Dr. Barbara Rothbaum, professor of psychiatry and director of the Trauma and Anxiety Recovery Program at the Emory School of Medicine in Atlanta, pointed out that it may be useful to differentiate between PTED and other types of stress disorders in terms of treatment.
"The mechanism behind anxiety and anger and what you do about them is different," Rothbaum said. "With anxiety, you do exposure therapy and help a person confront what they're scared of in a therapeutic manner. That's not the way anger works. The more you focus on it, the more angry you get. ... You want to see people move through [those feelings] and not get stuck in it."
Except for Linden, few have researched the psychology of lasting bitterness, and little evidence exists about the difference between PTED and the existing cadre of trauma and stress disorders.
"Whether or not [PTED] is different from PTSD is something the DSM committee needs to think about," said Dr. Anand Pandya, vice chair of the Department of Psychiatry at Cedars-Sinai Medical Center in Los Angeles.
Pandya pointed out that, for example, some people with depression cry often and others with depression do not.
"The realities are that any clinician who's treated trauma survivors knows that very often people have a variety of emotional reactions, complex emotions like bitterness," Pandya said. "The question is: Does that difference make a difference?"
Imagine, for a moment, the worst manifestations of aggression: domestic abuse, road rage, a tendency to pick fights for no good reason. While to some, such behavior would constitute a mere personality problem, to others it suggests a psychological condition known as intermittent explosive disorder.
"The way [intermittent explosive disorder] is described right now, it refers to somebody who repeatedly fails to control their aggressive drive," Galynker said. "They may act completely out of proportion to a situation."
And while the diagnosis may sound odd, it may be more common than you think. A June 2006 study funded by the National Institute of Mental Health found that intermittent explosive disorder may affect as many as 7.3 percent of adults in the United States, mostly men.
While these people may fly into uncontrolled rage on a fairly regular basis, many feel remorse or embarrassment for their actions afterward. For this reason, Galynker added that intermittent explosive disorder can be thought of most effectively as an "aggression disregulation" and that a lot of people have gradations of it.
But is it for real? Galynker, for one, thinks so. And he says those who live with Intermittent Explosive Disorder often experience the consequences of their rage.
"A lot of people can't manage their aggression, and a lot of them end up in jail after an explosion," he noted.
But, as with many such disorders, some people may question whether someone who has been diagnosed with such a condition should be held fully responsible for their actions. Indeed, while some may argue that applying such diagnoses to this type of disposition could give some people a blank check for bad behavior, others might say the condition could warrant leniency.
Galynker, however, is adamant that an intermittent explosive disorder diagnosis should not be enough to get someone off the hook for hyperaggressive behavior.
"The fact that people can't control their behavior doesn't mean that they are not responsible for their behavior," he says.