Children with Intermittent Explosive Disorder: Signs and Symptoms
The DSM-IV-TR states that certain criteria must be met for a diagnosis of IED, however, this criteria only applies to adults. Applying the accepted criteria from the DSM-IV-TR of intermittent explosive disorder to children can be a little more difficult because children have significant differences in developmental and cognitive abilities from adults.
Also, children are not always able to explain some of the physical symptoms that are typically associated with adult IED, such as irritability or feelings of rage, increased energy or “racing thoughts", tingling or tremors, heart palpitations or tightness in the chest, and headaches or pressure in the head. As a result, other signs and symptoms need to be observed to help determine if a child should be diagnosed with IED.
Children with IED tend to have very low tolerance levels for frustration and become aggressively angry very quickly with little to no obvious provocation. These episodes, referred to as “spells" or “attacks", can last as long as 30 minutes and generally lead to exhaustion and sleepiness. During an attack, the child can react so violently that they may injure themselves or others around them, even family members and younger siblings. After an attack, the child expresses sadness and regret about their behavior and may not even understand why they became so angry. Some may not even remember the attack at all.
Intermittent explosive disorder in children goes far beyond a temper tantrum. A child throws a temper tantrum in order to gain whatever it is they want. In other words, they are goal-oriented and the tantrum will stop if the child does not receive the intended attention or object. However, children with intermittent explosive disorder are acting out to release pent-up tension and aggression and will do so with or without an audience.