out of proportion to the provocation or to any precipitating psychosocial stressors. 
C. The recurrent aggressive outbursts are not premeditated (i.e., they are impulsive and/
or anger-based) and are not committed to achieve some tangible objective (e.g.,
money, power, intimidation).
D. The recurrent aggressive outbursts cause either marked distress in the individual or
impairment in occupational or interpersonal functioning, or are associated with finan-
cial or legal consequences. 
E. Chronological age is at least 6 years (or equivalent developmental level).
F. The recurrent aggressive outbursts are not better explained by another mental disor-
der (e.g., major depressive disorder, bipolar disorder, disruptive mood dysregulation
disorder, a psychotic disorder, antisocial personality disorder, borderline personality
disorder) and are not attributable to another  medical condition (e.g., head trauma, Alz-
heimer’s disease) or to the physiological effects of a substance (e.g., a drug of abuse,
a medication). For children ages 6–18 years, aggressive behavior that occurs as part
of an adjustment disorder should not be considered for this diagnosis. 
Note:  This diagnosis can be made in addition to the diagnosis of attention-deficit/hyper-
activity disorder, conduct disorder, oppositional defiant disorder, or autism spectrum dis-
order when recurrent impulsive aggressive outbursts are in excess of those usually seen
in these disorders and warrant independent clinical attention.
Diagnostic Features
The impulsive (or anger-based) aggressive outb ursts in intermittent explosive disorder have
a rapid onset and, typically, li ttle or no prodromal period. Ou tbursts typically last for less