Five Impulse Control Disorders

Medically reviewed by Karen Foster, LPC
Updated April 16, 2024by BetterHelp Editorial Team
Content warning: Please be advised, the below article might mention trauma-related topics that include abuse which could be triggering to the reader. If you or someone you love is experiencing abuse, contact the Domestic Violence Hotline at 1-800-799-SAFE (7233). Support is available 24/7. Please also see our Get Help Now page for more immediate resources.
The American Psychological Association (APA) defines impulse control disorder as “a disorder characterized by a failure to resist impulses, drives, or temptations to commit acts that are harmful to oneself or to others.”

Those who experience an impulse control disorder might repeatedly perform tasks or seek out severe behaviors regardless of adverse consequences for themselves and others. They may do this to relieve pressure or feel pleasure, and they may also experience subsequent feelings of shame and guilt. 

Below, we’ll discuss five impulse control disorders, similarities in these types of disorders, and options to treat impulse control disorders and maintain healthy interpersonal relationships for individuals who experience them. 

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Impulse control disorders

Depending on the symptom severity, impulse control disorders can potentially have a disruptive impact on the lives of those who experience them and may also affect their family, friends, and community. As with other psychiatric disorders, researchers believe that environmental and biological components can play a role in the development of impulse control disorders.

Symptoms can vary between disorders, but there tend to be some similarities. These may include obsessive and intense thoughts, acute impatience, anxiety before completing a compulsion, and an inability to resist urges. If you are navigating an impulse-control disorder, know that you are not alone, and there are treatments available. These options range from pharmacological management (medication) to talk therapy and positive reinforcement. 

The following are five impulse control disorders from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5):

Kleptomania

The APA defines Kleptomania as “an impulse-control disorder characterized by a repeated failure to resist impulses to steal objects that have no immediate use or intrinsic value to the individual, accompanied by feelings of increased tension before committing the theft and either pleasure or relief during the act.” Individuals who experience this disorder are typically not motivated by their own needs or profit, and they often disregard any negative ramifications caused by such behaviors. 

This disorder can affect people from many different age groups, and symptoms, signs, and behaviors can start as early as childhood. According to the Cleveland Clinic, kleptomania is relatively rare, affecting just 0.3%-0.6% of the population, and it has only been identified in 4%–5% of arrested shoplifters.

The causes of kleptomania are not certain, although research suggests that those diagnosed with this condition often have other co-occurring disorders and mental health diagnoses, such as anxiety, depression, eating disorders, or substance use disorders.

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. Support is available 24/7.

When someone with this condition steals, they often report shame and regret about their own behavior after doing so. Since the items stolen usually have nothing to do with want, need, or value, they may be thrown out or given away.

There is not yet an FDA-approved, dedicated medication for kleptomania or any other impulse control disorder, but some research has shown that the most effective treatment might be a combination of medication and therapeutic approaches. Because kleptomania and impulse control conditions at large often include co-occurring conditions, therapists might primarily aim treatment efforts at resolving better-understood conditions, which may in turn aid in reducing impulse-control symptoms. 

Pyromania

Considered rarer than other impulse control disorders, pyromania is characterized by the APA using the following criteria:

  • “Repeated failure to resist impulses to set fires and watch them burn, without monetary, social, political, or other motivations”

  • “An extreme interest in fire and things associated with fire”

  • “A sense of increased tension before starting the fire and intense pleasure, gratification, or release while committing the act”

Pyromania does not discriminate based on age, though late adolescence is a common onset period, with one study published in The Journal of Clinical Psychiatry showing the average age of onset was 18.

At the condition’s onset, some people may not jump straight to setting large fires. Instead, the condition may start small with easily-contained fire-setting behavior like burning papers or sticks and slowly escalate to more serious instances. Symptoms of pyromania may also unevenly ebb and flow over an individual’s lifetime.

According to the DSM-5, those experiencing pyromania do not typically set fires for monetary or social gain, political stance, or revenge purposes and do not normally act out of delusion or impairment. In other words, it doesn’t appear to be related to one specific factor in life (e.g., low socioeconomic status). Instead, in pyromania, starting fires is often directly related to the build-up and release of tension through fire setting

According to research published in The American Journal of Psychiatry, many people who start fires may not meet the criteria for pyromania. For example, someone who starts fires with criminal motives or while under the influence of alcohol or other substances likely would not meet the criteria for diagnosis despite exhibiting undesirable behavior related to fire-staring. Also, in other people who exhibit fire-starting behaviors, the presence of schizophrenia, personality disorders, or manic episodes, yet may not do so in relation to the build-up and release of tension associated with the act in pyromania. Because of its extremely low prevalence, research on pyromania is less robust than research on many other mental health conditions.

Intermittent explosive disorder

Intermittent explosive disorder is typically characterized by overwhelming aggressive outbursts that are disproportionate to what prompted them. Some of the impulses may include physical or verbal assault*, damage or destruction of property, starting physical fights, or frequent temper tantrums. These frequent, impulsive anger outbursts are not usually pre-meditated and are generally brief, lasting less than 30 minutes. 

According to the Mayo Clinic, intermittent explosive disorder can begin after the age of 6 or during adolescence. Treatment for intermittent explosive disorder may include medication (such as antidepressants) and talk therapy regarding the experience of impulsive aggression behaviors. Therapy may include cognitive behavioral therapy to help the individual identify triggers, learn to manage responses, and address psychosocial symptoms. Some therapists may also discuss the risk of community violence or deliberate and purposeful acts of aggression. 

One study in 2018 found that cognitive behavioral group therapy for psychiatric patients may be an effective means of reducing symptoms of intermittent explosive disorder (IED). The researchers concluded that “structured cognitive-behavioral group therapy, with a focus on anger management and cognitive coping, may be a promising approach to the treatment of IED.”

*If you or someone you love is experiencing verbal abuse or abuse of any kind, contact the Domestic Violence Hotline at 1-800-799-SAFE (7233). Free support is available 24/7.

Conduct disorder

Conduct disorder is included in the DSM-5 chapter on “disruptive, impulse-control, and conduct disorders,” which states that it is characterized by “a repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated.” This disorder is most diagnosed in children and youth up to age 19 and often co-occurs with ADHD. Adults who exhibit symptoms of conduct disorder might be diagnosed with antisocial personality disorder, which is similar and also related to psychosocial impairment. 

Some examples of this disorder’s impulsive behaviors include bullying or fighting, intentionally damaging or destroying other people's belongings, stealing, lying, and breaking rules. Treatment to improve outcomes for conduct disorder may include cognitive behavioral therapy, anger management therapy, and parent management training to address the symptoms of the mental illnesss and personal experiences related to them.

Oppositional defiant disorder

According to the DSM-5, oppositional defiant disorder is characterized by “a pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least 6 months,” as evidenced by interactions with someone who is not a sibling. 

According to the Cleveland Clinic, oppositional defiant disorder (ODD) affects 3.3% of children and adolescents in the United States. Individuals with ODD often have co-existing conditions, such as attention-deficit/hyperactivity disorder (ADHD), anxiety disorders, and mood disorders.

Treatments for ODD may vary according to a child’s age, symptoms, other conditions, and ability to participate in certain treatments. These may include talk therapy and school-based interventions. Also, parents of children with ODD may be asked to participate in parent management training.

Other impulse control conditions 

Impulse control disorders aren’t limited to the behaviors listed above – even if these five disorders don’t cover your behaviors, seeking help can be worthwhile. 

For example, suppose you frequently engage in risky sexual behaviors (e.g., having unprotected sex that can increase your risk of sexually transmitted diseases), excessive masturbation, and other sexual symptoms. In that case, you may be able to find treatment for hypersexuality. These symptoms could point to an impulse control disorder or a related condition like bipolar disorder. 

Likewise, suppose you feel that you’ve acted impulsively since a young age. In that case, chronic exposure to these behaviors by your caregivers may have predisposed you to such symptoms, and discussing them with a therapist could provide relief.

Getting help for an impulse control condition or disorder

If you or someone you know is experiencing an impulse control disorder, know that help is available. A licensed therapist may be able to provide a diagnosis and develop a personalized treatment plan. If the symptoms make it difficult to see a therapist in office, you might consider online therapy, which research has demonstrated to be just as effective as in-person therapy.

By signing up for online therapy, you can connect with a licensed therapist from home or anywhere you have an internet connection. You can communicate in a way that’s most comfortable for you—via phone, live chat, or videoconferencing. You may find this helpful if you experience challenging impulses in between therapy sessions.

Have questions about impulse control?

Takeaway

The DSM-5 includes five types of impulse control disorder: kleptomania, pyromania, intermittent explosive disorder, conduct disorder, and oppositional defiant disorder. These conditions vary in prevalence and symptomology, but all can have a major effect on people’s lives. If you or someone you know is experiencing impulse-related symptoms, it may help to speak with a licensed therapist, whether in person or online. With BetterHelp, you can be matched with a licensed counselor who has experience treating people with impulse control disorders, as well as their family members. Take the first step toward getting support with impulse control disorders and contact BetterHelp today.
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