Impulse Control Disorders: A Clinician’s Guide to Understanding and Treating Behavioral Addictions
Jon E. Grant
Overview—Contents—Excerpt
Several disorders have been classified in the DSM-IV as impulse control disorders, including: pathological gambling, kleptomania, intermittent explosive disorder, trichotillomania (compulsive hair-pulling), and pyromania. In addition, several other disorders have been proposed as belonging to this category, such as: compulsive Internet use, compulsive sexual behavior, pathologic skin picking, and compulsive buying. Impulse control disorders are extreme versions of behaviors that people have suffered from for centuries. In their pathological versions, these disorders are experienced by approximately 5-15% of the U.S. population. This means that between 14 and 42 million Americans have struggled with these behaviors.
The impulse control disorders have generated a remarkable amount of data supporting the claims that these are truly common and disabling behaviors. Clinicians need to understand these behaviors and how to address them. Impulse Control Disorders is the first comprehensive book on this topic for clinicians, providing clear clinical guidance on assessment, diagnosis, and treatment in a variety of modes, and follow-up.
Because many clinicians are unfamiliar with impulse control disorders, this book provides a detailed method for assessing and treating them. A screening instrument is provided, and the book provides evidence-based approaches to both pharmacological and psychosocial treatment interventions. Problems with keeping people in treatment and the role of the family are also examined. Many impulse control disorders raise legal issues that often make clinicians uncomfortable. Impulse Control Disorders examines some common legal problems associated with certain impulse control disorders.
Designed as a wide-ranging and up-to-date guide for both new and experienced clinicians, Impulse Control Disorders provides a detailed understanding of impulse control disorders and treatment options.
Contents
1. Clinical Characteristics of Impulse Control Disorders
2. Models for Understanding Impulse Control Disorders
3. The Compulsive-Impulsive Spectrum: The Compulsive Aspects of Impulse Control Disorders
4. Comorbidity with Drug and Alcohol Disorders: Understanding the Addictive Aspects of Impulse Control Disorders
5. Intermittent Explosive Disorders: Relationship to Impulse Control Disorders?
6. Etiology of Impulse Control Disorders
7. Assessment of Impulse Control Disorders
8. How to Treat Impulse Control Disorders
9. The Role of the Family
10. Legal Issues in Impulse Control Disorders
Appendix: Resources for Clinicians
Appendix: Referral Sources for Patients
Excerpt
From Impulse Control Disorders:
An understanding of impulse control disorders allows clinicians the opportunity to address common and disabling behaviors that a large number of people struggle with on a daily basis. An examination of the biology and psychology of these behaviors also affords clinicians greater comprehension of how and why people find any number of behaviors rewarding. The impulse control disorders are extreme versions of behaviors that people have engaged in for centuries—gambling, sex, acquiring possessions, etc. In their pathological versions, these disorders are experienced by approximately 5–15% (a conservative estimate) of the United States population. This means that between 14 and 42 million Americans have struggled with these behaviors. It would therefore be difficult to find someone who has not known a close friend or family member who suffers from an impulse control disorder. More than an academic interest, clinicians need to understand these behaviors and how to address them.
Clinical ignorance surrounds these disorders and may reflect their complexity. What does it mean that someone cannot stop their behavior? Some may argue that people with these behaviors must not be trying hard enough to control themselves or that they lack will power or have a character flaw. Many clinicians may not even consider these disorders to be legitimate psychiatric conditions. Some might argue that psychiatrists are attempting to pathologize poor judgment or personal deficits beyond the scope of medicine.
These complaints misunderstand impulse control disorders and the growing evidence of the neurobiology of these disorders. Although these disorders leave use with many still unanswered questions, strong evidence supports the genetic and neurochemical basis underlying these behaviors. These complaints also further stigmatize these behaviors and the people who suffer from them. The embarrassment associated with these disorders make it difficult for people to voluntarily offer information about their behaviors. Clinicians therefore need to ask about these disorders and do so in a knowledgeable and supportive manner. This book should provide the information clinicians need to begin addressing these disorders.
About the Author
Jon E. Grant, J.D, Ph.D., MPH, is Associate Professor of Psychiatry at the University of Minnesota. Dr. Grant runs an outpatient clinic for impulse control disorders at the University of Minnesota in Minneapolis, MN. An author of over 100 peer-reviewed articles, Dr. Grant is also the editor-in-chief of the Journal of Gambling Studies. He lives in Minneapolis, Minnesota.
ISBN 10: 0-393-70521-8
ISBN 13: 978-0-393-70521-8
January 2008; 288 pages; Hardcover
