This is the latest Jon E. Grant ‘production’ on impulse control disorders; his previous titles include Pathological Gambling – A Clinical Guide to Treatment and Stop Me Because I Can't Stop Myself – Taking Control of Impulsive Behaviour. Jon E. Grant is an opinion leader, a credible academic and an experienced clinician in the field of impulse control disorders. So what does this book offer?
I ask myself three key questions when reading a book that is presented as a clinician's guide: Is it written by an expert clinician? Does it speak the language of the clinician? Does it infuse me with sufficient confidence to assess and treat a patient with that particular disorder? This book affirmatively answers all three questions. In essence, it provides a sufficiently detailed and clinically focused overview of the various impulse control disorders such as pathological gambling, kleptomania, intermittent explosive disorder, trichotillomania and pyromania. It takes the reader on a journey of knowledge-building and evidence base-sharing, starting with descriptions of the clinical characteristics of impulse control disorders, through the various theoretical models and finally to their assessment and treatment.
Using case vignettes to illustrate the disorders makes the book an easy read and maintains its clinical perspective. Three chapters discuss, at considerable length, the various and as yet unexplained conceptual models for understanding impulse control disorders, including the obsessive–compulsive spectrum model, behavioural addictions model and affective disorder model. Discussion of the aetiology of impulse control disorders, complicated by the heterogeneity between and within these disorders, offers preliminary insights into neurobiological markers and psychological theories. The chapters on assessment and treatment are a must-read. They provide a useful and productive blend of evidence drawn from the latest research and the author's experience borne out of a decade of specialist clinical practice, offering clear guidance to the clinician. The exhaustive (more than 400) and up-to-date reference list is a valuable resource for the researcher.
This book should be read in the context of the patchy systematic research evidence available on impulse control disorders and so the following criticisms merely highlight knowledge gaps in the field and are, on a more ambitious note, perhaps a call for further research. Considerable conceptual and nosological ambiguity shroud these disorders; aetiological mechanisms are far from clear; reliable and valid assessment tools are lacking; and as yet, no pharmacological agent is licensed to treat any of these disorders. That said, this book provides an excellent overview of a topic that is still in its infancy and is a userfriendly guide for the clinician. In an era of ever-increasing sub-specialisation within psychiatry, this book is one for the specialist.
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