When do Repetitive Angry Outbursts become an Illness?

April 9th, 2010 | Sources: Wall Street Journal

Anger management programs are a popular antidote these days for immature celebrities, road ragers, obstreperous airline passengers, and foul-mouthed employees.

saywhatBut the programs, which range from pricey private sessions with therapists to anonymous group sessions on a conference line, may or may not work. Few studies have been designed to find that out.

There are no licensing requirements for trainers and no regulatory oversight of the programs, and there have been notorious failures—those Columbine kids attended one before shooting up their school in 1999, for example. 

The problem is made worse by the fact that clinicians often can’t determine whether a pattern of angry outbursts signifies mental illness or a simple behavioral issue. This means that some people who need psychiatric help don’t get it. 

Psychiatrists typically recommend a psychiatric exam for people with repetitive outbursts, because anger often accompanies common psychiatric disorders.

The closest thing to a psychiatric diagnosis for isolated anger is Intermittent Explosive Disorder, which is defined as recurrent episodes of aggression against people or property that is out of proportion to any provocation. Scientists estimate that 5% of Americans (mostly men) fit these criteria.

“These people are hot heads, and the people around them are walking on egg shells. They don’t know when they are going to blow up next,” University of Chicago psychiatrist Emil Coccaro told the Wall Street Journal.

While some people with IED respond antidepressants, most psychologists believe that individual talk therapy is the way to go for treating the condition. 

For their part, anger-management trainers think psychiatrists over-diagnose the condition. 

“I don’t want everybody who calls up for anger management to be assumed to have a mental illness,” Ian Shaffer told the Journal. Shaffer is chief medical officer for MHN, which runs employee-assistance programs including anger management. MHN claims that ¾ of the employees whose jobs were on the line when they began the program were in good standing upon its completion.


 

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