Intermittent explosive disorder (abbreviated IED) is a behavioral disorder characterized by extreme expressions of anger, often to the point of uncontrollable rage, that are disproportionate to the situation at hand. It is currently categorized as an impulse control disorder. Some have reported that they have emotional changes prior to an outburst which could lead one to think that a person is aware when an outburst is about to occur.
Prevalence is higher in men than in women. The disorder itself is not easily characterized and often exhibits with dual diagnoses with other mood disorders, particularly bipolar disorder. Individuals diagnosed with IED report their outbursts were brief (lasting less than an hour), with a variety of bodily symptoms such as sweating, chest tightness, twitching, palpitations. The violent acts were frequently reported accompanied by a sensation of relief, and in some cases, pleasure, but accompanied by remorse after the fact; similar to that of an addict getting a fix.
The DSM-IV criteria for IED include:
• Occurrence of discrete episodes of failure to resist aggressive impulses that result in violent assault or destruction of property.
• The degree of aggressiveness expressed during an episode is grossly disproportionate to provocation or precipitating psychosocial stressor.
• Diagnosis is made only when all other mental disorders and all general medical condition that may cause violent outbursts have been ruled out.
Intermittent Explosive Disorder is treated through both cognitive behavioral therapy and psychotropic medication. Therapy goal is to help patient recognize the impulses that lead to the outburst with the reasoning, if they can recognize and are aware of the changes, they can take necessary action to control the outburst. It also aims to treat the emotional stress that comes with these violent outburst. Medications have shown effective in alleviating some of the pathopsychological symptoms.
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