Is Road Rage A Psychiatric Disorder?

Recent headline: “Road Rage may be due to medical condition called Intermittent Explosive Disorder (IED)”

WHAT IS THE SCIENCE BEHIND THIS?
The study, reported in the June (2006) issue of the Archives of General Psychiatry was based on a national face-to-face survey of 9,282 U.S. adults who answered diagnostic questionnaires in 2001-03. It was funded by the National Institute of Mental Health.

Results? About 5 percent to 7 percent of the nationally representative sample had had the disorder, which would equal up to 16 million Americans. That is higher than better-known mental illnesses such as 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.

IS IT REAL?
This study has created much controversy regarding exactly what is “medical” about road rage and how it differs from plain bad, inconsiderate behavior.

Take the two following headline which were published recently:
News Item #1: “Police search for shooter following road rage incident”

Date: June 10, 2006. City: Indianapolis, Indiana.
The event: At an intersection, two drivers were involved in a confrontation when one of them opened fire on the other at a stoplight.

News Item #2: “Man, 21, charged in road rage shooting.”
Date: May 21, 2006. City: San Antonio, Texas.
The event (according to news reports): “Around 3AM Samuel Hitchcock, 21, Daniel Pena, 17, and another man were driving when a pickup passed them on an inside lane, striking Hitchcock’s side mirror. Hitchcock followed the truck into a residential area to gather information and the truck made a sudden turn, stopping. Hitchcock pulled up next to the truck. Pena, who was in the front passenger seat told police the truck’s driver pulled a gun and started shooting at them, striking him and killing Hitchcock.

Are all cases like this due to Intermittent Explosive Disorder? Very Unlikely! Some are and some are not. This is why it is important to have a professional assessment of each case of “road rage” to determine the underlying cause, such as IED — or some other problem.

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

ROAD RAGE VS AGGRESSIVE DRIVING
The person who weaves in and out of traffic, tail gates, or cuts in front of you may not be showing “road rage” per se, but inconsiderate aggressive driving. He is not angry at you; he probably doesn’t even know you exist, being preoccupied with his own selfish needs.

IED SEEN IN OTHER LIFE AREAS
It is also important to remember that persons who do indeed suffer from Intermittent Explosive Disorder may explode in many other situations besides road rage. Often they “blow up” at spouses, children, co-workers, or customer service employees.

REMEDIES FOR ROAD RAGE
If road rage is indeed due to IED, there are two treatments that can help both adolescents and adults: (1)medications , and (2) cognitive training

The medications usually involve SSRIs (a type of anti-depressant). In my opinion, most people who show rage on the road do not need medication, but some do and will benefit greatly from them.

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

In our anger management classes and programs, we teach specific cognitive and behavior skills to control aggressive, inconsiderate, and dangerous driving behaviors. These skill include:
*managing life stress better, including time-management skills
*developing empathy for other drivers
*learning healthy “self-talk” phrases
*adjusting expectations of others on the road.