Intermittent explosive disorder

간헐적 폭발성 장애(Intermittent explosive disorder, IED)는 와해적, 충동-조절 및 품행 장애(Disruptive, Impulse-Control, and Conduct Disorders)에 속하는 장애로 가끔씩 스트레스의 정도와 무관하게 폭력적인 행동이 나타나며 반사회적 인격장애와는 다르게 폭력적인 행동이 꾸준하지 않고, 폭력적인 행동 후 죄책감, 후회를 하는 특징이 있다.

진단

• DSM-5
  • Recurrent outbursts that demonstrate an inability to control impulses, including either of the following:
    • Verbal aggression (tantrums, verbal arguments or fights) or physical aggression that occurs twice in a week-long period for at least three months and does not lead to destruction of property or physical injury (Criterion A1)
    • Three outbursts that involve injury or destruction within a year-long period (Criterion A2)
    • Aggressive behavior is grossly disproportionate to the magnitude of the psychosocial stressors (Criterion B)
    • The outbursts are not premeditated and serve no premeditated purpose (Criterion C)
    • The outbursts cause distress or impairment of functioning, or lead to financial or legal consequences (Criterion D)
    • The individual must be at least six years old (Criterion E)
    • The recurrent outbursts cannot be explained by another mental disorder and are not the result of another medical disorder or substance use (Criterion F)
  • It is important to note that DSM-5 now includes two separate criteria for types of aggressive outbursts (A1 and A2) which have empirical support
    • Criterion A1: Episodes of verbal and/or non damaging, nondestructive, or non injurious physical assault that occur, on average, twice weekly for three months. These could include temper tantrums, tirades, verbal arguments/fights, or assault without damage. This criterion includes high frequency/low intensity outbursts.
    • Criterion A2: More severe destructive/assaultive episodes which are more infrequent and occur, on average, three times within a twelve-month period. These could be destroying an object without regard to value, assaulting an animal or individual. This criterion includes high-intensity/low-frequency outbursts.