9990 · 1.3.3
Treatment and management of impulse control disorders flashcards
Revision flashcards for Cambridge 9990 Treatment and management of impulse control disorders (syllabus 1.3.3). Flip, recall, then mark a real past-paper question.
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SSRIs for ICDs?
Increase serotonin — may reduce urge intensity and compulsive quality; evidence strongest for kleptomania co-occurring with OCD features.
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CBT for impulse control?
Identify triggers, challenge rationalisations, develop **urge-surfing** and alternative coping — relapse prevention planning.
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Covert sensitisation?
Imagining unpleasant consequences paired with urge — aversive conditioning; ethical concerns about aversive methods.
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Impulse control training?
Teaches stop–think–act sequence, problem-solving, and delay strategies — builds executive skills.
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Relapse prevention?
Identify high-risk situations, early warning signs, support network — maintenance phase after initial treatment gains.
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Ethical issue with aversive therapy?
Covert sensitisation and punishment raise **human rights** concerns — less acceptable than CBT/pharmacology in modern practice.
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What is the biochemical rationale for using SSRIs to treat kleptomania?
SSRIs (Selective Serotonin Reuptake Inhibitors) increase levels of serotonin in the brain. Low serotonin has been linked to impulsivity and obsessive-compulsive features. By boosting serotonin, SSRIs may help regulate mood and reduce the uncontrollable urges to steal.
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Describe the process of covert sensitisation.
A behavioural therapy where the client imagines performing the impulsive act (e.g., stealing) and then immediately imagines a highly unpleasant consequence (e.g., being arrested and publicly shamed). This aims to create a conditioned aversive response to the impulsive urge through classical conditioning.
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What is the role of an opioid antagonist like naltrexone in treating pathological gambling?
It blocks the brain's opioid receptors, which are involved in the experience of pleasure and reward. This reduces the 'high' or 'buzz' a gambler gets from the behaviour, decreasing its reinforcing properties and thus the motivation to gamble.
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How does imaginal desensitisation work?
It is a relaxation-based therapy. The client learns relaxation techniques and then visualises being in a situation that triggers the impulse, while consciously maintaining a relaxed state. This counter-conditions the excitement or anxiety associated with the urge, using a hierarchy of scenarios.
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What is a key cognitive component of CBT for an impulse control disorder?
Identifying and challenging cognitive distortions. For example, a person with intermittent explosive disorder might challenge the thought 'This person is deliberately disrespecting me and I must react' by reframing it to a less hostile and more balanced interpretation.