Impulse Control Disorders: Types, Symptoms, & Treatments

What Is an Impulse Control Disorder?

Impulse control disorders relate to heightened emotions and impulsive thoughts. For example, individuals may experience uncontrollable urges to engage in risky behavior, commit crimes, break social norms, or lie. While they may not want to engage in these actions, they struggle with self-control and managing impulses. These tendencies and behaviors are typically evident from childhood.

How Common Are Impulse Control Disorders?

Impulse control disorders are relatively common but can vary in their prevalence. One of the most common impulse control disorders in adults is kleptomania, resulting in a recurrent urge to steal items with little personal or monetary value. Research estimates that this condition affects around 0.6% of the general population. Other common impulse control disorders include intermittent explosive disorder, characterized by recurrent aggressive outbursts, and pathological gambling, characterized by persistent and problematic gambling behavior.

Impulse Control Disorders Symptoms

Specific impulse control disorders have unique diagnostic criteria but share similar observable characteristics. Generally, many individuals display outwardly destructive behavior and a lack of impulse control, often involving others or target objects.

Symptoms of impulse control disorders may include:⁴

Behavioral symptoms

• Risky or promiscuous behaviors
• Violent outbursts against others or the property of others
• Extreme defiance
• Drastic mood swings
• Theft or other criminal activity
• Compulsive or pathological lying
• Ignoring social norms

Physical symptoms

• Physical injuries as a result of acting out behaviors
• Sexually transmitted diseases
• Burn marks from fire-starting

Mental health symptoms

• Intrusive thoughts
• Obsessions
• Uncontrollable urges
• Ongoing agitation
• Increased irritability
• Inability to concentrate
• Feeling detached from emotions and surroundings
• Feelings of guilt/regret
• Low self-esteem/self-worth

Types of Impulse Control Disorders

Impulse control disorders can take many forms, resulting in different symptom manifestations, consequences, and challenges. Depending on the type of disorder, symptoms can contribute to increased aggression, criminal activity, arson, and violence.

Oppositional Defiant Disorder (ODD)

Oppositional defiant disorder is an impulse control disorder in children and adolescents. These children exhibit angry or irritable moods, argumentative or defiant behavior, and vindictiveness that can negatively affect their social, family, and school functioning.⁵

While all children exhibit some oppositional behavior, those with ODD have markedly worse, prolonged, and persistent defiance.⁶ These children often run into trouble with authority figures and encounter situations where their behavior has serious consequences. They can be touchy, easily annoyed, and prone to temper tantrums. Impulse typically drives this behavior, and the child may not recognize or understand the impacts of their condition.²

Intermittent Explosive Disorder

Intermittent explosive disorder results in rage episodes or temper tantrums lasting at least 30 minutes. During these fits, the person may become physically and verbally aggressive, making direct threats, throwing objects, or striking others around them.

Afterward, many experience a sense of relief followed by regret or embarrassment for their actions.⁶ The hallmark of this disorder is that the person has little to no control over their behavior during explosive episodes. The risks of this behavior are criminal charges, guilt, and potential bodily harm to those subject to outbursts.

Conduct Disorder

Another example of an impulse control disorder is conduct disorder. Typically, adolescents and adults with this condition display persistent behavior that violates the rights of others or social norms. These individuals may engage in physical violence, harming animals, sexual coercion, and criminal activities.²

Many individuals with conduct disorder have histories of animal violence and physical altercations at home or school. They may show no remorse for their actions, simply acting on impulses and desires without regard for the effects on others.

Antisocial Personality Disorder (ASPD)

Like conduct disorder, antisocial personality disorder (ASPD) includes persistently violating social norms and the rights of others. Individuals with ASPD exhibit an indifference to hurting, mistreating, or stealing from another person.

Adults with ASPD exhibited symptoms of conduct disorder in their youth and often prove burdensome to their families, communities, and loved ones. Unfortunately, those with the condition often experience higher addiction, suicide, and homicide rates.⁷

Pyromania

Pyromania relates to urges to set fires and obsessions with destruction by fire. People generally experience tension before committing arson, followed by a sense of pleasure, gratification, or relief. Individuals do not set these fires for external purposes or goals.⁸

Pyromania is a rare disorder predominantly seen in males. Common pyromaniac behavior includes pulling false fire alarms, deriving pleasure from fire-related topics or objects, and seeking proximity to fires.² Some pyromaniacs may even be firefighters.

Kleptomania

Kleptomania is a recurrent failure to resist impulses to steal objects, often unnecessary for personal use or monetary value. Kleptomaniacs experience momentary pleasure after stealing before significant distress and dysfunction upon realization of their actions.²

Of course, this behavior can result in criminal charges, with some research suggesting kleptomania accounts for an estimated 5% of shoplifting.⁹

Trichotillomania

Trichotillomania is an impulse control disorder characterized by the repeated urge to pull out hair, resulting in noticeable hair loss. Trichotillomania often begins during adolescence or early adulthood and can cause significant distress and impairment in daily functioning. Different treatment options, including therapy and medication, can be effective in managing symptoms and helping individuals regain control over this disorder.

Unspecified Impulse Control Disorder

An unspecified impulse control disorder describes symptoms that do not meet the specific criteria for any defined impulse control disorder. For example, this may include compulsive shopping, excessive skin picking, or repetitive self-harming actions.

The prevalence of unspecified impulse control disorders is challenging to determine due to the broad range of behaviors that fall under the umbrella. These disorders can have a significant impact on life and well-being, and seeking professional help is advisable to address the underlying issues and learn healthier coping strategies.

What Causes Impulse Control Disorders?

The causes of impulse control disorders are largely unknown. However, developmental, environmental, and hereditary factors likely affect development. Additionally, prefrontal cortex abnormalities may contribute to the manifestation of symptoms.¹

Possible impulse control disorder causes and risk factors include:¹⁰

• History of abuse: A history of abuse, whether physical, sexual, or emotional, can be a potential risk factor for impulse control disorders. Individuals who have experienced trauma or abuse may struggle with managing their emotions and impulses, leading to impulsive behaviors.
• Emotional dysregulation: Individuals who struggle with emotional dysregulation may use impulsive behaviors to cope with intense emotions.
• Inconsistent parenting: Children who grow up without consistent rules and expectations may struggle to develop self-control and stable decision-making skills.
• Brain variances: Brain variances, such as those seen in individuals with attention-deficit/hyperactivity disorder (ADHD), may also contribute to the development of impulse control disorders.
• Difficult temperament: A difficult temperament, such as being prone to frustration and irritability, may increase the risk of developing impulse control disorders.
• Substance use: Substance use, particularly alcohol or drug abuse, may exacerbate impulsive behaviors and increase the risk of developing an impulse control disorder.
• Trauma: Traumatic experiences can impact brain development and contribute to difficulties with emotional regulation and impulse control.
• Family history of mental illness: A family history of mental illness, including impulse control disorders, may increase susceptibility to developing these conditions.
• Pre-existing mental health conditions: Certain pre-existing mental health conditions can increase impulsive behavior, possibly leading to the development of an impulse control disorder.
• Being male: Being male is also a potential risk factor for impulse control disorders, as several studies have found higher rates of these disorders in males than females.

Impulse Control Disorders & Co-Occurring Conditions

Impulse control disorders often co-occur with various mental health conditions, further complicating treatment and management. Common co-occurring conditions with impulse control disorders include bipolar disorder, anxiety disorders, post-traumatic stress disorder (PTSD), and depression.

Below are common comorbid conditions with impulse control disorders:

• Bipolar disorder
• Anxiety disorders
• Post-traumatic stress disorder (PTSD)
• Depression

How Are Impulse Control Disorders Diagnosed?

A mental health professional will typically conduct a comprehensive assessment using the DSM 5 impulse control disorder criteria to evaluate the presence of symptoms and the severity of impairment. Clinicians may interview the individual, family members, and friends who have observed the impulsive behaviors.

While a specific impulse disorder test does not exist, certain self-report measures, questionnaires, or surveys can provide insight into symptoms. Ultimately, a diagnosis is based on recurrent and persistent failure to resist impulses and engaging in behaviors that cause harm or impairment.

Impact of Impulse Control Disorders

The impacts of impulse control disorders are far-reaching and significant. Children diagnosed with an impulse control disorder may struggle with social situations and face many consequences at school and home. Depending on the severity of symptoms, they may also affect others through violence, theft, and property damage.

As children age, the effects of impulse control disorders spread to career choices and opportunities, family relationships, and societal functioning. Adults may pile criminal charges related to their behavior, leading to struggles in finding and maintaining employment. Some also pose risks to others they encounter, whether through fits of violence, incidents of road rage, arson, domestic violence, theft, or vandalism.

Possible effects of impulse control disorders include:

• Poor work or academic performance
• Job loss
• Incarceration
• Violence or domestic abuse
• Arson
• Relationship problems
• Self-harm
• Aggressive tendencies
• Addiction or substance use disorders

Impulse Control Disorders Treatment Options

Treatment for impulse control disorders varies depending on the severity of symptoms and type of disorder. A combination of therapy and medication can benefit most individuals, and professionals can tailor treatment plans to fit their needs. Those who receive early intervention often achieve the best results by learning to manage symptoms related to their impulses and heightened emotions.⁷

Therapy

Several therapy options are available for individuals struggling with impulse control disorders. Therapy options may vary based on individual needs and the specific symptoms, so consult a mental health professional to determine the most appropriate therapy approach. An online therapist directory can help you find the right therapist.

Below are therapy options for impulse control disorders:

• Cognitive behavioral therapy (CBT): CBT focuses on identifying and challenging negative thought patterns and beliefs that contribute to impulsive behaviors. Clients learn to replace unhealthy coping strategies with healthier alternatives and develop problem-solving skills.
• Dialectical behavior therapy (DBT): DBT combines elements of CBT with mindfulness techniques to help individuals with impulse control problems learn skills to regulate their emotions, tolerate distress, and improve interpersonal relationships.
• Mindfulness-based therapy: This approach involves learning and practicing mindfulness techniques to increase awareness of thoughts, emotions, and behaviors. By being more mindful, individuals can better recognize their impulses and develop the ability to respond thoughtfully and calmly.
• Family therapy: Family therapy helps family members improve communication, set boundaries, and address issues that may contribute to or exacerbate impulse control problems. This method focuses on enhancing family dynamics and support networks to provide a supportive environment for individuals struggling with impulsivity.
• Group therapy: Group therapy provides a supportive and therapeutic environment where individuals can share their experiences, learn from others, and gain insights into their behaviors.

Medication

The FDA has not approved specific medications for impulse control disorders. However, many individuals can benefit from selective serotonin reuptake inhibitor (SSRI)* to reduce impulse control problems and aggression.¹¹ In other cases, prescribers may consider different pharmaceutical approaches if SSRIs prove ineffective. Consult your doctor about your symptoms, needs, and goals for treatment to determine the best route for medication management.

*This medication has a black box warning, the most serious kind of warning from the FDA for a risk of suicidal thoughts and behaviors in certain people. You should talk with your doctor about these risks before starting this medication.

Helping a Child With an Impulse Control Disorder

Supporting a child with low impulse control can be challenging, but parents can implement strategies to help them manage these behaviors. Every child is different, and finding the right techniques may require trial and error. Patience, understanding, and consistent support are crucial in helping children with low impulse control develop healthier coping mechanisms.

Here are tips for parenting and supporting a child with an impulse control disorder:

• Set clear and consistent boundaries: Establishing clear rules and expectations provides structure and helps the child understand appropriate behavior.
• Use positive reinforcement: Acknowledge and reward their efforts toward self-control and making good choices. Positive reinforcement can motivate and reinforce positive behaviors.
• Practice emotion regulation techniques: Teach the child strategies for identifying and managing emotions, such as deep breathing, counting to 10, or using calming techniques to reduce impulsivity.
• Break tasks into smaller steps: Help the child develop problem-solving skills by breaking tasks or goals into smaller, manageable steps. Doing so can help reduce frustration and impulsive reactions.
• Establish routines: Consistent routines and schedules can provide stability and predictability for the child, which can help regulate their behaviors and reduce impulsivity.
• Teach and model problem-solving skills: Help the child develop problem-solving skills by teaching them to consider alternatives and consequences before acting impulsively. Model these skills by thinking aloud and discussing situations with them.
• Provide distractors and outlets: Encourage the child to engage in activities that channel their energy and distract them from impulsive urges. For example, physical exercise, creative outlets, or hobbies can provide an outlet for their energy.
• Seek professional help: Seeking support from a mental health professional specializing in working with children with impulse control disorders if their impulsivity significantly interferes with their daily functioning and negatively impacts their well-being.