June 06, 2006
Intermittent Explosive Disorder More Prevalent Than Suspected

We live among lots of dangerous people.

A little-known mental disorder marked by episodes of unwarranted anger is more common than previously thought, a study funded by the National Institutes of Health's (NIH) National Institute of Mental Health (NIMH) has found. Depending upon how broadly it's defined, intermittent explosive disorder (IED) affects as many as 7.3 percent of adults — 11.5-16 million Americans — in their lifetimes. The study is based on data from the National Comorbidity Survey Replication, a nationally representative, face-to-face household survey of 9,282 U.S. adults, conducted in 2001-2003.

I bet these people with IED will eventually be identifiable with brain scans. Suppose a treatment to stop IED is developed. Will future societies support mandatory delivery of therapies that prevent violent episodes?

People with IED have other mental problems.

People with IED may attack others and their possessions, causing bodily injury and property damage. Typically beginning in the early teens, the disorder often precedes — and may predispose for — later depression, anxiety and substance abuse disorders. Nearly 82 percent of those with IED also had one of these other disorders, yet only 28.8 percent ever received treatment for their anger, report Ronald Kessler, Ph.D., Harvard Medical School, and colleagues. In the June, 2006 Archives of General Psychiatry, they suggest that treating anger early might prevent some of these co-occurring disorders from developing.

To be diagnosed with IED, an individual must have had three episodes of impulsive aggressiveness "grossly out of proportion to any precipitating psychosocial stressor," at any time in their life, according to the standard psychiatric diagnostic manual. The person must have "all of a sudden lost control and broke or smashed something worth more than a few dollars…hit or tried to hurt someone…or threatened to hit or hurt someone."

People who had three such episodes within the space of one year — a more narrowly defined subgroup — were found to have a much more persistent and severe disorder, particularly if they attacked both people and property. The latter group caused 3.5 times more property damage than other violent IED sub-groups. Affecting nearly 4 percent of adults within any given year — 5.9-8.5 million Americans — the disorder leads to a mean of 43 attacks over the course of a lifetime and is associated with substantial functional impairment.

Evidence suggests that IED might predispose toward depression, anxiety, alcohol and drug abuse disorders by increasing stressful life experiences, such as financial difficulties and divorce

Once we achieve the ability to reverse aging using SENS techniques the existence of people who are capable of explosive anger and physical attacks will be viewed as a much bigger threat due to the length of individual lives. A person who goes overboard in their reactions when they get angry is more likely to kill someone if they have centuries more to do so. If we live for thousands of years each of us will face a much larger risk of eventually getting murdered.

In an era when aging becomes fully reversible I expect we will witness movements to create new nations that have extremely selective immigration policies designed to keep out people with violent tendencies. New polities will be created by long livers who want to minimize their risk of death. Such polities will also implement very high safety standards.

Share |      Randall Parker, 2006 June 06 10:31 PM  Brain Violence

Robert Silvetz said at June 7, 2006 10:52 AM:

IED is so broadly defined as to be a meaningless term. I reject this study in its entirety.

As to RP's comments on the implication of SENS and violence. I go a step further. We will see the the absolute domination in time of something along the lines of a Zero Aggression Tolerance Principle. Anyone intitiating any kind of force, violence or property destruction will be made to suffer terribly painful consequences as a deterrent to this behavior. Since SENS will also, INMHO, eliminate the nation-state as we know it (confiscatory taxation for 1000 years of lifespan -- I don't think so...) the selective immigration policy will also be a transitional thing. SENS, as a technology, will move blindingly fast across the planet, homogenizing multiple societies.

Brett Bellmore said at June 7, 2006 2:33 PM:

We could live among a few really dangerous people, or a lot of relatively safe people, but if the sufferers of "IED" were both many, AND very dangerous, we'd tend to notice that, wouldn't we?

Robert Silvetz said at June 7, 2006 4:11 PM:


This disease probably doesn't exist. Basically I think they have taken a natural aspect of human behavior, loss of temper, and reconstructed it as a disease framework. I'm waiting to see what my alma mater says -- they don't take kindly to invented diseases.

But for the sake of argument, if we had SENS level tech and the IED disease existed, I bet we could get to the basis of the disorder with ease.

But I'm not going to lose sleep over this. So far the same NIH boobs talk about ADHD as if they have identified a common disease, yet the DSM criteria look to me like every undisciplined kid I ever knew. Nothing intense aerobic sports, tight study regimen and complete avoidance of simple sugars couldn't cure. I have met in 10 years only one case I would call confirmed ADHD and one I would call borderline. In my mind the overdiagnosis of ADD/ADHD is probably 100-to-1 or higher.

Garson Poole said at June 7, 2006 6:02 PM:

Randall Parker said “In an era when aging becomes fully reversible I expect we will witness movements to create new nations that have extremely selective immigration policies designed to keep out people with violent tendencies.”

This might be inevitable, but how does the new nation avoid the obviously implicated sequel scenario. The citizens of neo-utopia would be paralyzed by a visceral repugnance toward violence as outsiders systematically obliterated their cozy civilization. Perhaps people with “violent tendencies” are needed for societal viability but these tendencies must be exquisitely circumscribed.

Sean Lynch said at June 7, 2006 6:22 PM:

Your utter lack of skepticism forces me to remove your blog from my Rojo subscription list :(

Robert Nanders said at June 7, 2006 11:02 PM:

I can't help but wonder what the next discovered disorder is going to be. And wait until we find a lovely medication to help these poor folks cope with their problem. True or not, the more we remove responsibility from the person and their actions, the less responsibility we're going to see.

diane said at August 18, 2006 7:58 PM:

brett...we may not know...i suffered for years not knowing until my daughters school held an intervention with me and had case workers from women in crisis there to help me...i am not sure if it is truly an illness but i assure you that it wasnt safe for myself or my children to be around him before his diagnosis and medication and treatment....i myself think its a poor excuse to treat people worse than animals and to terrorise them on a daily basis until they develop PTSD but im not an expert !

Jenny said at April 10, 2012 11:28 AM:

IED is a disease.

It can destroy the individual or those around them.

It is an impulsive mental disorder, with sufferers predisposed towards kleptomania, pyromania, substance abuse, gambling, impulsive sexual relations etc.

People that suffer from this disease, have low self esteem, get envious of others, misinterpret other peoples actions and suffer from episodically impulsivity.

Their behaviour effectively leads them into trouble.

Their reactions to perceived situations and threats can be completely disproportunate.

This disease is no laughing matter.

They can hurt people and their property, when they suffer an episode.

Some sufferers experience periodic tingling across their bodies, which they cant explain.

No one has yet discovered the root cause of the illness.

Sufferers can periodically behave violently or aggressively to assert their authority.

Sufferers can damage people or property during an explosive outburst.

Children that have unstable childhoods that witness violence, have a higher tendency towards exhibiting the characteristics of IED.

The disease may be influenced by genetics.

IED sounds like nonsense until you know someone suffering with it.

Do you know a gambler, that likes to steal on the low level, that disrespects people, that likes to light fires, that acts impulsively and has risky sex, that suffers

from depression, that gets paranoid, that fundamentally distrusts people and has periodic violent episodic outburst?

After he's violent, he's contrite and will never do it again, but repeats the cycle of abuse.

IED's are all around us: It may be your partner, your neighbour, your brother, your father.

Im not sure if women are affected by it, but many men are.

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