Pyromania

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

Specific symptoms differentiate pyromaniacs from those who start fires for criminal reasons or due to emotional motivations unrelated to fire. A person with this disorder intentionally sets fires on multiple occasions, and prior to igniting the fire, they typically experience tension and emotional buildup. When in the presence of fires, an individual with pyromania exhibits intense interest or fascination and may also feel pleasure, gratification, or relief. Another long-term factor often associated with pyromania is the buildup of stress. Analyzing the lifestyle of someone with pyromania often reveals a buildup of stress and emotion, which is reflected in teens' attitudes toward friends and family. At times, it can be challenging to distinguish between pyromania and experimentation in childhood, as both can pleasure the fire.

Classification

ICD

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

Pyromania is characterized by a recurring inability to control intense impulses to set fires, resulting in multiple acts of, or attempts at, igniting property or other objects, without an apparent motive (e.g., monetary gain, revenge, sabotage, political statement, attracting attention or recognition). There is an increasing sense of tension or emotional arousal before instances of fire-setting, a persistent fascination or preoccupation with fire and related stimuli (e.g., watching fires, building fires, fascination with firefighting equipment), and a feeling 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 disorders. ICD-11 was produced by professionals from 55 of the 90 countries involved and is one of the most widely used references worldwide by clinicians, the other being the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR from 2022, DSM-5 from 2013, or their predecessors).

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, this classification was removed. However, in the Third Edition, pyromania reemerged under the category of impulse-control disorders. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), published in 2022, defines pyromania as "the presence of multiple episodes of deliberate and purposeful fire setting." Pyromania was moved from the DSM-IV chapter titled "Impulse-Control Disorders Not Otherwise Specified" to the chapter "Disruptive, Impulse-Control, and Conduct Disorders" in DSM-5.

Causes

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

Environmental

Environmental factors that may lead to pyromania include events experienced in the individual's living environment. These factors encompass parental neglect and physical or emotional abuse during early life. Additional causes include early exposure to adults or teenagers misusing fire and using fire as a means to relieve stress.

Treatment and prognosis

The appropriate treatment for pyromania varies based on the patient's age and the severity of the condition. For children and adolescents, treatment typically involves cognitive behavioral therapy sessions, where the patient's situation is assessed to determine what may have caused this impulsive behavior. Once the situation is analyzed, ongoing therapy sessions usually support recovery. Other crucial steps should also include interventions addressing the root cause of the impulsive behavior. Additional treatments may encompass 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. The prognosis for recovery in adolescents and children with pyromania relies on the influencing environmental or individual factors, but is typically positive. Conversely, pyromania is generally more challenging to treat in adults, often due to a lack of cooperation from the patient. In adults, treatment usually involves more medication to manage stress or emotional outbursts, along with long-term psychotherapy. However, the recovery rate for adults is generally poor, and if an adult does recover, it often requires a longer period of time.

History

In the 1800s, pyromania was considered a concept related to moral insanity and moral treatment but had not been classified as an impulse control disorder. Pyromania is one of the four recognized types of arson, alongside burning for profit, covering up a crime, and seeking revenge. It ranks as the second most common type of arson. Common synonyms for pyromaniacs in colloquial English include " firebug " (US) and " fire raiser " (UK), although these terms also apply to arsonists. Pyromania is a rare disorder, with an incidence of less than one percent in most studies, and pyromaniacs constitute a very small proportion of psychiatric hospital admissions. Interestingly, pyromania can manifest in children as young as three years old, though such cases are uncommon. Only a small percentage of children and teenagers arrested for arson are identified as child pyromaniacs. A significant majority of these individuals are male; one source indicates that ninety percent of those diagnosed with pyromania are male. 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 nine percent of the population. A 1979 study conducted by the Law Enforcement Assistance Administration found that only fourteen percent of fires were started by pyromaniacs or others with mental illnesses. A large epidemiological study in 1951 by Lewis and Yarnell found that thirty-nine percent of those who intentionally set fires had been diagnosed with pyromania.

External links

More information is available at [ Wikipedia:Pyromania ]

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