Mental Health Matters
Forensic Edition
September 2011.
Published by: Lepage Associates 

Impulse Control Disorders and Pathological Lying


Impulse control disorders are characterized by a person's inability to resist a temptation to carry out certain behaviors. While these behaviors may gratify the person at the time of performance, in the long run, the behaviors can be harmful to the person and others around him.  Also, a feeling of regret may develop through time. The categories of disorders are as follows:


1) Trichotillomania is the recurrent pulling out of one's own hair, which causes extensive hair loss. A person with trichotillomania may pull out her hair when she is in relaxed or stressful situations; however anxiety occurs when the person tries to resist pulling out her hair. Although the person feels a sense of relief when committing the act, she becomes distressed with the resulting hair loss.


2) Intermittent Explosive Disorder is characterized by impulsive acts of aggression. Common behaviors include physical and verbal assaults and purposely destroying property. Before an aggressive act is committed, the individual has an intense impulse to be aggressive. Following the act, the person feels a sense of relief. Eventually the individual may feel upset, remorseful, regretful, or embarrassed.


3) Pathological Gambling is characterized by persistent gambling that disrupts everyday family, work, and personal obligations. Pathological gamblers have a need for excitement rather than to actually win the money. Gambling becomes a way to forget about problems or to escape feelings of helplessness or guilt.


4) Kleptomania is the act of constantly stealing things that one does not need. The individual does not steal for personal use or because the item has monetary value, instead she feels a sense of pleasure. Before the act of stealing, the individual becomes anxious and tense. During the act of stealing, the individual is gratified and the anxiety and tension are released.  


5) Pyromania involves receiving gratification from setting fires, witnessing the effects of a set fire, and participating in the aftermath. Before setting a fire, the individual is tense and he relieves that tension after setting the fire. The individual is indifferent to the possible consequences of setting fires. Instead, he is more fascinated, curious, and attracted to setting fires.  


6) Disorders that are Not Otherwise Specified (NOS) include compulsive shopping, hyper-sexuality and Internet addiction.   


Pseudologia fantastica or Pathological Lying is not a disorder that is listed among the six categories of impulse control disorders in the DSM-IV. However, pathological lying does share similar symptoms as the other categories. Pathological lying can be defined as a history of repeated lying that occurs without motive or the intention of internal or external benefits. 'Regular' lies can occur because one wants to avoid punishment, challenge perceptions, or escape embarrassment. In all of the previous situations, there exists purpose in lying. Pathological liars do not lie with a purpose although the lying may have begun with a purpose. Often times, the lies told damage a person's credibility and are not beneficial to him/her.


Pathological lying is not a discriminatory disorder; both men and women are equally likely to be pathological liars. Although the onset of pathological lying as been observed in adolescent years, the discovery occurs in the early 20s. It is also prevalent in persons with average or slightly below average IQ scores.  


Development of the Disorders:

The shared qualities of impulse control disorders are that they are: 1) done repetitively without regard to resulting consequences, 2) done without the power to control the behavior, 3) followed by a tense, anxious, or craving state, and 4) carried out with gratification or an intense feeling of pleasure. Although the causes and prevalence of impulse disorders may vary, they begin largely in childhood to late adolescence. Various causes of impulse control disorders have been linked to social and biological factors. Some biological factors have been attributed to inherited genetic factors and the differences in how the brain processes neurotransmitters. Social factors that have influenced impulse control disorders include violent childhood experiences and alcohol consumption.  



Cognitive behavioral therapy and medications are two common treatments for Impulse Control Disorders. Cognitive behavioral therapy combines cognitive and behavioral therapy in order to help people learn to relax, cope with stress, combat negative thoughts and prevent damaging behaviors. Cognitive therapy examines the way people think about themselves and others, while behavior therapy examines ways people's actions influence their own lives and interactions with others.


Psychotherapy is the dominant form of treatment for pathological lying. Pharmacotherapy has been used as a means to suppress the urge to lie. Some believe that more effective treatment can occur if more research is conducted on the cause and effects of pathological lying. In the court system, it can be difficult to determine the competency of a pathological liar as his/her symptoms can be attributed to other mental disorder. How is the attorney able to work with his client? And how can anyone really be sure that the person understands court proceedings? More research could aid in determining what types of treatments are best when dealing with pathological liars and determining what is true from what is not.




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