Intermittent Explosive Disorder DMS 5 (IED) is a disorder characterized by recurrent aggressive and destructive outbursts.1 To meet the criteria for an Intermittent Explosive Disorder diagnosis, these outbursts must have an unspecified origin not caused by underlying mental disorders or a substance abuse disorder.
A lack of objective criteria has made the diagnosis of IED difficult, especially since there is no specific Intermittent Explosive Disorder test, but there are certain signs and symptoms that could be an indication of the presence of the disorder.
Intermittent Explosive Disorder can manifest in a variety of different ways. However, its identifying characteristic is explosive outbursts that can last up to 30 minutes. These outbursts can occur with little to no warning and can happen either frequently or sporadically. Intermittent Explosive Disorder can also be characterized by perpetual feelings of aggression and agitation. Signs and symptoms that may occur within an IED episode can include:2
According to the National Institute for Mental Health, Intermittent Explosive Disorder can affect up to 7.3% of adults.3 However, since diagnosis statistics for mental health disorders are often understated, alongside the lack of an objective Intermittent Explosive Disorder test, this percentage may be much larger.
The exact cause of IED has not yet been established, but researchers believe several genetic and environmental factors play a role in the development of the disorder.
There have been several studies linking the development of IED with exposure to trauma, especially in childhood. However, other factors can significantly raise the risk for development, including:
IED can increase the risk for the development of other conditions, both mental and physical, as a direct result of outbursts. Isolation as a form of self-treatment of both IED and trauma can lead to impaired mental health, which can cause depression and anxiety.
For IED to be diagnosed, the individual must experience the recurrent outbursts as described above: brief periods of intense emotion, usually rage, that can have destructive tendencies. Then, to ensure that the episodes have developed on their own, a certified health professional will conduct an exam to detect any underlying conditions or substance use disorders.
Trauma is how the body responds to the emotions associated with a distressing event, such as an accident or abuse, that overwhelms the mind’s coping abilities, resulting in long-term negative effects.
There are three main types of trauma: acute, chronic, and complex.4
Trauma can also be indirect, as seen through secondary or vicarious trauma. This type occurs when a person develops trauma symptoms due to close contact with someone who has experienced one of the three types of traumas. Vicarious trauma is most often seen in those who care for people suffering from negative experiences, such as family members or close friends.
Trauma occurs any time the body undergoes a distressing situation in which it is unable to cope. While there are no set criteria to evaluate whether trauma will manifest as the result of an event, there are certain circumstances where it occurs most often. Some of the most common causes of trauma are:
While the exact science between childhood trauma and IED is still being explored in today’s psychology world, there are several studies available that suggest a strong connection. Available information on early childhood brain development as well as trauma as a trigger incident points to this link.
One study published in Psychiatry Research found that, of 4844 trauma-exposed and 731 non-trauma-exposed adults, those who had pre-existing mental health conditions such as depression or anxiety, had experienced great trauma in the child, or who otherwise had a form of PTSD were more likely to have experienced IED. Development was most likely in those who’d first been exposed to trauma in childhood, such as through abuse or great loss.5
While genetics play a large, uncontrollable role in the development of IED, it is possible to help control the environmental factors that contribute to it. To prevent the condition, prevention measures must begin in childhood under the parents’ guidance.
Creating a healthy, safe environment for childhood development is one of the most significant steps in preventing Intermittent Explosive Disorder. IED tends to develop in children who grew up in a home where explosive behavior and different forms of abuse were common.
Treating trauma earlier can also be beneficial. If a parent’s child is exposed to trauma at an early age, undergoing treatment with a pediatric psychotherapist can aid in prevention.
Intermittent Explosive Disorder can be managed through a variety of forms of treatment, improving the individual’s quality of life.
Due to the correlation between childhood trauma and the presence of IED, one of the most common forms of treatment is trauma treatment. Trauma treatment can occur in many forms, including in-patient care and psychotherapy.
Intermittent Explosive Disorder treatment can consist of many different forms of medication, psychotherapy, and dual diagnosis for trauma and associated conditions. For many, in-patient rehabilitation can also be beneficial.