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      Cognitive inflexibility in a young woman with pyromania

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          Abstract

          Background

          Pyromania is a rare disorder that is characterized by multiple episodes of deliberate and purposeful fire-setting. It is typically associated with significant psychosocial dysfunction and legal problems. Even so, little research has examined cognitive aspects of the disorder.

          Case presentation/study

          In this study, we compared a 24-year-old woman with pyromania with 19 age- and gender-matched healthy controls using a battery of computerized neurocognitive tasks. Our participant affected by pyromania showed impaired cognitive flexibility but intact functioning on measures of impulsive action and decision-making.

          Discussion

          Although pyromania shares phenomenological similarities with other urge-driven disorders, our results suggest that pyromania may have features of compulsivity as well.

          Conclusions

          Pyromania is relatively understudied from a neurobiological perspective. Further research is needed to understand the pathophysiology, classification, and treatment of pyromania.

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          Most cited references 11

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          Compulsive aspects of impulse-control disorders.

          Impulsivity and compulsivity have been considered opposite poles of a continuous spectrum, but their relationship seems to be more complex. Disorders characterized by impulsivity often have features of compulsivity and vice-versa. Impulse-control disorders (ICDs) are characterized by repetitive behaviors and impaired inhibition of these behaviors, suggesting a similarity to the frequently excessive, unnecessary, and unwanted rituals of obsessive-compulsive disorder (OCD). There are, however, important differences be-tween ICDs and OCD. The construct of compulsivity as related to ICDs and OCD warrants additional investigation to identify the similarities and differences and to examine the implications for prevention and treatment strategies.
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            The DSM-III-R impulse control disorders not elsewhere classified: clinical characteristics and relationship to other psychiatric disorders.

            The authors reviewed available studies of DSM-III-R impulse control disorders not elsewhere classified in order to determine the relationship of these disorders to one another and to other psychiatric disorders. The review focused on the demographic and clinical characteristics, phenomenology, family history, biology, and response to treatment of individuals with intermittent explosive disorder, kleptomania, pathological gambling, pyromania, and trichotillomania. Analysis was restricted to reports which either indicated use of operational diagnostic criteria or provided descriptions of the impulsive behavior detailed enough that patients could be judged as probably meeting the DSM-III-R criteria. Although different impulse control disorders have different sex ratios, all have similar ages at onset and courses. Studies on phenomenology, family history, and response to treatment suggest that intermittent explosive disorder, kleptomania, pathological gambling, pyromania, and trichotillomania may be related to mood disorders, alcohol and psychoactive substance abuse, and anxiety disorders (especially obsessive-compulsive disorder). Biological studies indicate that intermittent explosive disorder and pyromania may share serotonergic abnormalities similar to those reported in mood disorders. The impulse control disorders not elsewhere classified appear to be related to one another and to mood, anxiety, and psychoactive substance use disorders. Thus, like major depression, obsessive-compulsive disorder, panic disorder, bulimia nervosa, and attention deficit hyperactivity disorder, they may represent forms of "affective spectrum disorder."
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              Are obsessive-compulsive symptoms impulsive, compulsive or both?

              The relationships between obsessive-compulsive symptoms and distinct forms of impulsivity and compulsivity are unclear. Such examination would be relevant in terms of how best to classify psychiatric disorders and in understanding candidate 'traits' that extend across a continuum between normalcy and clinical disorders.
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                Author and article information

                Journal
                jba
                JBA
                Journal of Behavioral Addictions
                J Behav Addict
                Akadémiai Kiadó (Budapest )
                2062-5871
                2063-5303
                10 March 2018
                March 2018
                : 7
                : 1
                : 189-191
                Affiliations
                [ 1 ]Department of Psychiatry and Behavioral Neuroscience, University of Chicago , Chicago, IL, USA
                [ 2 ]Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen, Denmark
                [ 3 ] H. Lundbeck A/S , Valby, Denmark
                Author notes
                [* ]Corresponding author: Austin W. Blum, JD; Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S. Maryland Avenue, MC 3077, Chicago, IL 60637, USA; Phone: +1 773 834 1325; Fax: +1 773 834 6761; Email: ablum@ 123456uchicago.edu
                Article
                10.1556/2006.7.2018.09
                6035016
                29464963
                © 2018 The Author(s)

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium for non-commercial purposes, provided the original author and source are credited, a link to the CC License is provided, and changes – if any – are indicated.

                Page count
                Figures: 0, Tables: 1, Equations: 0, References: 11, Pages: 3
                Funding
                Funding sources: Internal funds.
                Categories
                CASE REPORT

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