Prevalence of DSM-IV intermittent explosive disorder in Black adolescents: Findings from the National Survey of American Life, Adolescent Supplement.

Little is known about the epidemiology of Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM­IV) intermittent explosive disorder (IED) in adolescents, and no information is currently available regarding the relationship between race/ethnicity and IED among Black youth in the United States. Using the World Health Organization World Mental Health Composite International Diagnostic Interview (Adolescent Version), we estimated the prevalence, severity, and disability of IED in a national, probability sample of African American and Caribbean Black youth (ages 13­17) from the National Survey of American Life, Adolescent Supplement. Face-to-face surveys of 810 African American and 360 Caribbean Black youth were conducted between 2001 and 2003. We calculated lifetime and 12-month diagnoses of IED using diagnostic algorithms based on DSM­IV and assessed IED disability using a modified Sheehan Disability Scale. Overall findings indicated lifetime and 12-month IED prevalence rates of 9.2% and 7.0%, respectively. Lifetime prevalence rates of IED were 9.0% for African American and 12.4% for Caribbean Black teens. Within the past 12 months, 6.7% of African American and 11.5% of Caribbean Black adolescents met diagnostic criteria for IED. Lifetime and 12-month IED were associated with anxiety disorders. In addition, few teens with lifetime IED received any treatment. Findings are consistent with recent evidence that intermittent explosive disorder may be more common than previously considered, especially among adolescents. Significant acts of aggression and impairment are associated with IED, and low treatment rates indicate that more research on this disorder and intervention options is warranted.

Classification and correlates of eating disorders among Blacks: findings from the National Survey of American Life.

OBJECTIVE: To assess classification adjustments and examine correlates of eating disorders among Blacks. METHODS: The National Survey of American Life (NSAL) was conducted from 2001-2003 and consisted of adults (n=5,191) and adolescents (n=1,170). The World Mental Health Composite International Diagnostic Interview (WMH-CIDI-World Health Organization 2004-modified) and DSM-IV-TR eating disorder criteria were used. RESULTS: Sixty-six percent of African American and 59% Caribbean Black adults were overweight or obese, while 30% and 29% of adolescents were overweight or obese. Although lifetime rates of anorexia nervosa and bulimia nervosa were low, binge eating disorder was high for both ethnic groups among adults and adolescents. Eliminating certain classification criteria resulted in higher rates of eating disorders for all groups. CONCLUSION: Culturally sensitive criteria should be incorporated into future versions of Diagnostic Statistical Manual (DSM) classifications for eating disorders that consider within-group ethnic variations.

Prevalence of eating disorders among Blacks in the National Survey of American Life.

OBJECTIVE: To provide information on the characteristics of eating disorders based on nationally representative samples of African American and Caribbean Black adults and adolescents. METHOD: Conducted between 2001 and 2003 the National Survey of American Life (NSAL) interviewed adults (n = 5,191) and adolescents (n = 1,170) in their homes. Professionally trained interviewers used the WMH Composite International Diagnostic Interview (WMH-CIDI-WHO Organization 2004-modified) to assess DSM-IV TR eating disorders. RESULTS: Anorexia was the rarest eating disorder among African American adults and adolescents, with age of onset for adults in mid adolescence. No 12-month case of anorexia was found among Caribbean Black adults. Binge eating was the most prevalent eating disorder among adults and adolescents. Persistence of disorders was lowest for anorexia and highest for binge eating disorder among adults. CONCLUSION: Prevalence of eating disorders within the U.S. Black population varies by type of disorder, age cohort, gender, and ethnic group among adults, and by type of disorder among adolescents. Clinicians need preparation and training to recognize and treat eating disorders in ethnically-diverse patient populations.