Disruptive, Impulse-Control, and Conduct Disorders II

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Overview – Disruptive Impulse Conduct Disorders, Part 2

Disruptive Impulse Conduct Disorders are mental illness disorders that affect children and adolescents, impacting millions worldwide. It is considered very rare for these types of behaviors to first manifest themselves in adulthood. For some, the characteristics or symptoms may become evident during preschool years. For others they show up in later childhood or early adolescence.  Although the underlying causes or risk factors of these disorders vary, they all seem to share common characteristics related to problems in regulating behaviors and emotions, the results of which cause significant impairment in daily functioning. 

Prevalence of any Disruptive Impulse Conduct Disorder is estimated at 24.8 percent of the general population. It is more commonly seen in boys than girls.

It is important to understand that nearly all children and adolescents experience symptoms of defiance, disobedience, and breaking rules at some point in their childhood development. In disruptive, impulse-control, and conduct disorders the behaviors significantly exceed the normative behaviors for the individual’s culture, age, and gender. The behaviors are also much more frequent and pervasive, resulting in significant impairment to the individual’s life.

In Disruptive Impulse Conduct Disorders, Part 1, information on four types of disorders was presented:

  1. Oppositional Defiant Disorder
  2. Conduct Childhood Disorder
  3. Conduct Adolescent Disorder
  4. Conduct Unspecified Disorder

Disruptive Impulse Conduct Disorders, Part 2, presents information about four additional disorders, one type each day for four days. These are: 

Intermittent Explosive Disorder

Intermittent Explosive Disorder is a common mental illness that is characterized by impulsive and explosive outbursts of anger with little or no warning. The verbal and behavioral outbursts are out of proportion to the situation. Typically, they last for 30 minutes or less. Those diagnosed with Intermittent Explosive Disorder may be irritable, impulsive, aggressive, or chronically angry most of the time. The episodes may occur frequently or be separated by weeks or months of nonaggression, although less severe verbal outbursts may occur in between episodes of physical aggression and violence. The exact cause of Intermittent Explosive Disorder is unknown.

Individuals who are diagnosed with Intermittent Explosive Disorder are more likely to experience:

  • Impaired interpersonal relationships that can lead to stress and divorce
  • Difficulty completing their education or holding a job
  • Potential vehicle accidents
  • Problems with alcohol or other substance abuse
  • Physical health issues
  • Mood disorders including anxiety and depression after an explosion
  • Intentional injuries or suicidal ideation
Antisocial Disorder

Antisocial Disorder is a serious psychiatric disorder; a mental illness that involves the habitual and pervasive disregard for the violation of the rights and considerations of others without remorse. The term antisocial indicates being against society: against rules, norms, laws, and acceptable behavior. Individuals with Antisocial Disorder tend to be charismatic, attractive, and very good at obtaining sympathy from others, often describing themselves as the victim of injustice. The average intelligence of individuals with a diagnosis of Antisocial Disorder may be higher than the norm. They tend to possess a superficial charm, can be thoughtful and cunning, have an intuitive ability to rapidly observe and analyze others, determine their needs and preferences, and present it in a manner to facilitate manipulation and exploitation. These individuals can cause great harm to those around them through financial exploitation, theft, emotional abuse, assault, sexual assault, and homicide. 

Those with Antisocial Disorder may be habitual criminals or engage in behavior which would be grounds for criminal arrest and prosecution. They may engage in behaviors which skirt the edges of the law or manipulate and hurt others in non-criminal ways which are widely regarded as unethical, immoral, irresponsible, or in violation of social norms and expectations. They often possess an impaired moral conscience and make decisions driven purely by their own desires without considering the needs or negative effects of their actions on others. 

Pyromania Disorder

Pyromania Disorder is a psychiatric disorder in which individuals repeatedly fail to resist impulses to deliberately start fires, in order to relieve some tension or for instant gratification. The term pyromania comes from a Greek word and is distinct from arson, the deliberate setting of fires for personal, monetary, or political gain. Pyromaniacs start fires to induce euphoria, and often fixate on institutions of fire control like fire houses and fire personnel. A diagnosis of Pyromania Disorder most often occurs alongside a past history of alcohol use disorder, and is most commonly comorbid with antisocial personality disorder, other disruptive impulse-control and conduct disorders.

Pyromania Disorder usually manifests in adolescence or late childhood. Although both genders may develop Pyromania Disorder, fire setting is predominantly a male condition. In a landmark study of 1,145 fire setters found that over two-thirds of the perpetrators were male. Intelligence may play a role, as about 70 percent of the adults in the study were found to have below normal intelligence, particularly in those with poor social skills or other learning disabilities, though it is unclear why gender disparity remains so strong. 

Kleptomania Disorder

Kleptomania Disorder is a psychiatric mental health impulse control disorder that is characterized by recurrent, powerful, and irresistible urges to steal. Kleptomania is not to be confused with shoplifting that is done for personal gain, triggered by peer pressure or a dare, or done out of rebellion. Kleptomania Disorder is characterized by ever-increasing tension leading up to the theft, followed by an intense feeling of gratification or relief. Stealing is not done from anger or to get back at anybody or from a delusion or hallucination. Individuals with Kleptomania Disorder often do have coexisting mental disorders. However, the behavior is not due to a Conduct Disorder or Antisocial Disorder or a manic episode. The underlying cause of Kleptomania has not been identified. It can last for several years or for a lifetime.

Interestingly, with a drive to steal that they feel can’t be stopped, people with Kleptomania tend to experience a sense of guilt after the theft, which often prompts them to attempt to return the items that were stolen. Individuals with Kleptomania may have difficulties in relationships because of stealing from their family members and friends. In addition, they may have problems at work due to stealing from the employer. Kleptomaniacs also risk legal problems as stealing is a crime. Many are diagnosed and enter into treatment only when forced to do so by the authorities. 

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