Many people exhibit various types of problems that occur repetitively, cause harm to the person, and seem virtually uncontrollable. Sometimes we’re asked if these problems are examples of obsessive compulsive disorder (OCD). Although these other disorders have similarities to OCD, they usually are not considered to be in the same category. What are we talking about here?

Specifically, we’re referring to the category of emotional disorders known as Impulse Control Disorders. The similarity to OCD is seen in the fact that they are all repetitive and very difficult for the person to bring under control. Furthermore, like OCD, they greatly disrupt and impair the sufferers’ lives.

Impulse Control Disorders also differ from OCD. Impulse Control Disorders, unlike OCD, often do not cause those afflicted great distress unless or until legal authorities are called in. Furthermore, anxiety and/or distress do not play a very large role in most Impulse Control Disorders. Finally, many of those with Impulse Control Disorders actually report feeling pleasure from their behaviors even though their lives are impaired by them.

Some of the major types of Impulse Control Disorders include:

• Pyromania: People with this problem find themselves drawn to setting fires. They aren’t out to make money as some arsonists are; rather, they set fires for the excitement of it. Regardless, their behavior often brings attention from law enforcement agencies.
• Pathological Gambling: Not just anyone qualifies as a pathological gambler and thus have an Impulse Control Disorder. Only those who gamble themselves into serious problems financially over and over again receive this label. These folks sometimes even steal or engage in other illegal behavior just to keep their habit going. They may “know” what they are doing is a problem, but report feeling unable to stop.
• Kleptomania: These folks find themselves stealing repeatedly, yet they rarely need the things they steal. Rather, they feel tension prior to stealing and great pleasure and excitement when executing the theft. Later, they may feel remorse, but it never stops the behavior. As you can imagine, more than a few of these people eventually wind up in jail.
• Intermittent Explosive Disorder: People with this problem report feeling unable to put the brakes on repeated episodes of aggression. They often harm property as well as people. When they feel the impulse to be aggressive, they say they “can’t help themselves.”
• Compulsive Buying: Though not officially recognized as an Impulse Control Disorder in the current version of professionals’ diagnostic manual, people with this problem look very much like other Impulsive Control Disorders. They can’t stop themselves from buying “stuff” that is frequently completely unnecessary. They do so to the extent that their finances end up in ruins. They feel great when they buy something, but that feeling is fleeting and often replaced by guilt. But they continue the cycle repeatedly.
• Trichotillomania: This is a common problem and involves repetitive, irresistible urges to pull out strands of hair. Sometimes Trichotillomania results in bald patches or even complete baldness. People with this problem often report feeling some pleasure from pulling hairs, whereas others say their main motivation is a reduction in anxiety or distress.

Treatment of Impulse Control Disorders has lagged behind the treatment of many other emotional disorders such as depression, anxiety, and obsessive compulsive disorder. A just published a preliminary study from the University of Minnesota (in the journal Archives of General Psychiatry) which found that an amino acid reduced symptoms of Trichotillomania. Much more research is needed before we get too excited about this finding. There are also some indications that treatments such as Habit Reversal Training may have value for Trichotillomania. However, most of the Impulse Control Disorders beg for more research on potential treatments.

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Elyssa Durant (July 9, 2009)

Prof.Lakshman (July 9, 2009)

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    Last reviewed: 9 Jul 2009