Simulated Interpersonal Provocation and Fears of a Loss of Impulse Control as Determinants of Aggressive Mental Intrusions

Although cognitive models of obsessive-compulsive disorder focus on the importance of misinterpretations of intrusive thoughts, they have given little attention to where intrusive cognitions come from, suggesting that they are merely “flotsam” of the mind. The present study is a preliminary test of an analysis that attempts to examine whether intrusive thoughts might actually have systematic, functional relationships to internal processes and external circumstances. Specifically, we advance and test the hypothesis that intrusive thoughts with aggressive-harming content can arise because current goals or passage to desired goals are blocked or thwarted, eliciting threat or frustration, most often because of the perceived provocative or threatening actions of other people (whether real or imaginary). On this hypothesis, this can instigate the generation of accompanying spontaneous imagined mental scenarios or fantasies about ways to rid oneself of the threat (e.g., remove the persons who are posing the obstruction). These imagined scenarios and images, elicited by provocation conditions, produce intense, distressing cognitions for individuals who are afraid of impulses. The results of a simulated provocation design provided evidence for this hypothesis.