Dangerous Rage May Be Common Among US Teens

Almost two-thirds of US teens have had an anger attack so severe they have destroyed property, or threatened or attacked another person, a recent study finds.

When these attacks persist, the syndrome is known as intermittent explosive disorder. One in 12 US teens may have the condition, which usually surfaces in late childhood, the researchers said.

"This is one of the most common adolescent disorders in America, and the most important ignored disorder among youth in America," said lead researcher Ronald Kessler, PhD, professor of Health Care Policy at Harvard Medical School in Boston.

"For reasons that are unclear to me, (this) has not been on the radar screen of the psychiatric profession," he added.

Whether the anger problem has increased or was just under-recognized is unclear, Dr. Kessler said. "But we know it's a big problem."

The condition can continue into adulthood and lead to depression and drug and alcohol abuse, he said.

While it is common for a child to have an explosion of anger, it is not normal for uncontrolled anger to be a steady pattern, Dr. Kessler said. "And if we are talking about a teen, it is definitely not normal and it really gets in the way of your life."

Inherited Tendencies

Many teens with intermittent explosive disorder have parents with violent tendencies or mothers with panic disorder, Dr. Kessler noted. Children in these situations may learn that anger is an acceptable reaction to problems, he said.

Although the problem is widespread, "there is not a great deal of scientific evidence on how to treat intermittent explosive disorder)," Dr. Kessler said.

Study Details

For the study, Dr. Kessler's team collected data from the US National Comorbidity Survey Replication Adolescent Supplement, a survey of teens 13 to 17 years old Information provided by nearly 6,500 teen-parent pairs was included in the study.

These data revealed that one in 12 US teens-about 8%-met the criteria for intermittent explosive disorder, meaning they've had three episodes of impulsive aggressiveness "grossly out of proportion to any precipitating psychosocial stressor," at any time during their life, according to the Diagnostic and Statistical Manual of Mental Disorders.

The researchers excluded anyone diagnosed with other mental health problems, such as bipolar disorder, attention-deficit/hyperactivity disorder, oppositional defiant disorder or conduct disorder, all of which are associated with aggressive behavior.

The condition was more common among teenagers not living with two biological parents and those with the most siblings.

More than one-third of those teens identified with chronic rage had received some treatment for emotional problems, but only 65% were treated specifically for anger, the researchers found.

The report was published in the Archives of General Psychiatry.

Expert Comment

Simon Rego, PsyD, director of psychology training at Montefiore Medical Center in New York City, said the findings indicate that the condition warrants more attention.

"Although it is not surprising that the researchers found [intermittent explosive disorder] to be a commonly occurring disorder among US adolescents, what is surprising is the fact that the data also show that intermittent explosive disorder) is being undertreated," Dr. Rego said.

This conclusion, plus the condition's potential for serious consequences, suggests more research is needed on this disorder, he said.

"Research should focus on the factors that put adolescents at risk, as well as any identifiable protective factors," Dr. Rego said. The goal, he added, is to help researchers and clinicians develop effective treatments that can be applied at an early age in those at risk.

Dr. Kessler's team believes school-based violence prevention programs might help with early detection.