Intermittent Explosive Disorder

When I talked about emotions, I explained the concept of the priority of negative emotions. This is an evolutionary concept, according to which negative emotions such as anger and fear are activated more quickly than others because they are adaptive. In other words, recognizing anger in others and in oneself helps avoid a potentially harmful escalation.

When one is unable to recognize their own anger (and consequently to self-regulate), they become “slaves” to their own aggressiveness. This aggressiveness may manifest in heated arguments and can escalate to property damage or physical injury to people or animals.

In certain contexts, we can understand the reasons behind someone’s anger (though not necessarily agreeing with their aggressive reaction). However, in the case of the anger outbursts typical of Intermittent Explosive Disorder, the anger is inexplicable. The anger (and the associated aggressive reaction) appears clearly disproportionate to the triggering event.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Intermittent Explosive Disorder is characterized by:

• Inability to control aggressive impulses
• The degree of aggressiveness during outbursts is grossly disproportionate to the context
• Outbursts of anger are not premeditated and do not serve a specific goal
• The individual is at least 6 years old
• The disorder causes significant personal and social distress
• The symptoms cannot be better explained by another condition

The inability to control aggressive impulses is met in one of the following cases:

1. Verbal or physical aggression directed toward property, animals, or people, without resulting in damage (if property is involved) or injury (if animals or people are involved). Such aggressions occur at least twice a week for 3 months.

2. At least three physical aggressions directed toward property, animals, or people that result in damage (to property) or injury (to animals or people) within a period of one year.

Sources:

• American Psychiatric Association (2013) – Diagnostic and Statistical Manual of Mental Disorders (5th ed.)
• Bernhill, J. W. (2014) – DSM-5 Clinical Cases

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