- Intermittent explosive disorder
(IED) is an aggressive behavioral condition marked
by frequent physical or verbal outbursts that often affects young
- Although essentially a neurobiological disorder, it is
often treated as a social-behavioral issue.
- New findings suggest that frequent aggressive behavior increases the
risk of future substance abuse by 5 times.
People who display frequent aggressive
behavior have five times greater risk for abusing substances such as alcohol,
tobacco and marijuana than those who do not display this behavior, according to
a new study by a research team from the University of Chicago.
This condition is termed as intermittent explosive disorder
(IED), which is marked by frequent physical
or verbal outbursts affecting about 16 million
Americans, more than bipolar disorder
‘Effective treatment of aggressive behavior using early psychological intervention, medication, and cognitive therapy will help to delay or prevent onset of substance abuse.’
It often affects
young adults, some of whom can be as young as 11 years before substance abuse
problems usually develop.
IED runs in
families and is thought to have a significant genetic component. But it is
often treated as a social-behavioral issue instead of as a true neurobiological
don't see this as a medical problem. They think of it as simply bad behavior
they have developed over the course of their lives, but it isn't. It has
significant biology and neuroscience behind it," said Coccaro, who is the
Ellen C. Manning Professor of Psychiatry and Behavioral Neuroscience at
University of Chicago.
Though it is known that substance abuse, like excessive drinking, can make aggressive
behavior worse, no studies have reported the relationship
between onset of IED and chronic
research had suggested that aggressive behavior in IED is due to the presence
of other psychiatric disorders, such as anxiety or depression. But the new
study found no such relationship.
team including Emil Coccaro, MD, and colleagues analyzed data from more than
9,200 subjects in the National Comorbidity Survey, a national survey of mental
health in the United States.
They found that
as the severity of aggressive behavior increased, so did levels of daily and
weekly substance use.
In cases where patients
developed both aggressive disorder and chronic substance abuse, IED preceded
substance abuse in 92.5% of the cases.
suggest that a history of frequent, aggressive behavior is a risk factor for
later substance abuse, and that substance abuse can be prevented or delayed in
young people by effective treatment of aggression.
The most effective therapies
to prevent or delay substance abuse problems in adolescents
diagnosed with IED are early psychological intervention,
medication and cognitive therapy.
you're really treating is the emotional dysregulation that leads to
aggression," Coccaro said. "The earlier you treat this dysregulation,
the more likely you are to offset other disorders that come later down the
The study is
published in the Journal of Clinical Psychiatry
Intermittent Explosive Disorder
explosive disorder is a chronic disorder that is characterized by sudden
episodes of repeated, impulsive, aggressive, violent or angry verbal outbursts.
mostly males are commonly affected by IED. This behavior can be very
destructive and lasts for years, though its severity diminishes with age.
incidence of IED ranges from 5% to 7%, according to the National Comorbidity
Survey Replication and the current prevalence is 3% to 4%.
involves medications and psychotherapy to help you control aggressive impulses.
- Emil Coccaro et al. Intermittent Explosive Disorder and Substance Use Disorder: Analysis of the National Comorbidity Survey Replication Sample. Journal of Clinical Psychiatry ; (2017) doi.org/10.4088/JCP.15m10306
- Intermittent Explosive Disorder - (http://www.mayoclinic.org/diseases-conditions/intermittent-explosive-disorder/basics/definition/con-20024309)
- Treating intermittent explosive disorder - (http://www.health.harvard.edu/newsletter_article/treating-intermittent-explosive-disorder)