Intermittent Explosive Disorder Research Articles

Comprehensive Review and Meta-Analysis of Psychological and Pharmacological Treatment for Intermittent Explosive Disorder: Insights From Both Case Studies and Randomized Controlled Trials.

Intermittent explosive disorder (IED) is characterized by sudden, disproportionate outbursts of anger that can severely impact individuals' quality of life, causing difficulties in maintaining relationships, issues at work or school and potential legal troubles. This study aimed to systematically review and meta-analyse the effectiveness of psychological and pharmacological treatments for IED, drawing insights from both case studies and randomized controlled trials (RCTs). A total of 12 RCTs and 14 case studies were included in this comprehensive analysis. The meta-analysis revealed that psychological treatments, particularly cognitive behavioural therapy (CBT), showed significant effectiveness in reducing aggression and achieving full remission compared to pharmacological treatments. However, the latter, notably fluoxetine, demonstrated notable efficacy in managing irritability and achieving treatment response. Subgroup analysis identified follow-up time and intervention type as significant moderators of treatment outcomes. The systematic review of case studies highlighted the successful application of deep brain stimulation (DBS) and various off-label medications, including SSRIs and mood stabilizers, in managing IED symptoms. Despite these insights, the study emphasizes the need for more robust evidence-based treatment protocols and further research into the underlying mechanisms of IED to develop targeted treatments.

Psychiatric, Neurological, and Somatic Comorbidities in Intermittent Explosive Disorder

Intermittent explosive disorder (IED) is an understudied psychiatric condition marked by impulsive aggression and poorly regulated emotional control, often resulting in interpersonal and societal consequences. Better understanding of comorbidities can improve screening, diagnosis, and treatment. To investigate the prevalence of IED and its associations with psychiatric, neurological, and somatic disorders. In this cohort study, matched groups of patients with and without IED were identified from the TriNetX Research Network (dated January 31, 2024). Electronic medical record data were analyzed. The mean (SD) time from the first to last known visits was 4.8 (5.4) years. Lifetime diagnosis of IED. Main outcomes were International Statistical Classification of Diseases, Tenth Revision, Clinical Modification diagnostic categories and root codes. Cox proportional hazard models were used to estimate and compare probabilities of acquiring other diagnoses. Key measures include the numbers and proportions of patients with these diagnoses and adjusted hazard ratios (HRs) for IED. Overall, 30 357 individuals with IED and 30 357 demographically matched controls were included. In each group, 21 313 (70%) were male, with a mean (SD) age at the first visit 26 (17) years. Despite only 0.03% of the total patient population having an IED diagnosis, extensive comorbidities with psychiatric, neurological, and somatic conditions were found. A notable 95.7% of individuals with IED (29 054 individuals) had another psychiatric diagnosis. All psychiatric subcategories and 92% of the psychiatric diagnoses were significantly associated with IED, with HRs ranging from 2.1 (95% CI, 2.0-2.2) for substance use disorder to 76.6 (95% CI, 65.4-89.6) for disorders of adult personality and behavior (excluding IED). Among neurological conditions, neurodegenerative diseases (HR, 5.0; 95% CI, 4.1-6.1) and epilepsy (HR, 4.9; 95% CI, 4.3-5.6) had the highest HRs, followed by movement disorders (HR, 3.1; 95% CI, 2.8-3.5), cerebral palsy (HR, 2.6; 95% CI, 2.2-3.0), and sleep disorders (HR, 2.2; 95% CI, 2.1-2.3). Significant associations with IED were also observed for many somatic diseases, including obesity (HR, 1.6; 95% CI, 1.5-1.7), hyperlipidemia (HR, 1.5; 95% CI, 1.4-1.5), hypertension (HR, 1.6; 95% CI, 1.5-1.7), and gastroesophageal reflux disease (HR, 1.7; 95% CI, 1.7-1.9). These findings highlight the extensive comorbidities between IED and psychiatric, neurological, and somatic disorders, emphasizing the need for integrated diagnostic and treatment approaches addressing both psychological and physical health aspects of IED. Limitations related to reliance on medical records and low diagnostic rates of IED caution the generalizability of these findings, underscoring the need for further validation in prospective studies and more accurate, inclusive diagnosis of IED in patients with mental disorders.

Self-Regulation in Adults with Intermittent Explosive Disorder and a History of Suicide Attempts

Self-Regulation in Adults with Intermittent Explosive Disorder and a History of Suicide Attempts

Effects of Patient Gender on Clinicians’ Diagnostic Assessment of Youth Disruptive Mood and Behavior

ABSTRACT Objective Youth disruptive behavior disorders (DBDs) have a male preponderance, but the extent to which gender biases in clinical assessment influence this imbalance remains unclear. The present study investigates whether a child patient’s gender affects clinicians’ diagnostic decision-making regarding Oppositional Defiant Disorder (ODD), Conduct Dissocial Disorder (CDD), and Intermittent Explosive Disorder (IED). Method Clinicians (N = 403; 57.1% male; M age = 48.96 years, SD = 11.09) participated in a global ICD-11 field study. Following an experimental design, participants were asked to use ICD-10 or ICD-11 diagnostic guidelines to evaluate two clinical case vignettes, randomly manipulating the patients’ gender (boy, girl) and symptom presentation (ODD-Defiant, ODD-Irritable, CDD, IED). Analyses tested whether clinicians’ diagnostic accuracy and perceptions of impairment and severity were affected by the patient’s gender. Results Overall, clinicians identified the correct diagnosis 64.7% of the time. Patient gender was not associated with clinicians’ diagnostic accuracy (ps= .090–.895, |φs| = 0.01–0.18) or severity or impairment ratings (ps = .079–.404, |ds| = 0.04–0.19). This pattern of nonsignificant differences and negligible/small effect sizes was consistent across all clinical presentations and analyses. Conclusions We found no evidence of an association between patient gender, diagnostic accuracy, or perceived severity or impairment when assessing youth DBDs in the present study. Results suggest that diagnostic judgments may be driven by clinical presentation rather than gender and that the male DBD preponderance may not be due to gender diagnostic biases. Further research is needed to replicate these findings among youths in clinical settings, with diverse gender identities, and with other mental health conditions.

Evaluation Of The Influence Of Reframing On Intermittentexplosive Disorder Among Female Inmates’ Violence Towards Male Partner In Selected Women Prisons, Kenya

The purpose of this study was to evaluate the influence of cognitive restructuring strategies on intermittent explosive disorder among female inmates’ violence towards male partners in selected women prisons in Kenya. The study helped to evaluate the influence of reframing on intermittent explosive disorder. The study was anchored on Social cognitive theory by Albert Bandura and self-evaluation maintenance theory by Abraham Tesser. The study used an Ex Post Facto research design. The study was carried out at Langata and Thika Women Prisons. Quantitative data was obtained from the sampled inmates using questionnaires; while qualitative data was collected using interview guides from the prison key informants. The study incorporated 8 constables, 4 counsellors, 3 chaplains as key informants. Stratified and proportionate simple random sampling was used to select a sample size of 307 inmates. Quantitative data was analyzed using both descriptive and inferential tests. Hypotheses were tested at p=.05 using Pearson’s Product Moment Correlation Coefficient. Qualitative data was analyzed thematically according to the study objectives. The findings showed there was a statistically nonsignificant positive relationship between reframing and intermittent explosive disorder as, [r (257) = .051, p = .417]. Increase in intensity of frame shift, target thoughts and evidence of thoughts led to increased traits of intermittent explosive disorder. Based on these findings, the study recommends that prison management through the ministry of Interior and Coordination of National Government, enhance provision of counselling programmes mbased on cognitive restructuring techniques in the prisons. Reframing as a technique would provide solutions on the past painful memories of the inmates; optimistically avoid violence and keep away from crime

Examination Of The Influence Of Problem Solving On Intermittent Explosive Disorder Among Female Inmates’ Violence Towards Male Partner In Selected Women Prisons, Kenya

The purpose of this study was to evaluate the influence of cognitive restructuring strategies on intermittent explosive disorder among female inmates’ violence towards male partners in selected women prisons in Kenya. The study used an Ex Post Facto research design. The study was carried out at Langata and Thika Women Prisons. Quantitative data was obtained from the sampled inmates using questionnaires; while qualitative data was collected using interview guides from the prison key informants. Target population was 1023 inmates. The study incorporated 8 constables, 4 counsellors, 3 chaplains as key informants. Stratified and proportionate simple random sampling was used to select a sample size of 307 inmates. Quantitative data was analyzed using both descriptive and inferential tests. Hypotheses were tested at p=.05 using Pearson’s Product Moment Correlation Coefficient. The study also revealed that there was a statistically non-significant negative relationship between problem solving and intermittent explosive disorder as, [r (257) = -.029, p = .639] with increase intensity of problem-solving indicators, there was decrease in the severity of intermittent explosive disorder. Based on these findings, the study recommends that prison management through the ministry of Interior and Coordination of National Government, enhance provision of counselling programmes based on cognitive restructuring techniques in the prisons

Intermittent Explosive Disorder

Intermittent explosive disorder is characterized by recurrent episodes of inability to resist aggressive impulses, resulting in damage to other people or other people's property. In the history of DSM, it first appeared as 'isolated explosive disorder' in DSM-III. However, with some changes in the diagnostic criteria, it is included under the title of 'destructive, impulse control and conduct disorders' in DSM-5. Although previous studies have shown it is a rare disorder, recent epidemiological studies suggest it may be more common than thought. For this reason, it is essential to master the clinical features and learn the treatment methods in order to recognize people with this disorder and apply the appropriate treatment.

Examining the Effect of Disorders upon Impulsive Behavior in Criminal Actions and its Legal Implications in Emergency Department: Systematic Review

Abstract: Background: There are significant concerns regarding the relationship between mental health and criminal culpability since impulse control problems have long been linked to the genesis of criminal behaviour. In trying to clarify the complex legal ramifications that result from this link, this study explores the close link between diseases that inhibit impulse control and their possible role in criminal behaviour in patients coming to the emergency department. Aim: This research aims to explore how impulse control disorders contribute to criminal actions, emphasizing significant correlations and calling for transformative changes in emergency help for psychiatric patients and in the criminal justice system. Methodology: This study utilized Bullion Words for a literature review, identifying 24,400 hits, and narrowing down to 24 papers after rigorous selection. The systematic review explores the interplay between impulse control disorders and criminal actions, emphasizing legal implications. Ethical considerations ensure confidentiality. The study concludes with key findings, relationship insights, legal discussions, and future research suggestions. Result: This systematic review reveals a nuanced understanding of how impulse control disorders contribute to criminal actions. Identifying specific disorders like kleptomania and intermittent explosive disorder emphasizes the complex interplay of genetic, environmental, and psychological factors. The legal implications highlight the need for a paradigm shift in the criminal justice system, advocating tailored interventions and rehabilitation strategies, and offering a novel perspective for future legal frameworks. Conclusion: This systematic review provides a comprehensive overview of the complex interconnection between impulse control disorders and criminal actions. The findings underscore the importance of recognizing these disorders in legal contexts and advocate for a nuanced approach to sentencing and treatment. Future research should focus on refining diagnostic criteria, exploring intervention strategies, and elucidating the long-term impact of impulse control disorders on legal outcomes. Overall, this review contributes to a more informed understanding of the legal implications surrounding impulse control disorders and criminal actions.

Psychiatric, Neurological, and Somatic Comorbidities in Intermittent Explosive Disorder: a retrospective cohort study of electronic health records.

Intermittent Explosive Disorder (IED) is an understudied psychiatric condition that presents with repeated episodes of impulsive aggression and poorly regulated emotional control, often resulting in interpersonal and societal consequences. Better understanding of comorbidities will allow for enhanced screening, diagnosis, and treatment of patients. To investigate prevalence and associations of IED with psychiatric, neurological, and somatic disorders using real-world data. Matched cohorts of patients with or without IED diagnosis were identified using data from the TriNetX Research Network (until January 31, 2024). Cox proportional hazard models were used to estimate and compare the probabilities of acquiring other diagnoses using patients' available medical records. Analysis of electronic medical records from two patient populations. 30,357 individuals with IED and equal number of demographically matched individuals without IED from the TriNetX Research. IED diagnosis identified through the associated ICD codes. The main outcomes were ICD-10-CM diagnostic categories and root codes for disorders and health conditions in both cohorts. Main measures are total numbers and proportions of patients who had the diagnostic codes, as well as adjusted hazard ratios for IED diagnosis. Although only 0.03% of the total patient population had an IED diagnosis, we found extensive and widespread comorbidities with psychiatric, neurological and somatic conditions. A significant 95.7% of the individuals with IED had another psychiatric diagnosis. All psychiatric sub-categories and 95% of the psychiatric diagnoses were significantly associated with IED, with HRs ranging from 2 to 77. Among neurological conditions, neurodegenerative diseases and epilepsy had the highest HRs, followed by extrapyramidal and movement disorders, cerebral palsy and other paralytic syndromes, and sleep disorders. Notable associations with IED also includes conditions such as obesity, hyperlipidemia, hypertension, and GERD. Our findings illuminate the extensive comorbid relationships between IED and psychiatric, neurological, and somatic disorders. This underscores the necessity for an integrated diagnostic and treatment approach that addresses both the psychological and physical health aspects of IED. Additionally, our work highlights the need for more accurate and inclusive diagnosis of IED in patients with mental disorders.

Psychological and pharmacological treatments of intermittent explosive disorder: a meta-analysis protocol

IntroductionIntermittent explosive disorder (IED) is characterised by recurrent, sudden episodes of impulsive aggression that are disproportionate to the provocation. The condition’s management remains challenging due to the variability in treatment...

A latent class analysis of cognitive-affective heterogeneity in current intermittent explosive disorder

Intermittent Explosive Disorder (IED) is a common, chronic, and impairing psychological condition characterized by recurrent, affective aggressive behavior. IED is associated with a host of cognitive and affective symptoms not included in the diagnostic criteria which may be a valuable indicator of heterogeneity in IED—such information can be useful to enhance understanding and treatment of this disorder in mental health settings. A preliminary investigation conducted on cognitive-affective symptom heterogeneity in individuals with a history of IED demonstrated that level of emotional dysregulation primarily differentiated IED subgroups, however the sample size was limited, and almost half of the individuals did not have current IED (only lifetime IED). The present study addressed these limitations by conducting a latent class analysis of cognitive-affective symptoms among a large (n = 504) sample of individuals diagnosed with current IED. The latent IED classes were then externally validated on several adverse outcomes, historical precursors, and demographic variables. Statistical and clinical indicators supported a four-class model, with classes primarily distinguished by patients' severity of emotion dysregulation. The two moderate emotion-dysregulated classes both endorsed callous-unemotional traits and low empathy relative to other classes, a finding which differs from the initial investigation. An external validation of the four classes revealed that they significantly differed on severity outcomes (e.g., aggression, suicide attempts, antisocial behavior, global functioning, comorbidities) and historical precursors (e.g., aversive parental care, childhood maltreatment). These findings provide further insight into the heterogeneity within IED and the associations of such variability with important precursors and clinical outcomes.

Olanzapine-Induced Mania: A Case Report with New Characteristics

Abstract olanzapine is an atypical antipsychotic widely used for the treatment of mania as monotherapy. In this case, it paradoxically caused mania symptoms in a 40-year-old patient with intermittent explosive disorder. This case presents different characteristics from previous reports, suggesting a direct link between olanzapine and mania symptoms. The patient did not have any psychotic or mood disorder, and the symptoms rapidly disappeared during a medication-free period. Furthermore, there was no discontinuation of other medications, no prominent family history of psychiatric disorder, and no addiction to substances, all of which suggest a connection between manic symptoms and olanzapine. Possible receptor and genomic explanations for this phenomenon are also discussed.

Comparing behavioral measures of aggression in the laboratory: Taylor Aggression Paradigm versus Point-Subtraction Aggression Paradigm.

Aggression refers to a wide range of behaviors with lasting individual and societal consequences. Recurrent, unplanned aggressive behavior is the core diagnostic criterion for intermittent explosive disorder (IED). In this study, we compared two behavioral measures of aggression in the laboratory: the Taylor Aggression Paradigm (TAP) and the Point-Subtraction Aggression Paradigm (PSAP). This sample (n = 528) included community participants who met DSM-5 criteria for IED (n = 156), met DSM-5 criteria for a nonaggressive psychiatric disorder (n = 205), or did not meet DSM-5 criteria for any psychiatric disorder (n = 167). All participants completed the TAP, a single-session PSAP, and relevant self-report measures. MANOVA analyses demonstrated differences between IED participants and nonaggressive participants; however, these group differences were no longer significant for the PSAP after including demographic variables. Correlation analyses found that the TAP and PSAP were positively related to one another and the composite variables associated with aggressive behavior (i.e., history of aggression, impulsivity, and propensity to experience anger) and; dependent correlations revealed that past aggression and trait anger were more strongly related to the TAP. Differences in TAP and PSAP outcomes may be partially attributed to operationalizations of aggression and methods of aggression and provocation. Further, as aggressive and nonaggressive participants differed on the PSAP somewhat mirroring the TAP, our results add to growing evidence of the validity of a single-session PSAP; further research is needed to fully establish single-session PSAP as a laboratory aggression task compared to the multi-session PSAP.

COVID-19: Sociodemographic determinants of selected mental health problems among adults in South-South Nigeria

During the outbreak of highly infectious COVID-19, the Nigerian Ministry of Health primarily emphasized preventive strategies such as personal hygiene, social distancing, and self-isolation. However, there was a notable lack of information addressing mental well-being and coping mechanisms from both the Nigerian government and other relevant agencies. Notably, social distancing and self-isolation are well-documented triggers for mental health problems. Our study aimed to identify the socio-demographic correlates of mental health problems among adults in South-South Nigeria during the COVID-19 lockdown restrictions. This cross-sectional descriptive survey involved 1240 respondents from this region who completed online questionnaires designed using the Kobo Toolbox. The questionnaire covered sociodemographic information and included standardized assessments for generalized anxiety disorder (GAD), anger disorder, and depression disorder. Specifically, the GAD-7 assessed GAD, Spielberger’s State-Trait Anger Expression Inventory-2 assessed anger disorder, and the beck depression inventory assessed depression disorder. Our results revealed that 37% of respondents experienced mild depression, 29% reported mild anxiety, and 27% experienced minimal anger. Significant associations were found between depression and factors such as marital status, age, and education level (p < 0.001). Similarly, anger expression was significantly associated with family size, monthly income, age, and marital status (p < 0.001). Anxiety also exhibited significant associations with sociodemographic characteristics (p < 0.001) in the study. In conclusion, our study highlights that sex, educational level, income, and marital status are important sociodemographic determinants of mental health outcomes.

Impulse control disorders due to cocaine and synthetic stimulants use: a systematic review

The introduction of ICD-11 has opened up new horizons in understanding the impact of modern narcotic substances on mental health, in particular, it has increased the list of possible mental disorders associated with drug use. The purpose of the work is to conduct a systematic review of the literature and describe the features of the pathogenesis, clinical picture, and effectiveness of various types of therapy for impulse control disorders associated with use of cocaine and synthetic stimulants. A systematic analysis of scientific publications was performed in the eLibrary, PubMed, CNKI, and Google Scholar databases according to PRISMA recommendations. 41 publications were selected from the initially found 4,953 articles. The pathogenesis of induced impulse control disorders is associated with the direct effect of stimulant drugs on the brain and consists in the activation of D3 and 5‑HT1A receptors, as well as activation of limbic brain regions and a lack of inhibitory effects of the frontal lobe. Increased impulsivity in users of cocaine and synthetic stimulants has been proven in a large number of neurophysiological and neuroimaging studies. The frequency of occurrence, clinical features, and approaches to therapy of impulse control disorders resulting from the use of drugs with dopaminergic action (drugs for the treatment of Parkinson's disease and hyperprolactinemia, third-generation antipsychotics, and venlafaxine in high doses) have been described in details. At the same time, there is indirect evidence that cocaine and synthetic stimulants should cause impulse control disorders, since they have similar neurotransmitter activity. In addition, there are descriptions of the predominance of individual symptoms of impulse control disorders in this group of drug users. However, at the time of the review, no detailed description of these drug-induced disorders has been found. These are the prospects for further research. The use of fluoxetine and oxcarbazepine (for intermittent explosive disorder) and naltrexone (for kleptomania), as well as comprehensive prevention of drug use relapse and psychotherapy, has the highest degree of evidence as a therapy for impulse control disorders.

Self-control problems in Intermittent Explosive Disorder: Presentation of an explanatory approach

Background and objectivesIntermittent Explosive Disorder (IED) is an impulsive aggression disorder with self-control problems. However, the mechanisms underpinning the self-control problems in IED have not been clearly investigated. Therefore, this study examined the nature of self-control problems and their types, including cognitive inhibition, behavioral inhibition, and emotional interference in IED. MethodsParticipants included three groups: IED (n = 54), psychiatric control (n = 59), and healthy control (n = 62). They were first screened with SCL-90-R, and then they were clinically interviewed. They all did computerized neurocognitive tasks, including Color-Word Stroop Task, Emotional Stroop Task, Go-NoGo Task, and Stop-Signal Task. ResultsMANOVA analyses showed that the IED group had poorer performance in cognitive inhibition, response inhibition, and increased emotional interference than the two psychiatric and healthy control groups. They performed much worse than the other two groups, particularly in action cancellation (Stop-Signal Task), and showed increasingly emotional interference. LimitationsThe brain reaction of individuals while doing the tasks was not examined, and some variables were not measured. Also, it is unclear how the emotional eruption interferes with cognitive content and behavioral inhibition. ConclusionsThese findings indicate that self-control problems in IED can be due to deficient cognitive, emotional, and behavioral inhibitions, each appearing sequentially during a step-by-step process and facilitating the onset of IED signs and symptoms. Such a distinguished understanding of the role of neurocognitive mechanisms can lead to the development of accurate explanatory approaches and increase the effectiveness of treatment.

Emotion regulation across psychiatric disorders.

Difficulties with emotion regulation have been associated with multiple psychiatric conditions. In this study, we aimed to investigate emotional regulation difficulties in young adults who gamble at least occasionally (ie, an enriched sample), and diagnosed with a range of psychiatric disorders using the validated Difficulties in Emotion Regulation Scale (DERS). A total of 543 non-treatment-seeking individuals who had engaged in gambling activities on at least 5 occasions within the previous year, aged 18-29 were recruited from general community settings. Diagnostic assessments included the Mini International Neuropsychiatric Inventory, Minnesota Impulsive Disorders Interview, attention-deficit/hyperactivity disorder World Health Organization Screening Tool Part A, and the Structured Clinical Interview for Gambling Disorder. Emotional dysregulation was evaluated using DERS. The profile of emotional dysregulation across disorders was characterized using Z-scores (those with the index disorder vs. those without the index disorder). Individuals with probable ADHD displayed the highest level of difficulties in emotional regulation, followed by intermittent explosive disorder, social phobia, and generalized anxiety disorder. In contrast, participants diagnosed with obsessive-compulsive disorder showed relatively lower levels of difficulties with emotional regulation. This study highlights the importance of recognizing emotional dysregulation as a trans-diagnostic phenomenon across psychiatric disorders. The results also reveal differing levels of emotional dysregulation across diagnoses, with potential implications for tailored treatment approaches. Despite limitations such as small sample sizes for certain disorders and limited age range, this study contributes to a broader understanding of emotional regulation's role in psychiatric conditions.

Mental health professionals' use of the ICD-11 classification of impulse control disorders and behavioral addictions: An international field study.

The ICD-11 chapter on mental, behavioral and neurodevelopmental disorders contains new controversial diagnoses including compulsive sexual behavior disorder (CSBD), intermittent explosive disorder (IED) and gaming disorder. Using a vignette-based methodology, this field study examined the ability of mental health professionals (MHPs) to apply the new ICD-11 diagnostic requirements for impulse control disorders, which include CSBD and IED, and disorders due to addictive behaviors, which include gaming disorder, compared to the previous ICD-10 guidelines. Across eleven comparisons, members of the WHO's Global Clinical Practice Network (N = 1,090) evaluated standardized case descriptions that were designed to test key differences between the diagnostic guidelines of ICD-11 and ICD-10. The ICD-11 outperformed the ICD-10 in the accuracy of diagnosing impulse control disorders and behavioral addictions inmost comparisons, while the ICD-10 was not superior in any. Thesuperiority of the ICD-11 was particularly clear where new diagnoses had been added to the classification system or major revisions had been made. However, the ICD-11 outperformed the ICD-10 only in a minority of comparisons in which mental health professionals were asked to evaluate cases with non-pathological high involvement in rewarding behaviors. Overall, the present study indicates that the ICD-11 diagnostic requirements represent an improvement over the ICD-10 guidelines. However, additional efforts, such as training programs for MHPs and possible refinements of diagnostic guidance, are needed to avoid over-diagnosis of people who are highly engaged in a repetitive and rewarding behavior but below the threshold for a disorder.

The concept of intermittent Explosive Disorder for children

The concept of intermittent Explosive Disorder for children

Combat Sports as an Intervention for Intermittent Explosive Disorder

Combat Sports as an Intervention for Intermittent Explosive Disorder