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Teen rage & violence “Intermittent Explosive Disorder” on the rise

By Benjamin Gaul

Nearly two-thirds of teenagers in the U.S. have acknowledged that they have experienced fits of anger severe enough to the point that they threatened violence, damaged property or were violent towards another person, according to a new study from Harvard Medical School.

The research suggests that these attacks of rage are more prevalent among teens than previously thought. Based on a national survey of 10,148 adolescents, Intermittent Explosive Disorder (IED) –a condition in which a person is plagued by uncontrollable anger attacks unrelated to a specific mental disorder– effects one out of every 12 adolescents in the U.S. That’s nearly six million teens.

Other names for IED include rage attacks, anger attacks, and episodic dyscontrol. Patients diagnosed with IED usually feel a sense of arousal or tension before an outburst, and relief of tension after the aggressive act. They believe that their aggressive behaviors are justified; however, they often then feel genuinely upset, regretful, remorseful, bewildered or embarrassed by their impulsive and aggressive behavior, afterward.

When positive behavioral examples are scant or missing during a child’s developmental years, and they only observe coping mechanisms based in anger or withdrawal in their parents and caretakers, it is hardly surprising that a significant percentage adopt those same behaviors during adolescence. Children raised in stable, two parent homes, where self-discipline is encouraged and reasoned disciplinary measures are administered with love and understanding — only as necessary — are the least likely candidates for IED. Haldoral and Ritalin are still poor excuses for actual Parenting.

Ronald Kessler, senior author and McNeil family professor of health care policy at Harvard Medical School, said in a statement that only 6.5 percent of those diagnosed with IED obtained treatment specifically targeting anger.

IED, most often manifesting in males, typically begins in late childhood and persists through a person’s middle years. In order to be diagnosed, a person must have multiple instances of uncontrollable anger attacks – “completely out of proportion with the precipitating event” – which have resulted in violence or damage to property, according to the Mayo Clinic. The syndrome is often linked with the later onset of other debilitating conditions, such as depression and alcohol and drug abuse.

Recent findings suggest that IED may result from abnormalities in the areas of the brain that regulate behavioral arousal and inhibition. Research indicates that impulsive aggression is related to abnormal brain mechanisms in a system that inhibits motor (muscular movement) activity, called the serotoninergic system. This system is directed by a neurotransmitter called serotonin, which regulates behavioral inhibition (control of behavior). Some studies have correlated IED with abnormalities on both sides of the front portion of the brain. These localized areas in the front of the brain appear to be involved in information processing and controlling movement, both of which are unbalanced in persons diagnosed with IED. Studies using positron emission tomography (PET) scanning have found lower levels of brain glucose (sugar) metabolism in patients who act in impulsively aggressive ways.

Another study based on data from electroencephalograms (EEGs) of 326 children and adolescents treated in a psychiatric clinic found that 46 percent of the youths who manifested explosive behavior had unusual high-amplitude brain wave forms. The researchers concluded that a significant subgroup of people with IED may be predisposed to explosive behavior by an inborn characteristic of their central nervous system. In summary, there is a substantial amount of convincing evidence that IED has biological causes, at least in some people diagnosed with the disorder.

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