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Intermittent Explosive Disorder Treatment, Medication & Symptoms

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The main sign of the intermittent explosive disorder is a pattern of outbursts of anger that are out of proportion to the situation or event that caused them. Continue to read more about the intermittent explosive disorder signs and symptoms.

By We Level Up FL Treatment Center | Editor Yamilla Francese | Clinically Reviewed By Lauren Barry, LMFT, MCAP, QS, Director of Quality Assurance | Editorial Policy | Research Policy | Last Updated: Feburary 7, 2023

What is Intermittent Explosive Disorder (IED Disorder)?

The intermittent explosive disorder also called IED disorder, affects replicated rash outbreaks of impulsive, aggressive, violent conduct or angry verbal fits in which the individual responds grossly out of proportion to the situation. Road rage, domestic abuse, throwing or breaking objects, or other temper tantrums may indicate an intermittent explosive disorder.

These intermittent, explosive outbursts cause significant distress, negatively impact your relationships, work, and school, and can have legal and financial consequences. Intermittent explosive disorder is a chronic disorder that can continue for years, although the severity of outbursts may decrease with age. Treatment involves medications and psychotherapy to help you control your aggressive impulses.

Intermittent explosive disorder (IED disorder) is an impulse-control disorder characterized by sudden episodes of unwarranted anger. The disorder is typified by hostility, impulsivity, and recurrent aggressive outbursts. People with this condition essentially “explode” into a rage despite a lack of apparent provocation or reason. Individuals suffering from intermittent explosive disorder have described losing control of their emotions and becoming overcome with anger.

Intermittent Explosive Disorder DSM 5 Criteria

People with IED disorder symptoms may threaten or attack objects, animals, and other humans. IED is said to begin during the early teen years typically, and evidence has suggested that it has the potential to predispose individuals to depression, anxiety, and substance abuse disorders. Intermittent explosive disorder is not diagnosed unless a person has displayed at least three episodes of impulsive aggressiveness.

The essential feature of intermittent explosive disorder (IED), as defined in both DSM-IV and DSM-5, is the occurrence of repeated episodes of impulsive aggression resulting in verbal or physical assaults or property destruction. [1]

What is IED mental illness? Individuals with IED mental illness have reported feeling a sense of relief once they have released the tension that built up due to their rage. However, once the comfort wears off, some people report experiencing remorse or embarrassment. While IED can be highly disruptive to an individual’s life and those around them, IED can be managed through proper IED treatment, education about anger management, and possibly through intermittent explosive disorder medication.

Intermittent explosive disorder criteria is a lesser-known mental disorder marked by episodes of unwarranted anger.
What is IED disorder? What are IED disorder symptoms? Intermittent explosive disorder criteria is a lesser-known mental disorder marked by episodes of unwarranted severe anger.

Feelings of irritation, rage, and loss of control are commonly reported before or during the episode. A person with an IED mental disorder might experience racing thoughts or a sense of emotional detachment. For some individuals with IEDs, these episodes occur regularly. Others appear after weeks- or months-long stretches of nonaggressive behavior. Verbal outbursts may occur between acts of physical violence.

IED is associated with significant interference with work, social relations, and activities of daily living. individuals with I.E.D symptoms or IED disorder triggers also suffer from a substantial reduction in quality of life experience and satisfaction. But early intermittent explosive disorder interventions may minimize the consequences of IED and improve psychosocial functioning and quality of life. [2]

Intermittent Explosive Disorder Symptoms

When you are living with someone with intermittent explosive disorder, the impulsive, aggressive episodes that indicate IED can take many forms. Some behaviors that might be IED symptoms include:

  • Yelling and shouting
  • Intense arguments
  • Temper tantrums and rampages
  • Threats
  • Road rage
  • Assault
  • Punching walls or breaking plates
  • Damaging property
  • Physical violence, such as slapping or shoving
  • Fights or brawls
  • Domestic violence
  • Explosive anger and addiction

These episodes or attacks often occur with little to no warning. They are short-lived, rarely lasting longer than half an hour. They may appear alongside physical symptoms, such as:

  • Increased energy (adrenaline rush)
  • Headache or head pressure
  • Heart palpitations
  • Chest tightness
  • Muscle tension
  • Tingling
  • Tremors

Intermittent Explosive Disorder in Adults Statistics

A known mental disorder marked by episodes of unwarranted anger is more common than previously thought, a study funded by the National Institutes of Health’s (NIH) National Institute of Mental Health (NIMH) found. Depending upon how broadly it’s defined, intermittent explosive disorder (IED) affects as many as 7.3 percent of adults — 11.5-16 million Americans — in their lifetimes.


Researchers estimate that approximately 1.4% to 7% of people have intermittent explosive disorder.

Source: NIH


Nearly two-thirds of young adults (63.3%) reported lifetime anger attacks that involved destroying property, threatening violence, or engaging in violence. 

Source: NIH


Intermittent explosive disorder affects around 7.3% of adults at some point throughout their lifetimes.

Source: NIH

Intermittent Explosive Disorder (IED Disorder)

IED Disorder Fact Sheet

Intermittent explosive disorder definition: Intermittent explosive disorder involves repeated, sudden episodes of impulsive, aggressive, violent behavior or angry verbal outbursts in which you react grossly out of proportion to the situation.

Intermittent Explosive Disorder vs Disruptive Mood Dysregulation Disorder

Intermittent explosive disorder vs DMDD: Individuals with symptoms of IED present situations with severe outbursts similar to the ones with DMDD, but they don’t require the persistent disruption in mood between outbursts. Moreover, intermittent explosive disorder must show symptoms for only three months, in contrast to the 1-year requirement for DMDD. Consequently, the two diagnoses shouldn’t be made in the same person.

Intermittent Explosive Disorder in Females

Women in conflict-affected countries are at risk of mental disorders such as posttraumatic stress disorder and depression.

IED is prevalent and disabling amongst women in conflict-affected areas, impacting their health, child-rearing, and ability to participate fully in socio-economic development.

Parents with Intermittent Explosive Disorder

Parental bonding has been shown to have lasting impacts on the psychological development of children. Also, IED is believed to be hereditary for some people. Especially in those with a first-degree relative who suffers from this condition, research has concluded that some individuals have a genetic predisposition to developing IED.

Intermittent Explosive Disorder vs Bipolar

Bipolar disorder has been linked to increased agitation and aggressive behavior in some individuals. Still, for these individuals, aggressiveness is limited to manic and/or depressive episodes, whereas individuals with IED experience aggressive behavior even during periods with a neutral or positive mood.

DMDD vs Intermittent Explosive Disorder in Men

The primary difference between DMDD and IED is that the former represents a severe form of mood disorder in which anger is most of the time in men. At the same time, the latter describes individuals in whom aggressive outbursts are frequent but episodic and in whom anger is not present most of the time between outbursts.

Intermittent Explosive Disorder DSM-5

Recurrent episodes of aggressive, impulsive behavior toward people or property characterize IED in DSM-5.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, is the 2013 update to the Diagnostic and Statistical Manual of Mental Disorders, the taxonomic and diagnostic tool published by the American Psychiatric Association.

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7 Signs of Intermittent Explosive Disorder & IED Disorder Symptoms

1. Low tolerance for frustration. Having a low threshold for frustration tolerance suggests that you can’t handle difficult situations. You’re frustrated because you don’t feel like your needs have been satisfied, so you must let off a quick rush of fury to feel better.

2. Intense anger. You might be diagnosed with intermittent explosive disorder if you exhibit signs of intense anger.

3. Mood changes before an outburst. Since the phrase “mood swing” is so frequently used in ordinary speech, it is simple to underestimate how serious an authentic mood swing is.

4. Blinding rage. Blinding, uncontrollable anger is one of the “latter” symptoms, and intense outrage is one of the earlier ones. This outward sign of your rage may lead you to do unnecessary, undesirable things like hurting others, your loved ones, or even yourself. To get rid of the tense feelings of rage that have built up inside you, you could find yourself smashing things or damaging property.

5. Feeling out of control before “and” during an episode. Like mood changes before an episode, a person with an IED may recognize feeling entirely out of control of his or her situation and emotions before erupting into physical or verbal violence.

6. Guilt. The surge of shame and remorse you may experience after an episode, no matter how minor or significant, is another clear symptom that you may have an IED. Is intermittent explosive disorder hereditary? Although some specialists attribute rage problems to hereditary factors and neurological flaws, they are also frequently brought on by childhood trauma, such as neglect, rejection, abuse, or abandonment.

7. Depression. After the rage, the racing heart, the violence, and the screams, you may have deep sadness and guilt. Experts have reported that major depressive disorder – marked by persistent sadness, loss of interest in everyday life and people, or suicidal ideation — is a common co-occurring psychiatric disorder to IED. Still, it doesn’t appear in every case. However, the sorrow after an attack does appear for those with intermittent explosive disorder.

IED Disorder Diagnosis

The new edition of the Diagnostic and Statistical Manual (DSM-5) includes updated diagnostic criteria for intermittent explosive disorder (IED disorder). The new standards distinguish between:

  • More frequent episodes of verbal aggression without physically harming people or property
  • Less frequent acts of destructive or assaultive behavior that cause serious harm to people or property

Is intermittent explosive disorder a mental illness? Yes, it is a disorder characterized by impulsive and aggressive behavior that has appeared in all DSM editions. However, it was first called IED in the third edition. Before the third edition, it was believed to be rare. However, with updated diagnostic criteria and advances in IED research, it’s now considered much more common.

In 2005, a study found that 6.3% of 1,300 people seeking care for a mental health issue met the criteria for DSM 5 IED at some point in their lifetime. Furthermore, 3.1% met the criteria for a current diagnosis. A study with 9,282 individuals from 2006 found that 7.3% met the DSM-5 criteria for IED at some point in their lifetime, while 3.9% met the requirements in the past 12 months. [3]

Intermittent explosive disorder DSM 5 is characterized by recurrent discrete episodes of aggressive, impulsive behavior toward people or property. Nowadays, many are relying to online forums such as intermittent explosive disorder Reddit discussions; different people living with this condition might help with advice, but remember that it's best to connect with a mental health professional.
IED disorder or Intermittent explosive disorder DSM 5 is characterized by recurrent discrete episodes of aggressive, impulsive behavior toward people or property. Nowadays, many are relying to online forums such as intermittent explosive disorder Reddit discussions; different people living with this condition might help with advice, but remember that it’s best to connect with a mental health professional.

Causes of Intermittent Explosive Disorder (IED Disorder)

What causes IED disorder? Intermittent explosive disorder causes multiple components, including genetic, physical, and environmental factors. The following are some examples of these varying factors:

  • Genetic: It has been hypothesized that the traits that this disorder is composed of are passed down from parents to children; however, there is presently no specific gene identified as having a significant impact on the development of IED.
  • Physical: Research has suggested that intermittent explosive disorder may occur due to abnormalities in the areas of the brain that regulate arousal and inhibition. Impulsive aggression may be related to abnormal brain mechanisms that inhibit or prohibit muscular activity through serotonin. Serotonin, which sends chemical messages throughout the brain, may be composed differently in people with intermittent explosive disorder.
  • Environmental: The environment in which a person grows up can significantly impact whether or not they develop symptoms of IED. It has been hypothesized that people who grow up in homes subjected to harsh punishments are more likely to create an IED in adults. The belief is that these children will follow the example set by their parents and act out aggressively – their initial reaction to something negative. Another theory is that if children endure harsh physical punishments, they may find a sense of redemption in putting others through the same form of physical pain.

IED Disorder Risk Factors

  • Being male
  • Exposure to violence at an early age
  • Exposure to explosive behaviors at home (e.g., angry outbursts from parents or siblings)
  • Having experienced physical trauma
  • Having experienced emotional trauma
  • History of substance abuse
  • Certain medical conditions
DSM intermittent explosive disorder is a condition that involves sudden outbursts of rage, aggression, or violence.
DSM intermittent explosive disorder is a condition that involves sudden outbursts of rage, aggression, or violence.

Effects of Intermittent Explosive Disorder (IED Disorder)

IED can lead to devastating consequences for those with the disorder, but this depends on the person’s specific symptoms and behaviors. The following are examples of effects that untreated intermittent explosive disease can have on individuals:

  • Impaired interpersonal relationships
  • Domestic or child abuse
  • Legal problems
  • Incarceration
  • Drug or alcohol addiction
  • Trouble at work, home, or school
  • Low self-esteem and self-loathing
  • Self-harm
  • Suicidal thoughts and behaviors

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Intermittent Explosive Disorder & Co-Occurring Disorders

Is IED disorder a mental illness? Yes. The symptoms of the intermittent explosive disorder often directly mirror symptoms of various other diseases. Some of the most common mental disorders that co-occur with IED can include explosive anxiety disorder, bipolar explosive disorder, and the following:

Effective Treatment for Intermittent Explosive Disorder (IED disorder treatment)

How to treat IED disorder? If you are looking for the best IED disorder treatment, take comfort in that, there are several intermittent explosive disorder treatment (IED disorder) options. Most of the time, more than one treatment of intermittent explosive disorder (IED disorder) is used. No single treatment is best for everyone with intermittent explosive disorder. IED disorder treatment generally includes talk therapy or IED disorder psychotherapy and medication.

IED Disorder Therapy

Seeing a counselor, psychologist, or therapist alone or in a group setting may help a person manage symptoms of IED. Cognitive-behavioral therapy (CBT) involves identifying harmful patterns, coping skills, relaxation techniques, and relapse education to deal with aggressive impulses. Cognitive behavior therapy (CBT) is a psychotherapeutic IED therapy that helps individuals understand the thoughts and feelings that influence behaviors. CBT for intermittent explosive disorder is commonly used to treat many disorders, including phobias, addiction, depression, and anxiety.

IED Disorder Medication for Explosive Anger

There are no specific IED disorder medications for explosive anger, but certain medications may help reduce impulsive behavior or aggression. These include:

  • Antidepressants, in particular, selective serotonin reuptake inhibitors (SSRIs)
  • Mood stabilizers, including lithium, valproic acid, and carbamazepine
  • Antipsychotic drugs
  • Anti-anxiety drugs

How is intermittent explosive disorder treated with medication? Research on “IED medication” or medication for intermittent explosive disorder is limited. However, a 2009 study [3] found that the SSRI fluoxetine, more commonly known by its brand name Prozac, reduced impulsive-aggressive behaviors among people with IED. It can take up to three months of treatment to experience the full effects of SSRIs, and symptoms tend to reappear once the medication is stopped. In addition, not everyone responds to the drug.

IED Disorder Alternative Treatments

How to manage IED? Few studies have explored the effectiveness of alternative treatments and lifestyle changes for “IED behavior” and IED illness. Still, several interventions aren’t likely to have a negative impact. Some of these include:

  • Adopting a balanced diet
  • Trying alternative therapies, such as acupressure, acupuncture, or massage
  • Practicing meditation or other mindfulness techniques
  • Avoiding alcohol, drugs, and cigarettes
  • Reducing and managing sources of stress
  • Making time for relaxing activities, such as listening to music
  • Getting enough sleep
  • Staying physically active
DSM 5 intermittent explosive disorder falls in the category of impulse-control illness.
What is IED disorder? DSM 5 intermittent explosive disorder falls in the category of impulse-control illness. Intermittent explosive disorder (IED disorder) is a mental health condition characterized by sudden and repeated episodes of extreme aggression and violence. These episodes may involve verbal outbursts, physical altercations, or destruction of property. They are often disproportionate to the trigger and can have serious consequences for the person with IED and those around them.

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What are IED Disorder Complications?

I E D disorder symptoms can impact your close relationships and everyday activities. Frequent arguments and more aggressive behavior can make maintaining stable and supportive relationships difficult. Moreover, episodes of IED can cause significant harm to families. You might also experience consequences after behaving aggressively at work, school, or on the road. Possible complications are losing a job, expulsion from school, car accidents, and financial and legal repercussions. People with IED mental health symptoms are at an increased risk of having other psychological and physical health issues. Some of these include:

  • Depression
  • Anxiety
  • IED and ADHD
  • Alcohol or substance misuse
  • Other risky or impulsive behaviors, such as problem gambling or unsafe sex
  • Eating disorders
  • Self-harm and suicide
  • Chronic headaches
  • High blood pressure
  • Diabetes
  • Heart disease
  • Stroke
  • Chronic pain
  • Ulcers

Intermittent Explosive Disorder Test

The best way to diagnose Intermittent Explosive Disorder is through talking with a mental health professional. This involves describing your symptoms and behaviors and possibly answering questions, such as the ones on the Intermittent Explosive Disorder Self-Test, which can be found online.

There isn’t a definitive test for intermittent explosive disorder (IED disorder test). IED disorder was first presented as a psychiatric disorder in the third edition of the Diagnostic and Statistical Manual (DSM) in 1980. There is a screening tool for the condition called the intermittent explosive disorder test. This tool, the IED screening questionnaire (IED-SQ), can assess your risk of developing an IED. It may also help detect symptoms and determine if additional evaluation is necessary.

However, the IED-SQ doesn’t provide an official diagnosis. IED disorder test only determines the likelihood that your symptoms are due to IED. IED diagnosis is made by a mental health professional. They’ll use numerous methods and intermittent explosive disorder tests for adults to make a diagnosis.

IED Disorder Explosive anger disorder test will likely include:

  • Medical History. To understand your physical and psychiatric history, a doctor will request information about your health history.
  • Physical Examination. A general practitioner will look for possible physical IED causes of your symptoms. Your physical exam might include blood tests.
  • Psychological Evaluation. You’ll discuss your behavior, emotions, and thoughts. This lets the mental health professional rule out other psychiatric conditions.

Your mental health professional will then compare your symptoms to the criteria in the most recent edition of the DSM (DSM-5). You’ll be diagnosed with IED if you experience one of the following:

  • Verbal or physical aggression toward things, animals, or other people, twice a week (on average) within three months, which doesn’t cause physical damage or injury
  • three aggressive outbursts that cause harm or injury within 12 months

According to the DSM-5, diagnosis of IED disorder must also involve outbursts that:

  • are out of proportion to the situation
  • are not explained by another psychiatric disorder, like borderline personality disorder (BPD)
  • are not related to a medical condition or substance abuse
  • are impulsive and not associated with another purpose, like obtaining money
  • cause distress or disrupt your ability to work or maintain relationships

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Is IED Disorder Genetic?

Is IED hereditary? Intermittent explosive disorder is believed to be hereditary for some people. Especially in those with a first-degree relative who suffers from this condition, research has concluded that some individuals have a genetic predisposition to developing IED.

IED Disorder vs ODD

Oppositional defiant disorder is defined as rebellious, hostile, and disobedient behavior, usually directed at authority figures. Intermittent explosive disorder is explosive outbursts of anger, often to the point of rage, that are disproportionate to the situation.

IED Disorder vs BPD

The core behavior in an IED disorder episode is impulsive aggression, which is modulated by limbic brain structure — mainly the amygdala and hippocampus. In borderline and antisocial personality disorder, amygdala and hippocampal volume are reduced. If you have BPD, you may experience a range of often intense negative emotions, such as rage. IED can be misdiagnosed as bipolar disorder, borderline personality disorder (BPD), or post-traumatic stress disorder (PTSD).

IED Disorder ADHD Disorder

Several common characteristics of children with ADHD and intermittent explosive disorder put them at higher risk for developing and externalizing explosive behaviors. Poor impulse control, emotional dysregulation, irritability, and underlying mood disorders can all trigger explosive behaviors. According to research, while the risk of IED in those with ADHD is more significant than in those without ADHD, only a quarter of adolescents (24.5%) with lifetime ADHD were comorbid for lifetime IED, indicating that lifetime comorbidity with IED does not account for most cases of ADHD. The reverse was also true, with about an eighth of adolescents with lifetime IED (12.7%) having lifetime ADHD. [4]

While intermittent explosive disorder and ADHD commonly co-occur, intermittent explosive disorder and autism can also overlap. Adults diagnosed with autism disorders are prone to anger outbursts. 

IED Disorder and Bipolar Disorder

Explosive bipolar disorder has been linked to increased agitation and aggressive behavior in some individuals. Still, for these individuals, aggressiveness is limited to manic and depressive episodes, whereas individuals with IED experience aggressive behavior even during periods with a neutral or positive mood.

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The intermittent explosive disorder medications list typically involves SSRIs and psychotherapy (talk therapy) focused on changing thoughts related to anger and aggression. The list of vitamins for intermittent explosive disorder may involve L-Theanine supplements. It helps improve the effects of stress-busting GABA – helping maintain a calmer, more relaxed state of mind.
The intermittent explosive disorder medications list typically involves SSRIs and psychotherapy (talk therapy) focused on changing thoughts related to anger and aggression. The list of vitamins for intermittent explosive disorder may involve L-Theanine supplements. It helps improve the effects of stress-busting GABA – helping maintain a calmer, more relaxed state of mind.

How to Help Someone with Intermittent Explosive Disorder (IED Disorder)?

We Level Up FL treatment center provides world-class care with round-the-clock medical professionals available to help you cope. We work as an integrated team providing intermittent explosive disorder information and other aspects of mental health treatment. Make this your opportunity to reclaim your life.

Many people who have IEDs don’t seek intermittent explosive disorder treatment. But it’s nearly impossible to prevent the IED disorder causes and episodes of IED without professional help. Contact us today at We Level Up if you suspect you have an IED. Your call is private and confidential, and there is never any obligation.

5 Popular IED Intermittent Explosive Disorder Frequently Asked Questions

  1. What causes intermittent explosive disorder (IED disorder)?

    Exposure to violence and aggression during childhood, going through traumatic experiences, or being the victim of abuse and neglect are examples of some environmental factors that could bring about intermittent explosive disorder in children.

  2. How to deal with intermittent explosive disorder?

    Natural remedies for intermittent explosive disorder can help by improving self-care. Getting a good night’s sleep, exercising, and practicing general stress management daily can help improve your frustration tolerance. Avoiding alcohol or recreational or illegal drugs. These substances can increase aggressiveness and the risk of explosive outbursts. Caffeine and intermittent explosive disorder is not a good combination, too, so limit your coffee.

  3. How to treat intermittent explosive disorder?

    Individual or group therapy sessions that focus on building skills can be helpful. A commonly used type of therapy, cognitive behavioral therapy, helps people with the intermittent explosive disorder: Identify which situations or behaviors may trigger an aggressive response.

  4. Is explosive intermittent disorder caused by trauma?

    Yes. Traumas increase your risk of developing symptoms of intermittent explosive disorder2. People who were abused as children or experienced multiple traumatic events have an increased risk of intermittent explosive disorder.

  5. What does a sample treatment plan for intermittent explosive disorder look like?

    If you think you or your child may have intermittent explosive disorder DSM v criteria, you must talk to your healthcare provider. They’ll likely refer you to a mental health professional who’s experienced in diagnosing disruptive mood dysregulation disorder vs intermittent explosive disorder.

Search We Level Up FL Intermittent Explosive Disorder & Other Resources

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[2] Rynar L, Coccaro EF. Psychosocial impairment in DSM-5 intermittent explosive disorder. Psychiatry Res. 2018 Jun;264:91-95. DOI: 10.1016/j.psychres.2018.03.077. Epub 2018 Mar 30. PMID: 29627702; PMCID: PMC5983894.

[3] Coccaro EF, Posternak MA, Zimmerman M. Prevalence and features of intermittent explosive disorder in a clinical setting. J Clin Psychiatry. 2005 Oct;66(10):1221-7. DOI: 10.4088/JCP.v66n1003. PMID: 16259534.

[4] Radwan K, Coccaro EF. Comorbidity of disruptive behavior disorders and intermittent explosive disorder. Child Adolesc Psychiatry Ment Health. 2020 May 28;14:24. DOI: 10.1186/s13034-020-00330-w. PMID: 32514306; PMCID: PMC7257202.

[5] We Level Up – Trauma Treatment

[6] We Level Up – Trauma and Addiction

[7] We Level Up – PTSD Treatment

[8] Yaribeygi H, Panahi Y, Sahraei H, Johnston TP, Sahebkar A. The impact of stress on body function: A review. EXCLI J. 2017 Jul 21;16:1057-1072. DOI: 10.17179/excli2017-480. PMID: 28900385; PMCID: PMC5579396.

[9] Schneiderman N, Ironson G, Siegel SD. Stress and health: psychological, behavioral, and biological determinants. Annu Rev Clin Psychol. 2005;1:607-28. DOI: 10.1146/annurev.clinpsy.1.102803.144141. PMID: 17716101; PMCID: PMC2568977.

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