Intermittent Explosive Disorder: Issues and Discussions
(Institute/College/University)
Introduction
“Intermittent explosive disorder” is actions engaging repetitive, unforeseen episodes of violent, spontaneous, belligerent actions wherein the party acts in an inordinate manner relative to the situation at hand. Among the episodes that can be regarded as falling under this concept include episodes of domestic violence, hurling or destroying objects, ‘temper tantrums’ and ‘road rage’ form some of the indicators that can precede an episode. These chronic situations, violent outbursts can inflict significant amounts of stress, adversely affect one’s relationships, education and even work, and can inflict serious legal and financial ramifications (Mayo Clinic, 2016). This anomaly, according to Ploskin (2016), disables the capacity of the person for restraint to prevent the commission of an act that will be deleterious to themselves to other people. Regarded as a type of “impulse control disorder,” it is held that the conduct is not consistent; it explodes, or occurs in spurts. Even in instances when the person with the disorder is provoked, the response of the person with the disorder is often unwarranted related to the circumstances in the situation.
Juveniles with the condition haw low intolerance levels and are often irritated even by smallest annoyances; when these ‘vent’ their rages, these become verbally and physically belligerent that will lead to fights and property destruction. In addition, the people that have the condition aver to a sensation of being overshadowed by their anger and losing any sense of restraint; others on the other hand feel a tightening of the chest or head that is released when these lash out in a violent manner. It is common that these outbursts have short durations, normally lasting for half an hour, and are not planned or designed to achieve an actual objective. Furthermore, many of these adolescents with IED can inflict harm on themselves or committing self-mélange (Child Mind Institute, 2016).
Many in the US would just brush off ‘road rage’ as the inevitable product of the nation’s clogged roadways and the product of the modern lifestyle. However, road rage can inflict considerable financial setbacks as well. The National Highway Traffic Administration distinguishes between what can be regarded as “aggressive driving” and “road rage”. The former evinces hazardous driving practices such as “tailgating, “weaving,” and failing to stop at red lights; “road rage” is when the driver seeks to inflict harm or damage to the other driver and is located at the far extreme of the “aggressive driving spectrum.” MacDonald (2016) avers that the primary and mist fundamental difference between the two is that the former normally will result in the drive getting a traffic ticket; the latter can evolve into something more violent and turn into a criminal action.
In terms of car insurance, giving in to road rage can result in the voiding of one’s vehicle insurance. In this light, it can be said that people that were deliberately speeding and hit a person inadvertently, this will be covered by the insurance; however, within the context of road rage, if the person deliberately drives over the speed limit and hits someone owing to the rage of the driver, then that will not be covered by the insurance.
Background of the Study
Data from Valley Behavioral Health System (2016) aver that IED will impact approximately seven percent of the adult American population within their lifetimes. This figure equates to 11.5-116 million Americans; of those found with the condition in the United States, approximately 68 percent of those with IED will act their aggression in hostile manners against another, 20 percent will threaten air have threatened to attack another person, and 11 percent will have destroyed or damaged objects or property.
This data is parallel to the data taken from the “National Comorbidity Survey Replication” representative of the results from a person-to-person survey collected from more than 9,200 American adults spanning the years 2001-2003. With the condition commonly acknowledged as starting developing in the person’s juvenile years, the condition comes before or often indicates the predisposition if the person towards melancholy, and issues with alcoholism and illegal drugs. It was seen in the report of Kessler et al (2006) that people with IED are commonly seen with tendencies for the development of prevalence of these conditions in their lifetimes. In addition, the group avers that in the course of their research, more than 80 percent of those polled with IED had one or more of the conditions present; regrettably, only 28 percent of those surveyed received treatment for their condition (National Institute of Mental Health, 2006).
For a person to be identified as suffering from IED, a person must have at least actuated three episodes of violent uncontrollable behavior that is inordinately out of proportion with the circumstances that triggered the outbreak. Individuals who have had at least three episodes within one year were discovered to be suffering from a more aggressive form of the anomaly. The more aggressive form is in the group that, within the year, has attacked people and destroyed or damaged property within a given year. The less aggressive form is comprised of individuals with IED but have only either damaged small items or threatened harm on another person (National Institute, 2006).
A number of clinicians have established “road rage: as a new mental illness, and termed it as IED. The “Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), classifies IED as an “impulse control disorder” in the same category of ‘pyromania,’ ‘pathological gambling,’ and other ‘impulsive personality disorders.’ The condition is attendant to the decrease or destruction of cells in the left hemisphere of the brain, as well as other anomalies in the same region. Standing (2007, p. 5) avers that aside from these proffers, the condition is also being associated with a loss of serotonin, an emotion-altering chemical in the brain. In this light, it is generally prescribed with anti-depressants or anti-tension medications that are at times given together and combined with “cognitive behavioral therapy” that aids individuals in identifying the ‘triggers’ that set them off.
According to University of Chicago Medical School psychiatry department chair Dr. Emil Coccaro, people commonly think that bad manners on the road stems from the other drivers stems from just that-an ill attitude and disposition. However, in the work of Vrazilek (2006), Coccaro avers that many do not recognize road rage as a mental condition. According to Coccaro, people with IED on the average ‘explode’ at least 43 times a year, with each episode costing more than $1,300 in damages for each attack. Citing Kessler (2006), many believe that what is largely regarded as isolated cases of anger ‘getting out of hand’ is more prevalent than previously thought of.
Coccaro (2012) avers that IED was first classified as a “rare disorder,” and has been chronicled from the beginning of the DSM series. Though traditionally seen as one large but short duration outburst, it can also take the form of a lesser form of anger outburst that can be evinced over a period of one or several months; this is the form that more treatable compared to the short duration and high energy variety. Regrettably, though the condition was identified early and codified in the DSM, the diagnostic classifications were deficiently initialized, and empirical data on the condition was limited until the time that research criteria were established nearly a decade later.
Study design/Methodology
In the study of McLaughlin, Green, Hwang, Sampson, Zaslavsky, and Kessler (2013), the study was anchored on the factors as when the condition started to develop, or the “age at onset (AAO), the frequency of the attacks, the frequency of the attacks compared to the years that the person has been afflicted with the condition, and the number of attacks in the immediate year prior to the sampling. Lifetime disability was examined with questions regarding the cumulative amount of damaged properties the person has incurred and the number of times that the person had to seek medical assistance owing to the factor of an injury inflicted by an attack.
Results
At present, there is no mental analysis mechanism to establish behaviors that can be termed as “aggressive behavioral disorder.” In this light, violent disposition can be regarded as a symptom of various DSM-IV mental diagnoses, inclusive of “conduct disorders,” “oppositional defiant disorder,” IED and a number of personality anomalies (Sturmey, 2015). With the identification of the groups with prevalent attacks in their lifetimes, people with these conditions traditionally are disposed towards depression, anxiety attacks, substance abuse and even financial deprivation and marital failure.
With these factors, early intervention programs that establish the prevalence of IED in a child of juveniles can greatly mitigate possibilities that the child will be experiencing IED. School-based interdiction programs as well as according primary treatment programs can help in lowering the threat of IED in the juvenile or child. Though majority of the respondents in the studies had contacted or consulted with health professionals, a mere 11 percent of those surveyed were prescribed for their conditions in the last year prior to the study (National Institute, 2006).
Much of the research on strategies to address and counter road rage have assumed a position supporting a cognitive stance on the issue, focusing efforts on assisting persons with IED how to restrain their belligerent tendencies and control their impulses in highly emotional situations. In addition, studies done by Asbridge, Smart, and Mann (2006) have proffered that potential drivers be filtered for the possibility for road rage instances engaging the categories for IED. If the applicant would be determined as a possible road rage instigator, then the applicant will be made to undergo mandatory supplementary driving equipping seminars to learn “non-aggressive” driving techniques or managing and controlling their anger.
Traffic clinicians are also positing technical avenues to decrease instances of road rage. Among the designs being evaluated are automobiles designed to restrict drivers from nonsensically flashing their headlights or sounding their horns. Other designs incorporate sensors positioned in the grill area of the car that will monitor the distance between automobiles on the road and adjusts the speed of the car (Standing, 2007, p. 8).
References
Child Mind Institute (2016) “Intermittent explosive disorder” Retrieved 15 March 2016 from <http://childmind.org/guide/intermittent-explosive-disorder/
Coccaro, E.F (2012) “Intermittent explosive disorder as a disorder of impulsive aggression for DSM-5” Retrieved 15 March 2016 from <http://ajp.psychiatryonline.org/doi/abs/10.1176/appi.ajp.2012.11081259
MacDonald, J (2016) “Putting the brakes on road rage” Retrieved 15 March 2016 from <http://www.bankrate.com/finance/insurance/the-costly-risks-of-road-rage-1.aspx
Mayo Clinic (2016) “Intermittent explosive disorder” Retrieved 15 March 2016 from <http://www.mayoclinic.org/diseases-conditions/intermittent-explosive-disorder/basics/tests-diagnosis/con-20024309
McLaughlin, K.A., Green, J., Hwang, I., Sampson, N.A., Zaslavsky, A.M., and Kessler R.C (2013) “Intermittent explosive disorder in the National Comorbidity Survey Replication Adolescent Supplement” Retrieved 15 March 2016 from <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3637919/
National Institute of Mental Health (2006) “Intermittent explosive disorder affects up to 16 million Americans” Retrieved 15 March 2016 from <http://www.nimh.nih.gov/news/science-news/2006/intermittent-explosive-disorder-affects-up-to-16-million-americans.shtml
Ploskin, D (2016) “What is intermittent explosive disorder?” Retrieved 15 March 2016 from <http://psychcentral.com/lib/what-is-intermittent-explosive-disorder/
Standing, G (2007) “The psychology of road rage: a discussion of psychological explanations of road rage and policy implications.” Retrieved 15 March 2016 from <http://cranepsych.edublogs.org/files/2010/08/Roadrage.pdf
Sturmey, P. (2015) “Treatment interventions for people with aggressive behavior and intellectual disability” Retrieved 15 March 2016 from <http://www.wpanet.org/uploads/Education/Educational_Resources/autism-part4.pdf
Valley Behavioral Health Systems (2016) “Symptoms and signs of intermittent explosive disorder” Retrieved 15 March 2016 from <http://www.valleybehavioral.com/disorders/ied/signs-symptoms-causes#Statistics
Vrazilek, J (2006) “Road rage considered brain disorder” Retrieved 15 March 2016 from <http://www.cbsnews.com/news/road-rage-considered-brain-disorder/
