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.
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