All the Rage: Survey Extends Reach of Explosive-Anger Disorder

Article excerpt

A mental disorder that encompasses a wide range of recurring, hostile outbursts, including domestic violence and road rage, characterizes considerably more people than previous data had indicated, a national survey finds.

At some point in their lives, between 5.4 percent and 7.3 percent of U.S. adults qualify for a diagnosis of intermittent explosive disorder, concludes a team led by sociologist Ronald C. Kessler of Harvard Medical School in Boston. Those percentages, which depend on whether the syndrome is narrowly or broadly defined, correspond to between 11.5 million and 16 million people, respectively.

In any given year, intermittent explosive disorder affects between 2.7 percent and 3.9 percent of adults, or from 5.9 million to 8.5 million people, Kessler and his coworkers report. "We never thought we'd find such high prevalence rates for this condition" Kessler says.

In contrast, a 2004 study of 253 Baltimore residents estimated a lifetime prevalence of 4 percent for intermittent explosive disorder.

Intermittent explosive disorder features tirades, grossly disproportionate to the triggering circumstances, during which a person destroys property, tries to hurt or actually hurts someone, or threatens to do so. The expression of rage elicits a sense of relief, followed by remorse for the incident. The syndrome doesn't include outbursts that stem from other mental disorders or from alcohol or drug effects.

For lifetime-prevalence figures in the new survey, broadly defined intermittent explosive disorder consisted of at least three such episodes during a person's life. The narrowly defined version required three anger attacks in the same year.

For 1-year prevalence rates, the broad definition called for three or more anger attacks, at least one of which had occurred in the past year. …