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Is Road Rage Really a Mental Illness?
June 7, 2006
S. Robert Lichter Ph.D
The study neither says nor proves what the media claim it does

For most of us, road rage is like pornography — we can’t define it precisely, but we know it when we see it. Now researchers have made news by defining road rage as a mental illness. At least that’s the message the news coverage conveyed about a new scientific study on “intermittent explosive disorder” or IED.

In a June 5 dispatch headlined, “Road rage gets a medical diagnosis” the AP reported, “To you, that angry, horn-blasting tailgater is suffering from road rage. But doctors have another name for it — intermittent explosive disorder.” The story ran in outlets as diverse as USA Today, the San Francisco Chronicle and CNN. News accounts also noted that the disorder affects “up to 16 million people.”

But is there really such a thing as a “road rage” disorder? The news accounts were based on a study that was just published in the Archives of General Psychiatry about what the authors call “the prevalence and correlates” of intermittent explosive disorder. No reference to “road rage” appears in either the title or the abstract of their article. Road rage is just one of the correlates they discuss. And the results were based on responses to a national household survey, not actual reports by drivers or police.

A person is assumed to suffer from IED when he or she has at least three major aggressive outbursts involving property damage and/or threats of physical harm. The authors argue that many cases of road rage and spousal abuse are linked to IED, and this is true by definition, since every impulsive aggressive episode counts as one of the three instances necessary to diagnose the disorder. But not every case of road rage is an instance of IED, and not everyone with IED engages in road rage. It is just that that road rage can, in some cases, be a symptom of IED. (Along the same lines, a person who thinks about suicide may be depressed, and a depressed person may think about suicide, but that doesn’t mean that everyone who considers suicide is mentally ill.)

In addition, this approach raises the question of what is gained by translating socially inappropriate behavior into medical diagnostic categories. Instead of calling people hot-headed or hot-tempered, we can now say they suffer from IED. This simply redefines socially inappropriate behavior as an illness. But nothing new about their behavior is explained by substituting clinical language for everyday terms. Moreover, this doesn’t clarify the threshold at which aggressive driving becomes road rage.

Finally, classifying road rage as a psychiatric illness doesn’t necessarily explain it as a social ill. The “16 million” IED sufferers is an upper limit defined as anyone who has had three inappropriate outbursts of any sort in their entire lifetimes.

In short, the new study neither proves nor attempts to prove that road rage is itself a mental illness. In fact, it has far more to do with IED than with road rage. But a rage by any other name might not make news.