Pyromania

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Pyromania
Burned container.jpg
Garbage container vandalised by arson, the end result of pyromaniac delinquency
Specialty Psychiatry, clinical psychology
Symptoms Impulsive starting of fires
CausesParental neglect, early physical or emotional abuse, early observation of inappropriate fire usage
PreventionCareful parental attention

Pyromania is an impulse control disorder in which individuals repeatedly fail to resist impulses to deliberately start fires, [1] to relieve some tension or for instant gratification. The term pyromania comes from the Greek word πῦρ (pyr, 'fire'). Pyromania is distinct from arson, the deliberate setting of fires for personal, monetary or political gain. [2] Pyromaniacs start fires to release anxiety and tension, or for arousal. [3] Other impulse disorders include kleptomania and intermittent explosive disorder.

Contents

There are specific symptoms that separate pyromaniacs from those who start fires for criminal purposes or due to emotional motivations not specifically related to fire. Someone with this disorder deliberately and purposely sets fires on more than one occasion, and before the act of lighting the fire the person usually experiences tension and an emotional buildup. When around fires, a person with pyromania gains intense interest or fascination and may also experience pleasure, gratification or relief. [4] Another long term contributor often linked with pyromania is the buildup of stress. When studying the lifestyle of someone with pyromania, a buildup of stress and emotion is often evident and this is seen in teens' attitudes towards friends and family. [5] At times it is difficult to distinguish the difference between pyromania and experimentation in childhood because both involve pleasure from the fire. [6]

Classification

ICD

The World Health Organization's International Classification of Diseases (11th Revision) ICD-11, regarded as the global standard, was released in June 2018 and came into full effect from January 2022. [7] [8] It states the following about pyromania: [9]

Pyromania is characterised by a recurrent failure to control strong impulses to set fires, resulting in multiple acts of, or attempts at, setting fire to property or other objects, in the absence of an apparent motive (e.g., monetary gain, revenge, sabotage, political statement, attracting attention or recognition). There is an increasing sense of tension or affective arousal prior to instances of fire setting, persistent fascination or preoccupation with fire and related stimuli (e.g., watching fires, building fires, fascination with firefighting equipment), and a sense of pleasure, excitement, relief or gratification during, and immediately after the act of setting the fire, witnessing its effects, or participating in its aftermath.

— ICD-11, chapter 6, section C70

It also notes that pyromania has no relation to intellectual impairment, substance abuse, or other mental and behavioral disorder. [9] ICD-11 was produced by professionals from 55 countries out of the 90 countries involved and is one of the most widely used reference worldwide by clinicians, with the other being the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR from 2022, DSM-5 from 2013, or their predecessors) [8]

DSM

The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, First Edition, released in 1952, categorized pyromania as a subset of Obsessive–compulsive disorder. In the Second Edition, the disorder was dropped. In the Third Edition, it returned under the category of impulse-control disorders. [10]

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), released in 2022, states that the essential feature of pyromania is "the presence of multiple episodes of deliberate and purposeful fire setting." [11] Pyromania moved from the DSM-4 chapter "Impulse-Control Disorders Not Otherwise Specified," to the chapter "Disruptive, impulse-control, and conduct disorders" in DSM-5. [12]

Signs and symptoms

According to DSM-5, there are six signs of pyromania. Pyromania is mainly categorized by the purposeful setting of fire, tension or arousal before a fire is set, interest in or attraction to fire, and pleasure or relief after setting a fire. These fires not set for personal gain, are not meant to express anger or conceal illegal activity, are not in support of sociopolitical ideologies, are not in response to delusions, and are not signs of intellectual disability. For diagnosis, the setting of fire should not be better explained by a conduct disorder, manic episode, or a personality disorder (antisocial personality disorder). [11] ICD-11 also adds substance abuse to this list. According to ICD-11, signs of fire setting may occur "in response to feelings of depressed mood, anxiety, boredom, loneliness, or other negative affective states." Those with pyromania exhibit problems in social environments and learning disabilities. Women pyromaniacs "often report histories of exposure to trauma, including sexual abuse, and self-harm." Episodic fire setting may become more intense and violent over time, becoming potentially chronic if untreated. [9]

Causes

Most studied cases of pyromania occur in children and teenagers. [5] There is a range of causes, but an understanding of the different motives and actions of fire setters can provide a platform for prevention. Common causes of pyromania can be broken down into two main groups: individual and environmental. This includes the complex understanding of factors such as individual temperament, parental psychopathology, and possible neurochemical predispositions. [13] Many studies have shown that patients with pyromania were in households without a father figure present. [14]

Pyromania can be common in those with substance use disorders, problem gambling, mood disorders, disruptive behaviour, anti-social disorders, and/or another impulse-control disorder. [9]

Environmental

Environmental factors that may lead to pyromania include an event that the patient has experienced in the environment they live in. Environmental factors include neglect from parents and physical or emotional abuse in earlier life. Other causes include early experiences of watching adults or teenagers using fire inappropriately and lighting fires as a stress reliever. [4]

Treatment and prognosis

The appropriate treatment for pyromania varies with the age of the patient and the seriousness of the condition. For children and adolescents treatment usually is cognitive behavioral therapy sessions in which the patient's situation is diagnosed to find out what may have caused this impulsive behavior. Once the situation is diagnosed, repeated therapy sessions usually help continue to a recovery. [4] Other important steps must be taken as well with the interventions and the cause of the impulse behavior. Some other treatments include parenting training, over-correction/satiation/negative practice with corrective consequences, behavior contracting/token reinforcement, special problem-solving skills training, relaxation training, covert sensitization, fire safety and prevention education, individual and family therapy, and medication. [13] The prognosis for recovery in adolescents and children with pyromania depends on the environmental or individual factors in play, but is generally positive. Pyromania is generally harder to treat in adults, often due to lack of cooperation by the patient. Treatment usually consists of more medication to prevent stress or emotional outbursts, in addition to long-term psychotherapy. [4] In adults, however, the recovery rate is generally poor, and if an adult does recover, it usually takes a longer period of time. [4]

History

Pyromania was thought in the 1800s to be a concept involved with moral insanity and moral treatment, but had not been categorized under impulse control disorders. Pyromania is one of the four recognized types of arson, alongside burning for profit, to cover up an act of crime and for revenge. Pyromania is the second most common type of arson. [15] Common synonyms for pyromaniacs in colloquial English include firebug (US) and fire raiser (UK), but these also refer to arsonists. Pyromania is a rare disorder with an incidence of less than one percent in most studies; also, pyromaniacs hold a very small proportion of psychiatric hospital admissions. [16] Pyromania can occur in children as young as age three, though such cases are rare. Only a small percentage[ quantify ] of children and teenagers arrested for arson are child pyromaniacs. A preponderance of the individuals are male; [17] one source states that ninety percent of those diagnosed with pyromania are male. [5] Based on a survey of 9,282 Americans using the Diagnostic and Statistical Manual of Mental Disorders , 4th edition, impulse-control problems such as gambling, pyromania and compulsive shopping collectively affect 9% of the population. [18] A 1979 study by the Law Enforcement Assistance Administration found that only 14% of fires were started by pyromaniacs and others with mental illness. [19] A 1951 study by Lewis and Yarnell, one of the largest epidemiological studies conducted, found that 39% of those who had intentionally set fires had been diagnosed with pyromania. [20]

See also

Related Research Articles

<i>Diagnostic and Statistical Manual of Mental Disorders</i> American psychiatric classification and diagnostic guide

The Diagnostic and Statistical Manual of Mental Disorders is a publication by the American Psychiatric Association (APA) for the classification of mental disorders using a common language and standard criteria. It is the main book for the diagnosis and treatment of mental disorders in the United States and is considered one of the principle guides of psychiatry along with the ICD, CCMD and the Psychodynamic Diagnostic Manual.

Paraphilia is the experience of intense sexual arousal to atypical objects, situations, fantasies, behaviors, or individuals. It has also been defined as sexual interest in anything other than a consenting human partner.

Pornography addiction is the popular but unscientific application of an addiction model to the use of pornography. Pornography may be part of compulsive sexual behavior with negative consequences to one's physical, mental, social, or financial well-being. While the World Health Organization's ICD-11 (2022) has recognized compulsive sexual behaviour disorder (CSBD) as an "impulsive control disorder", CSBD is not an addiction, and the American Psychiatric Association's DSM-5 (2013) and the DSM-5-TR (2022) do not classify compulsive pornography consumption as a mental disorder or a behavioral addiction.

Kleptomania is the inability to resist the urge to steal items, usually for reasons other than personal use or financial gain. First described in 1816, kleptomania is classified in psychiatry as an impulse control disorder. Some of the main characteristics of the disorder suggest that kleptomania could be an obsessive-compulsive spectrum disorder, but also share similarities with addictive and mood disorders.

The term chronophilia was used by psychologist John Money to describe a form of paraphilia in which an individual experiences sexual fixation limited to individuals of particular age ranges. The term has not been widely adopted by sexologists, who instead use terms that refer to the specific age range in question. An arguable historical precursor was Richard von Krafft-Ebing's concept of "age fetishism".

Intermittent explosive disorder is a behavioral disorder characterized by explosive outbursts of anger and/or violence, often to the point of rage, that are disproportionate to the situation at hand. Impulsive aggression is not premeditated, and is defined by a disproportionate reaction to any provocation, real or perceived. Some individuals have reported affective changes prior to an outburst, such as tension, mood changes, energy changes, etc.

Impulse-control disorder (ICD) is a class of psychiatric disorders characterized by impulsivity – failure to resist a temptation, an urge, or an impulse; or having the inability to not speak on a thought. Many psychiatric disorders feature impulsivity, including substance-related disorders, behavioral addictions, attention deficit hyperactivity disorder, fetal alcohol spectrum disorders, antisocial personality disorder, borderline personality disorder, conduct disorder and some mood disorders.

According to proponents of the concept, sexual addiction, also known as sex addiction, is a state characterized by compulsive participation or engagement in sexual activity, particularly sexual intercourse, despite negative consequences. The concept is contentious; neither of the two major mainstream medical categorization systems recognise sex addiction as a real medical condition, instead categorizing such behavior under labels such as compulsive sexual behavior.

Pyrophilia is a relatively uncommon paraphilia in which a subject derives gratification from fire and fire-starting activity. It is distinguished from pyromania by the gratification being of a sexual nature.

Pedophilia is a psychiatric disorder in which an adult or older adolescent experiences a primary or exclusive sexual attraction to prepubescent children. Although girls typically begin the process of puberty at age 10 or 11, and boys at age 11 or 12, criteria for pedophilia extend the cut-off point for prepubescence to age 13. According to DSM-5-TR, a person must be at least 16 years old, and at least five years older than the prepubescent child, for the attraction to be diagnosed as pedophilic disorder.

A child pyromaniac is a child with an impulse-control disorder that is primarily distinguished by a compulsion to set fires in order to relieve built-up tension. Child pyromania is the rarest form of fire-setting.

Brief psychotic disorder ⁠— according to the classifications of mental disorders DSM-IV-TR and DSM-5 ⁠— is a psychotic condition involving the sudden onset of at least one psychotic symptom lasting 1 day to 1 month, often accompanied by emotional turmoil. Remission of all symptoms is complete with patients returning to the previous level of functioning. It may follow a period of extreme stress including the loss of a loved one. Most patients with this condition under DSM-5 would be classified as having acute and transient psychotic disorders under ICD-10. Prior to DSM-IV, this condition was called "brief reactive psychosis." This condition may or may not be recurrent, and it should not be caused by another condition.

Jack Drescher is an American psychiatrist and psychoanalyst known for his work on sexual orientation and gender identity.

A somatic symptom disorder, formerly known as a somatoform disorder, is any mental disorder that manifests as physical symptoms that suggest illness or injury, but cannot be explained fully by a general medical condition or by the direct effect of a substance, and are not attributable to another mental disorder. Somatic symptom disorders, as a group, are included in a number of diagnostic schemes of mental illness, including the Diagnostic and Statistical Manual of Mental Disorders.

Compulsive sexual behaviour disorder (CSBD), also known as hypersexual disorder, is a pattern of behavior involving intense preoccupation with sexual fantasies and behaviours that cause distress, are inappropriately used to cope with stress, cannot be voluntarily curtailed, and risk or cause harm to oneself or others. This disorder can also cause impairment in social, occupational or other important functions.

Sexual sadism disorder is the condition of experiencing sexual arousal in response to the extreme pain, suffering or humiliation of others. Several other terms have been used to describe the condition, and the condition may overlap with other conditions that involve inflicting pain. It is distinct from situations in which consenting individuals use mild or simulated pain or humiliation for sexual excitement. The words sadism and sadist are derived from the French writer and libertine Marquis de Sade, who wrote several novels depicting sexualized torture and violence.

Sexual masochism disorder (SMD) is the condition of experiencing recurring and intense sexual arousal in response to enduring moderate or extreme pain, suffering, or humiliation. The Diagnostic and Statistical Manual (DSM-5) of the American Psychiatric Association indicates that a person may have a masochistic sexual interest but that the diagnosis of sexual masochism disorder would only apply to individuals who also report psychosocial difficulties because of it.

Externalizing disorders are mental disorders characterized by externalizing behaviors, maladaptive behaviors directed toward an individual's environment, which cause impairment or interference in life functioning. In contrast to individuals with internalizing disorders who internalize their maladaptive emotions and cognitions, such feelings and thoughts are externalized in behavior in individuals with externalizing disorders. Externalizing disorders are often specifically referred to as disruptive behavior disorders or conduct problems which occur in childhood. Externalizing disorders, however, are also manifested in adulthood. For example, alcohol- and substance-related disorders and antisocial personality disorder are adult externalizing disorders. Externalizing psychopathology is associated with antisocial behavior, which is different from and often confused for asociality.

Passive-aggressive personality disorder, also called negativistic personality disorder, is characterized by procrastination, covert obstructionism, inefficiency and stubbornness. The DSM-5 no longer uses this phrase or label, and it is not one of the ten listed specific personality disorders. The previous edition, the revision IV (DSM-IV) describes passive-aggressive personality disorder as a proposed disorder involving a "pervasive pattern of negativistic attitudes and passive resistance to demands for adequate performance" in a variety of contexts. Passive-aggressive behavior is the obligatory symptom of the passive-aggressive personality disorder.

References

  1. ↑ "Pyromania | BehaveNet". behavenet.com. Archived from the original on 3 March 2015. Retrieved 27 February 2015.
  2. ↑ Robert E. Hales (2008). "Impulse Disorders Not Elsewhere Classified". In Stuart C. Yudofsky; Glen O. Gabbard (eds.). The American Psychiatric Publishing Textbook of Psychiatry. American Psychiatric Pub. p. 793. ISBN   9781585622573.
  3. ↑ "What Is Pyromania?". WebMD.com. Internet Brands. 22 June 2021. Archived from the original on 22 June 2021. Retrieved 28 July 2022.
  4. 1 2 3 4 5 Frey, Rebecca J. (2003). Pyromania. Gale Encyclopedia of Mental Disorders. Vol. 2. pp. 802–806.
  5. 1 2 3 "Impulse Control Disorders". Gale Encyclopedia of Childhood & Adolescence. Gale Research. 1998.
  6. ↑ Michael B. First; Allen Frances; Harold Alan Pincus (2004). DSM-IV-TR Guidebook. American Psychiatric Pub. p. 337. ISBN   978-1-58562-068-5. Archived from the original on 25 September 2014. Retrieved 24 February 2013.
  7. ↑ "WHO releases new International Classification of Diseases (ICD 11)". World Health Organisation (Press Release). Retrieved 29 October 2021.
  8. 1 2 Pickett D, Anderson RN (18 July 2018). Status on ICD-11: The WHO Launch (PDF) (Report). CDC/NCHS.
  9. 1 2 3 4 ICD-11.
  10. ↑ Antonino, Cristiano (4 May 2022). "Pyromania: ICD-11 Classification, Causes, Symptoms, Characteristics, Risks, Treatment, Medication". emergency-live.com. Emergency Live. Retrieved 30 July 2022.
  11. 1 2 American Psychiatric Association (May 2013). Diagnostic and Statistical Manual of Mental Disorders-V (Text Revision). Vol. 1. Arlington, VA, USA: American Psychiatric Publishing, Inc. pp. 476–477. ISBN   978-0-89042-555-8.
  12. ↑ "Highlights of Changes from DSM-IV-TR to DSM-5" (PDF). American Psychiatric Association. 17 May 2013. Archived from the original (PDF) on 26 February 2015.
  13. 1 2 Soltys, Stephen M (1 February 1992). "Pyromania and Firesetting Behaviors". Psychiatric Annals. 22 (2): 79–83. doi:10.3928/0048-5713-19920201-10.
  14. ↑ Sadock, B.J.; Sadock, V.A. (2008). Kaplan & Sadock's Concise Textbook of Clinical Psychiatry. Wolters Kluwer/Lippincott Williams & Wilkins. p. 365. ISBN   9780781787468 . Retrieved 27 February 2015.
  15. ↑ "ARSON: WITH SPECIAL REFERENCE TO PYROMANIA". 1 January 1967. Archived from the original on 9 May 2015.{{cite journal}}: Cite journal requires |journal= (help)
  16. ↑ "The arsonist's mind: part 2 – pyromania". Australian Institute of Criminology. 1 March 2005. Archived from the original on 21 June 2019. Retrieved 16 September 2021.
  17. ↑ Barker, A.F. (1994). Arson: A Review of the Psychiatric Literature. Oxford University Press.
  18. ↑ Alspach, Grif (1 August 2005). "1 – 2 – 3 – 4... Mental Illness Out the Door?". Critical Care Nurse. 25 (4): 8–10. doi: 10.4037/ccn2005.25.4.8 . PMID   16034028 . Retrieved 16 September 2021.
  19. ↑ Smith, Thomas E. (1 October 1999). "The Risk of Fire – Statistical Data Included". Risk & Insurance.
  20. ↑ Hales, Robert E. (2008). The American Psychiatric Publishing Textbook of Psychiatry. ISBN   9781585622573.
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