This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.Human aggression constitutes an act that results in physical (or verbal) injury to self, others or objects. It may be defensive, premeditated or impulsive. Defensive aggression is generally seen within the normal range of human behavior. Premeditated and impulsive aggressive behaviors are viewed as pathological (Eichelman 1991). The tendency to behave aggressively represents a behavioral trait. While the frequency of aggressive acts tends to decrease with age, studies document the trait of aggressiveness begins early in life and continues through adulthood (Olweus 1979). Data from studies consistently link impulsive, but not premeditated, aggression to biological (Coccaro 1998), environmental (Dodge et al., 1994), and to pharmacological (Sheard et al, 1976, Barratt et al., 1997) or psychological treatment responses. Data suggest that recurrent, problematic, impulsive aggression (defined as Intermittent Explosive Disorder/IED) affects at least 2.4% of the US population. It appears that this behavioral problem is common and amenable to treatment by medication and/or psychological treatment interventions. The proposed study has one major aim, to compare the efficiency of two different medications (Fluoxetine or Divalproex Sodium) against placebo in the treatment of impulsive aggressive behavior by men and women with Intermittent Explosive Disorder (IED). Subjects will be men and women, 21-55 years old, with a current diagnosis of Intermittent Explosive Disorder. All subjects will undergo a diagnostic and then trialed to one of three treatment conditions: (a) 12-week course of Fluoxetine, (b) 12 week course of Divalproex Sodium, or (c) 12 week course of Placebo (sugar pill). The study lasts 16 weeks.
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