July 6, 2012

Angry Adolescents: Overly Heated and Undertreated

(Ivanhoe Newswire) -- Around two-thirds of American adolescents have had an anger attack involving threatening violence, destroying property or engaging in violence toward others at some point in their lives.  A new study from the Harvard Medical School shows that these extreme anger attacks are much more common among adolescents than previously recognized.

The study was based on the National Co-morbidity Survey Replication Adolescent Supplement, a national face-to-face household survey of 10,148 U.S. adolescents. It found that nearly two-thirds of American adolescents have a history of anger attacks. Additionally, one in 12 young people–close to six million adolescents–meet criteria for a diagnosis of Intermittent Explosive Disorder (IED), a syndrome marked by persistent uncontrollable anger attacks that aren´t accounted for by other mental disorders.

IED typically appears in late childhood and tends to be quite persistent through the middle years of life. It is associated with the later onset of many other problems, such as depression and substance abuse. However, only 6.5-percent of adolescents with IED received professional treatment for their anger attacks.

IED is a severe, chronic, commonly occurring disorder among adolescents, but the study shows that IED is under-treated: although 37.8-percent of youths with IED obtained treatment for emotional problems in the 12 months prior to the study interview, only 6.5-percent received treatment specifically for anger. The researchers argue how important it is to identify and treat IED early, perhaps through school-based violence prevention programs.

"If we can detect IED early and intervene with effective treatment right away, we can prevent a substantial amount of future violence perpetration and associated psychopathology," senior author Ronald Kessler, McNeil Family Professor of Health Care Policy at HMS and leader of the team that carried out the study, was quoted as saying.

For an IED diagnosis, a person must have had three episodes of impulsive aggressiveness "grossly out of proportion to any precipitating psychosocial stressor," at any time in their life, according to the Diagnostic and Statistical Manual of Mental Disorders. The researchers used an even more rigid definition of IED, requiring that adolescents not meet criteria for other mental disorders associated with aggression, including bipolar disorder, attention-deficit/hyperactivity disorder, oppositional defiant disorder and conduct disorder. This resulted in research findings showing that 1 in 12 adolescents met criteria for IED.

Source: General Psychiatry, June 2012