Intermittent Explosive Disorder

About Intermittent Explosive Disorder

Intermittent explosive disorder is characterized by recurrent behavioral outbursts representing a failure to control aggressive impulses. DSM-5 describes either frequent verbal aggression or physical aggression that does not cause injury or damage, occurring regularly over a period of months, or a smaller number of outbursts within a year that involve damage to property or physical injury. The outbursts are grossly out of proportion to the provocation, are not premeditated or committed to achieve a goal, and cause distress, impairment or legal and financial consequences. The diagnosis applies from age six or the equivalent developmental level. Outbursts are typically brief, may be preceded by tension and followed by relief, and are often followed by regret or embarrassment. Onset is commonly in late childhood or adolescence. Research has linked the condition with differences in brain circuits involved in threat and emotion regulation, including heightened amygdala responses and reduced prefrontal control, as well as with serotonin function, and exposure to trauma in childhood is a common risk factor. It frequently co occurs with depression, anxiety and substance use. Cognitive behavioral therapy that includes relaxation training, cognitive restructuring and coping skills has the most evidence, and medications such as SSRIs and mood stabilizers are sometimes used to reduce aggression.