The co‐occurrence and correlates of anxiety disorders among adolescents with intermittent explosive disorder

Abstract

We examined the lifetime prevalence of anxiety disorders (ADs) among adolescents with lifetime intermittent explosive disorder (IED), as well as the impact of co-occurring ADs on anger attack frequency and persistence, additional comorbidity, impairment, and treatment utilization among adolescents with IED. IED was defined by the occurrence of at least three anger attacks that were disproportionate to the provocation within a single year. Data were drawn from the National Comorbidity Survey-Adolescent Supplement (N = 6,140), and diagnoses were based on structured lay-administered interviews. Over half (51.89%) of adolescents with IED had an AD, compared to only 22.88% of adolescents without IED. Compared to adolescents with IED alone, adolescents with IED and comorbid ADs: (a) were more likely to be female; (b) reported greater impairment in work/school, social, and overall functioning; (c) were more likely to receive an additional psychiatric diagnosis, a depressive or drug abuse diagnosis, or diagnoses of three or more additional disorders; and (d) had higher odds of receiving any mental/behavioral health treatment as well as treatment specifically focused on aggression. Adolescents with IED alone and those with comorbid ADs did not differ in the number of years experiencing anger attacks or the highest number of anger attacks in a given year. ADs frequently co-occur with IED and are associated with elevated comorbidity and greater impairment compared to IED alone. Gaining a better understanding of this comorbidity is essential for developing specialized and effective methods to screen and treat comorbid anxiety in adolescents with aggressive behavior problems.

Intermittent Explosive Disorder in Male Juvenile Delinquents in China

“…Further, the similarities between the two groups may have resulted from the diagnostic composition of the PC group in our research. Compared to previous studies that had significant percentages of mood disorder in their PC groups (7, 26–30), our PC group was mainly comprised of those with various externalized disorders, such as ADHD, ODD, and CD, all of which were also characterized by high levels of anger experience and expression (34, 35).…”

“…Individuals with IED, including adolescents, usually had significantly more major lifetime non-personality disorders, including mood disorder, anxiety, and substance dependence (7, 26–30). We also found that a considerable proportion of IED juvenile offenders were comorbid with other DSM-IV disorders, such as conduct disorder, attention deficit hyperactivity disorder, and oppositional defiance disorder; however, the proportion was not statistically different when compared to the PC group.…”

Voxel-based morphometry and cortical thickness in combat veterans suffering from impulsive aggression

“…As mentioned in the introduction, evidence suggests that symptoms of impulsive aggression and anxiety commonly co-occur and may share the same underlying (neural) mechanisms (Carré et al, 2012; Dugré et al, n.d.; Galbraith et al, 2018; Keyes et al, 2016). In line with this notion, we observed significantly and considerably higher scores on the MASQ-AA (measure of anxiety) in the impulsive aggression group, relative to the non-aggressive combat controls (Cohen's d = 1.52, p < 0.01).…”

“…anger, fear) (Coccaro, 2011). Evidence suggests that symptoms of aggression and anxiety-related phenomena commonly co-occur, and that they may share the same underlying mechanisms (Carré, Fisher, Manuck, & Hariri, 2012; Dugré, Dumais, Dellazizzo, & Potvin, n.d.; Galbraith et al, 2018; Keyes, McLaughlin, Vo, Galbraith, & Heimberg, 2016). The consequences of such potentially violent and/or destructive acts represent a major concern for the military, mental health care organizations, and society as a whole (Krug, Mercy, Dahlberg, & Zwi, 2002).…”

“…Hence, for the present purposes, sub-volume measurements were extracted from the participants' MR data for the basolateral and centromedial nuclei of the amygdala, along with the anterior (head), intermediate (body), and posterior (tail) segments of the hippocampus. Finally, based on the above established relationship between aggression and anxiety-related symptoms (Carré et al, 2012 ; Dugré et al, n.d. ; Galbraith et al, 2018 ; Keyes et al, 2016 ), the interplay between the extracted brain measures (volume or thickness) and levels of anxiety were also explored.…”