Anger & Rage is a Mental Illness
increasing among teens and may lead to other
problems, researchers say.
By Ronald Kotulak
Tuesday, June 06, 2006
CHICAGO — One
in 20 Americans might be susceptible to
uncontrollable anger attacks in which they
lash out in road rage, spousal abuse or
other severe transgressions that are totally
unjustified, researchers from Harvard University
and the University of Chicago report.
Their study found
that the condition called intermittent explosive
Anger disorder is not the rare occurrence
that psychiatrists had thought. About 5
percent of people in the study's nationally
representative sample were found to have
physically assaulted someone, threatened
bodily harm or destroyed property in a rage
an average of five times a year. That would
make the disorder more pervasive than better-known
mental illnesses such as schizophrenia and
bipolar disorder, said Dr. Emil Coccaro,
the University of Chicago's chief of psychiatry.
disorder is different from the common type
of anger most people exhibit from time to
time, when they pout, throw down a book
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.
People with rage
disorder often misinterpret another person's
harmless action as a personal threat to
them and respond violently, Coccaro said.
"Our new study
suggests IED is really out there and that
a lot of people have it," Coccaro 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 said the disorder
involves inadequate production or functioning
of serotonin, a mood-regulating and behavior-inhibiting
Coccaro also pioneered
therapy designed to treat the disorder involving
anti-depressants (of the serotonin reuptake
inhibitor class), 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 government-funded epidemiological
study of mental health.
The authors said
their findings suggest two disturbing trends
that will require additional study: that
IED is on the increase among teenagers and
that it might set the stage for the onset
of such other mental conditions as depression
and alcoholism. Eight of 10 people with
IED subsequently develop other mental disorders,
"Given its age
of onset, identifying IED early, determining
its causes and providing treatment might
prevent some of the associated secondary
disorders, such as anxiety and alcohol abuse,"
said Ronald Kessler, a professor of health
care policy at Harvard.
The study found that
the rage disorder typically begins at age
13 in boys and 19 in girls, that it increases
rapidly in the teen years, that it is less
prevalent among respondents in their 40s
and that it becomes even less so among people
in their 60s.
"Is there something
profoundly important about how society is
changing that's leading to this apparent
increase in people not being able to control
their emotions and lashing out at other
people?" asked Kessler. "Is it
that we're bad parents and we're creating
these little monsters? Is television doing
"We know there's
an awful lot of young people who have it
today, and older people tell us they've
never had it," he said. "Whether
they're lying or not, we don't know. But,
obviously, now that it's on our radar screen,
we're going to be monitoring it very carefully."
New brain imaging
studies show that people with IED have abnormal
brain signaling in areas that control anger
responses, Coccaro said.
When people with
rage disorder are shown pictures of angry
faces, their amygdala lights up far more
than is seen in healthy subjects. The amygdala,
deep in the center of the brain, governs
emotional responses to threats.
At the same time,
the front portion of their brain, which
serves as an executive control over emotional
urges, is less active than in normal people,
Coccaro said, indicating that people with
IED quickly lose control.
this problem have a low threshold for exploding,
and that's probably genetically and biologically
mediated," he said.
from The Associated Press.