Intermittent Explosive Disorder is significantly associated with a wide array of violent offending. That is the bottom line of a recently published article in International Journal of Forensic Mental. Below is a summary of the research and findings as well as a translation of this research into practice.
Featured Article | International Journal of Forensic Mental Health 2017, Vol. 16, No. 4, 293–303
Matt DeLisi, Department of Sociology, Iowa State University
Michael Elbert, United States Probation, Iowa
Daniel Caropreso, United States Probation, Iowa
Katherine Tahja, United States Probation, Iowa
Timothy Heinrichs, United States Probation, Iowa
Alan Drury, United States Probation, Iowa
‘Intermittent Explosive Disorder (IED) is a relatively rare psychiatric condition characterized by aggression, explosive outbursts towards people and property, and very poorly regulated emotional and behavioral control, but has rarely been studied in a criminal justice context. Drawing on data from 863 federal correctional clients from a supervised release population in the Midwestern United States, the current study examined the lifetime prevalence and correlates of IED and its associations with criminal careers. The lifetime prevalence of IED was 2.6% with another 1% of clients exhibiting symptoms of the disorder. Poisson and negative binomial regression models have shown that IED was significantly associated with arrests for murder, attempted murder, interference with police, aggravated assault, simple assault, and domestic assault despite controls for serious behavioral disorders, age of first arrest, and demographics. Clients with IED were also dramatically more likely to be habitual offenders and accumulate chronic arrests for assault-related crimes. These offenders pose considerable risk to staff safety and should be supervised with the highest level of supervision.’
Intermittent Explosive Disorder, crime, psychopathology, criminal careers, violence
Summary of the Research
“Intermittent Explosive Disorder (IED) has existed in various incarnations throughout psychiatric history. Since the initial Diagnostic and Statistical Manual of Mental Disorders published in 1952, the condition has been referred to as “passive-aggressive personality, aggressive type,” “explosive personality,” “isolated explosive disorder,” and “intermittent explosive disorder.” Despite variations in the actual name of the disorder, Intermittent Explosive Disorder has always been characterized by features relating to aggression, explosive outbursts towards people and property, and very poorly regulated emotional and behavioral control and is commonly comorbid with other psychiatric conditions” (p.293)
“By its very definition, IED is an important clinical disorder with explicit linkages to criminal offending; however, the construct has been largely overlooked by researchers. The current study seeks to examine the prevalence and correlates of IED in a population of federal correctional clients in the United States and examine its association with diverse forms of serious and pathological forms of criminal offending.” (p.295)
“The current study was based on archival data from the total population of 865 active clients in a federal probation juris- diction in the Midwestern United States (two clients had incomplete data thus the analytical sample is 863). All clients were on supervised release after a term of supervision in the Bureau of Prisons. The sample was 84% male and 16% female. The preponderance (79.4%) of clients were white, 20.6% were African American. 92% were non-Hispanic and 8% are Hispanic and the mean age was 44 years. The most prevalent conviction offenses were distribution of methamphetamine (35%), felon in possession of firearm (13%), bank fraud, money laundering, and/or identity theft (13%), distribution of cocaine base (crack) (12%), possession or manufacturing of child pornography (6.5%), distribution of marijuana (6%), use of firearm during a drug trafficking offense (4.5%), and distribution of cocaine (3.6%).” (p.295)
“Data collection occurred via two procedures. First, all data in the client’s Probation/Pretrial Services Automated Case Tracking System (PACTS) file were electronically extracted and converted to an Excel spreadsheet. PACTS is a case management platform used in all 94 federal districts to track federal defendants and offenders. This electronic extraction contained information on 110 variables including demographics, case information, conditions, federal post-conviction risk assessment (PCRA) and assorted risks, criminal history indices, and other documents relevant to the client’s social and criminal history.” (p.295)
“Second, information on 108 additional variables was manually collected by the senior author. These variables were extracted from presentence reports (PSR), offender dossiers from the Bureau of Prisons, local, state, and national criminal histories, confidential psychological and psychiatric reports, treatment reports, and other relevant documents located in PACTS.” (p.295)
“Intermittent Explosive Disorder: IED was measured based on secondary diagnostic information from psychological reports in the offender’s file and the client’s presentence reports where there was evidence that the offender exhibited symptoms of the disorder or had received a formal lifetime diagnosis. IED was coded on a 3-point scale with no evidence/ no symptoms D 0, some evidence/symptoms of IED but not enough for a formal diagnosis D 1, and definite evidence evidenced by a formal diagnosis D 2. The lifetime prevalence of IED (x D .06, SD D .33) was 3.6% (n D 31) with nine clients displaying lifetime symptoms of IED (1%), and 22 clients having a formal lifetime diagnosis (2.6%). Most—96.4%—clients had no evidence of IED in their psychiatric history.” (p.295)
“Even when controlling for serious behavioral disorders, age of arrest onset, and demographic characteristics, IED was significantly associated with a mélange of violent crime and chronic/sustained involvement in total arrest charges and assault-oriented charges. In other words, the DSM-5 criteria are consistent with the manifest severe criminal acts among federal correctional clients.” (p.298)
“IED exerts unique variance for serious crimes above and beyond the associations between other serious behavioral disorders, arrest onset, and demographic characteristics. IED is not just part and parcel of CD, ADHD, or ASPD, but instead captures offenders whose arrest records are disproportionately comprised of offenses suggesting a bellicose, reactive, unstable behavioral repertoire. For instance, the mean assault-related charges among clients who displayed no evidence of IED were 1.5 charges. Among those with symptoms of IED, the mean assault-related charges were 8.8 and among those with an IED diagnoses the mean was 12.7. Put another way, clients with the disorder had nearly 8.5 times more arrest charges on average for assault-related crimes than clients without the disorder” (p.299).
Other Interesting Tidbits for Researchers and Clinicians
“Given the association between the disorder and various forms of assault and physical noncompliance with police (e.g., the interference with police charge), correctional staff must be vigilant when interacting with them. A practical approach to enhancing the safety of officers who supervise defendants and offenders with IED diagnosis is to require at least two officers partner on all field contacts. Another advisable course is to ensure the district’s mental health specialist, supervisor and contract or non-contract mental health treatment professional are consulted regularly regarding the status and needs of the case. Given the heightened propensity for violence to be perpetrated by offenders and defendants with IED, it is imperative that parole and probation systems consider this condition as an important marker for future violence and develop individual case plans accordingly.”(p.299)
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