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Study: Road Rage a Symptom of Mental Illness

Story Courtesy of The Dallas Morning News
By Bill Marvel

Those drivers stuck bumper-to-bumper on Interstate 35 who suddenly lose it, screaming at other drivers and pounding the wheel, may be experiencing more than just anger.

They may be suffering from intermittent explosive disorder, a rarely diagnosed but surprisingly common mental illness, says a Harvard Medical School study published Monday.

According to the study, published in the Archives of General Psychiatry June issue, as many as 8.6 million adults each year will experience an episode of the disorder.

It is also reflected well beyond the nation's roadways: in violent attacks, spousal abuse and other outbursts that occur for for little or no apparent reason.

The study, led by Ronald Kessler, aHarvard professor of health care policy, also said the condition may predispose people to other forms of mental illness and to alcohol and drug abuse.

"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 anger attacks," said Dr. Kessler, who has a doctorate in sociology.

The study, funded by the National Institute of Mental Health, was based on a national survey of 9,282 U.S. adults who answered diagnostic questionnaires in 2001-03.

It doesn't take a Harvard study to convince Jonathan Campbell, owner of Campbell Couriers of Dallas, that sudden outbursts of rage are more common than most people suspect.

"If you're out, you probably see it every day," said Mr. Campbell, who drives 300 to 400 miles a day delivering messages and parcels. "You see people driving totally erratically, almost clipping off cars to get where they need to go, driving on the shoulder. Usually you'll see them in a wreck later on."

One of his drivers said he recently saw one motorist moon another in outrage.

Sometimes the results are more tragic: accidents or shootings sparked by anger.

Mr. Campbell suspects that something may lie behind the rage other than just clogged traffic or some trivial incident. "You never know what else is going on in that person's mind."

According to mental health experts, he's right.

The uncontrollable rage that marks intermittent explosive disorder is out of all proportion to the situations that trigger it, according to the Diagnostic and Statistical Manual of Mental Disorders, a 900-page desk reference on mental illness.

The manual's current edition, published in 1994, lists the disorder as "apparently rare."

Intermittent explosive disorder has been around a long time, says Dr. Joel Holiner, a Dallas psychiatrist and executive medical director of Green Oaks Hospital. "Counseling professionals and psychiatrists have been aware of it for many years."

The difference now, he says, it that new studies such as Harvard's indicate that the disorder is more common than once thought, "because it involves violence, particularly in young people."

Society is more focused on violence than it used to be, Dr. Holiner says. Because violence these days is often more lethal than in the days when a couple of kids just duked it out behind the school, people are no longer interested in explaining it away, he said.

"There is less tolerance of violence," he said. "We think, 'Gosh, if a kid goes and slugs somebody over some minor insult, is that going to be the kid who brings a rifle to school, or a handgun?' "

Ephrem Fernandez, a Southern Methodist University professor of clinical psychology, likens intermittent explosive disorder to kleptomania, pyromania and similar compulsive problems.

"It's an impulse-control disorder," he said.

Dr. Fernandez treats the disorder with vaSious anger management techniques such as deep breathing, muscle relaxation, distraction and learning to recognize and control the early phases of anger before it explodes into rage.

Dr. Holiner said psychological counseling and mood-stabilizing drugs may prove helpful.

"No one really knows what the cause is," he said.

The Associated Press contributed to this story

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