DR.

RAM MANOHAR LOHIYA NATIONAL LAW UNIVERSITY, LUCKNOW

2018-2019

PSYCHOLOGY PROJECT

TOPIC: IMPULSE CONTROL DISORDERS

SUBMITTED TO: SUBMIITED BY:

Ms. Isha Yadav Simran Yadav
Assistant Professor 180101136
Law Faculty (RMLNLU) Section –B
Ist Year, IInd Semester
B.A.LL.B.(Hons.)

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 TABLE OF CONTENTS

1. Acknowledgement…………………………………………………………………………….2.

2. Objective………………………………………………………………………………………4.

3. Research question……………………………………………………………………………..4.

4. Introduction……………………………………………………………………………………5.

5. Kleptomania……………………………………………………………………………………9.

6. Pyromania………..…………………………………………………………………………..14.

7. Conclusion……..……………………………………………………………………………..18.

8. Reference……………………………………………………………………………………..19.

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 ACKNOWLEDGEMENT

I would like to use this opportunity to extend my heartiest gratitude to all the people who have
helped me develop this project.
First and foremost, I would like to thank my Psychology professor, Ms. Isha Yadav, who has
been constantly supporting me, guiding me and helping me with all queries and difficulties
regarding this project since its fledging stage. Without her enthusiasm, inspiration and efforts to
explain even the toughest of jargons in the most lucid manner, the successful inception of this
project would have been a Herculean task. 
Next, I would like thank the librariarns of Dr. Madhu Limaye library for helping me find the
correct resources for my research and for helping me enrich my knowledge.
Finally, I would like to extend my gratitude to my batch mates and seniors for providing me
some unique ideas and insights which helped me make this project even better.
I know that despite my sincerest efforts some discrepancies might have crept in, I hope and
believe that I would be pardoned for the same.

Thanking You

Simran Yadav

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 OBJECTIVE

 To understand about the meaning and various types of impulse control disorders, symptoms
of ICD in people and how it affects different genders also about its treatment . To analyze
more about how ICDs had impact on lives of some people through some case studies.

RESEARCH QUESTION

 What are the causes, symptoms and treatment of Impulse Control Disorder?
 How Impulse Control Disorders affect the people of different age groups and different
gender differently ?

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 INTRODUCTION

As humans, the ability to control our impulses-or urges-helps distinguish us from other species
and marks our psychological maturity. Most of us take our ability to think before we act for
granted. But this isn’t easy for people who have problems controlling their impulses. People with
an impulse control disorder can’t resist the urge to do something harmful to themselves or others.
Impulse control disorders include addictions to alcohol r drugs, eating disorders, compulsive
gambling, paraphilias sexual fantasies and behaviors involving non-human objects, suffering,
humiliation or children, stealing, fire setting and intermittent explosive attacks of rage.

Some of these disorders, such as intermittent explosive disorder, kleptomania and pyromania are
similar in terms of when they begin and how they progress. Usually, a person feels increasing
tension or arousal before committing the act that characterizes the disorder. During the act, the
person probably will feel pleasure, gratification or relief. Afterward, the person may blame
himself or feel regret or guilt. People with these disorders may or may not plan the acts, but the
acts generally fulfill their immediate, conscious wishes. Most people, however, find their
disorders highly distressing and feel a loss of control over their lives.

Impulse control disorders are characterized by four main qualities which include:

 The perpetuation of repeated negative behaviors regardless of negative consequences

 Progressive lack of control over engaging in these behaviors
 Mounting tension or craving to perform these negative behaviors prior to acting on them
 Sense of relief or pleasure in performing these problematic behaviors.

Changes to the Diagnostic and Statistical Manual of Mental Disorders, the main diagnostic tool
used by mental health professionals in the United States, from the DSM-IV to the DSM-5 place
impulse control disorders in a chapter entitled “Disruptive, Impulse Control, and Conduct

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Disorders.” The changes also moved disorders like compulsive gambling, sexual addiction, and
other addictive disorders, as well as trichotillomani, out of the impulse disorder
category, Psychiatry Advisor reports. The new chapter in the DSM-5 includes various disorders,
such as kleptomania, pyromania, intermittent explosive disorder, conduct disorder, antisocial
personality, and oppositional defiant disorder. All of these disorders may interfere with a
person’s ability to function in daily life as they all include issues with controlling impulses and
harmful behavior towards others.
Males may be slightly more prone to impulse control disorders than females, according to Psych
Central, and these disorders may commonly co-occur with other mental health disorders or with
issues involving substance abuse. Impulse control disorders may be regularly overlooked or
misdiagnosed, meaning that many individuals suffering from these disorders may not always get
the help they need. A better understanding of the disorder can help close the treatment gap and
get individuals proper care for improving symptoms. Treatment for impulse control disorders
may be largely therapeutic in nature, with behavioral therapies frequently implemented and
medications also potentially beneficial.

Some common impulse control disorders are:

 Compulsive Buying Disorder

 Pathological Gambling
 Hyper sexuality
 Compulsive Eating
 Kleptomania
 Pyromania
 Intermittent Explosive Disorder (Compulsive Violent Outbursts)

What Causes Impulse Control Disorders?

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Impulse control disorders are likely caused from a combination of biological, social and
psychological factors. Researchers believe that this disorder is caused by a neurotransmitter
imbalance in your brain. Studies also support the theory that hormone imbalances can lead to
risky behaviors commonly associated with impulse control disorders such as violent and/or
aggressive tendencies.

Common Impulse Control Disorder Symptoms:

The symptoms of an impulse control disorder vary depending on the specific problem. In all
cases, you will be unable to control your actions despite knowing that these behaviors will likely
produce negative consequences. In some cases, it can be difficult to distinguish between healthy,
controllable impulsive behaviors and this disorder because the consequences vary so greatly. For
example, a very wealthy person may not be significantly affected financially by a compulsive
buying disorder, but a low-income individual may suffer serious financial difficulties from the
disorder.
Person suffering from ICDs usually shows following symptoms:

 The perpetuation of repeated negative behaviors regardless of negative consequences

 Progressive lack of control over engaging in these behaviors
 Mounting tension or craving to perform these negative behaviors prior to acting on them
 Sense of relief or pleasure in performing these problematic behaviors

Distinguishing Features of Any Impulse Control Disorder:

 You perform the impulsive act alone.

 You engage in the impulsive activity fully knowing that it will produce consequences, such
as harm to self or others.
 Before the act, you feel tense and/ aroused.
 You become incredibly excited during the act.
 After the act, you are filled with guilt and/or shame.
 You feel out of control in regards to your actions.

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How Are Impulse Control Disorders Treated?

Impulse control disorders hare typically treated with a combination of psychotherapy, behavioral
modification therapy and pharmacology. With cognitive therapy, you are encouraged to identify
your behavioral patterns and the negative consequences associated with those behaviors.
Behavioral modification therapy teaches you how to avoid the situation and use self-restraint
techniques to expose the situation.
Exposure therapy helps you gradually build up a tolerance to the situation while exercising self-
control. For example, if you have a pathological gambling disorder, you may first be shown
pictures of a Blackjack table and then given a deck of cards to hold. Over time you will work
your way to standing inside the casino without gambling.

The FDA has not approved specific medications in the treatment of impulse control disorders;
however, some medications have proven effective such as SSRI antidepressants. SSRI
medications are mu-receptor antagonists. These antagonists have gained FDA approval for
treating impulse control-related alcohol and opiate addictions. Alternative therapies such as
meditation, hypnotism, and herbal remedies have also proven beneficial in treating impulse
control disorders.

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 KLEPTOMANIA

Kleptomania is a psychological disorder. The characteristic feature of this disease is an

irresistible urge to steal things, which are not needed or of not much value to the person, who is
stealing them. It is a psychological condition and is not due to any flaw in the person’s character.
One of the causes of this disorder includes emotional disturbances.
Kleptomania is a rare disorder, affecting 0.3%- 0.6% of people, all over the world. It is seen in
people of all age groups, especially in teenagers or young-aged adults.
Kleptomania is more common in women than in men. There is no cure for this psychological
disorder, but treatment options are available to reduce or completely stop the constant feeling to
steal something.

WHAT IS KELPTOMANIA?

People who are kleptomaniac have this symptom of stealing something; they do this act without
any intention or need of the items for them, and they can buy things easily.
It is a type of impulse control disorders (a type of mental illnesses) that involve the failure to
resist impulses to act in a way, which is dangerous to self or for the people around them.
Kleptomaniacs are different from shoplifters. The shoplifters steal things intentionally, but the
kleptomaniac people steal unintentionally. Kleptomaniacs do not get any material benefits out of
their act of stealing, because most of them either return or donate the items.

CAUSES OF KLEPTOMANIA:
Causes of kleptomania are not clearly known. However, some of the following factors
responsible for the condition are:

 Alteration in the levels of serotonin, a chemical in the brain, that regulates moods and
emotions
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 Imbalances in the opioid system of the brain, which mainly regulates the feeling of urges
 Release of chemicals like dopamine from the brain, reward the person with a feeling of
pleasure, during the act of stealing and triggers the recurrence of the urge to steal.
 Psychological depression
 Obsessive-compulsive disorders
 Stress either at home or work

DSM-IV-TR DIAGNOSTIC CRITERIA FOR KLEPTOMANIA:

A. Recurrent failure to resist impulse to steal objects that are not needed for personal use or for
their monetary value.
B. Increasing sense of tension immediately before committing the theft.
C. Pleasure, gratification, or relief at the time of committing the theft.
D. The stealing is not committed to shoe anger or vengeance and is not in response to a delusion
or hallucination.
E. The stealing is not better accounted for by conduct disorder, a maniac episode or antisocial
personality disorder.

FEATURES OF PEOPLE WITH KELPTOMANIA:

 People with kleptomania have some common characteristics:

 They do not steal because of any personal gain or as an act of dare or revenge.
 Most of them either return or donate the stolen items.
 They do not have any prior plan to steal, the action is made involuntarily or suddenly.
 They do not have any financial problems to buy the things that they steal.
 Most of them have this urge to steal on and off, and the feeling keeps recurring.

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 They mostly steal from public places like supermarkets.

TREATMENT FOR KELPTOMANIA:

Treatment for kleptomania is essential as this disease is not self-limiting type. If any patient with
the disease symptoms is not treated on time, it may become a life-long psychological disorder.

Treatment includes both medical management and psychiatric therapy or psychotherapy.

Medical Management:
This type of treatment includes the use of drugs like naltrexone, to reduce the symptoms of
urge to steal. These drugs act on chemicals like opioids of the brain to prevent the urge to
steal.
Anti-depressants like fluoxetine are administered to relax and calm down the brain.
Psychological medications may show some side-effects like nausea, vomiting and
drowsiness.

Psychiatric Treatment:
It includes behavioral modification therapy or talks therapy.

Some of the important techniques of this therapy include:

 Patients will be instructed to imagine the consequences of the urge to steal,

negatively as being punished for the theft.
 The patients are taught to deviate their concentration when the symptoms of the
urge to steal start.
 Instructions are also given on the practice of relaxation techniques like deep
breathing techniques when the patient’s brain triggers the urge to steal
something.

Psychological Counseling or Therapy: Counseling or therapy may be in a group or one-on-one

setting. It is usually aimed at dealing with underlying psychological problems that may be
contributing to kleptomania. Possible treatments include:

 Behavior modification therapy
 Family therapy
 Cognitive behavioral therapy

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 Psychodynamic therapy

Family therapy also helps to relieve the disease symptoms. It involves, engaging the patient with
family and peer group for most of the time.

CASE STUDY

CASE 1: A 60-year-old, divorced Indian woman who had completed Primary 6 education and
had various manual jobs, started shoplifting from the age of 30. She had multiple convictions of
theft and several remand admissions. She was diagnosed with recurrent depression. She reported
acts of stealing both during and outside her depressive episodes. The acts of stealing were
typically due to failure to resist the tension and strong urge to take the items without paying, and
feeling satisfied after taking them. The items typically were of no use to her. She stated that the
acts of shoplifting helped to lift her mood temporarily during the depressive episodes. However,
she would later feel guilty, which subsided when she either threw away or gave the items to
others. Regarding her shoplifting behaviours when she was not suffering from depressive
episodes, she stated she could recognise that her mood would be marginally low during those
times but she was still able to function normally. The diagnostic criteria for kleptomania do not
exclude depressive disorders as a contributory factor for the diagnosis of kleptomania. This case
illustrates that depressive disorder is closely linked to kleptomania and makes us think whether
kleptomania may represent another form of affective spectrum disorder.

CASE 2: A 23 years old female reported stealing behviour since the age of 5 years. She stole
money when she was presented with an opportunity and without any premeditation despite
having no financial difficulities. The impulse to steal arouse upon seeing money. She had
difficulty in controlling the impulses. The increased tension befor the theft was followed by a

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sense of relief and pleasure after stealing.she did not have impulse in presence of the others. At
times she tried to resisit the urge. Although there wassome degree of shame and guilt . she did
not feel persistent and unbearable guilt about stealing. She stole small amount of money once or
twice a month. Her behavior was not detected until recently.after an act of stealing was
discovered she had to leave her workplace.

The patient was commenced on a Selective Serotonin Reuptake Inhibitor (SSRI), fluoxetine 20
mg which was increased to 40mg a day. Initially a benzodiazepine was added due to insomnia.
Exposure and response prevention techniques were used in her management: she was exposed to
money kept at random places, at home, without her prior knowledge. This was done after
educating the patient and her parents about exposure and response prevention. The techniques of
covert desensitisation were also used to further strengthen her ability to resist the impulses. A
major component of management involved dealing with family members who expressed a high
level of emotions regarding her symptoms. Her feelings of guilt and abandonment subsequent to
the discovery of stealing behaviour and the social consequences were dealt with supportive
psychotherapy. The patient initially found the thought to steal difficult to resist. However, with
repeated exposure to money, she was able to resist the compulsion completely after 12 sessions.
She only developed thoughts of stealing infrequently. After completion of the course of therapy
she was reviewed monthly. Currently, after six months of treatment, she remains well with no
recurrence of symptoms.
Studies using clinical samples have consistently reported that the majority (approximately two-
thirds) of kleptomania patients are women.Without epidemiological data, however, the true
percentage of men and women with kleptomania remains unknown. Some have suggested that
greater numbers of females seek treatment for kleptomania because men are more likely to be
sent to jail if caught shoplifting.12

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 PYROMANIA

Pyromania is an obsessive desire or irresistible impulse to set fire to things. 

CAUSES OF PYROMANIA:

In looking at what causes pyromania there are two groups of factors—individual and
environmental.

When considering the individual causes of pyromania, a person’s social life and
experience are some of the most important factors. Some examples would be:

 Being the victim of bullying

 Lack of social supports including siblings or friendships
 Lack of attention from adult caregivers
 Inappropriate sexual urges

Environmental factors include early-life traumas and witness to pyromaniac behaviors

as a child. For example, pyromania may be caused by:

 Experiencing neglect as a child

 Victim of physical or sexual abuse as a child
 Watching older adolescents and adults set fires frequently

These factors that may cause pyromania are relatively common traits. Thus, it should
not be assumed that someone with these traits is fated to be a pyromaniac. People
diagnosed with pyromania disorder have a marked inability to control impulses and
typically have several of these causative factors.

DSM-IV-TR DIAGNOSTIC CRITERIA FOR PYROMANIA:

A. Deliberate and purposeful fire setting on more than one occasion.

B. Tension or affective arousal before the act.

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C. Fascination with, interest in, curiosity about or attraction to fire and its situational contexts
(e.g., paraphernalia, uses and consequences).
D. Pleasure, gratification or relief when setting fire, or when witnessing or participating in their
aftermath.
E. The fire setting is not done for monetary gain, as an expression of sociopolitical ideology, to
conceal criminal activity, to express anger or vengeance, to improve one’s living
circumstances, in response to delusion or hallucination , or as a result of impaired judgment
(e.g., dementia, mental retardation, substance intoxication).
F. The fire setting is not better accounted for by conduct disorder, a maniac episode, or
antisocial personality disorder.

PYROMANIACS HAVE THE FOLLOWING FEATURE :

 Previously occurred episodes of arson or attempts to start a fire without any motives and
material purposes. Psychiatrists will talk about the disease only if a person committed at least
two unmotivated incendiaries;
 Preparing for an arson, a pyromaniac feels excitement and tension that recedes after the
realization of the conceived;
 The patient enjoys the sight of fire;
 A pyromaniac constantly thinks about objects related to fire, the child’s interest can be
manifested in drawings, conversations, and games;
 A person suffering from pyromania can call the fire department, reporting on non-existent
fires;
 A pyromaniac is haunted by obsessive thoughts about how and where to set another fire;
 Observing the flame, the patient may experience sexual arousal.

Often, pyromania occurs along with other disorders, for example, alcoholism. Such patients in a
state of intoxication can become completely uncontrollable and cause great harm, seeking to set

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a fire to a particular object. In addition, such people never take responsibility for what they have
done.
It is worth noting that it is not always easy to diagnose a person with pyromania. So, it is
necessary to differentiate the described mental disorder with deliberate arson in the absence of
deviations in the psyche.

PYROMANIA TREATMENT:

There has been limited research conducted on pyromania treatment due to it being a
rare condition. Treatment of pyromania has been based largely on accepted treatments
for other impulse control disorders. When considering the most appropriate treatment
for pyromania, most consider medication and cognitive behavioral therapy to be the go-
to options.

a) Medications for Treating Pyromania: this time there have been no studies conducted on
medication for pyromania. While there is no medication specifically indicated for
pyromania there are several classes of medication that have been used with moderate
success.
b) Antidepressants  –  Antidepressants have been used in some cases under the rationale
that the underlying cause of pyromania is likely to stem from traumatic events and
feelings of depression or isolation. Some theorize that by treating the emotional trigger
for pyromania that a pyromaniac may not feel the same level of intensity a desire to set
fires.
c) Mood Stabilizers  –  Mood stabilizers, like antidepressants, have been utilized due to
commonly accepted theories on what causes a person to develop pyromania. Medical
professionals who advocate for the use of mood stabilizers for pyromania are focused on
the impulse control aspect of the disorder. It has been suggested that if a pyromaniac no
longer has significant mood swings they may be less likely to feel the need to set fire to
release emotional pain.

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 d) Antipsychotics  –Some believe that pyromaniac fire setting occurs as a form of
psychotic behaviors. The thought is that antipsychotic medication may prevent a person
from losing touch with reality and as a result, prevent fire-setting behaviors.

Therapy for Treating Pyromania:

While there is no evidence-based therapeutic approach for treating pyromania, there have been
some promising results from the use of cognitive behavioral therapy.

Cognitive Behavioral Therapy:

The Diagnostic and Statistical Manual of Mental Disorders, more commonly known as the DSM,
only mentions one possible course of treatment for pyromania in the most recent edition. This
approach called cognitive behavioral therapy works to identify how a person’s thoughts, feelings,
and behaviors are intertwined. Cognitive behavioral therapy involves challenging thoughts and
beliefs that may be inaccurate to create behavioral change. It has been suggested that if a
pyromaniac is able to learn to identify when they are experiencing the early stages of emotional
tension building up, they can cope and release these emotions in a healthier way. It may also be
possible for a person to identify faulty thinking patterns that have led to their fire-setting. If
challenged and a new effective philosophy replaces the faulty belief, a person may no longer feel
the compulsion to set fires.

CASE STUDY:

 20 yr. old homeless male

 Informally admitted to a psychiatric unit after reports of fire setting
 Previous history of fire setting as a child

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  Admission staff noted low mood associated with anhedonia, reduced motivation, and
cognitive depressive symptoms
 Within first three weeks, hospital staff noticed affective arousal, followed by feelings of
gratification and tension reduction during JO's fire setting episodes
 Doctor's concluded that JO's arousal was based on the "idea" of fire setting rather than the
harm/damage it caused Fire setting created a temporary lift out of lethargy. Kelly, B.D.
(2005,June 1).

Pyromania can take place in children as young as three years old. Only a small proportion of
children and adolescents apprehended for arson are suffering from pyromania. Ninety percent of
individuals diagnosed with pyromania belong to the male population.
In a survey participated by 9,282 Americans using DSM-IV-TR, individuals suffering
from impulse control disorders, collectively affected 9% of the entire population.

CONCLUSION

Impulse control disorders are quite rare but involve compulsive acts that may be harmful to the
individuals as well as to the others. Clinical symptoms include the inability to function socially
or occupationally in response to psychosocial stressor. Impulse control disorders hare typically
treated with a combination of psychotherapy, behavioral modification therapy and
pharmacology. With cognitive therapy, you are encouraged to identify your behavioral patterns
and the negative consequences associated with those behaviors.
Behavioral modification therapy teaches you how to avoid the situation and use self-restraint
techniques to expose the situation.

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Exposure therapy helps the patients gradually build up a tolerance to the situation while
exercising self- control.

BIBLIOGRAPHY

WEBSITES:

 (what-are-impulse-control-disorders) (Placeholder1). (n.d.). Retrieved from

pyshcentral.com: https://pyschcentral.com/lib/ (what-are-impulse-control-disorders)
(Placeholder1)/
 conditions/pyromania. (n.d.). Retrieved from www.psychologytoday.com:
https://www.psychologytoday.com/us/conditions/pyromania

 Impulse+Control+Disorders. (n.d.). Retrieved from medical-

dictionary.thefreedictionary.com: https://medical-
dictionary.thefreedictionary.com/Impulse+Control+Disorders
 what-are-impulse-control-disorders. (n.d.). Retrieved from psychecentral.com: https://lib/
 co-occurring-disorders/impulse-control-disorder. (n.d.). Retrieved from
americanaddictioncenters.org:  https://americanaddictioncenters.org/co-occurring-
disorders/impulse-control-disorder

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  doi/abs/10.1176/appi.books.9780890425596.dsm15. (n.d.). Retrieved from
dsm.psychiatryonline.org:https://dsm.psychiatryonline.org/doi/abs/10.1176/appi.books.97
80890425596.dsm15

BOOKS:

 Butcher, C. &. Abnormal Psychology.

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