Achieving convergence between a community-based measure of explosive anger and a clinical interview for intermittent explosive disorder in Timor-Leste

• Published in: Journal of affective disorders 2013-09, Vol.150 (3), p.1242-1246
• Main Authors: Liddell, Belinda J, Silove, Derrick, Tay, Kuowei, Tam, Natalino, Nickerson, Angela, Brooks, Robert, Rees, Susan, B. Zwi, Anthony, Steel, Zachary
• Format: Article
• Language: English
• Subjects: Adult; Adult and adolescent clinical studies; Affective disorders; Anger; Biological and medical sciences; Clinical concordance; Concordance; Conflict (Psychology); Convergence; Cross-Cultural Comparison; Cultural sensitivity; Diagnostic and Statistical Manual of Mental Disorders; Disruptive, Impulse Control, and Conduct Disorders - diagnosis; Disruptive, Impulse Control, and Conduct Disorders - epidemiology; Double-Blind Method; East Timor; Explosives; Female; Humans; IED; Indonesia; Intermittent; Intermittent explosive disorder; Male; Medical sciences; Middle Aged; Mood disorders; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Residence Characteristics; Timor-Leste; Timor-Leste - epidemiology; Violence
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/j.jad.2013.06.006

Abstract Background There is growing research interest in understanding and analyzing explosive forms of anger. General epidemiological studies have focused on the DSM-IV category of Intermittent Explosive Disorder (IED), while refugee and post-conflict research have used culturally-based indices of explosive anger. The aim of this study was to test the convergence of a culturally-sensitive community measure of explosive anger with a structured clinical interview diagnosis of IED in Timor-Leste, a country with a history of significant mass violence and displacement. Methods A double-blind clinical concordance study was conducted amongst a stratified community sample in post-conflict Timor-Leste ( n =85) to compare a community measure of anger against the Structured Clinical Interview (SCID) module for IED. Results Clinical concordance between the two measures was high: the area under the curve (AUC) index was 0.90 (95% CI: 0.83–0.98); sensitivity and specificity were 93.3% and 87.5% respectively. Limitations Response rates were modest due to the participant's time commitments. Conclusions It is possible to achieve convergence between culturally-sensitive measures of explosive anger and the DSM-IV construct of IED, allowing comparison of findings across settings and populations.