Silove Derrick, Brooks Robert, Bateman Steel Catherine Robina, Steel Zachary, Hewage Kalhari, Rodger James, Soosay Ian
Centre for Population Mental Health Research, Sydney, Australia.
Soc Sci Med. 2009 Sep;69(5):670-7. doi: 10.1016/j.socscimed.2009.06.030. Epub 2009 Jul 17.
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.
几十年来，临床医生记录了严重侵犯人权行为幸存者中爆发性愤怒的一种模式。然而，在冲突后国家，对爆发性愤怒进行调查的流行病学研究却很匮乏。在2004年3月至11月于东帝汶进行的本研究中，我们确定了一个用于描述爆发性愤怒的本土术语，并将该指标纳入东帝汶心理健康流行病学需求研究中。这是一项针对1544名居住在城乡地区的成年人的小范围总人口调查。其他测量指标包括过去创伤事件、创伤后应激和一般心理困扰的指数，以及社会人口统计学变量。我们发现，38%的人口达到了每月爆发一次愤怒的定义阈值（平均每2 - 3天发作一次）。只有少数有爆发性愤怒的人达到了创伤后应激和一般心理困扰的阈值分数。高水平的创伤暴露是爆发性愤怒最强的预测因素。潜在类别分析确定了有爆发性愤怒的三个亚组：居住在首都的受创伤影响的失业年轻成年人；一个年龄较大的群体，主要是男性，他们经历了广泛的暴力，包括战斗、袭击和酷刑；以及一组特征不太明确的女性。这些发现为爆发性愤怒的序贯模型提供了支持，在该模型中，过去受迫害的经历因冲突后环境中的挫折而加剧。这些数据为进一步探索创伤诱发的愤怒在冲突后国家普遍存在的暴力循环中的作用奠定了基础。
