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CTV.ca News are reporting: Disorder may explain road rage: study
Mon. Jun. 5 2006 11:26 PM ET
When someone flips the bird, goes heavy on the horn, or tailgates another car most people refer to it as road rage. But a new study suggests there may be a medical explanation for the behaviour.
Intermittent explosive disorder (IED) is the medical term researchers are giving those who succumb to road rage on a frequent basis.
Lead author Ronald Kessler, a health care policy professor at Harvard Medical School, said the disease is more common than expected, affecting up to 16 million Americans.
"It is news to a lot of people even who are specialists in mental health services that such a large proportion of the population has these clinically significant attacks," Kessler said.
In Montreal, Alex Park delivers flowers -- taking messages of love and sympathy. But on the road, he sees just the opposite.
"They honk, they scream at you, they swear at you," Park says.
He's not alone. Nearly two-thirds of Canadians say they've faced road rage while driving.
Until now, most people attribute the public outbursts on the stress and frustration of increasingly busy lives. Or simply on bad manners.
But Dr. Emil Coccaro, chairman of psychiatry at the University of Chicago's medical school, says the rage is rooted in a chemical imbalance.
"People think it's bad behaviour and that you just need an attitude adjustment, but what they don't know... is that there's a biology and cognitive science to this," Coccaro said.
Doctors have diagnosed Nikki Cooper with IED. She says road conditions trigger her outbursts making her angry and belligerent.
"Everybody in this city probably knows the sound of my horn," says Cooper, a Chicago resident.
Of course, anyone has the potential to blow up in their cars after hours spent in heavy traffic or after a stressful day. However, a lawyer with expertise in automotive law is warning that IED should not be used by drivers looking for an easy excuse in court.
"Once you've been declared that you're incapable of behaving rationally behind the wheel, they're never going to let you go back behind the wheel again," lawyer Jordan Charness told CTV News.
But researchers say the study could help identify troubled drivers who could then obtain antidepressant drug treatment or behaviour therapy.
These treatments would be effective since IED is linked to an inadequate production or functioning of serotonin, a mood-regulating brain chemical that can inhibit behaviour, Coccaro said.
The findings are contained in the latest issue of the Archives of General Psychiatry.
Context Little is known about the epidemiology of intermittent explosive disorder (IED).
Objective To present nationally representative data on the prevalence and correlates of DSM-IV IED.
Design The World Health Organization Composite International Diagnostic Interview was used to assess DSM-IV anxiety disorders, mood disorders, substance use disorders, and impulse control disorders.
Setting The National Comorbidity Survey Replication, a face-to-face household survey carried out in 2001-2003.
Participants A nationally representative sample of 9282 people 18 years and older.
Main Outcome Measure Diagnoses of DSM-IV IED.
Results Lifetime and 12-month prevalence estimates of DSM-IV IED were 7.3% and 3.9%, with a mean 43 lifetime attacks resulting in $1359 in property damage. Intermittent explosive disorder–related injuries occurred 180 times per 100 lifetime cases. Mean age at onset was 14 years. Sociodemographic correlates were uniformly weak. Intermittent explosive disorder was significantly comorbid with most DSM-IV mood, anxiety, and substance disorders. Although the majority of people with IED (60.3%) obtained professional treatment for emotional or substance problems at some time in their life, only 28.8% ever received treatment for their anger, while only 11.7% of 12-month cases received treatment for their anger in the 12 months before interview.
Conclusions Intermittent explosive disorder is a much more common condition than previously recognized. The early age at onset, significant associations with comorbid mental disorders that have later ages at onset, and low proportion of cases in treatment all make IED a promising target for early detection, outreach, and treatment.
can't believe the ***** garbage that gets put on this ***** forum by stupid ***** people with pooncy avatars like ANDY (little britain) i'm so mad feel like smashing this ***** monitor no no i feel like KICKING something where's the cat!!!
Here is ScienceDaily's take on this story: Intermittent Explosive Disorder Affects Up To 16 Million Americans
A little-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) has 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. The study is based on data from the National Comorbidity Survey Replication, a nationally representative, face-to-face household survey of 9,282 U.S. adults, conducted in 2001-2003.
People with IED may attack others and their possessions, causing bodily injury and property damage. Typically beginning in the early teens, the disorder often precedes -- and may predispose for -- later depression, anxiety and substance abuse disorders. Nearly 82 percent of those with IED also had one of these other disorders, yet only 28.8 percent ever received treatment for their anger, report Ronald Kessler, Ph.D., Harvard Medical School, and colleagues. In the June, 2006 Archives of General Psychiatry, they suggest that treating anger early might prevent some of these co-occurring disorders from developing.
To be diagnosed with IED, an individual must have had three episodes of impulsive aggressiveness "grossly out of proportion to any precipitating psychosocial stressor," at any time in their life, according to the standard psychiatric diagnostic manual. The person must have "all of a sudden lost control and broke or smashed something worth more than a few dollars ... hit or tried to hurt someone ... or threatened to hit or hurt someone."
People who had three such episodes within the space of one year -- a more narrowly defined subgroup -- were found to have a much more persistent and severe disorder, particularly if they attacked both people and property. The latter group caused 3.5 times more property damage than other violent IED sub-groups. Affecting nearly 4 percent of adults within any given year -- 5.9-8.5 million Americans -- the disorder leads to a mean of 43 attacks over the course of a lifetime and is associated with substantial functional impairment.
Evidence suggests that IED might predispose toward depression, anxiety, alcohol and drug abuse disorders by increasing stressful life experiences, such as financial difficulties and divorce.
Given its earlier age-of-onset, identifying IED early -- perhaps in school-based violence prevention programs -- and providing early treatment might prevent some of the associated psychopathology, propose the researchers. Although most study respondents with IED had seen a professional for emotional problems at some time in their lives, only 11.7 percent had been treated for their anger in the 12 months prior to the study interview.
Although the new prevalence estimates for IED are somewhat higher than previous studies have found, the researchers consider them conservative. For example, anger outbursts in people with bipolar disorder, which often overlaps with IED, were excluded. Previous studies have found little overlap between IED and other mental illnesses associated with impulsive violence, such as antisocial and borderline personality disorders.
Also participating in the study were Dr. Emil Coccaro, University of Chicago, Dr. Maurizio Fava, Massachusetts General Hospital, and Dr. Savina Jaeger, Robert Jin, and Ellen Walters, Harvard University.
In addition to primary funding from the NIMH, the National Comorbidity Survey Replication received supplemental funding from a number of sources, including National Institute on Drug Abuse (NIDA) and the Substance Abuse and Mental Health Services Administration (SAMHSA).