IED is characterized by recurrent behavioral outbursts representing a failure to control aggressive impulses. Children and adolescents with IED have low frustration tolerances and are disproportionately enraged by small annoyances. The behavioral outbursts manifest as:
- Verbal aggression (e.g., temper tantrums, tirades, verbal arguments, fights)
- Physical aggression toward property, animals or other individuals
Some children and adolescents 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 child or adolescent senses increasing tension prior to committing the act and experiences pleasure, gratification or relief during or following the act. The impulsive aggressive outbursts have a rapid onset and typically last for less than 30 minutes.