Isolated Explosive Disorder: An Overview
Introduction
Explosive disorder is a term used to describe a range of behavioral, emotional, and sometimes physical reactions that are characterized by extreme and often uncontrollable outbursts of anger or rage. Isolated explosive disorder (IED) is a specific subtype of explosive disorder and is characterized by episodic outbursts of extreme aggression and/or violence. This disorder is often referred to as intermittent explosive disorder (IED) and is classified as a mental disorder in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5).
Definition
IED is defined as recurrent, impulsive, and aggressive outbursts that are disproportionate to the situation and that lead to destruction of property, physical assault, and/or verbal aggression toward others. Outbursts are typically out of proportion to the situation and involve physical aggression, property destruction, and/or verbal aggression. The outbursts are typically sudden and unpredictable and may last for several minutes to hours.
Diagnosis
The DSM-5 criteria for IED is as follows:
1. Recurrent aggressive outbursts with verbal aggression, physical assault, or property destruction that occur in response to a perceived slight or provocation
2. Aggressive outbursts are out of proportion to the provocation or are grossly disproportionate to the social context
3. Onset of aggressive outbursts typically occurs before the age of 30
4. Aggressive outbursts are not premeditated or planned
5. Aggressive outbursts are not premeditated, planned, or due to another medical condition or mental disorder
Risk Factors
The exact cause of IED is not known, however, there are certain risk factors that may contribute to the development of this disorder. These risk factors include a family history of aggression, a history of childhood trauma or abuse, a history of substance abuse, a history of psychiatric illness, and other environmental factors.
Treatment
Treatment for IED typically includes a combination of psychotherapy and medication. Cognitive behavioral therapy (CBT) is an evidence-based psychotherapy that has been shown to be effective in treating IED. CBT helps individuals to identify and challenge maladaptive thoughts and behaviors, while teaching skills to manage emotions and develop more adaptive coping strategies. Additionally, medications such as selective serotonin reuptake inhibitors (SSRIs) may also be prescribed to help reduce the frequency and intensity of outbursts.
Conclusion
IED is a mental disorder characterized by recurrent, impulsive, and aggressive outbursts that are disproportionate to the situation and lead to destruction of property, physical assault, and/or verbal aggression toward others. Although the exact cause of this disorder is not known, a combination of psychotherapy and medication can be effective in managing symptoms.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Kazdin, A. E. (2013). Psychosocial treatments. In B. J. Sadock, V. A. Sadock, & P. Ruiz (Eds.), Kaplan and Sadock’s comprehensive textbook of psychiatry (9th ed., pp. 1777-1804). Philadelphia, PA: Lippincott Williams & Wilkins.
Sansone, R. A., & Sansone, L. A. (2013). Intermittent explosive disorder. Psychiatry (Edgmont), 10(8), 54-58.