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

J Affect Disord. 2013 Sep 25;150(3):1242-6. doi: 10.1016/j.jad.2013.06.006. Epub 2013 Jul 5.


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.

Keywords: Anger; Clinical concordance; East Timor; IED; Intermittent explosive disorder; Timor-Leste.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anger*
  • Conflict, Psychological
  • Cross-Cultural Comparison
  • Diagnostic and Statistical Manual of Mental Disorders
  • Disruptive, Impulse Control, and Conduct Disorders / diagnosis*
  • Disruptive, Impulse Control, and Conduct Disorders / epidemiology*
  • Double-Blind Method
  • Female
  • Humans
  • Indonesia
  • Male
  • Middle Aged
  • Residence Characteristics
  • Timor-Leste / epidemiology
  • Violence