Impulse Control Disorders

IMPULSE CONTROL DISORDERS

Many of the self-control disorders involve disturbances in the ability to regulate an impulse - an urge to act. People with impulse control disorders act on certain impulses involving some potentially harmful behavior that they cannot resist. Impulsive behavior in and of itself is not necessarily harmful; in fact, we all act impulsively upon occasion. Usually our impulsive acts have no ill effects, but in some instances they may involve risk. Consider the following two examples. While walking through a clothing store, a young woman decides on the spur of the moment to charge an expensive sweater which is over her budget; she may regret her decision later, but few serious consequences will result. Were she to use all her financial resources to buy an expensive sports car, the consequences would be considerably more serious. Neither of these situations is as threatening as that of another woman, who invites a man she has just met at a singles bar to her apartment where they have unprotected sex--a behavior that puts her at serious risk. People with impulse control disorders repeatedly engage in behaviors that are potentially harmful, feeling unable to stop themselves, and experience mg a sense of desperation if they are thwarted from carrying out their impulsive behavior.

Impulse control disorders have three essential features. First, people with these disorders are unable to stop from acting on impulses that are harmful to themselves or others. Some people attempt to fight their impulses and others give in when they feel the urge to act. The act can be spontaneous or planned. Second, before they act on their impulse, people with these disorders feel pressured to act, experiencing tension and anxiety that can only be relieved by following through on their impulse. Some people with these disorders experience a feeling of arousal that they liken to sexual excitement. Third, upon acting on their impulse, they experience a sense of pleasure or gratification, also likened to the release of sexual tension.

Individuals with impulse control disorders are not usually conflicted at the moment of choosing to engage in the behavior. Conflict, regret, and remorse, if they do occur, appear afterwards.

KLEPTOMANIA

You may have heard the term kleptomaniac used to describe a person who shoplifts or takes things from other people's houses. People with the impulse control disorder called kleptomania do not take things on a whim or out of economic necessity, but because they are driven by persistent urges to steal.

If you thought that a kleptomaniac was someone driven to acquire possessions, it may surprise to to learn that people with this impulse control disorder are driven by the desire to steal, not the desire to have. The main motivation for their behavior is an urge to release tension. The act of stealing provides this release and gives the kleptomaniac a temporary thrill, even though the individual regards the urge to steal as unpleasant, unwanted, intrusive, and senseless. Kleptomaniacs steal just about anything, although the most common objects include food, clothes, jewelry, cosmetics, records, toys, pens and paper, and, in some cases, money. While most kleptomaniac steal from a store or workplace, for some the behavior is limited to stealing from a particular person, perhaps someone about whom they feel intense feelings of attraction or jealousy. Keep in mind that it is not the intrinsic value of these objects that motivates the kleptomaniac to steal, but rather the act of stealing itself. In fact, most kleptomaniacs are perplexed about what to do with their acquired items. Some hoard the objects, as in the case of a woman whose closet was overflowing with thousands of inexpensive plastic combs and brushes taken over the course of several years. Others give away the items, or may even throw them in the trash. This lack of interest in the stolen items is the main feature that differentiates a typical shoplifter or burglar from a kleptomaniac.

• Theories and treatments

Although kleptomania is a fascinating psychological disorder, it has received relatively little attention from researchers, perhaps because relatively few cases come to professional attention except for those referred to forensic psychologists. Clinicians usually become aware of a person's kleptomania only when the individual is in treatment for some other psychological problem such as an anxiety disorder, psychoactive substance abuse, eating disorder, or mood disorder (Bradford & Balmaceda, 1983; McElroy et al., 1991). The fact that most kleptomaniacs seen in a clinical context also suffer from another psychological disorder raises some interesting questions. Is