Katherine M Keyes1, Katie A McLaughlin2, Thomas Vo1, Todd Galbraith3, Richard G Heimberg3. 1. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York. 2. Department of Psychology, University of Washington, Seattle, Washington. 3. Department of Psychology, Temple University, Philadelphia, Pennsylvania.
Abstract
BACKGROUND: Evidence suggests that impulsive aggression and explosive anger are common among individuals with anxiety disorders; yet, the influence of intermittent explosive disorder (IED) on the onset, course, consequences, and patterns of comorbidity among those with anxiety disorders is unknown. METHODS: Data were drawn from the National Comorbidity Survey Replication (N = 9,282) and Adolescent Supplement (N = 9,632), nationally representative surveys conducted between 2001 and 2004. Diagnoses were based on structured lay-administered interviews. Lifetime diagnoses were assessed with structured instruments. Outcomes included comorbidity, functional and role impairment, and treatment utilization. RESULTS: Adolescents with a lifetime anxiety disorder had a higher prevalence of a lifetime anger attacks (68.5%) and IED (22.9%) than adolescents without a lifetime anxiety disorder (48.6 and 7.8%, respectively), especially social phobia and panic disorders. Similar elevation was found for adults. Age of onset and course of anxiety disorders did not differ by IED. Severe functional impairment associated with anxiety was higher among adolescents (39.3%) and adults (45.7%) with IED than those without IED (29.2 and 28.2%, respectively). Comorbidity for all other disorders was elevated. However, individuals with anxiety disorders and IED were no more likely to use treatment services than those with anxiety disorders without IED. CONCLUSIONS: Individuals with IED concomitant to anxiety disorder, especially social phobia and panic, are at marked risk for worse functional impairment and a higher burden of comorbidity, but onset and course of anxiety disorder do not differ, and those with anxiety and IED are no more likely to utilize treatment services. Assessment, identification, and specialized treatment of anger in the context of anxiety disorders are critical to reducing burden.
BACKGROUND: Evidence suggests that impulsive aggression and explosive anger are common among individuals with anxiety disorders; yet, the influence of intermittent explosive disorder (IED) on the onset, course, consequences, and patterns of comorbidity among those with anxiety disorders is unknown. METHODS: Data were drawn from the National Comorbidity Survey Replication (N = 9,282) and Adolescent Supplement (N = 9,632), nationally representative surveys conducted between 2001 and 2004. Diagnoses were based on structured lay-administered interviews. Lifetime diagnoses were assessed with structured instruments. Outcomes included comorbidity, functional and role impairment, and treatment utilization. RESULTS: Adolescents with a lifetime anxiety disorder had a higher prevalence of a lifetime anger attacks (68.5%) and IED (22.9%) than adolescents without a lifetime anxiety disorder (48.6 and 7.8%, respectively), especially social phobia and panic disorders. Similar elevation was found for adults. Age of onset and course of anxiety disorders did not differ by IED. Severe functional impairment associated with anxiety was higher among adolescents (39.3%) and adults (45.7%) with IED than those without IED (29.2 and 28.2%, respectively). Comorbidity for all other disorders was elevated. However, individuals with anxiety disorders and IED were no more likely to use treatment services than those with anxiety disorders without IED. CONCLUSIONS: Individuals with IED concomitant to anxiety disorder, especially social phobia and panic, are at marked risk for worse functional impairment and a higher burden of comorbidity, but onset and course of anxiety disorder do not differ, and those with anxiety and IED are no more likely to utilize treatment services. Assessment, identification, and specialized treatment of anger in the context of anxiety disorders are critical to reducing burden.
Authors: Ronald C Kessler; Patricia Berglund; Olga Demler; Robert Jin; Kathleen R Merikangas; Ellen E Walters Journal: Arch Gen Psychiatry Date: 2005-06
Authors: Ronald C Kessler; Johan Ormel; Maria Petukhova; Katie A McLaughlin; Jennifer Greif Green; Leo J Russo; Dan J Stein; Alan M Zaslavsky; Sergio Aguilar-Gaxiola; Jordi Alonso; Laura Andrade; Corina Benjet; Giovanni de Girolamo; Ron de Graaf; Koen Demyttenaere; John Fayyad; Josep Maria Haro; Chi yi Hu; Aimee Karam; Sing Lee; Jean-Pierre Lepine; Herbert Matchsinger; Constanta Mihaescu-Pintia; Jose Posada-Villa; Rajesh Sagar; T Bedirhan Ustün Journal: Arch Gen Psychiatry Date: 2011-01
Authors: Michael S McCloskey; Royce Lee; Mitchell E Berman; Kurtis L Noblett; Emil F Coccaro Journal: Aggress Behav Date: 2008 Jan-Feb Impact factor: 2.917
Authors: Ronald C Kessler; Shelli Avenevoli; E Jane Costello; Jennifer Greif Green; Michael J Gruber; Steven Heeringa; Kathleen R Merikangas; Beth-Ellen Pennell; Nancy A Sampson; Alan M Zaslavsky Journal: Int J Methods Psychiatr Res Date: 2009-06 Impact factor: 4.035
Authors: Ronald C Kessler; Shelli Avenevoli; E Jane Costello; Jennifer Greif Green; Michael J Gruber; Steven Heeringa; Kathleen R Merikangas; Beth-Ellen Pennell; Nancy A Sampson; Alan M Zaslavsky Journal: J Am Acad Child Adolesc Psychiatry Date: 2009-04 Impact factor: 8.829
Authors: Todd Galbraith; Hannah Carliner; Katherine M Keyes; Katie A McLaughlin; Michael S McCloskey; Richard G Heimberg Journal: Aggress Behav Date: 2018-07-24 Impact factor: 2.917