E. The fire setting is not done for monetary gain. as an expression of sociopolitical ideol- ogy, to conceal criminal activity, to express anger or vengeance, to improve one’s living circumstances, in response to a delusion or hallucination, or as a result of impaired judgment (e.g., in major neurocognitive disorder, intellectual disability [intellectual de- velopmental disorder], substance intoxication).
F. The fire setting is not better explained by conduct disorder, a manic episode. or anti- social personality disorder.
The essential feature of pyromania is the presence of multiple episodes of deliberate and purposeful fire setting (Criterion A). Individuals with this disorder experience tension or at- fective arousal before setting a fire (Criterion B). There is a fascination with, interest in, cu- riosity about, or attraction to fire and its situational contexts (e.g., paraphernalia, uses, consequences) (Criterion C). Individuals with this disorder are often regular ”watchers” at fires in their neighborhoods, may set off false alarms, and derive pleasure from institutions, equipment, and personnel associated with fire. They may spend time at the local fire depart- ment, set fires to be affiliated with the fire department, or even become firefighters. Individ- uals with this disorder experience pleasure, gratification, or relief when setting the fire, witnessing its effects, or participating in its aftermath (Criterion D). The fire setting is not done for monetary gain, as an expression of sociopolitical ideology, to conceal criminal ac- tivity, to express anger or vengeance, to improve one’s living circumstances, or in response to a delusion or a hallucination (Criterion E). The fire setting does not result from impaired judgment (e.g., in major neurocognitive disorder or intellectual disability [intellectual devel- opmental disorder]). The diagnosis is not made if the fire setting is better explained by con- duct disorder, a manic episode, or antisocial personality disorder (Criterion F).
Individuals with pyromania may make considerable advance preparation for starting a fire. They may be indifferent to the consequences to life or property caused by the fire, or they may derive satisfaction from the resulting property destruction. The behaviors may lead to property damage, legal consequences, or injury or loss of life to the fire setter or to others. Individuals who impulsively set fires (who may or may not have pyromania) often have a current or past history of alcohol use disorder.
The population prevalence of pyromania is not known. The lifetime prevalence of fire set— ting, which is just one component of pyromania and not sufficient for a diagnosis by itself, was reported as 1.13% in a population sample, but the most common comorbidities were antisocial personality disorder, substance use disorder, bipolar disorder, and pathological gambling (gambling disorder). In contrast, pyromania as a primary diagnosis appears to be very rare. Among a sample of persons reaching the criminal system with repeated fire setting, only 3.3% had symptoms that met full criteria for pyromania.
There are insufficient data to establish a typical age at onset of pyromania. The relation- mented. In individuals with pyromania, fire-setting incidents are episodic and may wax and wane in frequency. Longitudinal course is unknown. Although fire setting is a major problem in children and adolescents (over 40% of those arrested for arson offenses in the
United States are younger than 18 years), pyromania in childhood appears to be rare. Ju- venile fire setting is usually associated with conduct disorder, attention—deficit/hyperac- tivity disorder, or an adjustment disorder.
Pyromania occurs much more often in males, especially those with poorer social skills and learning difficulties.