Impulse Control Disorders: Not Otherwise Specified?>

Impulse control disorders are characterized by an inability to control one's behavior, even when it's painful, causes financial or legal difficulties or seriously endangers one's health and welfare.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), the essential reference work for mental health professionals, defines the following as impulse control disorders;

• Dermatillomania, or skin picking
• Intermittent Explosive Disorder
• Kleptomania, or compulsive stealing
• Pathological Gambling
• Pyromania, or compulsive fire starting
• Trichotillamania, or compulsive hair pulling.

But all these categories don't quite cover every circumstance in which a mental health professional determines that a patient's behavior is caused by lack of impulse control. That's why the DSM-IV includes the "Not Otherwise Specified," or "NOS" category, to cover impulse control disorders outside the six listed that aren't covered elsewhere in the DSM-IV.

Other Impulse Control Disorders

Along with the inability to control or resist specific urges, impulse control disorders are characterized by a buildup of tension before the behavior, a feeling of relief or pleasure following the behavior and feelings of guilt, shame or remorse following the behavior. Other impulse control disorders that fall into the "Not Otherwise Specified" Category include:

• Addiction to Sex: Also known as "impulsive sexual behaviors" or "sexual addiction," addiction to sex includes compulsive masturbation, compulsive use of Internet or telephone pornography, habitual promiscuity and dependence on pornography.
• Addiction to Shopping: More common in women than men, addiction to shopping, also known as "compulsive spending" or "oniomania," is linked to anxiety disorders and attempts at mood regulation.
• Repetitive Self-Mutilation: This category covers impulsive cutting or burning by people who don't have other psychiatric disorders and aren't deemed to be suicidal or psychotic. This irresistible behavior seems to be how they deal with emotional problems.

How Is Addiction to Shopping Different From Compulsive Over-Eating?

After exploring the category of other impulse control disorders, one may wonder why addiction to sex is included in this group, but not substance abuse.

That's because behaviors like substance abuse or eating disorders are defined under different headings in the DSM-IV, unlike addiction to sex or addiction to shopping.

Psychiatric disorders such as bipolar disorder or border personality disorder might prompt poor impulse control, but these conditions are defined as diseases in their own right, with impulse control components.

DSM classifications change over time. With the publication of the DSM-V in 2013, changes in classification will be made for a host of mental health issues, including impulse control disorders like pathological gambling and other impulse control disorders like addiction to sex and addiction to shopping.

Resources

Ellis-Christensen, T. (2010). What are the different types of impulse control disorders? Retrieved July 16, 2010, from http://www.wisegeek.com/what-are-the-different-types-of-impulse-control-disorders.htm.

Encyclopedia of Mental Disorders. (2010). Impulse-control disorders. Retrieved July 16, 2010, from http://www.minddisorders.com/Flu-Inv/Impulse-control-disorders.html.

Hucker, S. J. (2005). Not otherwise specified. Retrieved July 16, 2010, from http://www.forensicpsychiatry.ca/impulse/nos.htm.