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  • Print publication year: 2010
  • Online publication date: July 2010

23 - Pyromania: Clinical Aspects

from Section IV - Sexual and Aggressive Impulses


This chapter discusses the cumulative effect of oral parafunctions (OPFs) on the health of a patient's natural dentition, dental restorations, oral soft structures, and temporomandibular joints (TMJs). Nail biting and other OPFs are common in young children. Consequently, unmanaged parafunctional habits may contribute to the etiology of trauma in the stomatognathic systems of adolescents and adults. Prevention, early detection, and intervention are important clinical activities to diminish the influences of chronic OPFs on the teeth, muscles, and temporomandibular joints. The dentist can assist in detecting OPFs, protecting vulnerable oral and TMJ structures, and making appropriate referrals. Although occlusal splints can protect the oral structures from wear, they have little effect on parafunctional habits. Growing evidence suggests that psychological interventions to address factors contributing to the maintenance of these adverse habits can assist patients in overcoming them.


American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: American Psychiatric Association, 1952.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 2nd edition. Washington, DC: American Psychiatric Association, 1968.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 3rd edition. Washington, DC: American Psychiatric Association, 1980.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision. Washington, DC: American Psychiatric Association, 2000.
Awad GA, Harrison SI. A female firesetter: A case report. J Nerv Ment Dis 163:432–437, 1976.
Barker AF. Arson: A Review of the Psychiatric Literature. Institute of Psychiatry, Maudsley Monographs no. 35. Oxford: Oxford University Press, 1994.
Barnett W, Spitzer M. Pathological fire-setting, 1951–1991: A review. Med Sci Law 34:4–20, 1994.
Barratt ES, Patton JH. Impulsivity: Cognitive, behavioral and psychophysiological correlates, in Biological Bases of Sensation Seeking, Impulsivity and Anxiety. Edited by Zuckerman M. Hillsdale, NJ: Erlbaum, 1983.
Birchill LE. Portland's firesetters program involves both child and family. Am Fire J 23:15–16, 1984.
Boling L, Brotman C. A fire-setting epidemic in a state mental health center. Am J Psychiatry 132:946–950, 1975.
Bourget D, Bradford JMW. Female arsonists: A clinical study. Bull Am Acad Psychiatry Law 17:293–300, 1989.
Bradford JMW. Arson: A clinical study. Can J Psychiatry 27:188–193, 1982.
Bradford JMW, Dimock J. A comparative study of adolescents and adults who willfully set fires. Psychiatr J Univ Ott 11:228–234, 1986.
Byrne A, Walsh JB. The epileptic arsonist. Br J Psychiatry 155:268, 1989.
Carpenter PK, King AL. Epilepsy and arson. Br J Psychiatry 154:554–556, 1989.
Carstens C. Application of a work penalty threat in the treatment of a case of juvenile firesetting. J Behav Ther Exp Psychiatry 13:159–161, 1982.
Cohen MAA, Aladjem AD, Bremin D et al. Firesetting by patients with the Acquired Immuno Deficiency Syndrome (AIDS). Ann Intern Med 112:386–387, 1990.
Cowen P, Mullen PE. An XYY man. Br J Psychiatry 135:79–81, 1979.
Dalton K. Cyclical criminal acts in premenstrual syndrome. Lancet 2:1070–1071, 1980.
Dalton R, Haslett N, Daul G. Alternative therapy with a recalcitrant fire-setter. J Am Acad Child Psychiatry 25:713–717, 1986.
Eberle AJ. Klinefelter syndrome and fire-setting behavior. Pediatrics 83:649, 1989.
Esquirol JED. Mental Maladies: A Treatise on Insanity. Philadelphia: Lea & Blanchard, 1845.
Forehand R, Wierson M, Frame CL et al. Juvenile firesetting: A unique syndrome or an advanced level of antisocial behavior. Behav Res Ther 29:125–128, 1991.
Freud S. The acquisition of power over fire. Int J Psychoanal 13:405–410, 1932.
Geller JL. Firesetting in the adult psychiatric population. Hosp Community Psychiatry 38:501–506, 1987.
Geller JL. Arson in review: From profit to pathology. Psychiatr Clin North Am 15:623–645, 1992a.
Geller JL. Pathological firesetting in adults. Int J Law Psychiatry 15:283–302, 1992b.
Geller JL, Bertsch G. Fire-setting behavior in the histories of a state hospital population. Am J Psychiatry 142:464–468, 1985.
Gold JH. Psychiatric profile of the firesetter. J Forensic Sci 7:203–228, 1962.
Grant JE, Kim SW. Clinical characteristics and psychiatric comorbidity of pyromania. J Clin Psychiatry 68:1717–1722, 2007.
Grant JE, Levine L, Kim D et al. Impulse control disorders in adult psychiatric inpatients. Am J Psychiatry 162:2184–2188, 2005.
Grant JE, Williams KA, Potenza MN. Impulse control disorders in adolescent psychiatric inpatients: Co-occurring disorders and sex differences. J Clin Psychiatry 68:1584–1592, 2007.
Greenberg A. Pyromania in a woman. Psychoanalysis 35:256–262, 1966.
Griesinger W. Mental Pathology and Therapeutics. London: The New Sydenham Society, 1867.
Grinstein A. Stages in the development of control over fire. Int J Psychoanal Bull Int Psychoanal Assoc 33:416–420, 1952.
Gunzel H. Brandstiftung bei psychosen und unter alkoholischer beeinflussung. Krim Forensische Wiss 66:175–180, 1987.
Harris GT, Rice ME. Mentally disordered firesetters: Psychodynamic versus empirical approaches. Int J Law Psychiatry 7:19–34, 1984.
Heath GA, Hardesty VA, Goldfine PE et al. Diagnosis and childhood firesetting. J Clin Psychol 41:571–575, 1985.
Heidrich H, Schmidtke A, Lesch KP et al. Cerebellar arachnoid cyst in a firesetter: The weight of organic lesions in arson. J Psychiatry Neurosci 21:202–206, 1996.
Hill RW, Langevin R, Paitich D et al. Is arson an aggressive act or a property offense? A controlled study of psychiatric referrals. Can J Psychiatry 27:648–654, 1982.
Holland CJ. Elimination by parents of fire-setting behavior in a 7 year-old boy. Behav Res Ther 7:135–137, 1969.
Hurley W, Monaham TM. Arson: The criminal and the crime. Br J Criminol 9:4–21, 1969.
Jacobson RR. The subclassification of child firesetters. J Child Psychol Psychiatry 26:769–775, 1985.
Joukamaa M, Touvinen M. Criminality and psychological disturbance of Finns remanded for psychiatric examination. J Forensic Sci Soc 23:170, 1983.
Kafry D. Playing with matches: Children and fire, in Fires and Human Behavior. Edited by Canter D. New York: Wiley, 1980.
Kaler SG, White BJ, Kruesi MJP. Firesetting and Klinefelter's syndrome. Pediatrics 84:749, 1989.
Kaufman I, Heims LW, Reiser DE. A re-evaluation of the psychodynamics of firesetting. Am J Orthopsychiatry 31:123–136, 1961.
Koles MR, Jenson WR. Comprehensive treatment of chronic firesettings in a severely disordered boy. J Behav Ther Exp Psychiatry 16:81–85, 1985.
Kolko DJ. Multicomponent parental treatment of firesetting in a six year old boy. J Behav Ther Exp Psychiatry 14:349–353, 1983.
Kolko DJ. Community interventions for juvenile firesetters: A survey of two national programs. Hosp Community Psychiatry 39:973–979, 1988.
Kolko DJ. Efficacy of cognitive-behavioral treatment and fire safety education for children who set fires: Initial and follow up outcomes. J Child Psychol Psychiatry 42:359–369, 2001.
Kolko DJ, Kazdin AE. Assessment of dimensions of childhood firesetting among patients and non-patients: The Firesetting Risk Interview. J Abnorm Child Psychol 17:157–176, 1989a.
Kolko DJ, Kazdin AE. The Children's Firesetting Interview with psychiatrically referred and nonreferred children. J Abnorm Child Psychol 17:609–624, 1989b.
Kosky RJ, Silburn S. Children who light fires: A comparison between fire-setters and non fire-setters referred to a child psychiatric outpatient service. Aust NZ J Psychiatry 18:251–255, 1984.
Koson DF, Dvoskin J. Arson: A diagnostic study. Bull Am Acad Psychiatry Law 10:39–49, 1982.
Lejoyeux M, Arbaretaz M, McLoughlin M et al. Impulse-control disorders and depression. J Nerv Ment Dis 190:310–314, 2002.
Lejoyeux M, Feuche N, Loi S et al. Study of impulse-control disorders among alcohol-dependent patients. J Clin Psychiatry 60:302–305, 1999.
Lejoyeux M, McLoughlin M, Ades J. Pyromania, in Clinical Manual of Impulse-Control Disorders. Edited by Hollander E, Stein DJ. Washington, DC: APPI, pp. 229–250, 2006.
Lewis NDC, Yarnell H. Pathological Firesetting (Pyromania). Nervous and Mental Disease Monographs no. 82. New York: Coolidge Foundation, 1951.
Lindberg N, Holi MM, Tani P et al. Looking for pyromania: Characteristics of a consecutive sample of Finnish male criminals with histories of recidivist fire-setting between 1973 and 1983. BMC Psychiatry 5:47, 2005.
Linnoilam M, Virkkunen M, Seneinin M et al. Low cerebral spinal fluid 5-hydroindolacetic acid concentration differentiates impulsive from nonimpulsive violent behavior. Life Sci 33:2609–2614, 1983.
Lowenstein LF. The diagnosis of child arsonists. Acta Paedopsychiatrica 47:151–154, 1981.
Lowenstein LF. The etiology, diagnosis and treatment of the fire-setting behavior of children. Child Psychiatry Hum Dev 19:186–194, 1989.
MacGrath P, Marshall PG, Prior K. A comprehensive treatment program for a firesetting child. J Behav Ther Exp Psychiatry 10:69–72, 1979.
Marc M. Considérations médico-légales sur la monomanie et particulièrement sur la monomanie incendiaire. Ann Hyg Publ Med Leg 10:367–484, 1833.
Mavromatis M, Lion JR. A primer on pyromania. Dis Neur Syst 38:954–955, 1977.
McElroy SL, Hudson JL, Pope HG et al. The DSM-III-R impulse control disorders not elsewhere classified: Clinical characteristics and relationships to other psychiatric disorders. Am J Psychiatry 149:318–327, 1992.
McGuire RJ, Carlisle JM, Young BG. Sexual deviations as conditioned behavior: A hypothesis. Behav Res Ther 2:185–190, 1965.
Miller M, Sulkes S. Fire-setting behavior in individuals with Klinefelter syndrome. Pediatrics 82:115–117, 1988.
Minuchin S. Families and Family Therapy. Cambridge, MA: Harvard University Press, 1974.
Molnar G, Keitner L, Harwood BT. A comparison of partner and solo arsonists. J Forensic Sci 29:574–583, 1984.
Nielsen J. Criminality among patients with Klinefelter's syndrome and the XYY syndrome. Br J Psychiatry 117:365–369, 1970.
Noblett S, Nelson B. A psychosocial approach to arson – a case controlled study of female offenders. Med Sci Law 41:325–330, 2001.
Nurcombe B. Children who set fires. Med J Aust 1:579–584, 1964.
O’Sullivan GH, Kelleher MJ. A study of fire-setters in the south-west of Ireland. Br J Psychiatry 151:818–823, 1987.
Prins H. Offenders, Deviants, or Patients? London: Tavistock, 1980.
Raines JC, Foy CW. Extinguishing the fires within: Treating juvenile firesetters. Fam Soc 75:595–604, 1994.
Ray I. A Treatise of Medical Jurisprudence of Insanity, 2nd edition. Boston: Tickner, 1844.
Repo E, Virkkunen M, Rawlings R et al. Criminal and psychiatric histories of Finnish arsonists. Acta Psychiatr Scand 95:318–323, 1997.
Rice ME, Chaplin TC. Social skill training for hospitalized male arsonists. J Behav Ther Exp Psychiatry 10:105–108, 1979.
Rice ME, Harris GT. Firesetters admitted to a maximum security psychiatric institution: Characteristics of offenders and offenses. Penetanguishene Ment Health Centre Res Rep 7:1–27, 1990.
Ritchie EC, Huff TG. Psychiatric aspects of arsonists. J Forensic Sci 44:733–740, 1999.
Rix KJ. A psychiatric study of adult arsonists. Med Sci Law 34:21–34, 1994.
Rosenstock HA, Holland A, Jones PH. Fire-setting on an adolescent in-patient unit: An analysis. J Clin Psychol 41:20–22, 1980.
Rothstein R. Explorations of ego structures of firesetting children. Arch Gen Psychiatry 9:246–253, 1963.
Royer FL, Flynn WF, Osadca BS. Case history: Aversion therapy for fire-setting by a deteriorated schizophrenic. Behav Ther 2:229–232, 1971.
Schaefer CE, Millman HL. Therapies for Children. San Francisco: Jossey-Bass, 1978.
Schumacher W. Das brandstiftersyndrom in psychodynamischer sicht, in Medizinrecht Psychopathologie Recht-medizin: diesseits und jenseits der Grenzen von Recht und Medizin. Festschrift für Günter Schewe. Edited by Schutz H, Schewe G, Kaatsch HJ et al. Berlin: Springer, 1991, pp. 290–300.
Siegel L. Case study of a thirteen year old firesetter: A catalyst in the growing pains of a residential treatment unit. Am J Orthopsychiatry 27:396–410, 1957.
Singer L, Dautais G, Freyman Jr et al. Passages à l’acte meurtriers et incendiaires avec amnésie lacunaire chez deux malades épileptiques. Ann Med Psychol (Paris) 136:609–617, 1978.
Slavkin ML. Child and adolescent psychiatry: What every clinician needs to know about juvenile firesetters. Psychiatr Serv 53:1237–1238, 2002.
Soltys SM. Pyromania and fire setting behaviors. Psychiatr Ann 22:79–83, 1992.
Stawar TL, Fable MOD. Operantly structured fantasies as an adjunct in the modification of firesetting behavior. J Behav Ther Exp Psychiatry 7:285–287, 1976.
Stekel WC. Peculiarities of Behavior. New York: Boni & Liveright, 1924.
Stickle TR, Blechman EA. Aggression and fire: Antisocial behavior in fire setting and nonfire setting juvenile offenders. J Psychopathol Behav Assess 24:177–193, 2002.
Stone AA. Vernon adopts Tarasoff: A real barn-burner. Am J Psychiatry 143:352–355, 1986.
Taylor PJ, Gunn J. Violence and psychosis. BMJ 228:1945–1949, 1984.
Tonkonogy JM, Geller JL. Hypothalamic lesions and intermittent explosive disorder. J Neuropsychiatry Clin Neurosci 4:45–50, 1992.
U.S. Department of Justice, Federal Bureau of Investigations. Uniform Crime Report for the United States. Washington, DC: U.S. Department of Justice, Federal Bureau of Investigation, 1982.
Virkkunen M. On arson commited by schizophrenics. Acta Psychiatrica Scand 50:152–160, 1974.
Virkkunen M. Reactive hypoglycaemic tendency among violent offenders: A further study by means of the glucose tolerance test. Neuropsychobiology 8:35–40, 1982.
Virkkunen M. Reactive hypoglycaemic tendency among arsonists. Acta Psychiatrica Scand 69:445–452, 1984.
Virkkunen M, De Jong J, Bartko J et al. Relationship of psychobiological variables to recidivism in violent offenders and impulsive fire setters. Arch Gen Psychiatry 46:600–603, 1989.
Vreeland RG, Lewin BM. Psychological aspects of firesetting, in Fires and Human Behaviour. Edited by Canter D. New York: Wiley, 1980, pp. 31–46.
Webb NB, Sakheim GA, Town-Miranda L et al. Collaborative treatment of juvenile firesetters: Assessment and outreach. Am J Orthopsychiatry 60:305–310, 1990.
Welsh RS. The use of stimulus satiation in the elimination of juvenile fire-setting behavior, in Behavior Therapy with Children. Edited by Graziano AM. Chicago: Aldine, 1971, pp. 283–289.
Woolf PG. Arson and Moebius syndrome: Case study of stigmatization. Med Sci Law 17:68–70, 1977.
Wolff R. Satiation in the treatment of inappropriate firesetting. J Behav Ther Exp Psychiatry 15:337–40, 1984.
World Health Organization. International Classification of Diseases, 10th edition. Geneva: World Health Organization, 2002.
Yesavage JA, Benezech M, Ceccaldi P et al. Arson in mentally ill and criminal populations. J Clin Psychiatry 44:128–130, 1983.
Yoshimasu S. Two cases of arson in the prodromal stage of Huntington's chorea. Acta Criminol Med Leg Jpn 31:25–31, 1965.
Zuckerman M, Eysenck SBG, Eysenck HJ. Sensation seeking in England and America: Cross-cultural, age and sex comparisons. J Consult Clin Psychol 46:139–149, 1978.