4.3 Impulse Control Disorders

2026 📋 Syllabus Objectives

By the end of this topic, you should be able to:

  1. Describe the diagnostic criteria for kleptomania, pyromania, and gambling disorder — and know what the K-SAS is.
  2. Explain impulse control disorders using biological explanations (dopamine) and psychological explanations (behavioural/positive reinforcement; cognitive/Miller's feeling-state theory).
  3. Describe treatments and management, including biological treatments (drugs vs. placebo — Grant et al., 2008) and psychological treatments (covert sensitisation, imaginal desensitisation).

📖 Main Content

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What Is an Impulse Control Disorder?

An impulse control disorder is a mental health condition where a person repeatedly fails to resist a strong urge or impulse to do something, even when that behaviour is harmful — to themselves or others. The person usually feels a growing tension before performing the act, and then a sense of pleasure or relief while doing it. Afterwards, they may feel guilt or shame. These disorders are not about making a deliberate choice to misbehave — the person genuinely struggles to stop themselves.

Objective 1: Diagnostic Criteria

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Diagnostic criteria means the specific signs and symptoms a person must show for a doctor or psychologist to say they have a particular disorder.

🔹 Kleptomania

Kleptomania is the repeated failure to resist urges to steal objects — even objects the person does not need and could easily afford to buy.

Key diagnostic features:

  • The person feels a growing sense of tension just before stealing.
  • They feel pleasure, gratification, or relief at the moment of stealing.
  • The stealing is not done out of anger, revenge, or to gain money.
  • The stealing is not caused by another mental health condition (e.g., hallucinations or delusions telling them to steal).
  • The person may feel guilt, shame, or remorse afterwards — but still cannot stop.

💡 Simple example: Someone with kleptomania might steal a small item from a shop, even though they have plenty of money in their pocket and do not want or need the item. The act of stealing itself provides a release of tension.

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