Anger attacks common - explosive disorder affects 1 in 20

Anger attacks common and U. of C. study helps tell why

Intermittent explosive disorder affects 1 in 20, much more serious than mild temper tantrums
By Ronald Kotulak Tribune science reporter

One in 20 Americans may be susceptible to repeated, uncontrollable anger attacks in which they lash out in road rage, spousal abuse or other unjustifiably violent actions, researchers from Harvard and the University of Chicago have found.

Their nationwide study suggests a condition called intermittent explosive disorder, or IED, is not the rare occurrence that psychiatrists had previously thought. Four to five percent of people in the study were found to have physically assaulted someone, threatened bodily harm or destroyed property in a rage an average of five times a year.

Intermittent explosive disorder is different from the common type of anger most people exhibit from time to time when they pout, throw a book down or walk out of a room, activities that are better described as mild temper tantrums. IED is defined as repeated and uncontrollable anger attacks that often become violent.

"Our new study suggests IED is really out there and that a lot of people have it," Dr. Emil Coccaro, the U. of C.'s chief of psychiatry, said. "That's the first step for the public to actually get treated for it, because if you don't think it's really a disorder, you're never going to get treated for it."

Coccaro was the first to show, through a preliminary 2004 study, that IED might be an unrecognized major mental health problem. He also pioneered therapy designed to treat the disorder involving anti-depressants, mood disorder medications like lithium and cognitive therapy.

The new research, reported in the current issue of the Archives of General Psychiatry, involved person-to-person interviews of 9,282 people 18 years and older conducted from 2001 to 2003. The subjects were part of the National Comorbidity Survey Replication, a governmentepidemiological study of mental health.

Some disturbing trendsRelief turns to remorse

During a rage attack people often feel a sense of relief, but they mostly feel remorse afterward, Coccaro said. They run a high risk of getting divorced, losing friends, getting into trouble with the law and being fired from jobs, he said.

Anger attacks can be reduced with drug therapy to raise the threshold at which people explode or with cognitive behavioral intervention that teaches people how to relax when they feel tense and how to recognize that another person is not trying to hurt them, Coccaro said.

"The simplest coping skill is to get out of the encounter," he said. "If you feel you're going to explode you just walk away, take a timeout."