Intermittent Explosive Disorder

Intermittent explosive disorder is a behavioural disorder exhibited by episodes of eruptive outbursts of inexplicable anger, rage and/or violence.

Behaviour Help is a registered NDIS provider.

Image of the sections of the brain

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. 

 

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.

(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

Behaviour Help

If you are supporting an individual with this diagnosis, please refer to our services and resources. They aim to help children, adolescents and adults achieve better communication, social, emotional, behavioural and learning outcomes. So whether you are wanting guidance on parenting, teaching, supporting or providing therapy, Behaviour Help is at hand.

Note: This is not an exhaustive list of all the possible causes, symptoms and types but some general information that can be further explored. Based on what you have read if you have any concerns about an individual, please raise them with the individual/s. The caregiver can then raise these concerns with their local doctor who can provide a referral to the relevant professional (e.g. paediatrician, psychologist, psychiatrist, allied health professional and learning specialists) for diagnosis and treatment if appropriate.

Which resources are right for you?

Apps

Based on the Taking CHARGE of Rainbow of Emotions Workbook this app helps children of all ages develop emotional regulation skills. The app guides the child to firstly, identify and express their emotion in appropriate ways. Then the child is guided to use emotional management tool/s from the CHARGE tool kit to manage their emotions in a healthy way.

The acronym CHARGE stands for the different categories of emotional management tools – Chat tools, Helpful thinking tools, Amusement tools, Relaxation tools, Good routine tools and Exercise tools.

Behaviour Help App - Using the evidence-based approach of Positive Behaviour Support (PBS), the Behaviour Help web-based app allows people supporting individuals with emotional and behavioural difficulties to complete a Functional Behaviour Analysis and put together a comprehensive Behaviour Support Plan (BSP). The BSP can then be used by everyone interacting with the individual to manage and prevent challenging behaviours and ultimately improve their lives, and the lives of those who support them.

Books

If you want to learn more about emotional and behavioural difficulties then we have a great range of books you can read on your Kindle or order from Amazon.

Coaching

Personalised and practical one to one help tailored specifically to your family.

Online Courses

Access these online courses anytime online to learn about a range of diagnoses, practical skills and strategies to help develop the individual’s emotional regulation skills. Also learn to utilise the positive behaviour support framework to address anxiety, aggression, ADHD, ASD and ODD.

SEL Educational Videos

Minimise or eliminate the occurrence of challenging behaviours by teaching children of all ages appropriate ways of communicating, interacting, managing their emotions and behaviours.

The SEL curriculum uses video modelling to provide direct, explicit and systematic teaching of the various skills by discussing the importance of the skill, modelling the skill so the child learns what the skill looks like? sounds like? feels like? and learn the skill in staged situations that simulate real life scenarios.

Therapy

Personalised and practical behaviour therapy tailored specifically to your family.

Webinars

Webinars discuss a range of practical strategies to guide your child learn positive ways of behaving and managing their emotions.

Workshops

Attend our practical and interactive workshops to learn about a range of diagnoses, practical skills and strategies to help develop the individual’s emotions, behaviours, social and communication skills in your learning environment.

Ask Dolly

Since you’re here, you probably have questions and concerns. I am Dolly Bhargava, am here to help. I am a NDIS registered behaviour support practitioner and speech pathologist.

I have worked in a number of settings for over 21 years so, how can I help?

Please tell me what is worrying you right now and I will do my best to recommend resources and/or services that will be most useful to you in your situation.

Meet Dolly Bhargava, profile picture