Intermittent explosive disorder amongst women in conflict affected Timor-Leste: associations with human rights trauma, ongoing violence, poverty, and injustice

Rees, Susan, Silove, Derrick, Verdial, Teresa, Tam, Natalino, Savio, Elisa, Zulmira, Fonseca, Thorpe, Rosamund, Liddell, Belinda, Zwi, Anthony, Kuowei, Tay, Brooks, Robert, and Steel, Zachary (2013) Intermittent explosive disorder amongst women in conflict affected Timor-Leste: associations with human rights trauma, ongoing violence, poverty, and injustice. PLoS ONE, 8 (8). pp. 1-7.

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Abstract

Women in conflict-affected countries are at risk of mental disorders such as posttraumatic stress disorder and depression. No studies have investigated the association between experiences of abuse and injustice and explosive anger amongst women in these settings, and the impact of anger on women's health, family relationships and ability to participate in development.

A mixed methods study including an epidemiological survey (n = 1513, 92.6% response) and qualitative interviews (n = 77) was conducted in Timor-Leste. The indices measured included Intermittent Explosive Disorder, posttraumatic stress disorder; severe distress; days out of role (the number of days that the person was unable to undertake normal activities); gender-specific trauma; conflict/violence; poverty; and preoccupations with injustice.

Women with Intermittent Explosive Disorder (n = 184, 12.2%) were more disabled than those without the disorder (for >5 days out of role, 40.8% versus 31.5%, X²₍₂₎ = 12.93 p = 0.0016). Multivariable associations with Intermittent Explosive Disorder, controlling for the presence of PTSD, psychological distress and other predictors in the model, included the sense of being sick (OR 1.73; 95% CI 1.08–2.77); victimization as a result of helping the resistance movement (OR 2.33, 95% CI 1.48–3.68); war-related trauma specific to being a woman (OR 1.95, 95%, CI 1.09–3.50); ongoing family violence and community conflict (OR 1.88, 95% CI 1.27–2.77); extreme poverty (OR 1.23, 95%, CI 1.08–1.39); and distressing preoccupations with injustice (relating to 2/3 historical periods, OR 2.10, 95% CI 1.35–3.28). In the qualitative study, women elaborated on the determinants of anger and its impact on their health, family and community functioning, child-rearing, and capacity to engage in development. Women reflected on the strategies that might help them overcome their anger.

Intermittent Explosive Disorder is prevalent and disabling amongst women in conflict-affected Timor-Leste, impacting on their health, child-rearing and ability to participate fully in socio-economic development.

Item ID: 28546
Item Type: Article (Refereed Research - C1)
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ISSN: 1932-6203
Funders: Australian Research Council (ARC), National Health and Medical Research Council (NHMRC)
Projects and Grants: Discovery Grant DP0987803, Program Grant 568970
Date Deposited: 12 Aug 2013 22:52
FoR Codes: 16 STUDIES IN HUMAN SOCIETY > 1607 Social Work > 160799 Social Work not elsewhere classified @ 10%
16 STUDIES IN HUMAN SOCIETY > 1699 Other Studies in Human Society > 169901 Gender Specific Studies @ 50%
16 STUDIES IN HUMAN SOCIETY > 1605 Policy and Administration > 160512 Social Policy @ 40%
SEO Codes: 92 HEALTH > 9205 Specific Population Health (excl. Indigenous Health) > 920507 Womens Health @ 40%
92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920401 Behaviour and Health @ 30%
94 LAW, POLITICS AND COMMUNITY SERVICES > 9401 Community Service (excl. Work) > 940113 Gender and Sexualities @ 30%
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