New study claims 1 in 12 teens have intermittent explosive disorder

Nadine Kalinauskas
Good News Writer
Daily Brew

Harvard Medical School researchers have found that 1 in 12 teens suffer from what's being called "a controversial mental illness": intermittent explosive disorder.

The findings were based on a study which involved in-person interviews of over 10,000 individuals, including 6,483 adolescents and their parents. Researchers determined that about 8 per cent of the young people interviewed met the criteria for intermittent explosive disorder, or IED.

The disorder is "characterized by frequent and often unpredictable episodes of extreme anger or physical outbursts. Between episodes, there is typically no evidence of violence or physical threat."

"The attacks must involve failure to control aggressive impulses and not be accounted for by another mental disorder or physiological effects of a substance. Intermittent explosive disorder is the only DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) disorder for which the core feature is impulsive aggression," the study defines.

For IED to be diagnosed in an individual, his or her behaviour cannot be accounted for by another mental disorder. There is currently no agreed-upon number of outbursts necessary for an IED diagnosis.

"Nearly two-thirds of adolescents (63.3 per cent) reported lifetime anger attacks that involved destroying property, threatening violence, or engaging in violence," the study, published in the Archives of General Psychiatry, found. So while only 8 per cent met the criteria for IED, most teens exhibited some of the symptoms.

"It's an enormous problem that mental health professionals have not taken seriously," said Ronald Kessler, a psychiatric epidemiologist at Harvard Medical School in Boston and lead author of the study. "I think it's clear from this study that needs to change."

Fellow study author, clinical psychologist and psychiatric epidemiologist Katie McLaughlin, added, "There's a contrast between how common the disorder is and how much we know about it."

Christopher Lane, author of Shyness: How Normal Behaviour Became a Sickness, worries that even for those who meet the criteria for an IED diagnosis, "it's still a big, unsettled question whether their periodic anger and threatened or actual violence should be considered a lifelong mental disorder rather than a psychological crisis involving major life-stressors such as job loss, poverty, home foreclosure, debt issues and drug and alcohol addiction."

Dr. Allen Frances, former chairman of the psychiatry department at Duke University's School of Medicine has called IED an "unstudied" and "inherently unreliable category that probably shouldn't be in the DSM at all."

Causes and treatment strategies for IED remain unclear.

"It bears studying, because what we currently know remains speculative," Dr. Bela Sood, chair of child and adolescent psychiatry at VCU Medical Center in Richmond, Virginia, told ABC News.

Critics of the study worry that these findings could trigger a "manufactured epidemic" in which extreme-but-predictable adolescent behaviour gets labelled as a mental illness possibly requiring mood-altering drugs.

Earlier this year, child and adolescent psychologist Dr. Elizabeth Roberts criticized the over-medication of children in America.

"We are medicating children sometimes for ferociously awful behaviour based on poor parenting," she told CNN, claiming that ADHD and even bipolar disorder can be misdiagnosed in children from unhealthy homes.

Roberts added that some parents have even requested drugs for "because their kids misbehave in school, get low grades or got a lower SAT score than they had hoped for."

In the last 30 years, the usage of attention-deficit drugs has increased twenty-fold, L. Alan Sroufe claims in his New York Times essay "Ritalin Gone Wrong."

"Putting children on drugs does nothing to change the conditions that derail their development in the first place," Sroufe wrote.

Still, some children have exhibited significant behavioural improvement with treatment for attention-deficit and mental-health disorders.

"Uncontrollable anger and domestic violence are, of course, serious concerns requiring attention," said Lane. But so is overmedicating our kids — and telling teens their angry outbursts are indicative of a mental illness.