or the equivalent developmental level (Criterion  E), or to individual s whose aggressive out-
bursts are better explained by another mental di sorder (Criterion F). A diagnosis of intermit-
tent explosive disorder should not be gi ven to individuals with disruptive mood
dysregulation disorder or to individuals whose impulsive aggressive outbursts are attribut-
able to another medical condition or to the phys iological effects of a substance (Criterion F).
In addition, children ages 6–18 years should not receive this diagnosis when impulsive ag-
gressive outbursts occur in the context of an adjustment disorder (Criterion F). 
Associated Features Supporting Diagnosis 
Mood disorders (unipolar), anxiety disorders, and substance use disorders are associated
with intermittent explosive di sorder, although onset of thes e disorders is typically later
than that of intermitte nt explosive disorder. 
Prevalence
One-year prevalence data for intermittent expl osive disorder in the United States is about
2.7% (narrow definition). Intermittent explosive disorder is more prevalent among
younger individuals (e.g., youn ger than 35–40 years), compared with older individuals
(older than 50 years), and in individuals with a high school education or less. 
Development and Course
The onset of recurrent, problematic, impulsive aggressive beha vior is most common in late
childhood or adolescence and ra rely begins for the first time  after age 40 years. The core
features of intermitte nt explosive disorder, typically, ar e persistent and continue for many
years.
The course of the disorder may be episodic, with recurrent periods of impulsive ag-
gressive outbursts. Intermittent  explosive disorder appears to follow a chronic and persis-
tent course over many years. It also appears to be quite common regardless of the presence