The behavioral outbursts manifest as:
- Verbal aggression (e.g., temper tantrums, tirades, verbal arguments, fights)
- Physical aggression toward property, animals or other individuals
Some adults with IED will engage in verbal aggression or physical aggression that results in damage or destruction of property or in physical injury to animals or other individuals. Others will have less severe episodes of verbal and physical aggression that don’t result in injury or destruction.
The magnitude of aggression expressed during the recurrent outbursts is grossly out of proportion to the provocation or to any precipitating psychosocial stressors. The recurrent outbursts are not premeditated, nor are they committed to achieve a tangible objective such as money, power, or intimidation.
The violent outbursts that characterize intermittent explosive disorder are generally preceded by a brief prodrome. The impulse is usually preceded by an increasing sense of tension or arousal that progresses quickly. Some adults will experience irritability, rage, increased energy, racing thoughts, and poor communication skills. They may also experience somatic symptoms such as numbness, trembling, palpitations, and chest tightness. The impulsive aggressive outbursts have a rapid onset and typically last for less than 30 minutes.
