INABILITY TO CONTROL RECURRING AGGRESSIVE IMPULSES: PSYCHOLOGICAL MANAGEMENT. A CASE REPORT

Background: Intermittent explosive disorder is recurrent behavioral outburst with failure to control aggressiveimpulses. A case of intermittent explosive disorder with differential diagnosis of Adjustment disorder and BorderlinePersonality traits. Mental Status Examination reflected guilt, regret and distress due to inability to control angerfollowed by aggressive action. Millon Clinical Multiaxial Inventory III (MCMI-III) and Rorschach Ink Blot Test wereused for psychological evaluation. Assessments results indicates traits of lower stress tolerance, feels uncomfortableabout her ability to deal adequately with negative feelings and often have problems modulating her own affectivedisplays and impulsive. Methodology: A re-educative approach of treatment was planned with short term goals toincrease awareness of anger, avoidance and escape, managing physical arousal, relaxation skill development. Thelong term goals were focused on cognitive restructuring, assertive training, self-instructional and self-regulationtraining. Treatment Outcome: After psychological management, patient reported more satisfied and better awareof physiological arousal when angry, use distraction technique when required and regulate anger. There wasimprovement in daily functioning, coping and problem solving and in relationship with his parents and peer. Futureplan is focused on providing Neurofeedback training to enhance her self-regulation. Implication andRecommendation: In cases like Intermitted explosive disorder and other conditions of Impulse control disorder,along with psychotherapy or pharmacotherapy, effect of neurofeedback training could be explored.