Treating Aggressive Behaviour in Children and Adolescents - Intermittent Explosive Disorder

Intermittent Explosive Disorder (IED) is a mental health condition characterized by sudden, recurrent episodes of impulsive, aggressive, violent behaviour or angry verbal outbursts that are disproportionate to the situation.

These explosive episodes can result in serious physical assaults or property destruction. Individuals with IEDs typically experience a sense of tension or arousal before the act and a sense of relief or pleasure during the episode, followed by remorse or distress afterwards.

The disorder significantly impacts an individual’s social, occupational, and interpersonal functioning, leading to challenges in maintaining friendships (and, if not treated, relationships and stable employment in adults). Diagnostically, IED is classified under the Disruptive, Impulse-Control, and Conduct Disorders in the DSM-5, which helps distinguish it from other mental health conditions. Understanding IED involves recognizing these patterns of behaviour and the significant distress or impairment they cause in various aspects of life.

• What are the Risk Factors of IEDs?
• How is IED Diagnosed?
• Can Intermittent Explosive Disorders be Treated?
• How Can Art Therapy Treat Aggressive Behaviour?
• How can Art Therapy Improve Self-Esteem in Children?
• More Resources

What are the Risk Factors of IEDs?

Several risk factors contribute to the development of Intermittent Explosive Disorder (IED). Genetic predisposition plays a significant role, with studies indicating a higher likelihood of IED among individuals with a family history of mental health disorders. Neurobiological factors, including abnormalities in brain structures and neurotransmitter imbalances, are also associated with IEDs.

Adverse childhood experiences, such as physical and emotional abuse, neglect, and exposure to violence, significantly increase the risk. Environmental factors, including living in high-stress or violent environments, further exacerbate the likelihood of developing IED.

Additionally, co-morbid psychiatric conditions such as attention deficit hyperactivity disorder (ADHD), anxiety disorders, and other impulse-control disorders often coexist with IED, complicating its presentation and management. Early identification and understanding of these risk factors are crucial for developing effective prevention and intervention strategies to mitigate the disorder’s impact on individuals' lives.

How is IED Diagnosed?

Diagnosing Intermittent Explosive Disorder (IED) involves a thorough clinical evaluation to differentiate it from other mental health conditions. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), provides specific criteria for IED diagnosis. Key criteria include recurrent outbursts of verbal aggression or physical violence occurring twice weekly on average for at least three months or three behavioural outbursts resulting in damage or physical injury within a year. These outbursts must be disproportionate to the provocation and not premeditated.

A comprehensive assessment typically includes detailed patient history, behavioural observations, and collateral information from family members or caregivers. Mental health professionals may also use structured interviews and validated rating scales to assess aggressive episodes' frequency, intensity, and impact. Diagnosing IED requires ruling out other medical conditions, substance use, and psychiatric disorders to ensure accurate identification and appropriate treatment planning. Clinical psychologists and psychiatrists are trained in diagnosing this condition.

Can Intermittent Explosive Disorders Be Treated?

Yes, Intermittent Explosive Disorder (IED) can be treated through a combination of pharmacotherapy and psychotherapy. Cognitive Behavioral Therapy (CBT) is a widely used approach that helps individuals identify and change negative thought patterns and behaviours associated with aggression. CBT techniques focus on anger management, impulse control, and coping strategies to reduce the frequency and intensity of outbursts. Art and play therapy are also effective, especially for children and adolescents.

Additionally, Art therapy can also help treat IEDs. Art therapy allows individuals to express their emotions creatively, providing insight into underlying issues and facilitating emotional regulation. Play therapy is another form of creative arts therapy that offers a safe space for children to explore their feelings and behaviours through play, promoting emotional healing and behavioural change. These therapeutic approaches (offered at Therapedia Centre in Toronto) can be tailored to the individual's needs, helping them develop healthier ways to manage anger and improve interpersonal relationships.

How can Art Therapy Treat Aggressive Behaviour?

Art therapy is an effective intervention for treating aggressive behaviour, particularly among children with learning disorders and ADHD. It provides a non-threatening medium for expressing emotions and underlying issues that may contribute to aggressive outbursts. Through activities like drawing and painting, children can externalize their anger and frustration in a safe environment, which helps reduce physical and verbal aggression.

Art therapists in Toronto structure their sessions to encourage self-expression, enhance emotional awareness, and develop coping strategies. These sessions often include activities to foster relaxation, self-reflection, and problem-solving skills, which help mitigate aggressive tendencies. Studies have shown that children who participate in art therapy exhibit significant reductions in various forms of aggression, such as verbal outbursts, aggression against property, and physical aggression.

How can Art Therapy Improve Self-esteem in Children?

Art therapy plays a crucial role in enhancing self-esteem among children, especially those with learning disorders and ADHD. Engaging in creative activities can help children achieve a sense of accomplishment and self-worth. The process of creating art allows children to explore their identity, express their feelings, and gain a better understanding of themselves.

This therapeutic approach helps children build confidence in their abilities as they see tangible results of their efforts, fostering a positive self-image. Moreover, art therapy sessions in Toronto often include group activities that promote social interaction, cooperation, and mutual support, further enhancing children's self-esteem. Research indicates that children who undergo art therapy significantly improve their self-esteem, demonstrating increased confidence, self-acceptance, and emotional resilience.

Resources for Intermittent Explosive Disorder (IED) in Children

Learning Resources

Child Mind Institute: Offers articles on specific strategies for managing IED in children, such as setting limits and using positive reinforcement.

National Institute of Mental Health (NIMH): Provides information on IEDs in general, including symptoms and treatment options.

Treatment and Coping Strategies

American Academy of Child and Adolescent Psychiatry (AACAP): Provides information on treatment options for children with IED, including medication and therapy.

Books and Literature

"The Explosive Child" by Ross W. Greene: A helpful guide for parents and caregivers of children with explosive behaviour.

"Anger Management For Dummies" by Bill Knaus: A practical guide to understanding and managing anger.er.