Emotion processing in intermittent explosive disorder

• Published in: Psychiatry research 2019-03, Vol.273, p.544-550
• Main Authors: Fahlgren, Martha K., Puhalla, Alexander A., Sorgi, Kristen M., McCloskey, Michael S.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aggression - physiology; Aggression - psychology; Alexithymia; Anger - physiology; Disruptive, Impulse Control, and Conduct Disorders - diagnosis; Disruptive, Impulse Control, and Conduct Disorders - psychology; Emotion processing; Emotions - physiology; Empathy; Female; Humans; Intermittent explosive disorder; Male; Middle Aged; Quality of Life - psychology; Rumination; Self Report; Young Adult
• ISSN: 0165-1781; 1872-7123
• DOI: 10.1016/j.psychres.2019.01.046

•Intermittent explosive disorder is associated with difficulty identifying feelings.•Intermittent explosive disorder is associated with high anger rumination.•Intermittent explosive disorder is not associated deficits in empathy.•Anger rumination facilitates aggression in intermittent explosive disorder.•Sadness rumination inhibits aggression in intermittent explosive disorder. Intermittent explosive disorder (IED), a disorder characterized by outbursts of affective aggression, is associated with deficits in regulating emotions. However, less is known about specific deficits in understanding and processing emotions in IED. This study sought to fill that gap by examining components of emotion processing (rumination, alexithymia, and empathy) in those with IED. Participants completed diagnostic interviews and self-report measures, and were categorized into three diagnostic groups: IED (n = 177), Psychiatric Control (PC; n = 171), and Healthy Volunteer (HV; n = 144). Those with IED reported more anger rumination and greater difficulty identifying their feelings than PC or HV participants. Interestingly, those with IED reported higher affective empathy scores than those in the HV group, with no other group differences on measures of empathy. Amongst those with IED, increased anger rumination and decreased sadness rumination predicted greater lifetime aggression, while increased sadness rumination predicted poorer quality of life. These findings suggest that although those with IED have a harder time recognizing their emotions, once they identify feeling angry, they spend more time focused this emotion than those with other disorders. These findings also suggest that cognitive intervention techniques may be beneficial for those with IED.