Intermittent explosive disorder (Ied) is a behavioral disorder characterized by greatest expressions of anger, often to the point of unruly rage, that are disproportionate to the situation at hand. Ied is marked by several various episodes of failure to resist aggressive impulses that consequent in serious assaultive acts or destruction of property. It occurs most often in young men.
Ied should be grand from Personality change Due to a general healing Condition, Aggressive Type, which is diagnosed when the pattern of aggressive episodes is judged to be due to the direct physiological effects of a diagnosable general healing condition.
Ied attacks are out of proportion to the communal stressors triggering them and are not due to other mental disorder or the effects of drugs or alcohol, according to the Diagnostic and Statistical by hand of mental Disorders, Fourth Edition (Dsm-Iv).
This is more base than once thought, according to study funded by the National institute of mental condition in a June 2006, but is relatively rare in citizen aged 60 and older. Intermittent explosive disorder "is very widely distributed in the citizen rather than being concentrated in any one segment of society," one researcher writes.
People with intermittent explosive disorder may have an imbalance in the amount of serotonin and testosterone in their brains. Individuals with Intermittent Explosive Disorder sometimes review intense impulses to be aggressive prior to their aggressive acts.
Signs and symptoms--
Explosive eruptions, regularly continuing 10 to 20 minutes, often consequent in injuries and the deliberate destruction of property. These episodes may occur in clusters or be separated by weeks or months of nonaggression.
Aggressive episodes may be preceded or accompanied by:
· Chest tightness
· Head pressure
· Hearing an echo
Most citizen with this disorder grew up in families where explosive behavior and verbal and bodily abuse were common. Being exposed to this type of violence at an early age makes it more likely for these children to exhibit these same traits as they mature.
There may also be a genetic component, causing the disorder to be passed down from parents to children. Other conditions that must be ruled out before making a diagnosis of intermittent explosive disorder contain delirium, dementia, oppositional resistant disorder, antisocial personality disorder, schizophrenia, panic attacks, and substance withdrawal or intoxication. Lives have been torn apart by this disorder, but medications can help operate you or your loved one's aggressive impulses.
Many psychiatrists do not place intermittent explosive disorder into a isolate clinical category, but reconsider it a indication of illness of other psychiatric and mental disorders. Many psychiatric disorders are connected with impulsive aggression, but some individuals demonstrate violent outbursts of rage, which are variously referred to as rage attacks, anger attacks, episodic dyscontrol, or intermittent explosive disorder.
Explosive episodes may be connected with affective symptoms such as irritability or rage, increased energy, and racing thoughts while the aggressive impulses and acts, and rapid onset of depressed mood and fatigue after the acts. Some individuals may also description that their aggressive episodes are often preceded or accompanied by symptoms such as tingling, tremors, palpitations, chest tightness, head pressure, or hearing an echo.
Some disorders have similar or even the same symptoms. However, women also have problematic impulsive aggression, and some women have reported an growth in intermittent explosive symptoms when they are premenstrual. The aggressive episodes may take the form of "spells" or "attacks," with symptoms starting minutes to hours before the actual acting-out. If a sick person appears to be intoxicated by a drug of abuse or suffering symptoms of withdrawal, a doctor may order a toxicology screen of the patient's blood or urine to settle the possible source of the acting -out.
Age, race and socioeconomic status don't seem to be factors in predicting who suffers from Ied-but gender does: Studies find nearly twice as many men display symptoms than women. Clinicians may be at fault for concentrating on secondary symptoms, such as anxiety or depression, and not asking about outbursts of anger. Sometimes what appears as discipline problems are symptoms of a pathology.
People with other mental condition problems - such as mood disorders, anxiety disorders and eating disorders - may be more likely to also have intermittent explosive disorder. Substance abuse is other risk factor. This disorder may consequent in job loss, school suspension, divorce, auto accidents or incarceration.
Ied, an imbalance in brain chemicals, affects up to one in 20 citizen -- more men than women. Ied-related injuries occur 180 times per 100 lifetime cases and is significantly comorbid with most Dsm-Iv mood, anxiety, and substance disorders.
Individuals with narcissistic, obsessive, paranoid or schizoid traits may be especially prone to intermittent explosive disorder. As children, they may have exhibited severe temper tantrums and other behavioral problems, such as stealing and fire setting.
Ied can fuel road rage, spousal abuse, etc., and may also predispose citizen to other mental illnesses, such as depression and anxiety, and substance abuse problems. Ied could very well be an overlooked explanation for the frequency of violent crimes committed by violent offenders.
Individuals with intermittent explosive disorder may attack others and their possessions, causing bodily injury and property damage. Later, they may feel remorse, regret or embarrassment about the aggression.
Screening and diagnosis--
The diagnosis is based on these criteria:
· Multiple incidents in which the man failed to resist aggressive impulses that resulted in deliberate destruction of property or attack of other person.
· The aggressive episodes aren't accounted for by other mental disorder, and are not due to the effects of a drug or a general healing condition.
· The degree of aggressiveness expressed while the incidents is wholly out of proportion with the precipitating event.
Other conditions that must be ruled out before making a diagnosis of intermittent explosive disorder contain delirium, dementia, oppositional resistant disorder, antisocial personality disorder, schizophrenia, panic attacks, and substance withdrawal or intoxication.
People with intermittent explosive disorder may have an imbalance in the amount of serotonin and testosterone in their brains. They may also show some minor irregularities in neurological signs and electroencephalograms (Eegs).
Many separate types of drugs are used to help operate intermittent explosive disorder, including:
· Anti-anxiety agents in the benzodiazepine family, such as diazepam (Valium), lorazepam (Ativan) and alprazolam (Xanax).
· Anticonvulsants, such as carbamazepine (Tegretol), phenytoin (Dilantin), gabapentin (Neurontin) and lamotrigine (Lamictal).
· Antidepressants, such as fluoxetine (Prozac) and paroxetine (Paxil).
· Mood regulators like lithium and propranolol (Inderal).
Group counseling sessions, focused on rage management, also have proved helpful. Some citizen have found freedom techniques useful in neutralizing anger.
Treatment could involve medication or therapy along with behavioral modification, with the best diagnosis utilizing a composition of the two. rehabilitation with antidepressants, along with those that target serotonin receptors in the brain, is often helpful, along with behavior therapy akin to anger management.
If the sick person appears to be a danger to himself or others, he may be committed against his will for added treatment. Researchers found that although 88% of individuals with Ied studied were upset by the results of their explosive outbursts, but only 13% had ever asked for rehabilitation in dealing with it.
Since the cause(s) of Ied are not fully understood as of the early 2000s, preventive strategies should focus on rehabilitation of young children (particularly boys) who may be at risk for Ied before they enter adolescence. These patients often need psychological rehabilitation along with medication treatment, and it is often very helpful to base their psychological rehabilitation on addiction-based models.
Some patients with Ied, often adult males who have assaulted their wives and are trying to save their marriages, are aware that their outbursts are not general and seek rehabilitation to operate them. Younger males with Ied are more likely to be referred for diagnosis and rehabilitation by school authorities or the youthful justice system, or brought to the doctor by concerned parents.
The success of rehabilitation with lithium and other mood-stabilizing medications is consistent with findings that patients with Ied have a high lifetime rate of bipolar disorder. Given its earlier age-of-onset, identifying Ied early - perhaps in school-based violence prevention programs - and providing early rehabilitation might forestall some of the connected psychopathology.
While 60 percent of citizen with Ied seek professional rehabilitation for a mood or substance problem, only about 29 percent receive rehabilitation for their anger.Intermittent Explosive Disorder