The "Diagnostic and Statistical Manual of Mental Disorders Fourth Edition, Text Revision"--or DSM-IV-TR--defines Impulse control disorder as the inability to restrain activity which typically results in harm to oneself or others. An impulse control disorder can be initiated by anxiety and stress; post-traumatic stress; onset of schizophrenia; pyromania, or the desire to set fires; trichotillomania, or compulsive hair pulling; intermittent explosive disorder, or having aggressive impulses; kleptomania, uncontrolled desire to steal; pathological gambling; sexual deviance, road rage; or cutting and other self-injurious behaviors.
Pharmacotherapy
Psychopharmacotherapy--the use of drugs to treat symptoms accompanying a mental disorder--is not perfect or a cure-all, but the can certainly help. Drugs used in the treatment of impulse control disorders can include selective serotonin reuptake inhibitors, lithium and anticonvulsants. The University of Minnesota Impulse Control Disorder Clinic also prescribes opioid antagonists to reduce cravings in those with comorbid addictions such as pathological gambling.
Cognitive Behavioral Therapy
Cognitive Behavioral Therapy, or CBT, is generally used to counter impulse problems and compulsiveness involved with impulse control disorders by retraining the brain's response and pleasure perceptions. "A Brief Introduction to Cognitive Behavior Therapy" defines multiple methods used under the CBT umbrella as Rational Behavior Therapy, Multimodal Therapy, Dialectical Behavior Therapy and Schema Therapy. Each therapy has a common underlying goal--to alter the way individuals perceive their environment and change thought processes accordingly.
Acute Inpatient Treatment
Acute inpatient treatment services take place in a structured, controlled, 24-hour setting in a hospital or other approved clinical environment. The City of Philadelphia's Behavioral Health Services Division describes service protocols involved with acute inpatient treatment as a multimodal approach that includes stabilization and emergency psychiatric treatment, psychotherapy, CBT, family therapy and social services, daily psychiatric nursing evaluations, daily care by a Board Certified psychiatrist and medication management. Other inpatient offerings typically include daily living skills mastery, outreach and social supports needed to stabilize behaviors in the home environment to maintain safety after release, establish a medication and outpatient therapy routine, and to work on setting and achieving goals.
References
- "Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition, Text Revision"; American Psychological Association; 2004
- University of Minnesota Impulse Control Disorder Clinic; Principles of Treatment; 2010
- "A Brief Introduction to Cognitive Behavior Therapy"; Froggatt, W.; February 2006
- City of Philadelphia Behavioral Health Services: Acute Inpatient Treatment
