Recent Headline: “Road Rage May Be Due to a Medical Condition Called Intermittent Explosive Disorder (IED)”

WHAT IS THE SCIENCE BEHIND THIS?

The study, published in the June (2006) issue of the Archives of General Psychiatry was based on a national face-to-face survey of 9,282 US adults who responded to diagnostic questionnaires in 2001-03. It was financed by the National Institute of Mental Health.

Results? About 5 to 7 percent of the nationally representative sample had had the disorder, which would be equivalent to 16 million Americans. That’s higher than more well-known mental illnesses like schizophrenia and bipolar disorder.

The average number of lifetime attacks per person was 43, resulting in $1,359 in property damage per person. About 4 percent had suffered recent attacks.

IT IS REAL?

This study has created a lot of controversy regarding what exactly is “medical” about road rage and how it differs from just bad and inconsiderate behavior.

Take the following two headlines that were published recently:

News story #1: “Police looking for shooter after road rage incident”

Date: June 10, 2006. City: Indianapolis, Indiana.

The Fact: At an intersection, two drivers got into a confrontation when one of them opened fire on the other at a traffic light.

News story #2: “Man, 21, charged in highway shooting.”

Date: May 21, 2006. City: San Antonio, Texas.

The event (according to press reports): “At around 3 a.m., Samuel Hitchcock, 21, Daniel Peña, 17, and another man were driving when a pickup truck passed them in an inside lane and hit Hitchcock’s side mirror. Hitchcock followed the truck into a residential area to gather information and the truck made a sudden turn, coming to a stop. Hitchcock pulled up next to the truck. Pena, who was in the front passenger seat, told police that the truck driver he pulled out a gun and began shooting at them, hitting and killing Hitchcock.

Are all cases like this due to Intermittent Explosive Disorder? Very unlikely! Some are and some are not. That’s why it’s important to have a professional evaluation of every case of “road rage” to determine the underlying cause, such as an IED, or some other problem.

Other causes that could come into play would be: alcohol or drug intoxication, stress, depression or bipolar disorder and, of course, bad, selfish or inconsiderate behaviors.

ROAD RAGE VS AGGRESSIVE DRIVING

The person pulling in and out of traffic, tailgates, or cutting in front of you may not be displaying “road rage” per se, but inconsiderate aggressive driving. He is not mad at you; he probably doesn’t even know you exist, since he’s preoccupied with his own selfish needs.

FDI SEEN IN OTHER AREAS OF LIFE

It is also important to remember that people with Intermittent Explosive Disorder may explode in many other situations besides road rage. They often “break out” with spouses, children, coworkers, or customer service employees.

REMEDIES FOR ROAD RAGE

If the rage behind the wheel is really due to an IED, there are two treatments that can help both teens and adults: (1) medication and (2) cognitive training

Medications often include SSRIs (a type of antidepressant). In my opinion, most people who exhibit road rage do not need medication, but some do and will benefit greatly from it.

cognitive training it means learning to think differently about driving, road aggression, and other drivers. Cognitive training is an important element in many anger management programs, which some states now require for “rage at the wheel” behavior and/or aggressive driving.

In our anger management classes and programs, we teach specific cognitive and behavioral skills to control aggressive, inconsiderate, and dangerous management behaviors. These skills include:

• better manage life stress, including time management skills

• develop empathy for other drivers

• learn healthy “internal dialogue” sentences

• adjusting the expectations of others along the way.