The DSM defines impulse control disorders, including pyromania, kleptomania, intermittent explosive disorder, trichotillomania, pathological gambling, and “not otherwise specified.” These disorders involve an inability to control harmful behavior, such as stealing or starting fires. Other disorders, such as bipolar disorder or borderline personality disorder, may also have impulse control components.
It is important to understand how the types of impulse control disorders are defined. In psychiatric and mental health medicine, the Diagnostic and Statistical Manual of Mental Disorders (DSM) defines which conditions refer to poor impulse control. These definitions may leave out some diseases that are defined elsewhere in the text or that may only have impulse control problems as a feature. The major types of impulse control disorders defined by the DSM are pyromania, kleptomania, intermittent explosive disorder, trichotillomania, pathological gambling, and the final generic type referred to as “not otherwise specified”.
Any impulse disorder can be defined as an inability to control behavior of a certain type, even when that behavior hurts the person or harms others. Trichotillomania is an example of a behavior that most harms the individual. In this condition, people pull out their hair, often leaving bald patches or the absence of eyelashes and eyebrows. The urgency to do so overrides the fact that the behavior often leads to personal embarrassment and can further cause permanent hair loss or skin damage. Over time, people with this disorder can be helped through special counseling, although the disease becomes much more difficult to treat in adults.
Another such disorder is kleptomania, which is the urge to steal things from shops or other places. Compulsive theft definitely puts a person’s reputation at risk and could result in jail time. Pyromania also has this double harmful potential, as people who feel the constant compulsion to start fires can injure or kill themselves and others. Pathological gambling can be harmful to the gambler and to any family members from whom the gambler may take money, with or without permission. Some compulsive gamblers have lost their families’ life savings and decimated their own finances.
Intermittent explosive disorder, also sometimes called anger disorder, is a condition in which people have extreme, violent reactions to situations. This could involve bodily harm to others, destruction of property, or an attempt to injure something or someone. It is usually diagnosed in the absence of other conditions such as depression or substance abuse and can occur in adolescents and adults, and occasionally in children.
In the category of not otherwise specified, some impulse control disorders include sexual addiction, compulsive shopping, or repeated self-mutilation (cutting or other injury). Many people wonder where other addictive behaviors, such as some forms of obsessive-compulsive disorder, alcohol and drug addiction, or paedophilia, are defined in the DSM. These disorders involve problems with impulse control, but are defined under different headings in the DSM.
There are many psychiatric conditions that could create poor impulse control, such as bipolar disorder or borderline personality disorder. However, these are defined as separate diseases that have impulse control components. Separate sections of the DSM that may address impulse control less directly include those areas that cover substance abuse and eating disorders and conditions such as anxiety disorders, mood disorders, or paraphilias such as pedophilia.
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