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Here is a compilation of essays on ‘Impulse Disorders’ for class 11 and 12. Find paragraphs, long and short essays on ‘Impulse Disorders’ especially written for school and college students.
Essay on Impulse Disorders
Essay Contents:
- Essay on Pathologic Gambling
- Essay on Kleptomania
- Essay on Pyromania
- Essay on Intermittent Explosive Disorder
- Essay on Compulsive Buying
Essay # 1. Pathologic Gambling:
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A chronic and progressive failure to resist impulses to gamble and gambling behaviour that compromises, disrupts or damages personal, family or vocational pursuits.
Epidemiology:
The estimates in USA place prevalence at 2-3% of the adult population. The disorder usually begins in adolescence and waxes and wanes, tending to be chronic.
Clinical Picture:
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These individuals have the attitude that money is the cause and is also the solution to all their problems. As the gambling increases, the individual is usually forced to lie in order to obtain money and to continue gambling but hides the extent of the gambling.
The common predisposing factors may include: loss of parent by death, divorce or desertion before the child is 15 years of age: inappropriate parental discipline (absence, inconsistency or harshness); exposure to gambling activities as an adolescent; a high family value on material and financial symbols; and lack of family emphasis on saying, planning and budgeting.
Etiology:
Numerous theories have been invoked to explain the origin of compulsive gambling including unconscious motivations, behavioural anomalies, variant of an affective disorder, addiction and biologic abnormalities.
The common complications of pathological gambling may range from borrowing, lying, illegal acts, arrest, divorce, alcohol abuse, emotional breakdown, suicidal ideation and attempts.
Differential Diagnosis:
(i) Social Gambling
(ii) Mania or Hypomania
(iii) Antisocial Personality Disorder
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Management:
A number of diverse treatments which have been used to treat compulsive gambling are Psychoanalysis, Behavioural therapy, Cognitive therapy, medications and electroconvulsive therapy.
Essay # 2. Kleptomania:
The diagnostic feature is a recurrent failure to resist impulses to steal objects that are for immediate use or their monetary value; the objects taken are either given away, returned surreptitiously or kept and hidden.
Epidemiology:
Little is known about the epidemiology of kleptomania. The age at onset may be as early as childhood.
Clinical Picture:
The individual experiences an increasing sense of tension before committing the act and intense gratification while committing it. The diagnosis is not made if the stealing is due to conduct disorder or Antisocial Personality Disorder.
The individual often displays signs of depression, anxiety and guilt.
Etiology:
Kleptomania is believed to be dominated by the Oedipus complex-which is certainly far from accident. There is also an association of stealing with psychosocial stress. To punish others by punishing themselves; hysterical secondary gain; or in the newly poor, to keep up appearances.
Differential Diagnosis:
(i) Ordinary Stealing
(ii) Malingering
(iii) Conduct Disorder, Antisocial Personality Disorder or Mania
(iv) Schizophrenia
(v) Organic Mental Disorders
Management:
The only treatment reasonably well documented in the literature is psychoanalysis. There are reports of treating kleptomaniacs with systematic desensitization and a covert punishing contingency respectively.
Essay # 3. Pyromania:
I. Deliberate and purposeful fire-setting on more than one occasion.
II. Increased tension or affective arousal immediately before setting the fire.
III. Fascination with, interest in, curiosity about or attraction to fire.
IV. Intense pleasure, gratification or relief when setting fires or witnessing.
V. Fire setting is not done for monetary gain, as an expression of sociopolitical ideology, to conceal criminal activity, to express anger or vengeance, to improve one’s living circumstances, or in response to a delusion or hallucination.
Pyromania has been described as “motivationless arson.”
Epidemiology:
Onset is usually in childhood. The disorder is diagnosed far more commonly in males than females.
Clinical Picture:
Individuals are recognized as regular “watchers” at fires in their neighbourhoods, frequently set off false alarms and show interest in fire-fighting paraphernalia.
Etiology:
A symbolic solution to his conflict between instinct and reality. Sigmund Freud considered fire setting as a masturbatory equivalent with homosexual features.
Differential Diagnosis:
(i) Young children’s experimentation and fascination.
(ii) Conduct disorder, antisocial personality disorder.
(iii) Schizophrenia.
(iv) Organic mental disorder.
Management:
Psychoanalysis has been reported as a successful treatment in some cases.
Most behavioural researchers have used aversive therapy to treat fire setters, although some have used positive reinforcement with threats of punishment, stimulus satiation and operant structured fantasies with positive reinforcement.
Essay # 4. Intermittent Explosive Disorder:
The essential features are sudden discrete episodes of loss of control of aggressive impulses that result in serious assault or destruction of property e.g., with no or little provocation, the individual may suddenly start to hit strangers and throw furniture.
Epidemiology:
It may begin at any stage of life, but more commonly begins in the second or third decade. The disorder is apparently more common in males than in females.
Clinical Picture:
The degree of aggressivity expressed during an episode is grossly out of proportion to any precipitating psychosocial stressor. There are no signs of generalized impulsivity or aggressiveness between the episodes.
Prodromal affective or autonomic symptoms may signal an impending episode.
The changes in sensorium and subsequent amnesia (partial or spotty) may occur.
Incarceration or chronic hospitalization may result. There may also be impairment in social relations.
Etiology:
Any toxic agent such as alcohol and conditions conducive to brain dysfunction such as prenatal trauma, infantile seizures, head trauma and encephalitis may predispose to this disorder.
Differential Diagnosis:
(i) Underlying Physical Disorder
(ii) Antisocial Personality Disorder
(iii) Dissociative Disorder
(iv) Paranoid Disorder or Schizophrenia, Catatonic Type.
Management:
The underlying organic or psychosocial precipitant needs identification and treatment. The various reports indicate the usefulness of benzodiazepines, neuroleptics in lower doses, antidepressants, lithium and anticonvulsants etc. in this disorder. Psychoanalysis, behaviour therapy and hypnosis have been used with variable success.
Essay # 5. Compulsive Buying:
History:
Although many believe compulsive buying to be a recent phenomenon, it is not. In fact, German psychiatrist Emil Kraepelin wrote about “buying maniacs,” or “oniomaniacs,” nearly 100 years ago. His work is cited by Eugen Bleuler.
He may have been writing about people like Mary Todd Lincoln, whose excessive spending aroused her husband’s ire. Even after President Lincoln’s assassination, Mrs. Lincoln continued her undisciplined spending, which may have led to her confinement in a mental hospital.
More recently, Jacqueline Kennedy Onassis was said to have dismayed both of her husbands, President John Kennedy and Aristotle Onassis, which her lavish expenditures on clothes.
Imelda Marcos, the former First Lady of the Philippines, was a well-known jet-setter and clotheshorse.
Definition:
In DSM-IV, compulsive buyers are relegated to the residual category “Disorders of Impulse Control Not Otherwise Specified.”
McElroy et al., have recently developed an operational definition for clinical and research use that focuses on shopping cognitions (or preoccupations) and behaviours (Table 23.1).
Epidemiology:
The prevalence of compulsive buying in the United States has been estimated at 1.8% based on surveys using the Compulsive Buying Scale.
Etiology:
The etiology of compulsive buying is unknown. Psychoanalysts have written about deep-rooted conflicts as possibly prompting the behaviour. Krueger suggests: “The basic disorder is the absence of a stable internal self-image, so these individuals must turn to external sources to supplement deficient internal regulation.”
On the other hand, Lawrence states:
“Compulsive female shopping could be a deferred reaction to anxiety over castration, the first cognizance of the lack of a penis”.
Biologically oriented researchers have focused on its similarity with obsessive-compulsive disorder, other impulse control disorders like pathological gambling, and the mood and anxiety disorders. Other investigators have suggested that compulsive buying is similar in many respects to alcohol and drug addiction.
Comorbidity:
Compulsive buyers frequently meet criteria for other Axis I disorders on DSM-IV. In particular, mood, anxiety, substance use, and eating disorders are common.
Family History:
There is family history of mood disorder, alcohol or substance abuse, anxiety disorder or compulsive buying.
Clinical Symptoms:
See Table 23.2:
Treatment:
No controlled treatment studies have been reported for compulsive buyers. Antidepressants (SSRI’s), anxiolytics, mood stabilizers, antipsychotics have been tried in contribution with psychotherapy.
Support groups like Debtors Anonymous, patterned after Alcoholics Anonymous have also been developed. Many compulsive buyers accumulate substantial debts and could benefit from the help and support of those who are similarly afflicted.