INTERMITTENT EXPLOSIVE
DISORDER
BY: ALEX JARA
HOW CAN WE SEE SIGNS OF SOMEONE HAVING IED?
• IED stands for Intermittent Explosive Disorder
- This involves repeated episodes of impulsive, aggressive, violent behavior
or angry outburst in which you react grossly out of proportion to the situation
- Road rage, domestic abuse, throwing or braking objects, or other temper
tantrum may be a sing of IED
* Examples of this behavior include threatening to or actually hurting
another person and purposefully braking or damaging an object value
• A person may describe there episodes as “spells’ or “attacks” in which the
explosive behavior may is preceded by a sense of tension or arousal and
followed immediately by a sense of relief
• Often genuine regret is expressed after the outburst. Later the individual may
also feel upset, remorseful or embarrassed about the behavior.
• To be diagnosed with IED, an individual must have had three episodes of
impulsive aggressiveness
• One of the episodes is when you act “grossly out of proportion to any
precipitating psychosocial stressor” at any time in their life
• The person must have “all of a sudden lost control and broke or smashed
something worth more than a few dollars
• Hit or tried to hurt someone or threatened to hit or hurt someone
• Evidence suggest that IED might predispose toward depression, anxiety and,
alcohol and drug abuse disorders by increasing stressful life experiences, such
as financial difficulties and divorce
• Typically it begins in earlt teens, and also later may come with depression,
anxiety and substance abuse disorder. 82% of people who had IED were
diagnosed with one of these other disorders
• Out of these people only 28.8% received treatment for their anger
• This disorder could be caused by several factors
• Though many scientist don’t know the exact caused of the disorder, it is clear
that physical and emotional factors play roles in its development
• Like any other disorder causes can come from past experiences and or the
environment around them
• People who have IED are sometimes labeled as sub disorder because people
don’t want to believe it’s a disorder on its own
• dysfunctional neurotransmitters, or brain chemicals, such as serotonin
• hormones such as testosterone
• regions of the brain linked to emotions and memory, such as the limbic
system, or to planning and controlling impulses, such as the frontal lobes
• People might inherit or develop these physical/biological vulnerabilities,
which are sometimes associated with mild neurological abnormalities.
• Prediposing factors in childhood include expusre to drugs or alcohol, head
trauma, seizures and brain infections or inflammations
• Emotional or psychological causes
- studies have shown that people with impulse control disorders such as IED
are more likely to have a family history of addiction and mood disorders
- most likely growing up in unstable families marked by severe frustration,
physical and emotional abuse, alcoholism, violence, and life-threatening
situations
- they lack role models to teach them how to control their impulses and
emotions
• People might become explosive as a way of compensating for underlying
feelings of insecurity and low self-esteem, which are common among people
with the disorder
• They also might become explosive when confronted with situations that
remind them of bad childhood experiences
• Episodes of this explosive behavior is always most likely to occur during
periods of stress
HOW IS IED RECOGNIZED AND TREATED?
• IED is initially more common then experts believed
• The National Comorbidity Survey Replication, a community survey by the
National Institute of Mental Health, put the lifetime incidence in the 5% to 7%
range and the current prevalence at 3% to 4%, depending on how the
condition was defined
• a person with IED may have dozens of episodes over time, leading to injuries
requiring medical attention or causing thousands of dollars in property
damage
• In a controlled study with people who did not know had IED found that in first
degree relatives of IED had a significant elevated risk of IED
• Several studies suggest that the disorder is associated with abnormal activity
of the neurotransmitter serotonin in parts of the brain that play a role in
regulating, even inhibiting, aggressive behavior
• One study found that on some neuropsychological tests, people with IED
performed similarly to patients who had suffered damage to the prefrontal
cortex
• One of the biggest challenges are people who have trouble resisting their
violent impulses, no matter what the cause, these people are not very likely
to seek treatment
• Usually people with IED get psychiatric treatment but a minority get
treatment for their impulsive attacks
• Those who receive treatment usually wait a decade after onset of a symptom
to seek help. They usually come after a significant violent act has occurred or
because they are seeking treatment for another disorder
• There are a number of medications that are known to reduce aggression and
prevent rage outburst, including antidepressants, mood stabilizers, and
antipsychotic drugs
• In a study people who took SSSRI fluoxine (Prozac) showed increased activity
in their prefrontal cortex
• A 2009 study of 100 patients for that those who took fluoxetine for 12 weeks
experienced statistically significant reduction in impulsive aggressive behavior
compared with those who took a placebo
• Cognitive Behavioral theory
- this combines cognitive restructuring, coping skills training, and relaxation
training looks promising.
• The University of Chicago researchers compared a group and individual CBT
for the treatment of IED with a wait-list control group
- after 12 weeks sessions, patients participating in either individual or group
therapy were significantly less aggressive and angry, and less depressed, than
those in the control group
• Those who attended individual therapy sessions also reported improvement
in their overall quality of life
• It is easier to treat Intermittent explosive disorder if you treat it at a young
age
• Family members must know that kids who have IED can cause severe
disruption to family lie in many different areas
- economic cost of property damage
- emotional problems
- legal penalties
• It helps to get help early for kids because they could potentially prevent
suspensions in school, legal problems, hospitalizations, injuries, etc.
• You can put your kid in therapy where he/she can learn more about their
condition and accept it so they can later learn how to control it better
• Easier and could help future money cost on medical bills and damages
• Get a child into counseling so at school they do not harm themselves or the
people around them
• The earlier you go to seek treatment the potential of controlling and making
your disorder better is higher
CITATIONS
• Psychology Today. Intermittent Explosive Disorder. Retrieved march 29
http://www.psychologytoday.com/conditions/intermittent-explosive-disorder
Child Mind Institute. Mental Health Guide. Retrieved march 31
http://www.childmind.org/en/health/disorder-guide/intermittent-explosive-disorder
• Coccaro EF. Intermittent explosive disorder: development of integrated research criteria for Diagnostic and
Statistical Manual of Mental Disorders, Fifth Edition. Compr Psychiatry 2011; 52:119.
http://www.uptodate.com/contents/intermittent-explosive-disorder-in-adults-treatment-and-prognosis
Coccaro EF. "A Family History Study of Intermittent Explosive Disorder," Journal of Psychiatric Research
http://www.health.harvard.edu/newsletters/Harvard_Mental_Health_Letter/2011/April/treating-intermittentexplosive-disorder
(09,2008) Mayo Clinic Staff. Diseases and conditions. Retrieved march 31
http://www.mayoclinic.org/diseases-conditions/intermittent-explosive-disorder/basics/definition/con-20024309