Disruptive Disorders: IED Neurobiology, Treatment, Conduct Disorder and Bullying

Intermittent Explosive Disorder: Neurobiology

Etiology: possible serotonin imbalance; limited research.
Neuroimaging: diminished orbitofrontal cortex activity; amygdala hyperactivity.
OFC-amygdala dysfunction when viewing angry faces.
Family history: runs in families; unclear if genetic or environmental/parenting factors.

Cognitive-behavioral therapy (individual/group) reduces anger, aggression, hostile thinking, depressive symptoms; improves anger control; vs waitlist.
Pharmacology: Serotonin and norepinephrine reuptake inhibitors; mood stabilizers (e.g., lithium) shown to reduce aggression in small uncontrolled studies.

Integrative view: disorders result from interactions of biological and psychosocial factors; reciprocal effects.
Pathways: antisocial parents genes + parenting; downward social drift; poverty; toxins; violent neighborhoods; deviant peer groups.
Biological factors: Genetics; Neurobiological abnormalities
Social factors: Poverty; Toxins; Violent neighborhoods; Deviant peer groups
Psychological factors: Hostile, aggressive parenting; Abuse; Hostile views of others
Cycle: irritable/difficult children evoke hostility; negative reactions feed hostility; join deviant peers; poor achievement; crime; poverty; cycle repeats across generations.

Criteria: at least three symptoms over 12-month period, with at least one in the past 6 months.
Jake example: Ambushing indicates possible conduct disorder if persists; earlier fights provoked by teasing; unclear counts.
Bullying prevalence: 11\% victims; 13\% bullies; 6\% both.
Bullying associations: Higher likelihood of antisocial behaviors; bullies more likely to have conduct disorders in childhood and parental antisocial behavior; as adults, higher risk of crimes, antisocial personality disorder, substance use disorders.