A systematic review of the etiology and neurobiology of intermittent explosive disorder.

James Evans, Yanli Zhang-James, Stephen V Faraone, John Paliakkara, Stacy Ellenberg, Andrew Ursino, Abigail A Smith, Joseph Strayhorn

Journal: Psychiatry research 2025;347():116410

PMID: 40023093

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Abstract

Intermittent Explosive Disorder (IED) is characterized by repeated inability to control aggressive impulses. Although the etiology and neurobiology of impulsive anger and impulse control disorders have been reviewed, no systematic review on these aspects has been published for IED specifically. We conducted a systematic search in seven electronic databases for publications about IED, screened by two authors, and retained twenty-four studies for the review. Our findings highlight a multifactorial etiology and neurobiology of IED, emphasizing the role of the amygdala and orbitofrontal cortex in emotional regulation and impulse control, and supporting interventions that target serotonergic signaling. Research also shows that childhood trauma and adverse family environment may significantly contribute to the development of IED. Yet, genetic studies focusing on IED were largely lacking, despite many examining the genetics underlying aggression as a general trait or other related disorders. Future research using consistently defined IED as a phenotype is required to better understand the etiology and underlying mechanisms and assist in informing the development of more effective interventions for IED.

Address: Norton College of Medicine at SUNY Upstate Medical University, 766 Irving Ave, Syracuse, NY 13210, USA. Electronic address: [email protected].; Norton College of Medicine at Upstate Medical University, Adult Psychiatry Clinic Psychiatry and Behavioral Sciences, 713 Harrison Street, Syracuse, NY 13210 USA. Electronic address: [email protected].; Norton College of Medicine at Upstate Medical University, Adult Psychiatry Clinic Psychiatry and Behavioral Sciences, 713 Harrison Street, Syracuse, NY 13210 USA; Clinical & Forensic Psychology, 1101 Erie Blvd. East, Suite 207, Syracuse, NY 13210 USA. Electronic address: [email protected].; Health Sciences Library, Norton College of Medicine at SUNY Upstate Medical University, 750 East Adams Street, Syracuse, NY 13210, USA.; Norton College of Medicine at Upstate Medical University, Clinical Psychology Psychiatry and Behavioral Sciences, 719 Harrison Street, Syracuse, NY 13210 USA. Electronic address: [email protected].; Norton College of Medicine at SUNY Upstate Medical University, Departments of Psychiatry and Behavioral Sciences and Neuroscience and Physiology, Institute for Human Performance, 505 Irving Ave, Syracuse, NY 13210 USA. Electronic address: [email protected].; Norton College of Medicine at SUNY Upstate Medical University, Department of Psychiatry and Behavioral Sciences, Institute for Human Performance, 505 Irving Ave, Syracuse, NY 13210 USA. Electronic address: [email protected].

DOI: 10.1016/j.psychres.2025.116410

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MeSH Terms: Humans, Disruptive, Impulse Control, and Conduct Disorders, Amygdala, Prefrontal Cortex