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No randomized clinical trials have evaluated the efficacy of psychotherapy for intermittent explosive disorder (IED). In the present study, the authors tested the efficacy of 12-week group and individual cognitive-behavioral therapies (adapted from J. L. Deffenbacher & M. McKay, 2000) by comparing them with a wait-list control in a randomized clinical trial among adults with IED (N = 45). Aggression, anger, and associated symptoms were assessed at baseline, midtreatment, posttreatment, and 3-month follow-up. Group and individual cognitive-behavioral therapy tended not to differ, with each reducing aggression, anger, hostile thinking, and depressive symptoms, while improving anger control relative to wait-list participants. Posttreatment effect sizes were large. These effects were maintained at 3-month follow-up. Findings provide initial support for the use of multicomponent cognitive-behavioral therapy in the treatment of IED.

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Intermittent explosive disorder (IED) is the sole psychiatric diagnostic category for which aggression is a cardinal symptom. IED focuses on physical aggression, but researchers have argued for the inclusion of verbal aggression (VA) (e.g., arguing, threatening) as a part of the IED criteria set. The utility of VA in identifying clinically relevant aggression, however, is unknown. IED participants were compared to individuals without a marked history of physical aggression, but who report frequent (two or more times a week) VA, and non-aggressive personality-disorderindividuals on behavioral and self-report measures of aggression, self-report measures of related constructs (e.g., anger, affective lability), and a clinician assessment of psychosocial impairment. Both the IED and VA groups were more aggressive, angry, and clinically impaired than personality-disorder individuals, while the IED and VA groups did not differ from each other on these measures. These results support the clinical importance of frequent VA for future iterations of the IED criteria set.

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Although initial reports of genetic contributions to personality dimensions were promising, continued empirical support remains controversial. The focus has largely revolved around polymorphisms of the serotonin transporter gene-linked polymorphic region and the D4 dopamine receptor subtype. Equivocal findings likely stem from numerous sources including ethnic diversity of subject samples, phenotypic characterization of personality traits, and insufficient sample sizes. Research has begun to shy away from single gene causation in support of more complex polygenic models of personality traits. This search has identified numerous other candidate genes including dopamine D2 and D3 receptor subtypes, serotonin receptors, and catecholaminergic enzymes, to name a few. This article endeavors to review and evaluate the most recent literature within the context of this burgeoning field. Some considerations for future research are presented in summary.