DSM-5 Category: Disruptive, Impulse-Control, andConduct Disorders Introduction Disruptive, impulse-control, and conduct disorders are a class of diagnoses characterized by difficulties controlling emotions and behaviors. These disorders frequently involve uncontrolled impulses leading the individual to violate the rights of others through acts of aggression or destruction, as is the case in pyromania (The American Psychiatric Association, 2013). Pyromania remains a relatively under-researched and possibly under-reported impulse control disorder. The strong urges to watch existing fires or to set new fires may lead individuals who meet the criteria for pyromania to engage in acts of arson, often endangering their own lives and the lives of others. This is considered a significant risk to the individual with pyromania and those around them (The American Psychiatric Association, 2013). Symptoms of Pyromania Pyromania is hallmarked by fascination with and attraction to fire and fire-starting paraphernalia, as well as the deliberate and repeated setting of fires. Individuals diagnosed with pyromania often experience tension or affective arousal before setting a fire, and feelings of pleasure, gratification, or relief during or after fire-starting. Fire setting is not done for monetary or other gain, to conceal crimes, in response to delusion or hallucination, or as a result of a lack of judgment. Additionally, the fire setting behaviors should not be better explained by conduct disorder or other psychiatric illness (The American Psychiatric Association, 2013). Individuals with pyromania commonly spend time closely associated with fire departments, even becoming firefighters, and are often seen watching any fires in their neighborhoods. It is not uncommon for these individuals to set small fires or set off false alarms in order to see firefighting equipment (The American Psychiatric Association, 2013). Pyromania is diagnosed significantly more often in males, particularly in those with poor social skills or other learning disabilities, though it is unclear why gender disparity remains so strong (The American Psychiatric Association, 2013). Diagnosis of Pyromania Diagnosis of pyromania is typically based on criminal records of repeated or suspicious fire setting and patient reports regarding their emotional relationship with fire. The mechanisms behind pyromania are unclear, and patients often experience episodic remissions in firesetting urges (The American Psychiatric Association, 2013). Patients should not be diagnosed with pyromania if their fire setting occurs as a result of conduct disorder, antisocial personality disorder, as a result of hallucinations or other over 40% of individuals arrested for arson in the United States are under 8 years of age. Therefore. 2013). eleven male). revenge. . Co-morbidity of Pyromania Pyromania often occurs alongside a past history of alcohol use disorder. 2013).neurological conditions or intellectual disabilities. while channeling their urges into safe fire-setting techniques (The American Psychiatric Association. bipolar and depressive disorders. Through careful forensic analysis of fire scenes. and pathological gambling. or other malicious intent (The American Psychiatric Association. attention-deficit/hyperactivity disorder. Treatment of Pyromania There is a strong indication that individuals diagnosed with impulse-control disorders. it is important to distinguish between the criteria for pyromania and fire-setting behaviors in conduct disorder. Interestingly. and ten diagnosed with other impulsecontrol disorders (Gyant & Kim. it is unclear just how many individuals in the general population may meet the criterion for diagnosis with pyromania. and is most commonly comorbid with antisocial personality disorder. may respond well to an approach including the use of psychopharmaceuticals. Prevalence of Pyromania The true prevalence of pyromania is currently unknown. may provide more extensive insight into the nature and prevalence of pyromania and breakthroughs in potential treatments (Burton. they did match the emotional anticipation and release patterns consistent with pyromania. and concluded that the mean age of onset was 18 years. In these cases. Pyromania very rarely appears as a primary diagnosis (The American Psychiatric Association. over half (thirteen) of the twenty-one patients were also diagnosed with comorbid Axis I mood disorders. such as lighters. and has been diagnosed in only 3. As such. While many of the fires set by individuals in this study did not meet the criteria for arson. Further evaluations of fire scenes by forensic mental health experts. This data may be useful when analyzing the tendency for individuals with pyromania to obsess over paraphernalia related to fire. opiate antagonists. McNiel. & Binder. 2013). 2012). indicating that fire-setting in adolescents is a significant concern despite the fact that childhood diagnosis of pyromania remains quite rare. with fires set every 5.9 weeks on average. and other adjustment or impulse control disorders (The American Psychiatric Association.3% of individuals incarcerated due to repeated fire setting. experts may be able to provide more accurate data regarding the prevalence of intentional fire setting and techniques use in lighting these fires. Selective serotonin reuptake inhibitors (SSRIs). Currently. including pyromania. One study conducted evaluated twenty-one subjects diagnosed with pyromania (ten female. further research need to be conducted on pyromania to clarify the possible etiologies and comorbidities associated with the disorder. 2007). or with monetary. substance intoxication. 2013).13% of the population based on population sampling. Pyromania has been estimated to occur in approximately 1. substance use disorder. including but not limited to those attributed to arson. antiandrogens. and atypical use of antipsychotics may contribute to the successful reduction in the symptoms of pyromania (McIntyre. arson. and may make treatment of pyromania difficult (Grant. and the forensic mental health expert. & Prous. Schreiber. (2006). & Odiaug.R.. Firesetting. S.. R. beta blockers. (2006). lithium. D. . M. & Odiaug. 1077-1084. P. (2013). The (2013). L. Warling. C. Arlington.L.. the initial results are promising and should be followed with double-blind clinical trials (Roncero. et al. with antisocial behavior strongly predictive of recidivism in fire-starting behavior. Henderson. J. Due to the potentially dangerous. J. 68(11). 355-365. Del Bove.A. Diagnostic and statistical manual of mental disorders (5th ed. not to mention the possibility of conviction and incarceration for arson. B. Journal of the American Academy of Child and Adolescent Psychiatry..N.. Psychopharmacology of impulse-control disorders. & Prous.. Ultimately.E. L.R.. There is a gap in the body of literature related to treatment of impulse disorders. (2012). & Kim. This indicates that children. and antiepileptics may also be successful in controlling the impulsive symptoms of pyromania. J. MacKay. Phenomenology and treatment of behavioural addictions.. Marton. J. Journal of the American Academy of Psychiatry and the Law. Fire interest and antisociality as risk factors in the severity and persistence of juvenile firesetting... & Binder. consequences of pyromania. Serradell. Schreiber. Grant.mood stabilizers. Outcomes for Pyromania Interest in fire and the presence of antisocial behavior are significantly and positively correlated...N. (2007).R. G. N. McNiel.E.E. J. individuals should remain in lifelong contact with qualified psychiatric personnel. (2013). there has not been a significant level of success in controlling the symptoms of pyromania through any one specific treatment. and adults who demonstrate antisocial behaviors and interest in fire should be monitored and kept in treatment to prevent the urges associated with pyromania from emerging in a dangerous manner (MacKay. 31(3).E. Serradell.). Burton. 252-259. D.. & Casas. Moral. B. 1717-1722. Drugs of the Future. 58(5). Canadian Journal of Psychiatry. Grau-Lopez. VA: American Psychiatric Publishing.W. 2006). 2009). References American Psychiatric Association. P. 2006). Rodriguez-Urrutia. Moral.. & Root.R. 45(9).S. Clinical characteristics and psychiatric comorbidity of pyromania. 40(3). McIntyre. Journal of Clinical Psychiatry. While research into the use of antiepileptics is new and primarily based on case reports. adolescents.. More recent research indicates that the use of naltrexone. 245-258.L..L. Gyant. S. J. or even fatal. pyromania. . M. ACTAS Espanolas de Psiquitria.Roncero. C.. L. Rodriguez-Urrutia.. Antiepileptic drugs in the control of the impulses disorders. 37(4). A.. 205-212. & Casas. (2009). Grau-Lopez. Some other behavoral disorders are Anorexia Nervosa. rash driving etc. some pyromaniacs start fires because they are fixated upon fire-fighting institutes and fire fighters. Bulimia Nervosa. They feel excited and aroused watching the effect of the fire. etc. which is mostly committed to achieve a financial/personal gain. and they cause fires just to see these people in action. Pyromania is common in people who struggle with personal issues and aggression. Awareness of destructive behavior and feeling unable to change it Massive mood swings Short and intense periods of anxiety and stress Domestic violence Suicidal behavior . watching it spread. Additionally. People feel a sense of gratification and relief after starting a fire. Pyromania is like kleptomania in that the patients commit criminal activities out of impulse and not for any perceived gain. mostly evident right before the fire gets started. Pyromaniacs usually set fire deliberately to induce euphoria. however. there has been no consensus in the scientific community about it.Pyromania Defining Pyromania Pyromania is an impulse control disorder in which the patients are unable to control their urge to start fires. Trichotillomania. There are a number of theories revolving around the psychological functioning behind such a fixation. Kleptomania. When the fire is out they may become upset that the fire has burned out and have the desire to start another one to being back the thrill. This is very different from arson. Signs and Symptoms of Pyromania Impulsive behavior Unsafe and risky indulgences like unprotected sex. Environmental factors also play an important role in activating the “fight or flight” mechanism of the human brain. Certain parts. This conditions the patient’s mind to check his actions before he commits the act of lighting the fire. including: Criminal conviction on charges of arson Social alleviation Risk seeking behavior Distress Progression into complete mental imbalance Treatment Because the exact causes of pyromania are unclear. the exact treatment alternatives are also hazy. Genetics. It is during these instances of extreme stress and anxiety that the patient’s brain that may lead to the desire for thrill and excitement. The intensity of the treatment is a function of the severity of the condition and the age of the patient. scientists and researchers attribute the exact causes of to a combination of factors. Patients of pyromania are exposed to many risks. Feeling hopeless and often misunderstood Self-hate and self-detestation Causes and Risk Factors The exact cause of pyromania and other impulse control disorders is still not ascertained. However. play the most pivotal role in causing such disorders. however. especially those in the hypothalamus of the brain may get damaged due to a stressful encounter. there are a number of ways in which treatment can be administered based on documented case studies from the past. . CBT aims at making the user aware of his condition and the exact fallouts of his impulsive behavior. CBT is a step by step process in which the patient is exposed to his urges and urged to control his impulses. a life threatening situation or an accident. Cognitive behavioral therapy (CBT) is the most well recognized treatment for pyromania. by far. Neurobiology and general defects in the brain also cause abnormalities. leading to disorders like pyromania. Genetic mutations can affect neurotransmitters in the brain that can inhibit the regular social functioning and prompt individuals to start fires. Treatment centers can also be helpful in helping patients overcome the symptoms and fallouts of withdrawal from their condition. Patients of pyromania can also seek treatment in a professional treatment center. . It is best to visit a rehabilitation facility for treatment of pyromania.Long term psychotherapy is also employed to treat pyromania. It is important to contact the preferred center before checking in to make sure that they have the treatments offered for pyromania available.