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

Abstract

BackgroundThere 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. MethodsA 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. ResultsClinical 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. LimitationsResponse rates were modest due to the participant's time commitments. ConclusionsIt 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.