Disorders due to addictive behaviors and impulse control disorders.

Abstract

This chapter focuses on two groupings of disorders in the 11th revision of the International Classification of Diseases World Health Organization [WHO], 2023): disorders due to addictive behaviors-namely, gambling disorder and gaming disorder-and impulse control disorders, which include pyromania, kleptomania, compulsive sexual behavior disorder, and intermittent explosive disorder. As described in the Clinical Descriptions and Diagnostic Requirements for ICD-11 Mental, Behavioural and Neurodevelopmental Disorders (CDDR; WHO, 2024), disorders due to addictive behaviors and impulse control disorders are disabling conditions sharing impulsivity and loss of control as core features. A common characteristic of these disorders is that they lie at the extreme pole of an impulsivity continuum linking normal behavior to dysregulated, pathological behavior (Padhi et al., 2012). At the symptomatic level, these disorders may also share common experiences of an overwhelming urge (or craving) before engaging in the behavior and a feeling of relief or pleasure afterwards. A vicious circle involving a dynamic interaction between positive and negative reinforcement therefore can contribute to the maintenance of these conditions (Dell'Osso et al., 2006). Positive reinforcement in the context of these conditions typically relates to feelings of gratification, pleasure, excitement, or euphoria, whereas negative reinforcement typically relates to the relief or reduction of aversive emotional states (e.g., dysphoria, boredom,