Article From: Valley Behavioural Health System

Intermittent explosive disorder (IED) is an impulse-control disorder characterized by sudden episodes of unwarranted anger. The disorder is typified by hostility, impulsivity, and recurrent aggressive outbursts. People with IED essentially “explode” into a rage despite a lack of apparent provocation or reason. Individuals suffering from intermittent explosive disorder have described feeling as though they lose control of their emotions and become overcome with anger. People with IED may threaten to or actually attack objects, animals, and/or other humans. IED is said to typically begin during the early teen years and evidence has suggested that it has the potential of predisposing individuals to depression, anxiety, and substance abuse disorders. Intermittent explosive disorder is not diagnosed unless a person has displayed at least three episodes of impulsive aggressiveness.

Individuals with IED have reported that once they have released the tension that built up as a result of their rage, they feel a sense of relief. Once the relief wears off, however, some people report experiencing feelings of remorse or embarrassment. While IED can be extremely disruptive to an individual’s life, as well as to the lives of those around him or her, IED can be managed through proper treatment, through education about anger management, and possibly through the use of medication.

Statistics

Intermittent explosive disorder is said to affect around 7.3% of adults at some point throughout their lifetimes. This equates to around 11.5-16 million Americans. Of the individuals in the U.S. who were diagnosed with IED, 67.8% had engaged in direct aggression against another person(s), 20.9% had threatened aggression against another person(s), and 11.4% had engaged in direct aggression against objects.

Causes and Risk Factors of Intermittent Explosive Disorder

The cause of intermittent explosive disorder is said to be a combination of multiple components, including genetic factors, physical factors, and environmental factors. The following are some examples of these varying factors:

Genetic: It has been hypothesized that the traits that this disorder is composed of are passed down from parents to children; however, there is presently not any specific gene identified as having a prominent impact in the development of IED.

Physical: Research has suggested that intermittent explosive disorder may occur as the result of abnormalities in the areas of the brain that regulate arousal and inhibition. Impulsive aggression may be related to abnormal mechanisms in the part of the brain that inhibits or prohibits muscular activity through the neurotransmitter serotonin. Serotonin, which works to send chemical messages throughout the brain, may be composed differently in people with intermittent explosive disorder.

Environmental: The environment in which a person grows up can have a large impact on whether or not he or she develops symptoms of IED. It has been hypothesized that people who grow up in homes in which they were subjected to harsh punishments are more likely to develop IED. The belief is that these children will follow the example set by their parents and will act out aggressively – their initial reaction to something negative that they encounter. Another theory is that if children endured harsh physical punishments, they may find a sense of redemption in putting others through the same form of physical pain.

Risk Factors:

  • Being male
  • Exposure to violence at an early age
  • Exposure to explosive behaviors at home (e.g. angry outbursts from parents or siblings)
  • Having experienced physical trauma
  • Having experienced emotional trauma
  • History of substance abuse
  • Certain medical conditions

Signs and Symptoms of Intermittent Explosive Disorder

There are a variety of symptoms that people who have intermittent explosive disorder will display based upon individual genetic makeup, development of social skills, coping strategies, presence of co-occurring disorders, and use or addiction to drugs or alcohol. The following are some examples of various signs and symptoms that a person suffering from IED may exhibit:

Behavioral symptoms:

  • Physical aggressiveness
  • Verbal aggressiveness
  • Angry outbursts
  • Physically attacking people and/or objects
  • Damaging property
  • Road rage

Physical symptoms:

  • Headaches
  • Muscle tension
  • Chest tightness
  • Palpitations
  • Tingling
  • Feelings of pressure in the head
  • Tremors

Cognitive symptoms:

  • Low frustration tolerance
  • Feeling a loss of control over one’s thoughts
  • Racing thoughts

Psychosocial symptoms:

  • Feelings of rage
  • Uncontrollable irritability
  • Brief periods of emotional detachment

Effects of Intermittent Explosive Disorder

IED can lead to devastating consequences for those with the disorder, but this depends upon the specific symptoms and behaviors the person exhibits. The following are examples of effects that untreated intermittent explosive disorder can have on individuals:

  • Impaired interpersonal relationships
  • Domestic or child abuse
  • Legal problems
  • Incarceration
  • Drug or alcohol addiction
  • Trouble at work, home, or school
  • Low self-esteem and self-loathing
  • Self-harm
  • Suicidal thoughts and behaviors

Co-Occurring Disorders

The symptoms of intermittent explosive disorder oftentimes directly mirror symptoms of various other disorders. Some of the most common mental disorders that co-occur with IED can include:

  • Attention deficit hyperactivity disorder (ADHD)
  • Conduct disorder
  • Oppositional defiant disorder (ODD)
  • Bipolar disorder
  • Anxiety disorders
  • Depressive disorders
  • Post-traumatic stress disorder (PTSD)

 

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