Impulse Control Disorder and Impulsive Behavior

stealing money from register
Employee stealing money from the cash register.

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An impulse control disorder is marked sudden, forceful, irresistible urges to do something that may violate the rights of others or conflict with societal norms. These impulsive behaviors may occur repeatedly, quickly, and without consideration of the consequences of the actions.

Pyromania (intentionally starting fires) and kleptomania (the urge to steal) are well-known types of impulsive disorders. Intermittent explosive disorder, trichotillomania (urge to pull your hair out), conduct disorder, oppositional defiant disorder, and unspecified impulse control disorder are a few others.

Signs and Symptoms of Impulse Control Disorder

There are signs and symptoms that may point to an impulse control disorder in some individuals. It is not always easy to identify this type of disorder, but the following may indicate a need for investigation.

  • Behavioral symptoms: Stealing, lying, starting fires, risky or promiscuous behavior, and aggressive or volatile behaviors
  • Cognitive symptoms: Obsessive behavior, trouble with organization, executive dysfunction, and poor concentration abilities
  • Social and emotional symptoms: Low self-esteem, social withdrawal or isolation, detachment and/or anxiety, drastic shifts in thoughts and moods, and feelings of guilt or regret

When Behavior Becomes a Disorder

Typically, an impulsive action results from tension that has built to the point where the person can no longer resist it. The immediate sense of relief from acting on an impulsive behavior is short-lived, however.

Feelings such as guilt or shame may follow. Repeated impulsive acts may also lead to a number of negative consequences, such as greater emotional distress or regret, in the long term.

When the emotional toll of impulsive behavior becomes unmanageable or seriously disrupts everyday life, an impulse control disorder is a likely cause.

Risk Factors for Impulse Control Disorder

Both internal and external stressors are known triggers for impaired impulse control. Many types of impulse control disorders are thought to stem from underlying neurological vulnerabilities coupled with environmental stresses.

Some risk factors of an impulsive disorder include:

  • Being male (males are more prone to impulse control disorders than females)
  • Genetic predisposition
  • Chronic drug or alcohol use
  • Being subjected to trauma, abuse, or neglect
  • Exposure to violence or aggression
  • Taking a dopamine agonist medication, such as those prescribed for Parkinson's disease

Certain chemical imbalances may contribute to an impulse control disorder in some individuals. Additional mental health issues, such as bipolar or personality disorders, often coexist in people with an impulse control disorder.

Types of Impulse Control Disorder and Treatments

The term impulse control disorder is a category of mental health problems. Treatments may differ for specific disorders.

Pyromania

People with this type of impulse control disorder deliberately start fires without regard to the destruction or injury their actions may cause. It is common for many convicted arsonists with evident pyromania to also have personality disorders such as antisocial and borderline personality disorders.

Research on treatments is somewhat limited because this condition is rare. That said, several case studies have found that various medications appear to help resolve this urge. Cognitive behavioral therapy techniques also offer some promise of effectiveness.

Kleptomania

Kleptomania is the constant and irresistible urge to steal. People who have this impulse control disorder often steal items that have little personal or monetary value.​

Kleptomania can have subtypes that are more like obsessive-compulsive disorder (OCD), and others more similar to addictive and mood disorders. It is common for people with kleptomania (and their first-degree relatives) to also have psychiatric diagnoses or addiction issues.

Effective treatment options for kleptomania may vary depending on the subtype. Cognitive behavior therapy and medication have been shown to be effective, while mood stabilizers, antidepressants, and opioid antagonist medications have also shown promise in certain circumstances.

Intermittent Explosive Disorder

Intermittent explosive disorder is diagnosed when a person has, on multiple occasions, acted on aggressive impulses and committed seriously aggressive acts, such as assault or destruction of property. One way it is identified is by the severity of the person's aggressive behavior (it is well out of proportion to the trigger that preceded it).

Studies have found a link between post-traumatic stress disorder (PTSD) and intermittent explosive disorder.​

Individuals with intermittent explosive disorder may benefit from cognitive behavioral therapy to learn relaxation and coping skills. Additionally, depending on symptoms and age, the person may also be prescribed medications such as antidepressants, antipsychotics, or mood regulators.

Trichotillomania

Tricho is Greek for "hair," tillo means "pull," and mania is an excessive behavior or activity. Thus, trichotillomania involves a compulsive urge to pull out your own hair. This impulsive behavior is more common in children and teens. When it does appear in adults, women have it nine times as often as men.

Behavioral therapy with habit-reversal training components appears to be the most effective treatment for trichotillomania, but some medications have provided positive results as well.

Conduct Disorder

Conduct disorder involves patterns of behavior that can include being aggressive to people and animals, destroying property, theft or other deceitful actions, and serious rule violations. This disorder can appear in young children (even those in pre-school) and isn't diagnosed beyond 18 years of age.

Conduct disorder and attention-deficit hyperactivity disorder (ADHD) often go hand-in-hand. Having this impulse control disorder in childhood commonly precedes the development of antisocial personality disorder in adulthood.

Conduct disorder treatment typically involves engaging in therapy with the child's parents or the entire family, Medications such as stimulants and antipsychotics may also be prescribed, especially if this disorder co-occurs with ADHD.

Oppositional Defiant Disorder

Like with conduct disorder, oppositional defiant disorder is diagnosed in childhood and adolescence. Its symptoms include irritable mood, being argumentative or defiant, and engaging in vindictive behaviors.

Effective treatment of this impulse control disorder often involves some type of psychotherapy. If another disorder exists, or if severe aggression is exhibited, medications may be used as well.

Unspecified Impulse Control Disorder

If someone has impulses that don't fit neatly into one of the other types, they may be diagnosed with unspecified impulse control disorder. Problematic internet use, for instance, may be classified as an unspecified impulse control disorder. Treatment varies based on the impulse symptoms and severity.

A Word From Verywell

If an impulse control disorder exists, a trained professional can provide a full evaluation and a comprehensive treatment program that builds and strengthens social skills. For example, a therapist may focus on problem-solving, ways to overcome a fixation with instant gratification, and strategies to curb impulses through techniques that help develop better self-control.

In some cases, medications can also enhance the treatment process, especially if there are other co-existing conditions. The type of medication prescribed can vary depending on which disorder exists.

Frequently Asked Questions

  • Is excessive gambling considered an impulse control disorder?

    Excessive gambling is no longer considered an impulse control disorder. Pathological gambling disorder used to be classified as an unspecified impulse control disorder, but the DSM-5 now categorizes it as an addiction.

  • What causes impulse control disorder?

    Genetics, substance use, and trauma can all increase the risk of an impulsive disorder. Certain medications can also lead to the development of an impulse control disorder, such as dopamine agonists often prescribed for Parkinson's disease.

  • How many people are affected by impulse disorder in the United States?

    In a study involving 293 adults, just under one-third (32.8%) were found to have an impulse control disorder. Impulse control disorder prevalence is slightly higher in individuals with Parkinson's disease, affecting up to 40% of those with this condition. This is largely due to medication side effects.

    The number of children with impulse control issues varies depending on the type. For instance, oppositional defiance disorder affects roughly 3.3% of children while the prevalence of conduct disorder is somewhere between 1.5% and 3.4%.

  • How can you help a child with impulse control issues?

    Creating routines, setting limits, and praising appropriate behavior are all ways to help a child with impulse control issues develop healthy behaviors. So can modeling the behaviors you want to see and only picking battles with them that are the most important.

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Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Additional Reading

By Matthew Tull, PhD
Matthew Tull, PhD is a professor of psychology at the University of Toledo, specializing in post-traumatic stress disorder.