Intermittent explosvive disorder (IED) descirbes invdividuals who have discrete episodes of losing control of aggressive impulses resulting in serious assault or the detrunctionof property. The degree of aggressiveness expressed is grossly out of proportion to any stresors that may have helped elicit the episodes. The symptoms, which the patient may describe as spells or attackss appear within minutes or hours and, regardless of duration, remit spontaneously and quickly. Each episode usually is followed by genuine regret or self reproach. Signs of genrealized impulsivity or aggressiveness are absent between attacks. The diagnosis of instermittent explosive disorder should not be made if the loss of control can be accounted for by schizoprenia, antisocial or borderline personality disorder, conduct disorder, or intoxication with a psychoative substannce.

OCCURANCE
   Intermittent explosive disorder is apparently very rare and appears to be more common in males than in females. The males are likely to be found in a correctionla institution, and the females in a psychiatric facility. There is evidence that intermittent explosive disorder is more common in first degree biological relatives of persons with the disorder. A variety of factors could be responsible, however, and a simple genetic explanation seems unlikely.

CAUSES
  Some investigators suggest that disordered brain physiology, particularly in the limbic system, is involved in most cases of episodic violence. It is generally belived, however, that an unfavorable enviornment in childhood is the major determinant. Predisposing factors in childhood are though to include perinatal trauma, infantile sezures, head trauma encephalitis and hyperactivity. The patients childhood environment is often filled with alcholism, heatings, threats to life, and promiscuity. Those workers who have concentrated on psyhogenesis in the etiology of episodic explosiveness have stressed indentification with asssaultive parental figures or the symbolism of the target of the violence. Early frustration, oppression, and hostility have been noted as predisposing factors. Situations that are directly or symbolically reminiscentof these early deprivations in become targets for destructive hostility. Typical patients have been described as physically large but dependent men, whose sense of masculine identity is poor. A sense of being useless and impotents or of being unable to change the environment often precedes the episode of physical violence.
CLINICAL FEATURES:
Individuals with IED display