Explosive anger as a response to human rights violations in post-conflict Timor-Leste

• Published in: Social science & medicine (1982) 2009-09, Vol.69 (5), p.670-677
• Main Authors: Silove, Derrick, Brooks, Robert, Bateman Steel, Catherine Robina, Steel, Zachary, Hewage, Kalhari, Rodger, James, Soosay, Ian
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age Distribution; Aggression; Anger; Biological and medical sciences; Chi-Square Distribution; Conflict; East Timor; Epidemiology; Female; Health Surveys; Human Rights; Human Rights Abuses - psychology; Human rights violations; Humans; Indonesia; Indonesia - epidemiology; Life Change Events; Male; Medical sciences; Mental health; Mental health Post-conflict Anger Trauma Timor leste Human rights; Middle Aged; Miscellaneous; Post-conflict; Post-conflict societies; Psychometrics; Public health. Hygiene; Public health. Hygiene-occupational medicine; Sex Distribution; Social conflict; Sociodemographic Factors; Socioeconomic Factors; Stress Disorders, Post-Traumatic - epidemiology; Stress, Psychological - epidemiology; Surveys and Questionnaires; Survivor; Survivors - psychology; Timor leste; Trauma; Urban Population; Victims; Violence; Violence - psychology; Young Adult
• ISSN: 0277-9536; 1873-5347
• DOI: 10.1016/j.socscimed.2009.06.030

Over several decades, clinicians have documented a pattern of explosive anger amongst survivors of gross human rights violations. Yet there is a dearth of epidemiological research investigating explosive anger in post-conflict countries. In the present study undertaken in Timor-Leste between March and November 2004, we identified an indigenous descriptor for explosive anger, including this index in the East Timor Mental Health Epidemiological Needs Study, a small area total population survey of 1544 adults living in an urban and a rural area. Other measures included indices of past trauma events, post-traumatic stress and general psychological distress, and socio-demographic variables. We found that 38% of the population reached the defined threshold of one attack of explosive anger a month (average = 1 episode every 2–3 days). Only a minority of persons with explosive anger reached threshold scores for post-traumatic stress and general psychological distress. High levels of trauma exposure represented the strongest predictor of explosive anger. Latent class analysis identified three sub-groups with explosive anger: young trauma-affected adults living in the capital city who were unemployed; an older group, predominantly men, who had experienced extensive violence, including combat, assault and torture; and a less well characterized group of women. The findings offer support for a sequential model of explosive anger in which experiences of past persecution are compounded by frustrations in the post-conflict environment. The data provide a foundation for exploring further the role of trauma-induced anger in the cycles of violence that are prevalent in post-conflict countries.