Disinhibition, also referred to asbehavioral disinhibition, is medically recognized as an orientation towards immediate gratification, leading toimpulsive behaviour driven by current thoughts, feelings, andexternal stimuli, without regard for past learning or consideration for future consequences.[1] It is one of five pathologicalpersonality trait domains in certainpsychiatric disorders.[1] Inpsychology, it is defined as a lack of restraint manifested in disregard ofsocial conventions, impulsivity, and poor risk assessment.[2]Hypersexuality,hyperphagia,substance abuse,money mismanagement, frequentfaux pas, andaggressive outbursts are indicative of disinhibited instinctual drives.[2]
Certainpsychoactive substances that have effects on thelimbic system of the brain may induce disinhibition.[3]
Disinhibition in psychology is defined as a lack ofinhibitory control manifested in several ways, affecting motor, instinctual, emotional, cognitive, and perceptual aspects with signs and symptoms, such as impulsivity, disregard for others and social norms, aggressive outbursts, misconduct, and oppositional behaviors, disinhibited instinctual drives including risk-taking behaviors and hypersexuality.[3][2]
Disinhibition is a common symptom following brain injury, or lesions, particularly to the frontal lobe and primarily to the orbitofrontal cortex.[4] The neuropsychiatric sequelae following brain injuries could include diffuse cognitive impairment, with more prominent deficits in the rate of information processing, attention, memory,cognitive flexibility, and problem-solving. Prominent impulsivity, affective instability, and disinhibition are seen frequently, secondary to injury to frontal, temporal, and limbic areas. In association with the typical cognitive deficits, these sequelae characterize the frequently noted "personality changes" in TBI (Traumatic Brain Injury) patients.
Disinhibition syndromes, in brain injuries and insults includingbrain tumors,strokes and epilepsy range from mildly inappropriate social behavior, and lack of control over one's behavior to the full-blownmania, depending on the lesions to specific brain regions. The previous several studies in brain traumas and insults have demonstrated significant associations between disinhibition syndromes and dysfunction of orbitofrontal and basotemporal cortices, affecting visuospatial functions, somatosensation, spatial memory, motoric, instinctive, affective, and intellectual behaviors.[4]
Disinhibition syndromes have also been reported with mania-like manifestations in old age with lesions to the orbitofrontal and basotemporal cortex involving limbic and frontal connections (orbitofrontal circuit), especially in the right hemisphere.[5] Behavioral disinhibition as a result of damage to frontal lobe could be seen as a result of consumption ofalcohol and othercentral nervous system (CNS)depressants (e.g.,benzodiazepines that disinhibit the frontal cortex from self-regulation and control).[6][7] It has also been argued that the hyperactive/impulsive subtype ofattention deficit hyperactivity disorder (ADHD) has a general behavioral disinhibition beyond impulsivity and many morbidities or complications of ADHD (e.g.,conduct disorder,antisocial personality disorder, substance abuse, and risk-taking behaviors are all consequences of untreated behavioral disinhibition).[8]
Disinhibition is a pathological trait domain in two prominentdimensional models of personality disorders, namely theAlternative DSM-5 model for personality disorders and theICD-11 classification of personality disorders. In the former, it is part of predefined specific personality disorders and can also be used for construction of apersonality disorder–trait specified diagnosis.[9] In theICD-11 system, a unified personality disorder is instead classified by severity, with there also being apersonality difficulty diagnosis for subclinical presentations. These diagnoses may be further specified by a qualifier, such asdisinhibition in personality disorder or personality difficulty.[10]
Certain psychoactive substances that have effects on the limbic system of the brain may induce disinhibition.[3] It is commonly induced byGABAergicdepressants such asalcohol,[11] andbenzodiazepines.[12]
 | This sectiondoes notcite anysources. Please helpimprove this section byadding citations to reliable sources. Unsourced material may be challenged andremoved.(June 2020) (Learn how and when to remove this message) |
Positive Behaviour Support (PBS) is a treatment approach that looks at the best way to work with each individual with disabilities. In this treatment, a behavioural therapist conducts a functional analysis of behaviour which helps to determine ways to improve the quality of life for the person, rather than trying only to lessen problematic behaviour. Furthermore, PBS relies on the belief in humans' ability to change, and it is most commonly applied to resolving problems in educational settings.[13] There are two main objectives: reacting situationally when the behavior occurs, and then acting proactively to prevent the behaviour from occurring.
Reactive strategies include:[14]
Proactive strategies to prevent problems can include:[14]