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Anger Management - Treatments Recommended For Road Rage – Intermittent Explosive Disorder (IED) is Identified and is Widespread

June 5th 2006

Anger Management - Treatments Recommended For Road Rage – Intermittent Explosive Disorder (IED) is Identified and is Widespread

Anger Management

Intermittent Explosive Disorder (IED), a disease characterized by recurring episodes of anger and potentially violent outbursts, is much more common than thought.  According to the researchers, the disorder can be diagnosed.  If a person has had three major episodes of impulsive aggressiveness at any time in his life which is significantly more explosive than what most normal people would have had in the same situation, they have the disorder. 

The outbursts are sudden and can include damage to property or physical harm.  The disorder could affect as many as 7.3 percent of adults.  That works out to 16 million Americans.  Harvard professor of health care, Ronald Kessler, PhD says that each year IED affects nearly 4 percent of Americans, or 8.6 million adults.

Interestingly, people feel a sense of relief during the uncontrollable outburst, but then feel remorseful about their actions.  There may be effective treatments for this condition.


According to researchers the treatment could include both “behavioral and pharmacological interventions.”  Selective serotonin reuptake inhibitors [SSRIs] and mood stabilizers could be prescribed. The behavioral therapy might involve cognitive restructuring, coping skills training, and relaxation training—a combination known as CRCST—which has proven to be effective in treating IED.

Coauthor Emil Coccaro, MD, the Ellen C. Manning professor and chair of the Department of Psychiatry at the University of Chicago Pritzker School of Medicine says “Ideally, people should be treated with both medicine and cognitive-behavioral therapy. Medicines increase the threshold at which people will explode, and cognitive-behavior therapy teaches people how to handle feelings of frustration or threat that often lead to explosive episodes.”


There may be a genetic link to the disease.  Coccaro says “In the general population, aggressiveness or ‘blowing up’ is considered bad behavior; people think, ‘This person just needs an attitude adjustment.’ But Intermittent Explosive Disorder goes beyond that, having strong genetic and biomedical underpinnings,  If people think these explosive outbursts are just bad behavior, they are not thinking of this problem as a serious biomedical problem that can be treated.”

In a story earlier this month on Best Syndication (Pfizer and GlaxoSmithKline Help Send Kids to Prison), we reported that SSRIs can be dangerous.  After visits to their family doctors, Christopher Pittman and Zachary Schmidkunz were both sent home with a bag of Zoloft samples with no warnings about the drug's side effects. They both went on to commit murder, were sent to prison, and are now waiting for hearings on their appeals.  Zoloft (sertraline hydrochloride) is a Selective Serotonin Reuptake Inhibitor (SSRI) used to treat depression and is not recommended by Coccaro as a treatment for IED. 


The American Psychological Association says that typically people that are easily angered come from families that are disruptive, chaotic and not skilled at emotional communications.  Experts say that the idea of “Let it all hang out” is a dangerous myth.  “Research has found that "letting it rip" with anger actually escalates anger and aggression and does nothing to help you (or the person you're angry with) resolve the situation. It's best to find out what it is that triggers your anger, and then to develop strategies to keep those triggers from tipping you over the edge.”

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Dan Wilson
Best Syndication

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