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Intermittent explosive disorder-revised: development, reliability, and validity of research criteria
E F Coccaro1, R J Kavoussi, M E Berman
1Department of Psychiatry, MCP-Hahnemann School of Medicine, Allegheny University of the Health Sciences, Philadelphia, PA 19129, USA.
Comprehensive Psychiatry
|November 26, 1998
Summary
This study introduces revised criteria for Intermittent Explosive Disorder (IED-R), improving the identification of impulsive aggression. IED-R demonstrates high reliability and validity in personality disordered individuals.
Area of Science:
- Psychiatry
- Clinical Psychology
- Behavioral Science
Background:
- Reliable diagnostic categories for impulsive aggression are lacking.
- Current DSM Intermittent Explosive Disorder (IED) criteria have theoretical and psychometric limitations.
- This hinders clinical and research efforts in understanding and treating aggressive behavior.
Purpose of the Study:
- To develop revised criteria for Intermittent Explosive Disorder (IED-R).
- To assess the reliability and validity of IED-R in personality disordered subjects.
- To improve the identification of individuals with clinically significant impulsive aggressive behavior.
Main Methods:
- Developed research criteria for IED-Revised (IED-R).
- Reviewed clinical, phenomenologic, and diagnostic data from 188 personality disordered individuals.
- Assigned IED-R diagnoses using a best-estimate process and examined reliability and construct validity.
Main Results:
- IED-R diagnoses showed high interrater reliability (kappa = .92).
- IED-R subjects scored higher on aggression and impulsivity measures and lower on global functioning.
- IED-R criteria were four times more sensitive than DSM-IV IED in identifying impulsive-aggressive behavior.
Conclusions:
- IED-R criteria can be reliably applied in personality disordered subjects.
- IED-R criteria demonstrate sufficient validity for further research.
- Further evaluation in field trials and various research domains is warranted.