Pyromania
Pyromania is classified as an impulse control disorder characterized by a recurrent inability to resist the urge to set fires, primarily driven by a fascination with fire and its effects rather than any intention of financial gain or revenge. Individuals diagnosed with pyromania derive pleasure and relief from the act itself, often disregarding the consequences. It is distinct from arson, which involves deliberate property destruction, and fire setting, a broader term that does not imply a specific motivation or mental health condition. The diagnostic criteria for pyromania are outlined in the DSM-V and DSM-V-TR, and the disorder is considered rare, with most fire-setting behaviors linked to substance abuse or other psychiatric conditions.
Research has shown that many individuals who set fires do not meet the criteria for pyromania, as their actions are often associated with specific intents like revenge or are influenced by substance intoxication. Among juvenile fire setters, common risk factors include behavioral issues, family dysfunction, and a history of abuse, highlighting the complexity of motivations behind fire-setting behaviors. Treatments for pyromania often involve cognitive-behavioral therapy, family therapy, and pharmacological interventions to address co-occurring mental health issues. Ongoing research aims to enhance understanding and improve prevention and treatment strategies for those affected.
Pyromania
CATEGORY: Psychological issues and behaviors
DEFINITION: Pyromania is an impulse control disorder involving repeated failure to control an impulsive urge to set a fire that will not yield monetary or other gain. The reward is the fire itself, which relieves inner tension and may confer pleasure or gratification. Consequences are disregarded by the pyromaniac.
Pyromania, Fire Setting, and Arson
The criteria set forth by the fifth edition and fifth edition-text revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V and DSM-V-TR) for diagnosing pyromania are specific. To qualify for the diagnosis, those affected will be fascinated with fire and its aftermath. Motives other than the fire itself—for example, vengeance and political expression—exclude the diagnosis, as will such conditions as dementia or other intellectual disabilities. In the DSM-V and DSM-V-TR, pyromania was reclassified in a new chapter called "Disruptive, Impulse-Control, and Conduct Disorders."
Psychiatric disorders will also take precedence over the pyromania diagnosis. Importantly, pyromania is excluded if the fire setting is better explained by impaired judgment owing to alcohol intoxication or substance-abuse influence. Furthermore, pyromania is only diagnosed if the exhibited behavior cannot be attributed to another conduct or psychiatric disorder.
Restricted by the exclusions, pyromania is therefore a rare disorder, considerably less frequent than either arson or fire setting. Pyromania, fire setting, and arson are commonly confused terms, often used interchangeably. Arson is a criminal act, a felony, which assumes willful, deliberate destruction of property by fire—including one’s own property. Fire setting, in contrast with both arson and pyromania, is a broad, inclusive term that implies no particular intent or pathology. Neither arson nor fire setting can assume pyromania is the cause.
A dubious understanding of the meaning of pyromania was demonstrated by a large group of professionals (police, firefighters, and fire investigators) attending an advanced training session. Despite the rarity of the psychiatric diagnosis, these personnel often used the term. Asked their definition of pyromania, the group demonstrated in open-ended responses that they were seriously misinformed about it. This confusion over terminology indicates a need for better education into the causes, nature, and mental health issues surrounding pyromania.
An often-quoted study analyzed the prison files and mental health records of 283 men and women convicted of arson. The pyromania diagnosis fit only three persons, or 1 percent of the group. Almost two-thirds (64 percent) had been abusing drugs or alcohol when they set their fires, and the overwhelming majority (90 percent) had histories of psychiatric disorders.
Spanning a twenty-one-year period, a Finnish study of 401 arsonists found twelve repeat offenders who fit the DSM-V-TR pyromania definition; nine of the twelve, however, had been acutely intoxicated with alcohol at the time of the arson. The remaining three were volunteer firefighters. The authors of this study questioned whether substance intoxication should still exclude the pyromania diagnosis.
Who Sets Fires?
A series of 153 adults convicted of arson exemplified most criteria that would eliminate pyromania. Most were young men with a psychiatric disorder. One in four had educational deficiencies, either because of a cognitive disability or because of a history of special schooling. Revenge was the motivation for one-third of the group. More than one-third were intoxicated when they set the fires.
Those who study the complex mix of behavioral factors that leads to fire setting generally consider children and adolescent fire setters as a distinct group. This population segment is responsible for a significant portion of the annual toll of property damage because of deliberate fire setting. Still, the path from normal to excessive interest in fires to pyromania is not well understood. Beginning as early as two to three years of age, children can express a normal interest in fire. By the time they reach six to ten years of age, the interest is a prevalent trait, particularly in boys.
Investigators have repeatedly tried to identify differences between children who set fires and their peers who do not. Young firesetters are a heterogeneous group, however, with varying motivations. Although consistent pictures have yet to emerge from multiple research approaches and disparate populations, some risk factors have become apparent.
Behavioral difficulties and conduct problems, such as disobedience and aggressive behavior, are frequently encountered in children and youths who set repeated fires. The family environments of many juvenile firesetters are marked by lax supervision and discipline, high levels of family conflict, and parental neglect and rejection. These factors have predicted repeated fire setting. Some young firesetters may have been subjected to severe emotional neglect and physical or sexual abuse. Ineffective monitoring leaves children with free access to incendiary materials, without consequences that would limit the behavior.
In a survey of almost four thousand adolescents in grades seven through twelve, more than one-fourth—more than one thousand students—reported that they had set fires in the past year. The prevalence was higher among boys and older students. Those who began setting fires before ten years of age were more likely to report frequent episodes in the past year. This early-onset group had a distinctive risk profile: psychological pathology and suicidal behavior, delinquency, and substance abuse. Another large national sample of children and adolescents yielded a composite picture of firesetting juveniles with deficient social skills and complex interactions with peers and teachers.
Prevention and Treatment
Guidelines for the treatment of pyromania or fire setting continue to be studied and established. The mix of motivations, life situations, and legal standings of those who deliberately set fires can preclude a uniform treatment formulation. Assessing family issues may be a first step for children and adolescents, perhaps pointing to family therapy. Early intervention for abused and emotionally neglected children would aim at reducing destructive and aggressive behavior.
Complicating the choice of treatment is the high prevalence of psychiatric disorders in adult firesetters. Evaluating comorbid disorders might indicate the appropriate psychotherapeutic or pharmacologic treatment.
When specific treatments are suggested, cognitive-behavioral therapy, counseling, and pharmacologic treatment are helpful. Further research and prevention trials are needed. Given the substantial costs of arson and fire setting to lives and property, finding an effective treatment would pay significant dividends.
In the twenty-first century, progress has been made in understanding the diagnosis and treatment of pyromania. Cognitive therapy remains the first line of defense in treating those with pyromania, helping patients identify troubling thoughts and behaviors before they are tempted to act out on them through firesetting. Therapists can introduce coping strategies to assuage impulses. Medications that treat comorbid mental health disorders continued to be vital in treating those with pyromania, as well as behavior therapies, such as aversion therapy. Although neurological insights into pyromania continue to link it with other conditions, such as obsessive-compulsive disorder (OCD), this overlap between pyromania and other psychological disorders also continues to be an obstacle to effective and efficient diagnosis.
Further Reading
Altamura, A. C., et al. "Epidemiologic and Clinical Updates on Impulse Control Disorders: A Critical Review." European Archives of Psychiatry and Clinical Neuroscience, vol. 256, no. 8, 2006, pp. 464-475, doi.org/10.1007/s00406-006-0668-0. Accessed 21 Aug. 2024.
Bhandari, Smitha. "Pyromania: What Is It, What Causes It, and How Is It Treated." WebMD, 19 July 2023, www.webmd.com/mental-health/what-is-pyromania. Accessed 21 Aug. 2024.
Blum, Austin W., et al. "Cognitive Inflexibility in a Young Woman with Pyromania." Journal of Behavioral Addictions, vol. 7, no. 1, 2018, pp. 189-191, doi.org/10.1556/2006.7.2018.09. Accessed 21 Aug. 2024.
Burton, Paul R. S., Dale E. McNiel, and Renee L. Binder. "Firesetting, Arson, Pyromania, and the Forensic Mental Health Expert." Jounral of the American Academy of Psychiatry and Law, vol. 40, no. 3, 2012, pp. 355–56.
Frierson, Cathy A. All Russia Is Burning! A Cultural History of Fire and Arson in Late Imperial Russia. Seattle: U of Washington, DC P, 2002.
Geller, J. L., M. McDermeit, and J. M. Brown. "Pyromania? What Does It Mean?" Journal of Forensic Sciences, vol. 42, no. 6, 1997, pp. 1052–57.
Grant, Jon E., and S. W. Kim. Stop Me Because I Can’t Stop Myself: Taking Control of Impulsive Behavior. New York: McGraw-Hill, 2003.
Kolko, David J., editor. Handbook on Firesetting in Children and Youth. San Diego, CA: Academic, 2002.
Shafir, Hailey. "Pyromania: Definition, Symptoms, & Treatments." Choosing Therapy, 3 Nov. 2023, www.choosingtherapy.com/pyromania. Accessed 21 Aug. 2024.