'Road Rage' is Called a Diagnosable Disorder

Harvard Professor Ronald Kessler talks with Renee Montagne about a new study that shows "road rage" is a diagnosable disorder. Intermittent Explosive Disorder has a strict definition and has been a serious problem for years. Kessler is one of the authors of the study in the Archives of General Psychiatry.

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RENEE MONTAGNE, host:

Road rage is the subject of a new study out in a medical journal. Psychiatrists call it Intermittent Explosive Disorder, and it has a strict definition.

Intermittent Explosive Disorder has been a serious problem for years, but no one knew how common it was. Joining me is Ronald Kessler, of Harvard University. He's one of the authors of the report in the Archives of General Psychiatry.

Good morning.

Dr. RONALD KESSLER (Professor of Health Care Policy, Harvard Medical School): Good morning.

MONTAGNE: How common is Intermittent Explosive Disorder? When I, for instance, drive down the road, how many of those cars are being driven by people who could become threatening if I should, say, cut them off?

Dr. KESSLER: Well, about 5 to 7 percent of people in the population have had Intermittent Explosive Disorder at some time in their life. And it typically goes on as a rather chronic condition, maybe 20 years or so. So it could be that two or three out of every hundred cars have a person in it who has Intermittent Explosive Disorder.

MONTAGNE: Of course, it's known as road rage, but it's not just that, right?

Dr. KESSLER: No, road rage is kind of a new, popular phrase. But Intermittent Explosive Disorder more generally is people who blow up unexpectedly. And the typical place that that happens is in the home and the subjects of it are usually the spouse and the children. It happens at work and it happens in the grocery store, and occasionally it happens when they're in a traffic jam.

MONTAGNE: And are some people more prone to it than others? That is to say, they carry it with them on a daily basis?

Dr. KESSLER: Men are more likely to have this problem than women, but other then that it's a surprisingly equal opportunity problem. People of all social classes, all reaches of the country, urban and rural, are equally likely to have it.

MONTAGNE: And, you know, in terms of treatment, I mean, what first comes to mind is something as sort of straightforward as anger management. But does that apply in a situation like this?

Dr. KESSLER: Yeah, psychotherapy, cognitive behavioral kinds of psychotherapy, where people get taught to count to ten, and understand the triggers that set them off and things like that is very useful. We also find that these people have a high probability of being depressed, having anxiety disorders, a lot of alcoholism and drug problems that are associated with impulsivity; and medication sometimes helps. And the best of all is a combination of medication and psychotherapy.

MONTAGNE: You know this disorder, Intermittent Explosive Disorder, it's been in the psychiatric textbooks for years, so with this study, was it a surprise to you all that so many people actually have it?

Dr. KESSLER: Yes, it was. And the reason is that these people don't show up for treatment very often. Typically a person who, their main problem is having these explosive anger attacks, don't code themselves as having a mental health problem. They don't show up for treatment. They code the other people they're mad at as having the problem. So usually we don't see them unless they get depressed or they develop alcohol problems and those things bring them into treatment.

So when we went out into the community and knocked on thousands and thousands of doors and counted up how many heads have this thing, we were quite surprised at how many people there are who have pure versions of this disorder who are not getting any treatment at all.

MONTAGNE: And a lot of them still out there on the road.

Dr. KESSLER: A lot of them are out there on the road, but there are more of them that are in the house. That when you ask these people, tell me about your last attack, the vast majority of them are people who had these things behind closed doors, in their own family; and their spouse or their kids were the subject of their anger rather than strangers.

MONTAGNE: Thanks very much for joining us.

Dr. KESSLER: Sure. Nice being with you.

MONTAGNE: Ronald Kessler is a professor of health care policy at Harvard University. He's one of the authors of the report on Intermittent Explosive Disorder published in the Archives of General Psychiatry.

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