Intermittent Explosive Disorder or otherwise known as IED is characterized in the Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM-IV) as an Impulse-Control Disorder Not Elsewhere Classified (Franz, 2006). IED is a mood disturbance which creates repeated episodes of aggression and violence. A person with IED can cause harm to others and themselves as well as property damage. After these aggressive or violent outbursts, the individual is likely to feel remorse, regret, and embarrassment (Mayo Clinic, 2008).
As with all other disorders, a person must meet certain criteria in order to be diagnosed with IED. The first is that the individual must have had several previous episodes of violence or aggression which resulted in serious harm to another individual or the destruction of property (Franz, 2006). The second is that these outbursts are grossly out of proportion to the situation (Mayo Clinic, 2008). The third criterion is that the behavior cannot be a result of another disorder, medications, substance use, or brain injury (Franz, 2006).
IED has been found to be preceded or accompanied by racing thoughts, increased energy, irritability, rage, tingling, tremors, palpitations, tightness in the chest, pressure inside the head, and hearing echoes (Franz, 2006). Fatigue and depression are likely to develop shortly after an outburst. If depression develops, the individual is more likely to harm him or herself or attempt suicide. These individuals also have outbursts between episodes, the difference being because the outbursts involve yelling or screaming instead of physical violence (Franz, 2006). These episodes typically last for 10 to 20 minutes and can occur in clusters or can be spread out by weeks or months (Mayo Clinic, 2008).
Intermittent Explosive Disorder will affect approximately one in 14 U.S. adults (Mayo Clinic, 2008). In the United States, 80% of those individuals who are diagnosed with IED are adolescent and adult male (Franz, 2006). Over the course of a lifetime, IED results in approximately 43 episodes of aggression and violence and is associated with substantial functional impairment (NIMH, 2006). People who are diagnosed with this disorder usually have a family history of aggression or abuse. Because of this, IED can fall into the debate over nature vs. nurture.
There is a high possibility of people with IED also having other mental health problems such as mood disorders, eating disorders, and anxiety disorders as well as substance abuse problems (Mayo Clinic, 2008). People who have personality disorders such as antisocial and narcissistic also have a high risk of IED. Behavior problems as children, such as stealing, starting fires, and severe temper tantrums are also found in people diagnosed with Intermittent Explosive Disorder (Mayo Clinic, 2008). Abnormally low levels of the neurotransmitter serotonin have been found in patients diagnosed with IED (Franz, 2006). Other tests point to imbalances in testosterone and irregularities in neurological signs and electroencephalograms (EEG’s) (Mayo Clinic, 2008).
Many types of drugs are used to control Intermittent Explosive Disorder, such as Anticonvulsants, anti-anxiety agents, mood regulators, and antidepressants (Mayo Clinic, 2008). Medication along with therapy, group counseling sessions, rage management, and relaxation techniques have been found to be helpful in neutralizing anger (Mayo Clinic, 2008). Cognitive therapy can also be useful to the patient because he or she would be able to learn how this disorder affects other aspects of life including relationships and careers.
Human development and socialization are impaired in someone who has Intermittent Explosive Disorder. Because of the fits of rage, aggression, and violence having a relationship with someone who has been diagnosed with IED becomes difficult. Marriages often end in divorce and children are prone to verbal and physical abuse. Fortunately, with help IED can be controlled.
References
Franz, J. (2006). Intermittent Explosive Disorder. Gale Encyclopedia of Medicine.
The Gale Group. Retrieved electronically October 11, 2008 from
