A new study finds that people with intermittent explosive disorder (IED) are at five times greater risk of abusing substances such as alcohol, tobacco, and marijuana than those who don’t display frequent aggressive behavior.
IED is described as a condition marked by frequent physical or verbal outbursts.
Researchers from the University of Chicago analyzed data from more than 9,200 subjects in the National Comorbidity Survey, a national survey of mental health in the United States. They found that as the severity of aggressive behavior increased, so did levels of daily and weekly substance use.
The findings suggest that a history of frequent, aggressive behavior is a risk factor for later substance abuse, and effective treatment of aggression could delay or even prevent substance abuse in young people.
Emil Coccaro, M.D., led the study, which appears in the Journal of Clinical Psychiatry.
The research is relevant as IED affects as many as 16 million Americans, more than bipolar disorder and schizophrenia combined. It is often first diagnosed in adolescents, some of whom are as young as 11, years before substance abuse problems usually develop.
IED runs in families and is thought to have a significant genetic component, although Coccaro said people tend to treat it as a social-behavioral issue instead of as a true neurobiological disorder.
“People don’t see this as a medical problem. They think of it as simply bad behavior they have developed over the course of their lives, but it isn’t. It has significant biology and neuroscience behind it,” said Coccaro.
Previous research has implied that aggressive behavior in IED is due to the presence of other psychiatric disorders, such as anxiety or depression. But the new University of Chicago study found no such relationship.
While substance abuse, like excessive drinking, can clearly make aggressive behavior worse, the onset of IED almost always precedes the development of chronic substance abuse.
Coccaro and his team found that IED preceded substance abuse in 92.5 percent of the cases where subjects developed both disorders.
Coccaro emphasized that early psychological intervention, medication and cognitive therapy are the most effective treatments to prevent, or at least delay, substance abuse problems in adolescents diagnosed with IED.
“What you’re really treating is the emotional dysregulation that leads to aggression,” Coccaro said.
“The earlier you treat this dysregulation, the more likely you are to offset other disorders that come later down the road.”
Source: University of Chicago/EurekAlert