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1. INTERMITTENT EXPLOSIVE DISORDER
A. Several discrete episodes of failure to resist aggressive
impulses that result in serious assaultive acts or destruction
of property.
B. The degree of aggressiveness expressed during the episodes
is grossly out of proportion to any precipitating psychosocial
stressors.
C. The aggressive episodes are not better accounted for by
another mental disorder (eg, antisocial personality disorder,
borderline personality disorder, a psychotic disorder, a manic
episode, conduct disorder, or attention-deficit / hyperactivity
disorder) and are not due to the direct physiological effects of
a substance (eg, a drug of abuse, a medication) or a general
medical condition (eg, head trauma, Alzheimer's disease).
2. KLEPTOMANIA
A. Recurrent failure to resist impulses to steal objects that
are not needed for personal use or for their monetary value.
B. Increasing sense of tension immediately before committing
the theft.
C. Pleasure, gratification or relief at the time of
committing the theft.
D. The stealing is not committed to express anger or
vengeance and is not in response to a delusion or a
hallucination.
E. The stealing is not better accounted for by conduct
disorder, a manic episode or antisocial personality disorder.
3. PYROMANIA
A. Deliberate and purposeful fire setting on more than one
occasion.
B. Tension or affective arousal before the act.
C. Fascination with, interest in, curiosity about, or
attraction to fire and its situational contexts (eg,
paraphernalia, uses, consequences).
D. Pleasure, gratification, or relief when setting fires, or
when witnessing or participating in their aftermath.
E. The fire setting is not done for monetary gain, as an
expression of sociopolitical ideology, to conceal criminal
activity, to express anger or vengeance, to improve one's living
circumstances, in response to a delusion or hallucination, or as
a result of impaired judgment (eg, in dementia, mental
retardation, substance intoxication).
F. The fire setting is not better accounted for by conduct
disorder, a manic episode, or antisocial personality disorder.
4. PATHOLOGIC GAMBLING
[Ludopathy]
A. Persistent and recurrent maladaptive gambling behavior as
indicated by five (or more) of the following:
(1) is preoccupied with gambling (eg, preoccupied with
reliving past gambling experiences, handicapping or planning the
next venture, or thinking of ways to get money with which to
gamble)
(2) needs to gamble with increasing amounts of money in
order to achieve the desired excitement
(3) has repeated
unsuccessful efforts to control, cut back, or stop gambling
(4)
is restless or irritable when attempting to cut down or stop
gambling
(5) gambles as a way of escaping from problems or of
relieving a dysphoric mood (eg, feelings of helplessness, guilt,
anxiety, depression)
(6) after losing money gambling, often
returns another day to get even ("chasing" one's
losses)
(7) lies to family members, therapist, or others to
conceal the extent of involvement with gambling
(8) has
committed illegal acts such as forgery, fraud, theft, or
embezzlement to finance gambling
(9) has jeopardized or lost a
significant relationship, job, or educational or career
opportunity because of gambling
(10) relies on others to provide
money to relieve a desperate financial situation caused by
gambling
B. The gambling behavior is not better accounted for by a
manic episode.
5. TRICHOTILLOMANIA
A. Recurrent pulling out of one's hair resulting in
noticeable hair loss.
B. An increasing sense of tension immediately before pulling
out the hair or when attempting to resist the behavior.
C. Pleasure, gratification, or relief when puling out the
hair.
D. The disturbance is not better accounted for by another
mental disorder and is not due to a general medical condition
(eg, a dermatological condition).
E. The disturbance causes clinically significant distress or
impairment in social, occupational, or other important areas of
functioning.
6. IMPULSE-CONTROL DISORDERS NOT OTHERWISE SPECIFIED
The diagnosis of impulse-control disorders not otherwise
specified (NOS) is given to patients who exhibit an
impulse-control problem that does not fit into one of the other
five categories or is not listed elsewhere in DSM-IV (eg,
substance abuse, a paraphilia). Common examples of
impulse-control disorders NOS are face picking, sexual
behaviors, compulsive shopping, or repetitive self-mutilation.
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