
- Psychiatric Times Vol 24 No 6
- Volume 24
- Issue 6
Intermittent Explosive Disorder and the Like: Overappreciated?
In "Intermittent Explosive Disorder: Common but Underappreciated"(Psychiatric Times,January 2007, page 1), Arline Kaplan wrote that intermittent explosive disorder (IED) "is not just another name for bad behavior." She quoted Dr Coccaro from the University of Chicago as asserting that patients with IED who react with rage to minor irritants have been shown to have reduced down-regulation of certain cortical nuclei that should be reined in by inhibitory stimuli from the frontal cortex.
In "Intermittent Explosive Disorder: Common but Underappreciated"(
Can it not be argued that in every case of disproportionate emotional or behavioral reaction some CNS circuit has failed to be properly modulated-whether current neuroimaging techniques can demonstrate it or not? Are we not moving ever closer to converting all "bad behavior" into psychiatric pathologies?
It is my impression from working in correctional facilities that most "domestic violence" defendants can claim to be reacting to provocation with responses so out of proportion that they later regret it. In fact, one such defendant reported to me that he had been told he suffered from "rage disorder" and planned to plead to reduced criminal responsibility.
I worry that psychiatry, as a specialty, may succumb to a universal medicalization of behaviors that should retain their status as being the responsibility of those who exercise them.
Ole J. Thienhaus, MD, MBA
Las Vegas
Articles in this issue
almost 18 years ago
Being an Effective Psychiatric Expert Witnessover 18 years ago
The Crisis of Overdiagnosed ADHD in Childrenover 18 years ago
Psychiatric Emergencies in Bipolar and Related Disordersover 18 years ago
Troubleshooting Delirium in Elderly Inpatientsover 18 years ago
Understanding the Mind of Your Bipolar Childover 18 years ago
The Therapeutic Potential of Neural Stem Cellsover 18 years ago
Daydreamingover 18 years ago
Mariella's EyeNewsletter
Receive trusted psychiatric news, expert analysis, and clinical insights — subscribe today to support your practice and your patients.