Introduction to Impulse Control Disorders

The Diagnostic and Statistical Manual of Mental Disorders includes a chapter on “Impulse-Control Disorders Not Elsewhere Classified”. Because we aim to mirror the DSM when this is practical, we offer this Impulse Control Disorders topic center.

The impulse control disorders are a loosely grouped set of conditions that have in common that they all centrally feature behavior that is acted out in an uncontrolled, and impulsive manner that often has self-destructive consequences. The DSM lists the following impulse control disorders:

• Intermittent Explosive Disorder (characterized by uncontrolled fits of extreme anger and violence)
• Kleptomania (characterized by irresistible urges to steal various items from stores and homes)
• Pyromania (characterized by irresistible urges to set fires)
• Pathological Gambling (characterized by compulsive, uncontrollable gambling)
• Trichotillomania (characterized by uncontrollable hair twisting and pulling, often resulting in bald spots on an otherwise normal-haired person)

The DSM treats the Impulse-Disorder category as a ‘catch-all’; other disorders involving irresistible urges exist, but are better treated as part of other ‘families’ of disorders. Although not listed here, impulse-control problems are at the heart of substance abuse disorders (addiction to alcohol or drugs), and many of the paraphillia/perversion sexual disorders (exhibitionism, frotterism, child molestation, etc.). DSM offers a sometimes arbitrary system of organization and classification, it’s true – but it mostly works.