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FIGURE 1–1. Diagram showing stages of impulse control disorder and compulsive disorder cycles related to the sources of reinforcement.

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FIGURE 1–1. Diagram showing stages of impulse control disorder and compulsive disorder cycles related to the sources of reinforcement.In impulse control disorders, an increasing tension and arousal occurs before the impulsive act, with pleasure, gratification, or relief during the act. Following the act there may or may not be regret or guilt. In compulsive disorders, there are recurrent and persistent thoughts (obsessions) that cause marked anxiety and stress followed by repetitive behaviors (compulsions) that are aimed at preventing or reducing distress (American Psychiatric Association 1994). Positive reinforcement (pleasure/gratification) is more closely associated with impulse control disorders. Negative reinforcement (relief of anxiety or relief of stress) is more closely associated with compulsive disorders.Source. Reprinted from Koob GF: "Allostatic View of Motivation: Implications for Psychopathology," in Motivational Factors in the Etiology of Drug Abuse (Nebraska Symposium on Motivation, Volume 50). Lincoln, NE, University of Nebraska Press, 2004. Used with permission.

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