[0:00]Hey, Ross here again. So we're going to be covering a new chapter. Uh, a new chapter called impulse control disorders. And what's going to be happening is I'm going to go through a very general overview of this chapter. Once again, because we're talking about A2 level studies, you need to read beyond the slides, beyond the textbook, beyond just this single YouTube video. Reason being, because you have to write a lot of information when it comes to A2 essays. So you really need to go in depth. And the only way you're going to get in depth is if you read the actual studies which are involved. Right? So in order to do that, you must, you know, download those studies, go and find them on Google. You can pretty much find anything on Google these days. So please, if you see things that you don't recognize, words that you don't understand, please go and Google them, search, understand so that you can write better. Okay? But anyway, I'll give you I'll I'll give you a general overview. I usually ask my students this question, what impulses do you find hard to resist? And usually the answer I get is sleeping, right? Teacher, uh, Mr. Ross, we we love to sleep and it's hard. In in fact, I even struggle with that in the morning, you know, I really don't like getting up in the morning. I I really find it hard to uh resist the impulse to just go back and sleep and wish that the world was not in a pandemic, but you know, such is life. Anyway, so let's look at some of the characteristics of impulse control disorders. Uh, firstly, uh, we have to look at the definition uh, from Griffith, right? Uh, there are some addictions, okay, I'll explain why we're talking about addictions, but there are some addictions that don't involve drugs, okay? Such as addictions to gambling, sex, exercise, video games, and so on, so forth, right? A person can be a gambling addict, a sex addict, you know, addicted to exercise, addicted to playing video games, 24 hours a day, 7 days a week, right? These are in a sense related to our topic of impulse control disorders, but they have a slightly unique place, right? Because they're kind of an addiction, right? It's just like how you feel an impulse to gamble, right? Gamblers feel an impulse to gamble, and in fact, there's a disorder called gambling disorder, where they feel that strong impulse to go and do it. Uh, but unlike, for example, at um smoking, you know, smoking is an addiction where your body is addicted to nicotine, right? And the nicotine is what is is is that strong, it's is driving your body to get more and more of it, right? Your your body is dependent on the nicotine. Whereas there are some addictions that that don't involve drugs, and that are more related to impulse control disorders, right? And they share similar components with ICDs, right? Impulse control disorders. So, the components that we talk about in terms of impulse control disorders are, first of all, salience. Right? So, what is salience? Salience is the, uh, when something, how to explain it? It's the only thing that you focus on in your life, right? So, it is like, um, you you forget everything else and you just focus on one thing. And that's salience, which is just double check that to make sure I'm correct, but it should be. Yep. So, it's it's when the activity that you're doing takes over, uh, everything, right? It takes over your brain, it that's all you think about, right? So, let's say a gambler, all you think about is gambling, gambling, gambling, right? That's called salience. Next, um, uh, mood modification. All right? So, for example, what happens here is that when you feel the need to do something, an impulsive action, the mood modification is where you feel uh uh your mood feels high. You feel like you're on drugs, you feel like high, you're excited, um, all you want to do is is enjoy that feel that buzz. People say you get a feel a buzz, a feeling of escape, a feeling of peace while you're doing that thing. Next, you experience tolerance, right? So, uh, just like a typical addict, right? If you take a little bit of something, you need to take a little bit more the next time, a little bit more and more and more, right? So, if you're addicted to smoking, for example, maybe you start off with just one cigarette, and then you need two cigarettes to get the same feeling, then you need three, four, five, so your body develops a tolerance towards it. You need to do it more and more in order to feel the same feeling of high. Then you might go through withdrawal, right? So, you try to stop this addictions, you know, it's bad for you, it's bad for your health. You try to stop and you feel a sense of withdrawal. You get very annoyed, angry, very unpleasant feelings, you need to keep doing it in order to feel good again, right? And then you go through conflict. So, conflict is what happens when you start fighting with people around you, your family, your friends, you get into a lot of arguments with them. Uh, it affects your life, their life, and everybody who's closest to you is affected by it, because you keep wanting to go and do these addictions, and it hurts other people, right? Lastly, is relapse, okay? So, perhaps after a certain amount of time, you really try not to go back to these addictions, and then sometimes you might have relapse, right? So, maybe three months you stop smoking, stop gambling, and then suddenly you start it start doing it again, right? So, that can happen as well, okay? Uh, so there's this video here, uh, which I won't be showing it, but essentially, it was about a, uh, gambling addict, right? This is a re-enactment of a true story, I believe, of someone in Singapore. Right? So, he he would do all these bettings, right? I would bet in denominations of S$500 per game. So, in a week itself, I reckon it's like S$3,000 to probably S$10,000. Can you imagine just giving out S$10,000 every week, just betting and betting and betting? He had debts of S$70,000, but he would continue betting. He had to go and see counseling services, he had to go for a a religious help with his church and all that, and it was really, really difficult, right? It affected every single person around him, okay? I won't show you the whole thing, but you can find the video online, just like gambling addict Singapore and so on and so forth. You get that, okay? So, uh, it's really quite difficult having an addiction, having an impulse control disorder. Um, and um, okay, so this is an activity I usually do with my students, try and, uh, match up, uh, which, uh, uh, uh characteristic goes to which explanation, right? So, look at explanation A, compromises relationships, compromises work, social activities, internal distress, I want to stop, but I can't. I think I put the arrows from left to right, so salience first, okay? Salience is B, most important activity, dominates thinking, feeling, behavior, craving for the activity, all you can think about is that activity, right? What about mood modification?
[6:23]Okay, look at the answers. Where does mood modification go to?
[6:33]Okay, it goes uh, tolerance goes to more of the activity is needed. Sorry, I accidentally pressed the button. Withdrawal is unpleasant feelings, physical effects when the behavior is reduced or stopped. Conflict is a compromising relationships, compromising work, social activities, internal distress, want to stop, but can't. Okay, relapse, return to addiction even after years of controlling it, right?
[7:15]Okay, I'll give you a second to think.
[7:26]Okay. All right, so uh, just keep this in mind. These are six characteristics. It can be a little bit hard to keep track, but um, just you you kind of just have to uh memorize it.
[7:53]Okay, uh, next, let's look at the DSM. So, I always like to look back at the DSM and how they classify disorders. Um,
[8:14]Uh, these are different from ICDs, and addiction disorders, because, uh, sorry, excuse me. These are different from ICDs because these are related to a substance addiction, right? So, there's substance related disorders, you can look there, alcohol is there, there's alcohol intoxication, alcohol withdrawal, blah, blah, blah. Cannabis is there, so we, you know, uh, hallucinogens and stuff like that. So, these are disorders where it's it's directly caused by an addiction to a substance. Now, it has to be different from an ICD because in an impulse control disorder, there's no substance, right? Now, we looked at gambling, gambling, gambling is a little bit unique, but um, it, uh, essentially, you have to realize that, uh, even though someone with these addiction disorders may have similar characteristics to a person with impulse control disorders, they are classified slightly differently, right? It depends on whether or not there there there's a substance behind it, okay? That's why you have here, disruptive impulse control and conduct disorders. So, this is all the impulse control disorders. You can see down there, oppositional defined disorder, intermittent explosive disorder, conduct disorder, anti-social personality disorder, pyromania, which we'll be looking at, kleptomania, we'll also be looking at that. Other specified, uh, disruptive, impulse control, conduct disorder, unspecified, impulse control, and so on. So, right? So, although they they share similar characteristics, the difference here is that these disorders, um, don't depend on a substance. You're not doing them out of the sake, uh, of of of, you know, getting a high from taking a substance, whereas addictive disorders, they are based on a substance. But gambling, you see, doesn't have a substance, right? Although people call it a gambling addiction, right? Or gambling disorder, so it has a bit of a special place, sort of like in between, but usually it comes under ICD rather than addiction, okay? So, what happens what what is the the process that goes through a person, or rather a person goes through when they're uh carrying this out, right? So, first, they feel an impulse, okay? I need to do something, I need to steal, or I need to gamble, right? They feel the impulse, driving them to do something. So, that that creates a sense of tension. They know they shouldn't be doing it, right? But they really feel the need to do it, I need to do it, I need to do it, but they feel the tension there, right? In your mind. And then after you've done it, you feel a sense of incredible pleasure, right? After you gamble, you you steal something, you you feel, oh my gosh, it feels so good, right? It feels amazing, right? Then you get this sense of relief, right? All the tension is gone, so you feel relief, ah, okay, I've done it, okay? And then you might set feel a sense of guilt, if you know that you shouldn't have done it, right? Or in some cases, you may not feel guilt, right? If you haven't hurt or done anything, you know, too bad to a person, right? So, you may not feel guilty, right? It depends on the person, depends on the situation, but this is usually what happens, impulse, tension, pleasure, relief, and then guilt or no guilt, right? So, uh, the first one we're looking for is this impulse to steal. Who knows what it's called? It starts with a letter K. We looked at it earlier, just a moment ago, right? Um,
[11:45]And uh, it's called kleptomania, right? For those of you who know it, kleptomania. So, kleptomania is the impulse control disorder to steal, right? So, uh, there are many types, you're in your syllabus, we cover kleptomania. It's an impulse control disorder, can't resist stealing objects, tension followed by pleasure. Uh, 0.3 to 0.6% of population, female greater than males. Urges to steal equals affect a person. Now, is it the same as being a thief? Right? This is something I ask my students. What do you think? Is having an impulse control disorder, this urge to steal, is it the same as being a thief? Right? What do you guys think? Yes, no? Well, not exactly. You see, a thief doesn't have an impulse to steal. Rather, a thief plans to steal something of value, right? That's what thieves do. They want to steal money, they want to steal valuable things so they can sell it, make money and, you know, whatever, right? A person who's a kleptomaniac, first and foremost, they don't plan to steal anything. It's just they suddenly as they're walking around, they get an urge to just want just grab stuff, right? This is an urge to do it that they can't resist. Secondly, they don't steal anything of value. So, what makes kleptomaniacs interesting is that they don't steal valuable things, they usually steal things which are of no value. They're just like small little things like, you know, just they just grab it if it's just in front of them, they just grab it, right? It's not something like gold or money or anything expensive, they just grab it, right? And so, it's not exactly the same as being a thief. In fact, I remember reading a case study where a woman had kleptomania, and she had a friend who had, uh, who ran a convenience store. And this woman suffered with kleptomania, her friend, right? And she couldn't control it, so she always had the urge to steal, and she always gets in trouble. So, her friend who runs a convenience store said, hey, you have kleptomania, I have a convenience store, why don't you just come into my store every day and just take something, right? Because she knows that as a friend, she's not going to do anything with the stuff that she takes, right? Kleptomaniacs don't care about the things they take, they just take anything that's in front of them, and then her friend is just going to go to the house, take back her stuff and put it back in the convenience store. That way, her friend will not get into trouble with the police, and and you know, will not be called a criminal, because she's not really stealing. She's just taking stuff from her friend's shop and and bring it back home, and her friend gets it back later. So, I thought that was a pretty clever way to, you know, solve the problem, right? Of course, stealing can have comes with consequences, right? If you go to another person's shop who doesn't know who you are, and you have this urge to steal, and you steal, that's that's a criminal offense. Right? It's it's crime. So, you can get sent to prison, and that's a problem for people who are kleptomaniacs. They don't mean to do it, they don't want to really do it, but they have this uncontrollable urge to just steal. And this is a recognized mental disorder. So, you know, if if you can plead in court that you have this mental problem, you may get away with it, right? Now, how do you measure this? How do you know whether someone has kleptomania? So, there is a scale, kleptomania symptom assessment scale, K-SAS, right? Um, it goes from zero to four, none to extreme, right? So, let's look at some of the questions, right? The following questions are aimed at evaluating kleptomania symptoms, please read the questions carefully before you answer. If you have had urges to steal during the past week, on average, how strong were your urges? Please circle the most appropriate number, so you you guys can answer this in your head, how strong were your urges to steal. I didn't feel any urge to steal, so I'm going to put zero, right? Someone with kleptomania probably put three or four, right? Next question, during the past week, how many times do you experience urges to steal? And so on, and so forth, right? So, uh, there are a variety of questions that which which test I can't remember how many questions exactly. Uh, but you should make an effort to go and find this scale online, download it, read it, and memorize at least two of the items, right? Because it might come out in the exam, you know, right, what are one of the items, you know, is it a valid scale? Is it quantitative, you know, how many items are there? So, uh, you should know the scale, um, like the back of your hand. So, it tests for impulses, thoughts, feelings, and behaviors that are all related to kleptomania. It is a type of self-report, right? So, this is something that you can just do as a survey on your own. There are 11 items on a scale of zero to four, right? The higher your score, the higher you have kleptomania, the higher, uh, the higher your kleptomania, uh, characteristics, right? Um, it also has very good retest reliability, so this is when you administer a test to someone, and then you administer it again at a different time, and again at a different time, and it seems that this test has a very high retest reliability, meaning that you can administer to the same person over and over again and they get the same response, which is a good thing, right? It also shows a lot of concurrent validity, okay? Concurrent validity, okay, let me explain, what does concurrent validity mean, right? Uh, concurrent validity is when, okay, so I'm talking about validity, so whether something is accurately measuring what it's supposed to measure. Concurrent here means that, um, together with another scale, it measures in the direction that it should be measuring, uh, in in the expected direction. I'll give you an example. I'm just trying to remember what the name of the GAFS scale is. Okay, it's global assessment of functioning scale, right? Global assessment of functioning scale. So, essentially, in a sense, if you score high on the GAFS, it means that you can function well, right? If you score high on kleptomania, it means you are stealing a lot, right? So, you have, you know, in in another way of saying bad functioning. So, if a person has a high kleptomania score, would you expect them to have a high or a low GAFS score? They should have a low GAFS score, because obviously, if they have kleptomania, they're probably not functioning very well in society, right? So, if you have a high kleptomania and a low GAFS score, that shows concurrent validity, right? It makes sense that this person scores low on GAFS and high on kleptomania. If a person scores high on kleptomania and high on GAFS, that doesn't make sense. You can't have impulse control disorder and be a very good functioning human being, right? That doesn't make logical sense. So, that's what concurrent validity is. You take a scale that you can logically understand if this scale goes in this particular direction, I should get either the same direction or an opposite direction from another scale, right? So, it shows concurrent validity, which is good, and also it produces quantitative data, which makes it easy to calculate and compare, you know, between people, okay?
[19:43]But also remember that although this sounds good, what are the weaknesses of self-reports, for example, right? Oftentimes, we have to evaluate, right? In our essay questions, what are the weaknesses of this or weaknesses of that, right? So, when it comes to self-report, what's the weakness? The weakness is that it is, right, it's rather biased, right? Because a person can answer whatever they want. Especially when you ask someone questions which are very sensitive about their disorder, they may not feel comfortable sharing about it, you know, to any any random stranger. And so, because of that, um, they may give biased or very inaccurate results, right? So, you have to be aware that although self-reports are easier for people to fill out, they're not so, um, they they can contain bias, and people may may report dishonestly, okay? Okay, the next, the next impulse control disorder, what does that look like?
[20:41]Anybody can guess? Okay, so it's pyromania, right? If you heard the word pyromania, I I refer to it earlier in the DSM. So, pyromania is this incredible impulse to set things on fire, right? It's a fascination with fire, right? I, in fact, when I was a young boy, I was quite fascinated with fire. Uh, you know, I'm actually a magician. I love performing magic tricks, and I often I for my class, I actually did a fire magic trick for my students to watch. And so, I'm very fascinated by fire, right? But I don't feel an insatiable or or an unresist irresistible impulse to set everything on fire, right? People who have pyromania have that problem, right? So, it's an impulse control disorder, it's an impulse to start fires, right? Um, so, again, it's tension, followed by pleasure. You feel this tension that, you know, you shouldn't start a fire randomly anywhere, you know, you are, and that's why you start a fire, and then you feel the pleasure after doing it, right? So, it's also a fascination with fire, right? It's people who are fascinated by fire and they just want to keep looking at it. They just want to look at things. In fact, it doesn't even have to be fire, it could be other things, you could just it could just be watching a movie that has fire in it, right? And that could also give them that sense of pleasure, right? Um, they're also attracted to accelerance and explosions. So, accelerance are things like, you know, gas, fuel, lighter fluid and stuff like that. And, you know, those things that make fires bigger and stuff like that, you know, explosions, boom, boom, boom, right? They want to see explosions, they want to see things go go up in flames, right? Um, now, some people who have pyromania, they could be indifferent, right? So, it doesn't matter to them if they set things on fire, but some people could feel distressed, right? So, for example, you set things on fire, and what if your whole house catches fire and it burns down, right? It could leave you in a sense of distress, right? You don't you don't mean to hurt people, right? Pyromaniacs are not there to hurt people, they don't want to cause pain to others, but they just have this strong urge and desire to set stuff on fire, and it's unfortunate, rather, that fire can be very damaging, right? So, because it damages things and and it can hurt people, they might feel distressed, right? But some people feel indifferent, they don't really care. So, it really depends. Now, what else might they do, right? As I gave you an example earlier, they might like to watch movies, which have, um, um, um fiery scenes or explosions in it. What else do you think they might do? What kind of jobs do you think, um, what jobs might these people seek? Think about that, if you have pyromania and you like things which are on fire, what what kind of job do you think would be suitable for you?
[23:54]All right? I I give the example of a fireman, right? A fireman, right? A fireman's job is, you know, to be around fire. Although, technically, a fireman's job should be to put out the fire, but at least you get to see fires more often on a daily basis compared to a normal person, right? So, they might might choose jobs like fireman, right? Okay, then disorder I talked about earlier, right? The disorder that is kind of like an addiction, but it's not really an addiction to a substance. This is the gambling disorder, right? So, gambling disorder is a bit unique, okay?
[24:34]Right? So, this is also sometimes called a non-substance addictive disorder. Right? So, yes, it's an addictive disorder, but it kind of falls in between addictive disorder and impulse control disorder, because you feel the impulse to gambling, but you don't have to take a substance to do it, right? So, there's no substance there. So, that's why it's a non-substance addictive disorder. It, uh, reason why people feel the, uh, uh, uh addiction is because when you gamble, it stimulates your brain's reward center, right? And this is similar to what happens to people who have substance abuse, right? So, when people smoke, and the nicotine, the chemical in in smoking that causes the addiction is nicotine, that stimulates your brain's reward center, right? Uh, alcohol, and all of this, it stimulates your brain in the way that your brain becomes addicted to the substance, right? So, substance abuse is when your brain gets stimulated, the reward center particularly, and you get addicted. So, what happens in gambling is that although there's no substance, the process that happens in the brain is similar, right? The reward center is stimulated, it's classified by very persistent and problematic behavior to do with gambling, where people cannot stop gambling. They lie to their friends and family, because they want to gamble, so they lie, oh, I really need to borrow S$500. I don't have any income this month, I need to to to go and buy groceries, and then they go and gamble it away, right? So, it compromise a lot of relationships with people. You can't trust anybody, your your parents and your family can't trust you, you know, because you keep lying and and and taking money to go and um gamble. So, again, why is this unique? It's unique because it's like an addiction, but it doesn't have a substance attached to it, right? So, it also has this impulse to gamble, so it's part of impulse control disorder, but it has a special name, right? Uh, there was a video here. Uh, what was this video?
[27:00]Okay, I think this video was just ah, this video was about EMDR therapy and stuff like that. You can find videos about EMDR online, okay, to see what what what they can show and, uh, you can see examples there, okay?
[27:27]I think this was a woman explaining it.
[27:54]Okay, anyway, that's it for now.
[27:59]Um, um, please do again, consult your textbook, consult your own lecturer, uh, go and read more information online and, um, um, um, um, very much I highly encourage you, please go and read the original studies, right? Miller's study, Glover's and all that, right? Um, if you want to follow me on Instagram and so on, you can, you know, casually, you can chat with me as well. My Instagram is @MagicRoss7, my name is Ross Stevenson, and that really is a picture of me with big afro. Uh, please help me out by liking, commenting and subscribing to my channel. This helps me, you know, build my YouTube channel from, you know, where it was, it started out with zero, and, uh, I got almost 800 plus views and 800 plus subscribers, and some of my videos have thousands of views. So, that's very encouraging, and I really thank you all so much. Um, if any of you are feeling generous, you want to donate to me, you can buy a PayPal, or if you live in Malaysia, you can contact me directly and I can give you my, you know, bank, uh, details so you can wire transfer from overseas or from Malaysia, or even if you want to pay me in cryptocurrency, that's perfectly fine, except Bitcoin, too. Okay, but only if you are able to, right? If you are a student and you're living on a tight budget, don't feel, uh, obliged to do it, right? Thank you so much, and all the best in your psychology.
