Intermittent Explosive Disorder

Definition of Intermittent Explosive Disorder

Intermittent explosive disorder is a behavioural disorder exhibited by episodes of eruptive outbursts of inexplicable anger, rage and/or violence such as sudden impulsive screaming, shouting or unwarranted and excessive scolding emitted to someone else but usually not prompted by any given cause, reason or event (APA, 2013). Sometimes it may be challenging to notice the disorder and it sometimes may be mistaken for bipolar disorder. 

Read more about strategies for managing anger.

Causes of Intermittend Explosive Disorder

The onset of intermittent explosive disorder can sometimes be in childhood. This disorder is however most common in younger adults than in older adults. The exact cause of the disorder is unknown, but it's most likely caused by a number of environmental and biological factors.

1. Environment – majority of those affected by this disorder may have grown in families or environments where explosive behaviour, and/or verbal and physical abuse happened regularly or were common. Being exposed to this type of violence at an early age makes it more likely these children will exhibit these same traits as they mature.
2. Genetics – there may be a genetic component, causing the disorder to be passed down from parents to children.
3. Differences in how the brain works – there may be differences in the structure, function and chemistry of the brain in people with intermittent explosive disorder compared to people who don’t have the disorder.
4. History of physical abuse – people who were abused as children or experienced multiple traumatic events have an increased risk of intermittent explosive disorder.
5. History of other mental health disorders – people who have antisocial personality disorder, borderline personality disorder or other disorders that include disruptive behaviours, such as attention-deficit/hyperactivity disorder (ADHD), have an increased risk of also having intermittent explosive disorder.

(APA, 2013; Coccaro, 2012; Hudspeth et al., 2015; McLaughlin et al., 2012 & Morland et al., 2012)

Types of Intermittent Explosive Disorder

There are two main ways that intermittent explosive disorder can be categorized, this is by the outburst that the affected person exhibits. This disorder can be exhibited through aggressive episodes which are more physical and/or explosive verbal and behavioural outbursts that are emotion related.

Symptoms of Intermittent Explosive Disorder

Intermittent explosive disorders can be characterized by the manner of sudden emotional episodes of frequent or non-frequent eruptive outbursts of negative emotion. There are various signs and symptoms that people who have intermittent explosive disorder may present with based on their distinct genetics, how they developed their social skills, unique coping tactics, the existence of simultaneous disorders and the use of, or addiction to drugs or alcohol. Some of the signs and symptoms that a person affected by this disorder may include:

Behavioural symptoms:

• Physical aggressiveness.
• Verbal aggressiveness.
• Angry outbursts
• Physically attacking people and/or objects.
• Damaging property.
• Inexplicable 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.

A simplified guide for managing anger can be found here: 'Strategies for managing anger'.  

(APA, 2013; Coccaro, 2012; Hudspeth et al., 2015; McLaughlin et al., 2012 & Morland et al., 2012)

References

American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.).

Arlington, VA: American Psychiatric Association.

Coccaro, E.F. (2012) Intermittent explosive disorder as a disorder of impulsive aggression for DSM-5. American Journal of Psychiatry. 169:577-588.

Hudspeth, E. F., Wirick, D., & Matthews, K. M. (2015). Intermittent Explosive Disorder. In G. M. Kapalka (Ed.), Treating Disruptive Disorders: A Guide to Psychological, Pharmacological, and Combined Therapies (pp. 161–179). Routledge/Taylor & Francis Group.

McLaughlin, K.A., Green, J. Hwang, I.,Sampson, N.A.,Zaslavsky, A.M & Kessler, R.C. (2012) Intermittent explosive disorder in the National Comorbidity Survey Replication Adolescent Supplement. Archives of General Psychiatry, 69(11): 1131-1139. 

Morland. L.A., Love, A.R, Mackintosh, M.A., Greene, C.J. & Rosen, C.S. (2012). Treating Anger and Aggression in Military Populations: Research Updates and Clinical Implications. Clinical Psychology: Science and Practice, 19 (3): 305-322