Welcome to the World of Impulse Control Disorders!
Have you ever felt a sudden urge to do something, like eat a chocolate bar or check your phone, even though you knew you shouldn't? Most of us can say "no" to these urges. However, for some people, these impulses become so powerful that they can't stop themselves, even if it ruins their lives. In this chapter, we will explore Impulse Control Disorders (ICDs) and Non-Substance Addictive Disorders. We’ll look at what they are, why they happen, and how psychologists try to treat them.
Don't worry if this seems like a lot of information! We’ll break it down into simple steps: the What (characteristics), the Why (explanations), and the How (treatments).
Section 1: Types and Characteristics
First, we need to know exactly what we are talking about. The syllabus focuses on three main types of disorders where people struggle to control their behavior.
1. Kleptomania
This is the compulsive urge to steal things. But here is the catch: the person doesn't steal because they need the item or because it's expensive. Often, they steal things they could easily afford or things they don't even want!
Example: Someone with kleptomania might steal a single paperclip or a cheap pack of gum just to satisfy the urge.
2. Pyromania
This is the compulsive urge to set fires. Again, this isn't for money (like insurance fraud) or for revenge. The person feels a huge amount of tension before the fire and a sense of "relief" or "pleasure" once the fire is burning. They are often fascinated by everything to do with fire (fire engines, burnt buildings, etc.).
3. Gambling Disorder
Unlike the others, this is a non-substance addictive disorder. It’s like being addicted to a drug, but the "drug" is the thrill of betting. People with this disorder continue to gamble even when they lose all their money, lie to their families, and lose their jobs.
How do we measure it? The K-SAS
Psychologists use the Kleptomania Symptom Assessment Scale (K-SAS). It is a 11-item self-report scale. It asks patients about:
• How strong their urges to steal are.
• How much time they spend thinking about stealing.
• How much distress the urges cause.
Quick Tip: Remember that because it's a self-report, it relies on the patient being honest! This is a common evaluation point in Psychology.
Quick Review: ICDs involve a cycle of Tension → Action → Relief. It is the "rush" that people are addicted to, not the object itself.
Section 2: Explanations – Why does it happen?
Psychologists look at the brain (Biological), our rewards (Behavioral), and our thoughts (Cognitive) to explain these disorders.
The Biochemical Explanation (Dopamine)
Think of Dopamine as the brain’s "reward chemical." Whenever we do something fun, our brain releases dopamine, and we feel great.
In people with ICDs, their "reward system" might be broken. They might have low levels of dopamine normally, so they perform impulsive acts (like stealing or gambling) to get a massive "hit" of dopamine to feel "normal" or happy. This is often called the Reward Deficiency Syndrome.
The Behavioral Explanation (Positive Reinforcement)
This is all about Learning. If you do something and get a reward, you are likely to do it again.
• Action: You bet on a horse.
• Reward: You win $50!
• Result: Your brain associates gambling with a "win," and you want to repeat the behavior. Even if you lose later, the memory of that one big win keeps you going. This is a powerful type of Operant Conditioning.
The Cognitive Explanation (Feeling-State Theory)
Miller (2010) suggested that these disorders happen because a feeling gets "glued" to a specific behavior.
Imagine a person feels powerful while they are shoplifting. According to Miller, the "Feeling-State" of Power and the Act of Stealing become one single memory. Later, whenever the person feels weak or bored, their brain tells them: "Hey, remember that 'Power' feeling? You need to go steal something to get it back!"
Key Takeaway: It’s not just one thing! It’s a mix of brain chemicals (Biology), rewards (Behavior), and "glitched" memories (Cognitive).
Section 3: Treatments – How can we help?
Now that we know the "Why," how do we fix it? We have three main paths.
1. Biochemical Treatment (Opiate Antagonists)
Grant et al. (2008) used a drug called Naltrexone.
How it works: Naltrexone is usually used for alcohol or drug addiction. It blocks the "high" in the brain. If a gambler takes this drug and then gambles, they won't feel that rush of excitement.
The Study: They found that participants taking Naltrexone had a significant reduction in their gambling symptoms compared to those taking a placebo (a fake pill).
Analogy: It’s like eating your favorite cake but not being able to taste the sugar. Eventually, you'll stop wanting the cake.
2. Covert Sensitization (Glover, 2011)
This is a behavioral therapy. Covert means "in your mind." Sensitization means "making you sensitive/disgusted."
In this study, a woman who compulsively stole was told to imagine she was about to steal, but then to imagine becoming violently nauseous and vomiting all over the counter and the shopkeeper.
By repeatedly imagining something disgusting paired with the act of stealing, her brain eventually started to associate stealing with being sick instead of with a "rush."
3. Imaginal Desensitization (Blaszczynski and Nower)
This is used for gamblers. It involves three steps:
1. Relaxation: The patient learns how to relax their muscles.
2. Visualization: They imagine a situation where they feel the urge to gamble (e.g., walking past a casino).
3. Walking away: While relaxed, they imagine themselves not gambling and leaving the situation calmly.
This "retrains" the brain to handle the urge without acting on it.
4. Impulse Control Therapy (Miller, 2010)
This goes back to the Feeling-State Theory. The goal is to "un-glue" the feeling from the behavior. The therapist helps the patient identify the specific "feeling" (like 'I am a winner') and uses Eye Movement Desensitization and Reprocessing (EMDR) to help the brain process that memory differently so the urge disappears.
Common Mistake to Avoid: Don't confuse Covert Sensitization with Imaginal Desensitization!
• Covert Sensitization = Imagine something gross/bad happening.
• Imaginal Desensitization = Imagine relaxing and walking away.
Final Summary Table
Disorder: Kleptomania, Pyromania, Gambling.
Measure: K-SAS (Self-report).
Bio Explanation: Dopamine / Reward Deficiency.
Bio Treatment: Opiate Antagonists (Naltrexone).
Cognitive Explanation: Feeling-State Theory (Miller).
Behavioral Treatment: Covert Sensitization (Glover).
Well done! You’ve just covered the core of Impulse Control Disorders. Remember, the key to Psychology is understanding how these different "approaches" (Biological, Cognitive, Behavioral) all try to solve the same puzzle in different ways.