title: Explosive anger as a response to human rights violations in post-conflict Timor-Leste.
abstract: Over several decades, clinicians have documented a pattern of explosive anger amongst survivors of gross human rights violations. Yet there is a dearth of epidemiological research investigating explosive anger in post-conflict countries. In the present study undertaken in Timor-Leste between March and November 2004, we identified an indigenous descriptor for explosive anger, including this index in the East Timor Mental Health Epidemiological Needs Study, a small area total population survey of 1544 adults living in an urban and a rural area. Other measures included indices of past trauma events, post-traumatic stress and general psychological distress, and socio-demographic variables. We found that 38% of the population reached the defined threshold of one attack of explosive anger a month (average=1 episode every 2-3 days). Only a minority of persons with explosive anger reached threshold scores for post-traumatic stress and general psychological distress. High levels of trauma exposure represented the strongest predictor of explosive anger. Latent class analysis identified three sub-groups with explosive anger: young trauma-affected adults living in the capital city who were unemployed; an older group, predominantly men, who had experienced extensive violence, including combat, assault and torture; and a less well characterized group of women. The findings offer support for a sequential model of explosive anger in which experiences of past persecution are compounded by frustrations in the post-conflict environment. The data provide a foundation for exploring further the role of trauma-induced anger in the cycles of violence that are prevalent in post-conflict countries.
authors.affiliation: Centre for Population Mental Health Research, Sydney, Australia. d.silove@unsw.edu.au
authors.forename: Derrick
authors.initials: D
authors.lastname: Silove
authors.forename: Robert
authors.initials: R
authors.lastname: Brooks
authors.forename: Catherine Robina
authors.initials: CR
authors.lastname: Bateman Steel
authors.forename: Zachary
authors.initials: Z
authors.lastname: Steel
authors.forename: Kalhari
authors.initials: K
authors.lastname: Hewage
authors.forename: James
authors.initials: J
authors.lastname: Rodger
authors.forename: Ian
authors.initials: I
authors.lastname: Soosay
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000786:Anger; D016009:Chi-Square Distribution; D005260:Female; D006306:Health Surveys; D045809:Human Rights Abuses / Q000523:psychology*; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D017678:Sex Distribution; D012959:Socioeconomic Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology; D013315:Stress, Psychological / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D014505:Urban Population; D014754:Violence / Q000523:psychology*; D055815:Young Adult