gression characterized by the diagnostic criter ia is proactive and predatory. Aggression in
oppositional defiant disorder is typically char acterized by temper ta ntrums and verbal ar-
guments with authority figures, whereas impu lsive aggressive outbursts in intermittent
explosive disorder are in response to a broader array of provocation and include physical
assault. The level of impulsive aggression in individuals with a history of one or more of
these disorders has been reported as lower than that in comparab le individuals whose
symptoms also meet intermitte nt explosive disorder Criteria  A through E. Accordingly, if
Criteria A through E are also met, and the impulsive aggressive out bursts warrant inde-
pendent clinical attention, a diagnosis of intermittent expl osive disorder may be given. 
Comorbidity
Depressive disorders, anxiet y disorders, and substance us e disorders are most commonly
comorbid with intermittent explosive disord er. In addition, individuals with antisocial
personality disorder or borderline personality disorder, and individuals with a history of
disorders with disruptive beha viors (e.g., ADHD, conduct di sorder, oppositional defiant
disorder), are at greater risk for como rbid intermittent explosive disorder.
Conduct Disorder
Diagnostic Criteria
A. A repetitive and persistent pattern of behavior in which the basic rights of others or ma-
jor age-appropriate societal norms or rules ar e violated, as manifested by the presence
of at least three of the following 15 criteria in the past 12 months from any of the cate-
gories below, with at least one criter ion present in the past 6 months:
Aggression to People and Animals
1. Often bullies, threatens, or intimidates others.
2. Often initiates physical fights.