Intermittent Explosive Disorder in Children and Adolescents


ICD-10 Code: F63.81

Intermittent Explosive Disorder (IED) is part of a cluster of diagnoses called the disruptive, impulse-control, and conduct disorders. Disruptive, impulse control and conduct disorders are a group of psychiatric conditions that include:

  • Oppositional Defiant Disorder
  • Intermittent Explosive Disorder
  • Conduct Disorder

These disorders are characterized by the presence of difficult, aggressive, or antisocial behavior. It is often associated with physical or verbal injury to the self, others, or objects or with violating the rights of others (e.g., destruction of property). These behaviors can appear in several forms and can be defensive, premeditated or impulsive. Individuals with disruptive, impulse control and conduct disorders may have an irritable temperament, be impulsive or inattentive, be defiant towards adults, be aggressive towards peers, and lack problem solving skills. They may also have a coercive interaction style and lack social skills.

Oppositional defiant disorder is defined as defiant, hostile, and disobedient behavior, usually directed at authority figures. Intermittent explosive disorder is explosive outbursts of anger, often to the point of rage, that are disproportionate to the situation at hand. Conduct disorder is repetitive and persistent aggression toward others in which the basic rights of others are violated. Disruptive, impulse control and conduct disorders appear to have addictive properties as they tend to have strong aspects of compulsion, craving, loss of control, and hedonistic release.

 

What is Intermittent Explosive Disorder?

In a survey of 6,000 children and adolescents, more than 60% reported at least one angry outburst that resulted in violence, threat of violence, or destruction of property. In the same sample, approximately 8% of participants met the criteria for IED. Epidemiological data is limited because there is a broad overlap with many disorders that feature impulsive, aggressive behavior. 

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Understanding Intermittent Explosive Disorder

IED is more prevalent among younger individuals. The average age of onset is 14 years old. The aggression that characterizes IED can be harmful to the aggressor as well as the victim. Children and adolescents with IED tend to experience interpersonal difficulties such as damaged friendships and poor social skills.

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How is intermittent explosive disorder treated?

IED is treatable. However, few controlled studies exist for the treatment of IED. Published treatment guidelines for disruptive disorders include those from the Society of Clinical Child and Adolescent Psychology, and the National Institute for Clinical Excellence. Treatment recommendations for IED can be found at PsychiatryOnline.  

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