Man jumping off of rock ledge into waterImpulsivity describes a tendency to react to stimuli quickly and without much thought. It often involves unplanned risky behavior, action without forethought, and decreased sensitivity to immediate or long-term consequences. Historically, the definition of impulsivity has been inconsistent, although research on the topic dates back 2,500 years. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) now categorizes impulse control issues separately from addictions and compulsions.

Understanding Impulsivity

According to recent studies, several theories have been established to refine the definition of impulsivity. Some theorists believe impulsivity is behavioral, while others see it as a cognitive phenomenon. There are biological, neuropsychological, and biopsychosocial perspectives on impulsivity as well. Another study found that people with lower levels of dopamine had higher rates of impulsive behavior, offering a biological explanation for impulsivity. Although definitions vary, impulsivity is most often defined as unplanned responses to stimuli with little or no thought given to consequences.

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Many researchers have distinguished between functional and dysfunctional impulsivity to clarify that not all impulsivity is negative. Impulsivity is common among children and young adults, even proving useful in some situations. For example, impulsive action might be what is required when responding to a crisis. It could also come in handy when trying something beyond one’s comfort zone. Impulsivity could save a life or bring feelings of satisfaction that come from taking a risk that pays off. 

However, not all impulsive behaviors have positive consequences. Regular and frequent impulsiveness is often categorized as a symptom of a larger issue, especially when it leads to harm of the self or others. 

Impulsivity as a Symptom

When a consistent pattern of impulsive behavior develops, this pattern can be classified as a symptom if the impulsive actions negatively impact an individual’s daily functioning. Because dysfunctional impulsivity can be accompanied by the negative effects of high-risk behaviors, it is often found among the criteria for several mental health conditions, including the following:

Although impulsivity is a common symptom of several mental health conditions, it is important to note that not all people who experience impulsivity meet the criteria for a mental health diagnosis. Impulsivity should only be viewed as a concerning symptom when a person’s functioning is impaired or they are consistently experiencing negative consequences due to impulsive actions. Conditions primarily associated with impulsivity are referred to as impulse control conditions.

What Are Impulse Control Conditions?

Diagnoses centered around impulse control issues can be taxing for those who experience them. Each type of impulse control issue comes with its own set of challenges. Unlike other mental health conditions, impulse control issues are primarily related to an individual’s difficulty with managing behavioral impulses. Impulse control conditions are characterized by an irresistible desire to complete an action, even if that action proves detrimental to their health or well-being. 

Research indicates that impulse control conditions share some core characteristics. The first of these is that the behavior continues despite negative or harmful consequences, meaning an individual could be having difficulty controlling their own behavior. Another sign of an impulse control condition is that control over behavior may continue to decline consistently. Cravings or urges may also occur prior to engagement in a tempting behavior. Finally, some form of pleasure reward often accompanies the behavior.

The chronic impulsivity associated with these conditions can be harmful to an individual or the people around them and often leads to serious issues like job loss, lack of social supports, financial hardship, or legal problems. Some of the more common impulse control conditions are explained below.

  • Intermittent explosive behavior (IED): Involves recurrent episodes of anger and aggression that occur without thought. Acts of aggression often result in harm and appear disproportionate to any apparent stressors.
  • Pyromania: Involves intentional setting of fires on more than one occasion. People are attracted to and fascinated by fire and often experience some sort of arousal prior to fire-setting acts. They generally report being drawn to fire and feelings of relief or pleasure upon completion of the behavior. 
  • Kleptomania: Involves the compulsive and repetitive stealing of objects that are rarely of any use to the person. The stealing behavior is accompanied by strong feelings of guilt, and the stolen items are often returned, hoarded, or thrown away. 

Addressing Impulsivity

Impulsive behavior is not necessarily something to worry about. Everyone acts impulsively at one time or another, and in some situations, acting on impulse is necessary. However, for those who struggle with impulse control on a regular basis and experience negative consequences as a result, help is available. A good first step might be to talk with a trusted doctor or mental health professional for an evaluation. 

When it comes to therapy, research indicates that cognitive behavioral therapy (CBT) may be effective in treating impulse control issues. CBT helps people determine their behavioral triggers and learn strategies to manage their responses. In terms of pharmacological options, some have found success in treating issues like kleptomania and pyromania with medication. A few studies have explored antidepressants for treating impulsivity. Nonetheless, more research is required to establish the efficacy of any one psychotropic medication. 

People interested in receiving support for impulsivity and impulse control conditions may find it helpful seek support from a trained mental health professional. In therapy, people are often able to learn skills and strategies for mitigating negative effects of impulse control conditions. 

Case Examples of Impulsivity

  • CBT for an impulse control condition: Elsbeth, 33, has been diagnosed with IED. She often finds herself having angry reactions that are disproportionate to a situation, like traffic or her children misbehaving. Before she thinks about it, she yells and acts erratically, and when the episode is over, she feels shame for losing control and often frightening her children. Wishing to learn how to better manage her reactions and redirect feelings of immediate anger, she begins speaking with a therapist who specializes in CBT. Elsbeth's therapist helps her learn different ways of thinking about and processing anger when a stressful situation comes up. Over time, she is able to gain back control over her impulsive anger reactions and channel her feelings in a more productive way.

References:

  1. Bakhshani, N. (2014, June 1). Impulsivity: A predisposition toward risky behaviors. International Journal of High Risk Behaviors and Addiction, 3(2). doi: 10.5812/ijhrba.20428
  2. Buckholtz, J. W., Treadway, M. T., Cowan, R. L., Woodward, N. D., Li, R., Ansari, M. S., Baldwin, R. M., et al. (2010, July 30). Dopamergic network differences in human impulsivity. Science, 329(5991), 532. doi: 10.1126/science.1185778 
  3. Iliades, C. (2014, November 17). Understanding impulse control and conduct disorders. Psychiatry Advisor. Retrieved from http://www.psychiatryadvisor.com/anxiety/understanding-impulse-control-and-conduct-disorders/article/383763/
  4. Moeller, F. G. (2011). Historical perspectives on impulsivity and impulse control disorders. The Oxford Handbook of Impulse Control Disorders. doi: 10.1093/oxfordhb/9780195389715.013.0014 
  5. Schreiber, L., Odlaug, B. L., & Grant, J. E. (2011, Feb 21). Impulse control disorders: Updated review of clinical characteristics and pharmacological management. Front Psychiatry, 2(1). doi: 10.3389/fpsyt.2011.00001