Aggression Disorder Linked to Substance Abuse

Woman struggling with her anger

A recent study by researchers at the University of Chicago unearthed significantly greater risks of substance abuse for individuals with an aggression disorder. Individuals with aggressive behavioral tendencies were found to be at five times greater risk for abusing substances such as alcohol, tobacco and marijuana than those who did not exhibit frequent aggressive behavior.

What is an Aggression Disorder?

Intermittent explosive disorder, also known as aggression disorder, is characterized by recurring, sudden episodes of impulsive, aggressive and violent behavior or angry outbursts. These episodes usually last for less than 30 minutes. The frequency varies where episodes may be separated by weeks or even months of absence of aggressive behavior.

Verbal outbursts of lesser severity may occur in between episodes of physical aggression. The person may experience irritability, impulsivity, aggression or chronic anger most of the time.

Aggressive episodes are typically characterized by emotional and physical changes, including rage, irritability, racing thoughts, tingling sensations, shivers, palpitations and chest tightness.

A sense of relief and tiredness usually ensues after the episode. However, later, the individual may experience remorse or shame.

Aggression disorder is a chronic disorder that can persist for years, even though a gradual decrease with age is usually noticed. Road rage, domestic abuse, damaging of property, tantrums, physical fights, assaults and tirades are all examples of intermittent explosive disorder.

Such aggressive episodes can prove to be a source of substantial grief and distress, hold profound repercussions for relationships, work and school, and even bear legal and financial consequences.

Man struggling with anger and substance abuseEven though the exact cause of intermittent explosive disorder remains unclear, numerous environmental and biological factors, such as genetics and brain chemistry, have been implicated in its onset. Furthermore, a history of physical or child abuse and other mental illnesses have been implicated to be significant risk factors. [1]

Relationship Between Aggression Disorder and Substance Abuse

The study was published earlier this year in the Journal of Clinical Psychiatry.

Emil Coccaro, MD, professor of Psychiatry and Behavioral Neuroscience at University of Chicago, and colleagues assessed data gathered from over 9,200 participants from the National Comorbidity Survey, which is a national survey of mental health in the United States.

A direct relationship was discovered where the severity of aggressive behavior was noticed to be directly proportional to the levels of daily and weekly substance use.

The findings highlighted a history of frequent, aggressive behavior as a risk factor for substance abuse in the future, and an effective treatment of aggression could not only delay, but even prevent substance abuse in young people altogether.

Intermittent explosive disorder affects almost 16 million Americans, higher than bipolar disorder and schizophrenia combined. The disorder is often initially diagnosed in early adolescence, some patients as young as 11 years before substance abuse problems commonly emerge. IED is believed to be largely genetic, as evidence has shown that it runs in families.

Yet, the study revealed that the public perception of aggression disorder tends to treat it as a social-behavioral problem rather than recognizing it as a neurobiological disorder that it really is.

“People don’t see this as a medical problem. They think of it as simply bad behavior they have developed over the course of their lives, but it isn’t. It has significant biology and neuroscience behind it,” said Coccaro.

Previously, research has linked disordered aggressive behavior to the existence of other psychiatric disorders, such as anxiety or depression. This new study, however, found no such substantiated relationship.

While substance abuse, like excessive drinking, can clearly make aggressive behavior worse, the onset of intermittent explosive disorder almost always precedes the development of chronic substance abuse.

The research team discovered that aggression disorder preceded substance abuse in 92.5 percent of the cases where both disorders emerged in the participants. [2]

A Treatment in Time

Coccaro emphasized that early psychological intervention, medication and cognitive therapy are the most effective treatments to prevent, or at least delay, substance abuse problems in adolescents diagnosed with IED.

Cognitive therapy can help identify the triggers to aggressive behavior and introduce anger management techniques such as relaxation training, cognitive restructuring and effective coping skills.

Woman struggling with aggressionRelevant medication may include certain antidepressants such as selective serotonin reuptake inhibitors and anticonvulsant mood stabilizers among other drugs.

“What you’re really treating is the emotional dysregulation that leads to aggression,” Coccaro said. “The earlier you treat this dysregulation, the more likely you are to offset other disorders that come later down the road.” [3]

Sana Ahmed photoAbout the Author:

A journalist and social media savvy content writer with wide research, print and on-air interview skills, Sana Ahmed has previously worked as staff writer for a renowned rehabilitation institute focusing on mental health and addiction recovery, a content writer for a marketing agency, an editor for a business magazine and been an on-air news broadcaster.

Sana graduated with a Bachelors in Economics and Management from London School of Economics and began a career of research and writing right after. The art of using words to educate, stir emotions, create change and provoke action is at the core of her career, as she strives to develop content and deliver news that matters.



The opinions and views of our guest contributors are shared to provide a broad perspective of addictions. These are not necessarily the views of Addiction Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Addiction Hope understand that addictions result from a combination of environmental and genetic factors. If you or a loved one are suffering from an addiction, please know that there is hope for you, and seek immediate professional help.

Published on June 2, 2017.
Reviewed By: Jacquelyn Ekern, MS, LPC on June 2, 2017
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About Jacquelyn Ekern, MS, LPC

Jacquelyn Ekern founded Addiction Hope in January, 2013, after experiencing years of inquiries for addiction help by visitors to our well regarded sister site, Eating Disorder Hope. Many of the eating disorder sufferers that contact Eating Disorder Hope also had a co-occurring issue of addiction to alcohol, drugs, and process addictions.