ABSTRACT
OBJECTIVE: To determine the lifetime and 1-month prevalence of intermittent explosive disorder (IED) by both DSM-IV and research criteria in a community sample. METHOD: The final 253 (34.1%) of individuals who were entered into the Hopkins Epidemiology Study of Personality Disorder and sampled in the context of a follow-up study of participants from the Baltimore Epidemiologic Catchment Area (ECA) study completed a supplemental interview that allowed for the determination of IED by DSM-IV and/or research criteria. RESULTS: The mean +/- SE percentage of subjects who met inclusion criteria was 11.07% +/- 1.97%, and 6.32% +/- 1.53% met full criteria, for lifetime IED by either diagnostic criteria set; 2.37% +/- 0.96% met full criteria for IED within the previous 1 month. Adjusting the prevalence rates to account for differential sampling from the original ECA study did not substantially affect these results. Onset of problematic aggressive behavior in IED subjects (described as lifelong in most subjects) began as early as childhood, peaked in the third decade, and declined steadily after the fifth decade. While distress and/or impairment due to aggressive behavior was documented in 87.5% of IED subjects, only 12.5% of IED subjects reported seeking help for this problem. CONCLUSIONS: Intermittent problematic aggressive behavior in the community, as defined by IED, may be far more common than previously thought. Conservatively estimated, the number of individuals in the United States with IED, based on these data, may be no lower than 1.4 million for current IED or nearly 10 million for lifetime IED.
Subject(s)
Disruptive, Impulse Control, and Conduct Disorders/epidemiology , Age Factors , Age of Onset , Baltimore/epidemiology , Comorbidity , Data Collection/statistics & numerical data , Diagnostic and Statistical Manual of Mental Disorders , Disruptive, Impulse Control, and Conduct Disorders/diagnosis , Female , Follow-Up Studies , Humans , Male , Middle Aged , Patient Acceptance of Health Care/statistics & numerical data , Personality Disorders/diagnosis , Personality Disorders/epidemiology , Pilot Projects , Prevalence , Psychiatric Status Rating Scales , Time Factors , United States/epidemiologyABSTRACT
The construction and initial psychometric evaluation of an interview assessment of clinically significant impulsivity (Lifetime History of Impulsive Behaviors; LHIB) is presented. Personality-disordered and control subjects participated by completing self-report measures of depression, anxiety and social desirability, along with self-report and laboratory analogue measures of impulsivity, and finally the LHIB. The LHIB demonstrated good to excellent internal consistency and test-retest reliability. Supporting concurrent construct validity, scores on the LHIB correlated with other self-report measures of impulsivity. Diagnostic group differences were obtained and the LHIB evidenced concurrent validity in its ability to classify subjects by scores. No relationship was obtained between the LHIB and laboratory analogue measures. While evidence of discriminant validity was mixed, these data suggest that the LHIB may be a useful instrument for the assessment of impulsive behavior.
