The DSM-V workgroup proposes to include impulse control disorders and conduct or disruptive behavior disorders in the same category. This implies, in my opinion, that there is something intrinsically similar among these conditions. Now I am personally strongly opposed to this connotation, as I was originally diagnosed with impulse control disorder NOS in 2008, and one of my major fears was being seen as merely behaviorally disordered. Now in the current DSM-V draft, only intermittent explosive disorder is listed along with conduct disorder, oppositional defiant disorder, dyssocial personality disorder (antisocial personality disorder) and disruptive behavior disorder not elsewhere classified. Trichotillomania, now called hair-pulling disorder, is reclassified under the obsessive-compulsive and related disorders. I have not yet seen what happed to kleptomania, pyromania and impulse control disorder NOS.
Now I can see why intermittent explosive disorder would be seen as a behavior disorder, in the sense that people do have an essential problem with aggression. However, etiologically speaking, there is quite a difference between willfully destroying property or attacking someone and doing so in an impulse. I know that for the victim it makes little difference, but that’s not my point. Treatment is also quite different if someone is malicious rather than impulsive.
Now the DSM should be focused on observable behavior, not on etiology. I am not sure, therefore, what I think yet. Is it merely my personal fear of being diagnosed with something seen as a behavior disorder again, or is it something else? As a side note, my current psychologist removed the diagnosis of impulse control disorder NOS from my file in 2010.
