Intermittent Explosive Disorder

Intermittent explosive disorder (IED) is characterised as extreme outbursts of aggressive behaviour that can lead to damage or destruction of property and physically injuring animals and/or people within a 12-month period and the behaviour is out of proportion to the circumstance.  The behaviour is short-lived and impacts social and vocational aspects of the individual’s life.  One example of IED behaviour is road rage as mentioned in the psychological literature.  

Over the years, research for IED has found that the disorder in the Diagnostic Statistical Manual I - IV was too narrow and each manual therefore broadened the disorder.  Initially the disorder excluded individuals who had generalised aggression between the explosive acts (DSM II), whereas in the DSM-5 it does allow these symptoms.  The implication for allowing generalised aggression between the explosive acts is that more people are able to become diagnosed and therefore receive appropriate treatment.  Another important change includes symptoms classified as severe to less severe meaning that IED is dimensional.  The challenges that researchers have found when reexamining the disorder was that there are over 200 meanings for aggression causing a lack of precision in creating measurement tools for research and that low prevalence rates did not provide enough participants for research purposes.  

Intermittent Explosive Disorder is not a part of another mental disorder but can be diagnosed in addition if it occurs when the other disorder is not present. Individuals with IED show characteristics of impatience, hostility, trait-anger, being assaultive and resentment.  They also have greater prevalence of mood disorder and higher levels of state and trait anxiety.  Individuals with IED tend to console their victims after the attack as they did not want the outburst to occur and became remorseful.

Research has found that individuals who have symptoms of IED are often in the correctional system and tend to miss out on treatment.  It is important to understand an individual's aggressive outbursts from a therapeutical point of view to correct the behaviour with the appropriate treatment.  

Sources:
American Psychiatric Association. Diagnostic and statistical manual of mental disorders (5th ed.).  Washington, DC:  Author, 2013.

Baron, R. A., & Richardson, D. R. (1994).  Human Aggression (2nd ed.). New York: Plenum Press.

Coccaro, E. F. (2010).  A family history study of intermittent explosive disorder.  Journal of Psychiatric Research, 44, 1101-1105.  

Coccaro, E. F., Kavoussi, R. J., Berman, M. E., & Lish, J. D. (1998).  Intermittent explosive disorder-revised: Development, reliability, and validity of research criteria.  Comprehensive Psychiatry, 39(8), 368-376.

Galovski,, T., & Blanchard, E. B. (2002).  Psychological characteristics of aggressive drivers with and without intermittent explosive disorder.  Behaviour Research and Therapy, 40, 1157-1168.

Saha, A. (2010).  A case of intermittent explosive disorder.  Industrial Psychiatry Journal, 19(1), 55-57.  doi: 10.4103/0972-6748.77639.