Impulsivity

2000 ◽  
Vol 14 (2_suppl1) ◽  
pp. S39-S44 ◽  
Author(s):  
E. Hollander ◽  
J. Rosen
Keyword(s):  
Pathological Gambling ◽  
Personality Disorders ◽  
Impulse Control ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Treatment Options ◽  
Borderline Personality ◽  
Obsessive Compulsive ◽  
Substantial Impact ◽  
Intermittent Explosive Disorder ◽  
Impulsive Aggression

Disorders characterized by impulsivity include disorders of impulse control (intermittent explosive disorder, pyromania, kleptomania, pathological gambling and trichotillomania), paraphilias, sexual impulsions and sexual addictions and impulsive aggression personality disorders (borderline, antisocial, histrionic and narcissistic personality disorders). Impulsivity has a substantial impact on both individuals and society. Impulse control disorders may be conceptualized as a subset of the obsessive-compulsive spectrum. In this article, we examine the genetic and neurobiological aetiology of these disorders and possible treatment options. The link between serotonergic dysfunction and the pathophysiology of impulsivity is discussed, and studies that examine the efficacy of various selective serotonin reuptake inhibitors and other alternatives in the treatment of impulsive disorders such as pathological gambling, sexual addictions and borderline personality disorder are presented.

OC Spectrum Disorders: The Impulsive and Schizo-Obsessive Clusters

CNS Spectrums ◽  
1999 ◽  
Vol 4 (S3) ◽  
pp. 16-21
Author(s):  
Eric Hollander ◽  
Jennifer Rosen ◽  
Keyword(s):  
Personality Disorders ◽  
Large Scale ◽  
Treatment Options ◽  
Obsessive Compulsive ◽  
Substantial Impact ◽  
Intermittent Explosive Disorder ◽  
Compulsive Disorder ◽  
Impulsive Aggression ◽  
Spectrum Disorders ◽  
Pathologic Gambling

AbstractTwo symptom clusters within the obsessive-compulsive (OC) spectrum—the impulsive cluster and the schizo-obsessive cluster—are discussed in this paper. Disorders characterized by impulsivity include disorders of impulse control (eg, intermittent explosive disorder, pyromania, kleptomania, pathologic gambling, trichotillomania); paraphilias, sexual impulsions, and sexual addictions; and impulsive aggression personality disorders (eg, borderline, antisocial, histrionic, and narcissistic personality disorders). The schizo-obsessive cluster includes comorbid symptoms of obsessive-compulsive disorder (OCD) and schizophrenia. Both clusters of disorders have a substantial impact on individuals and society. This article examines the overlap of symptoms between OCD and OC spectrum disorders, along with possible treatment options. Studies on the effectiveness of serotonin reuptake inhibitors in treating pathologic gambling, compulsive buying, and comorbid OCD and schizophrenia are presented. The need for additional large scale, adequately-controlled studies is discussed.

The Oxford Handbook of Impulse Control Disorders

2012 ◽  
Keyword(s):  
Decision Making ◽  
Impulse Control ◽  
Treatment Options ◽  
Impulse Control Disorders ◽  
Clear Understanding ◽  
Intermittent Explosive Disorder ◽  
Normal Behavior ◽  
Assessment And Treatment ◽  
Decision Making Processes ◽  
Psychopathological Disorders

Impulsivity, to varying degrees, is what underlies human behavior and decision-making processes. As such, a thorough examination of impulsivity allows us to better understand modes of normal behavior and action as well as a range of related psychopathological disorders, including kleptomania, pyromania, trichotillomania, intermittent explosive disorder, and pathological gambling—disorders grouped under the term "impulse control disorders" (ISDs). Recent efforts in the areas of cognitive psychology, neurobiology, and genetics have provided a greater understanding of these behaviors and given way to improved treatment options. The Oxford Handbook of Impulse Control Disorders provides a clear understanding of the developmental, biological, and phenomenological features of a range of ICDs, as well as detailed approaches to their assessment and treatment. Bringing together founding ICD researchers and leading experts from psychology and psychiatry, this volume reviews the biological underpinnings of impulsivity and the conceptual challenges facing clinicians as they treat individuals with ICDs.

scholarly journals Drug treatment of obsessive-compulsive disorder

2010 ◽  
Vol 12 (2) ◽  
pp. 187-197 ◽  
Keyword(s):  
Drug Treatment ◽  
Obsessive Compulsive Disorder ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Treatment Options ◽  
Future Research ◽  
Considerable Proportion ◽  
Preliminary Treatment ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Rational Drug

Knowledge of pharmacotherapeutic treatment options in obsessive-compulsive disorder (OCD) has grown considerably over the past 40 years. Serotonergic antidepressants, such as selective serotonin reuptake inhibitors (SSRls) and clomipramine, are the established pharmacologic first-line treatment of OCD. Medium to large dosages and acute treatment for at least 3 months are recommended until efficacy is assessed. In case of significant improvement, maintenance treatment is necessary, Unfortunately, about half of the patients do not respond sufficiently to oral serotonergic antidepressants; augmentation with atypical antipsychotics is an established second-line drug treatment strategy. Alternatives include intravenous serotonergic antidepressants and combination with or switch to cognitive behavioral psychotherapy. Remarkably, a considerable proportion of OCD patients still do not receive rational drug treatment. Novel research approaches, such as preliminary treatment studies with glutamatergic substances, and trials with further drugs, as well as needed aspects of future research, are reviewed.

Aggression, Impulsivity, and Personality Disorders

2012 ◽  
Author(s):  
Larry J. Siever ◽  
Joshua E. Kuluva
Keyword(s):  
Substance Abuse ◽  
Personality Disorders ◽  
Treatment Options ◽  
Morbidity And Mortality ◽  
Potential Treatment ◽  
Impulsive Aggression ◽  
Cluster B Personality Disorders ◽  
Future Direction ◽  
Type Of Behavior ◽  
Core Features

Aggressivity and impulsivity are traits that are core features of the Cluster B personality disorders. Within these disorders, impulsive aggression leads to a significant amount of morbidity and mortality. This type of behavior is intrinsically linked to violence, suicide, and substance abuse. In this chapter, we will discuss the phenomenology of these traits, the neurobiology of impulsive aggression, and some potential treatment options. We will conclude with some thoughts on the future direction of research in this filed.

scholarly journals Comorbid personality disorders and their impact on the presentation of severe dissociative experiences in patients with borderline personality disorder in Mexican patients

2018 ◽  
Author(s):  
Andres Rodriguez-Delgado ◽  
ivan arango ◽  
Ana Fresan ◽  
Edgar Miranda ◽  
Eduardo A. Garza-Villarreal ◽  
...  
Keyword(s):  
Personality Disorders ◽  
Logistic Regression Model ◽  
Primary Diagnosis ◽  
Borderline Personality ◽  
High Rate ◽  
Clinical Factors ◽  
Obsessive Compulsive ◽  
Axis Ii ◽  
Dissociative Experiences ◽  
Dsm Iv

The objective of this study was to identify personality disorders comorbid to BPD that confer greater risk for the presence of severe dissociative experiences. Three hundred and one outpatients with a primary diagnosis of BPD were evaluated using the Structured Clinical Interview for DSM-IV Axis II personality disorders (SCID-II), the Borderline Evaluation of Severity Over Time (BEST) and the Dissociative Experiences Scale (DES). Our results show that the most frequent personality disorders comorbid to BPD were paranoid (83.2%, n = 263) and depressive (81.3%, n = 257). On average, the patients scored with 43.3 points and 28.6 points in the BEST and DES scales respectively. We categorized the sample into patients with and without severe dissociative experiences (41% were positive). A logistic regression model revealed that Schizotypal, Obsessive-compulsive and Antisocial personality disorders conferred greater risk for the presence of severe dissociative experiences. The results suggest that a large proportion of patients with BPD present a high rate of severe dissociative experiences and that some clinical factors such as personality comorbidity confer greater risk for dissociation, which is related to greater dysfunction and suffering, as well as a worse progression of the BPD.

scholarly journals Drug treatment for personality disorders

2004 ◽  
Vol 10 (5) ◽  
pp. 389-398 ◽  
Author(s):  
Peter Tyrer ◽  
Anthony W. Bateman
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Monoamine Oxidase ◽  
Personality Disorders ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Antipsychotic Drugs ◽  
Borderline Personality ◽  
Trial Data ◽  
Careful Management

There is some evidence that antidepressants, particularly the selective serotonin reuptake inhibitors and the monoamine oxidase inhibitors, have some benefits in the management of borderline personality disorder, and lesser evidence (partly because of limited trial data) for the benefits of antipsychotic drugs and mood stabilisers. There is not sufficient distinction between the different personality disorders to recommend that any one disorder should be treated by any one drug, and successful treatment is dependent on careful management, sensitive to the patient's expectations.

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