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| Impusle control disorders | inability to resist behaviors that may bring harm to oneself or others; pts may or may not try to suppress their impulse and may not feel remorse or guilt after they have acted out; they have anxiety before the impulse and relief/satisfaction after action
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| DSM-IV criteria for Intermittent Explosive Disorder | fail to resist aggressive impusles that result in assault or property destruction; level of aggressiveness is out of proportion to any triggering events; events remit quickly/spontaneously and pt usually feels remorseful
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| Epidemiology of Intermittent Explosive Disorder | more common in men; onset often in late teens or twenties; may progress in severity until middle age
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| Etiology of Intermittent Explosive Disorder | Genetics, prenatal, environmental, neurobiological; pts may have history of child abuse, head trauma, or seizures
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| Treatment for Intermittent Explosive Disorder | SSRIs, anticonvulsants, lithium, propanolol; individual psychotherapy is difficult and ineffective, but group/family therapy may be useful
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| altered neurochemical levels in Intermittent Explosive Disorder | low serotonin
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| DSM-IV criteria for Kleptomania | failure to resist urges to steal objects that are not needed for personal or monetary reasons; pleasure/relief is experienced while stealing; purpose of stealing is not to express anger and is not d/t hallucinations or delusions
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| Epidemiology of Kleptomania | more common in women; under 5% of shoplifters; often occurs during time of stress; increased incidence of mood disorders, eating disorders, and OCD; usually chronic
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| Etiology of Kleptomania | biological factors and childhood family dysfunction
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| Treatment of Kleptomania | insight-oriented psychotherapy, behavior therapy (systematic desensitization and aversive conditioning), SSRIs, some anecdotal evidence for naltrexone use
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| DSM-IV criteria for pyromania | 1+ episode of intentional fire setting; tension present before act relieved by the act (or pleasure); fascination with or attraction to fire, it's uses and consequences; purpose of fire-setting is not for monetary gain, anger, politics, hallucination/delu
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| Epidemiology of Pyromania | more common in men and MR; prognosis better in children (often recover completely)
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| treatment for Pyromania | behavior therapy, supervision, SSRI
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| DSM-IV criteria for pathological gambling | 5+: preoccupied; need to use inc $ to get pleasure; restless/irritable if try to stop; gamble to escape probs/dysphoria; try reclaim losses; lying to hide it; illegal acts to finance; jeopardize relations/job d/t gamble; rely on others to $ support gamble
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| Epidemiology of Pathological Gambling | 1-3% of US adults; more common in men; inc. incidence of mood, anxiety, and OC disorders; predisposing factors include loss of parent in childhood, poor parental discipline in childhood, ADHD, lack of family emphasis on budgetting/saving $
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| Etiology of Pathological gambling | genetic, biological, environmental, neurochemical
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| treatment of Pathological Gambling | Gambler Anonymous is most effective; insight-oriented psychotherapy 3 months after abstinence; treat comorbid disorders (ie mood disorders, anxiety disorders, and substance abuse)
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| DSM-IV criteria for Trichtillomania | recurrent pulling out one's hair-->visible hair loss; usually scalp, but can be eyebrows,eyelashes, facial or pubic hair; tension present before action relieved by action (or pleasure); causes significant distress or impairment in daily fx
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| Epidemiology of Trichotillomania | 1-3% of population; more common in men; onset usually during childhood or adolescence, occurs after stressful even in 1/4 of patients
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| Etiology of Trichotillomania | biological, genetic, environmental
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| comorbid disorders with higher incidence in pts with trichotillomania | OCD, OCPD, mood disorders, borderline personality disorder
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| Prognosis for Trichotillomania | chronic or remitting; adult onset generally more difficult to treat
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| Treatment for Trichotillomania | SSRIs, antipsychotics, lithium, hypnosis, relaxation techniques, behavioral therapy (including substituting another behavior and/or positive reinforcement
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