Although the experience of anger and difficulties managing anger occur in a number of different mental health disorders, there is currently only one disorder in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition that directly focuses on anger -- Intermittent Explosive Disorder (IED).
What is Intermittent Explosive Disorder?
IED is a mental health disorder that is made up of the following symptoms:
- Several episodes of being unable to resist aggressive impulses that bring about major aggressive acts, such as assault or the destruction of property.
- The level of aggressiveness expressed during these episodes is well out of proportion to any trigger that preceded the episode.
- These episodes are not better accounted for by another disorder, such as borderline personality disorder or antisocial personality disorder.
Little is known about IED; however, several studies suggest that anywhere between 1 to 9% of the general population may develop IED at some point in their lifetime. IED has also been found to occur early in a person's life, generally during adolescence. It also frequently occurs along with other mental health disorders and, as one might expect, can interfere greatly with a person's life.
The Cause of IED
Given that IED can greatly interfere with relationships and negatively affect the quality of a person's life, mental health researchers have attempted to identify the cause of this disorder. One area that a number of researchers have focused on is the experience of traumatic events, particularly those that occur in childhood.
For example, one study of a large group of people from the general population across the United States looked at the relationship between exposure to childhood trauma and IED. They found that just having experienced any childhood trauma was found to be one of the strongest contributors to the development of IED in adulthood. In fact, it was a better predictor than the severity of the traumatic exposure and the presence of posttraumatic stress disorder (PTSD). In addition, they found that the experience of interpersonal childhood trauma in particular (for example, sexual abuse) was particularly associated with the development of IED.
Understanding the Connection between Childhood Trauma and IED
Childhood is obviously a very important time in our development. It is when we learn about interpersonal relationships and how to effectively manage our emotions. Childhood trauma can greatly disrupt this experience, and as a result, people may not adequately learn how to manage their emotions or negotiate interpersonal relationships. Consequently, when anger occurs, people with a history of childhood trauma may not know how to effectively manage those emotions, resulting in strong anger impulses and destructive behaviors.
That said, it is important to remember that this is all based on just a few studies. There may be other explanations as well. For example, it is possible that neurological issues, such as the inability to control certain impulses, may come into play. Traumatic brain injuries can also occur during abuse and may lead to difficulties in controlling anger and aggressive behavior.
Getting Help for IED and Childhood Trauma
Although there currently are not any treatments specifically designed for IED, there are treatments available that focus on improving the ability to manage emotions. Dialectical Behavior Therapy in particular has been found to be very effective in teaching people healthy ways of managing their emotions and reducing destructive behavior. If you are interested in learning more about DBT, there are numerous resources available on Dr. Linehan's Behavioral Tech website, including a database of mental health professionals who have been trained in, and provide, DBT.
In addition, there are treatments specifically designed for children exposed to traumatic experiences, such as trauma-focused cognitive behavioral therapy (TF-CBT). TF-CBT recognizes that childhood trauma can interfere with healthy emotional and interpersonal development, and as a result, is focused on helping children gain a better understanding of their emotions and healthy relationships. TF-CBT may thus help children develop healthy emotion regulation skills that prevent the development of IED. To find a therapist who provides TF-CBT, you would first want to look for someone who specializes and has experience in the treatment of children with trauma. You may be able to find such a therapist through websites that are designed to connect you with treatment providers in your area. In addition to providing resources for families who have a child that is dealing with the consequences of trauma, the Sidran Institute also provides information on therapists who may specialize in the treatment of children who have been exposed to a traumatic event.
Finally, it may be useful to speak with a psychiatrist about certain medications that are useful in controlling impulses associated with IED.
American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th Edition - Text Revision. Washington, DC: Author.
Nickerson, A., Aderka, I.M., Bryant, R.A., & Hofmann, S.G. (2012). The relationship between childhood exposure to trauma and intermittent explosive disorder. Psychiatry Research, 197, 128-134.