.

  1. Impulse control disorders: Definition, types, symptoms, and more. Medical News Today. MediLexicon International. Available at: https://www.medicalnewstoday.com/articles/impulse-control-disorders#signs-and-symptoms.
  2. Impulse control: How to identify and treat, Healthline. Healthline Media. Available at: https://www.healthline.com/health/mental-health/impulse-control.
  3. When is impulsive behavior a disorder?, Verywell Mind. Available at: https://www.verywellmind.com/impulse-control-disorder-impulsive-behavior-2797366.
  4. How to help someone with impulse control disorder: All you need to know. The Recovery Village Drug and Alcohol Rehab. Available at: https://www.therecoveryvillage.com/mental-health/impulse-control-disorder/help-someone-with-impulse-control-disorder.

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