Impulse Control Disorders Intermittent Explosive Disorder

The prominent feature of impulse control disorders is the repeated inability to stop behaving impulsively, or to resist the desire for short term satisfaction from behaviors and actions that result in great long term loss or harm.

Like other psychological disorders there is a profound inability to retain or to gain control in various situations. There is some form of pleasure or tension relief from the behavior, even when the behavior is disfiguring or painful. There is tension before the act of compulsion and there is either pleasure or relief afterward. In some cases, the behavior has an addictive quality, but is not from the use of addicting substances. The behavior, itself, results in consequences that are addictive.

In intermittent explosive disorder, the precipitating factors are quite out of proportion to the behavior that results: acting out physically and aggressively to destroy property or to assault people. There are also factors of inability to take responsibility for their actions, by blaming third parties, circumstances, or comments that were allegedly made, then inflated into upsetting statements.

The inability to both control impulses and to take responsibility cause intermittent explosive disorder to be a difficult problem in that these are roadblocks to changing behavior.

The time from the triggering to the episode, spell or attack of intermittent explosive disorder can vary from minutes to hours. Other names for the disorder are episodic dyscontrol, rage attacks or anger attacks. They appear to be manic episodes that are senseless, impulsive acts.  Involuntary impulses, impulses and even ideological obsessions are common triggers.

On a simpler level, individuals with intermittent explosive disorder have grave trouble with controlling their tempers. There is tension before the behavior and relief afterword, as with most other impulse disorders. There is remorse, upset and guilt afterword that is overwhelmed by a belief that the behavior is justified.

This is a disorder that is assigned, however, only after other disorders that cause intermittent explosive behavior have been ruled out. As such, it is a “diagnosis of exclusion”, and is assigned to the DSM-IV-TR as “Impulse Control Disorder-Not Elsewhere Classified”.

The causes range from brain abnormalities and cognitive distortions that develop from childhood abuse, trauma, and negative beliefs and attitudes towards others.  This is a rare and largely male disorder, with onset in the early 20s. Such behavior is likely to be more encouraged, excused, or accepted in males than females. But females also have the capacity to develop this disorder when they do not care what other people think about them.

There are also frequently diagnosed additional disorders that go along with intermittent explosive disorders, such as antisocial, borderline, personality and social adjustment disorders; substance abuse and physiological disorders of the brain.

When there are individuals who have filed criminal charges or when the personal relationships are at risk, the individual with these disorders are either ordered into treatment or they can voluntarily request help. Anger management and other behavioral and cognitive treatments and applications are provided.