Intermittent Explosive Disorder: An Actual Disorder or Just a Temperament Problem?

A study founded by the National Institute of Mental Health proved that five to seven percent, about 16 million Americans, of the nationally representative sample had intermittent explosive disorder. Intermittent explosive disorder involves multiple outbursts that are way out of proportion to the situation. These angry outbursts often include threats or aggressive actions and property damage. After the outburst the patient might feel genuine regret and embarrassment. This disorder is more common in men that in women and it affects more people than thought. Women have reported that the symptoms seem to increase during their premenstrual cycle. Since men seem to be more affected by it they have a history of traffic accidents, sexual impulsivity and they also develop an extreme sensitivity to alcohol. It shares similarities of some of its symptoms with Alzheimer’s disease, Anti Social Personality Disorder, Borderline Personality Disorder, Conduct Disorder, and Attention-deficit/ hyperactivity disorder. This disorder raises a sort of controversy among clinicians because they believe it is a symptom to other diagnoses rather than its own disorder.

A severe disorder might be undertaken like Dr. Emil Coccaro (pictured), chairman of the psychiatry at the University of Chicago’s medical school, states, “people think its bad behavior and that you just need an attitude adjustment, but what they don't know...is that there's a biology and cognitive science to this.” The disorder typically first appears in adolescence; in the study, the average age of onset was 14. A factor that has to be carefully watched is that people should not automatically diagnose themselves with this disorder just because they experience any of the symptoms mentioned previously. Even thought the intermittent explosive disorder has been included in the manual psychiatrists use to diagnose mental illness for several decades, they still react with admiration to it because of the many affected. As said by Ronald Kessler, “it is news to a lot of people even who are specialists in mental health services that such a large proportion of the population has these clinically significant anger attacks.”

Patients are often treated with psychological treatment along with medication treatment, and it is often very helpful to base their psychological treatment on addiction-based models. Studies suggest that patients with intermittent explosive disorders respond to treatment with antidepressants such as tricyclic antidepressants and serotonin reuptake inhibitors (SRIs) and mood stabilizers such as lithium, carbamazepine, and divalproex. Patients left unattended and those given no medication can display behavior that can result in extreme catastrophe. For example, David Edward Attias, a student from the University of California Santa Barbara, forced his car towards a crowd of students and triumphantly killed four of them. Victims who witnessed this crime described Attias as an insane person. He was often referred to as “crazy Dave” or “tweaker” by people in his dormitory. After he left the scene of the crime he went directly to a female student’s dormitory confessed he was a virgin and demanded she had sex with him. Instances like these call for immediate detection and treatment for the disorder so that tragedy can be avoided and innocent people would not be harmed.

Intermittent explosive disorder is unknown among many and their ignorance may lead them to leave it unattended. As new victims are affected, an effort should be made to inform people about this severe disorder that lingers amongst society. This will be beneficial in the near future because we never know when we might encounter a person that is affected by it in any public location. Both the victims and patients are at risk and without the information needed to learn about its danger, nothing can be done to keep it from spreading. Although intermittent explosive disorder contains many of the symptoms attributed to other mental illnesses, there should still be further research and studies done to provide the public with more useful information, treatments, and medications to contain it.