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. Keywords: OCD cognition; cognitive domains of OCD; OCD beliefs Recent theoretical and empirical work on normal and abnormal obsessions has indicated that intrusive thoughts are a common phenomenon experienced by most of the population. Moreover, current theorists have proposed dimensional models and suggested that intrusive thoughts are rooted in normal psychological processes. Consequently, cognitive theories have focused on possible reasons that individuals with obsessive-compulsive disorder (OCD) react so extremely to intrusive thoughts. These theories suggest that individuals with OCD attach distorted meanings to intrusive thoughts-such as that they are indicative that one is bad, mad, or dangerous-which lead to excessive negative significance and distress and exaggerated maladaptive coping responses to neutralize or suppress the distress and intrusive thoughts (e.g., Rachman, 1997, 1998). According to Rachman's (1997, 1998) model, for example, people are seen as primed to develop recurring obsessions if they interpret intrusive, unwanted thoughts as revealing hidden abhorrent aspects of their own personal character (e.g., they are immoral, freakish, or dangerous). Several other theories have highlighted the role of distorted inferences and beliefs about responsibility and control as they are related to unwanted intrusive thoughts. Salkovskis (Salkovskis, 1985; Salkovskis & Kirk, 1997), for instance, has stressed that unwanted intrusive thoughts escalate into significant obsessions in people who have inflated beliefs about their responsibility to prevent real events from occurring because of their intrusive thoughts (e.g., thinking one can cause someone to have an automobile accident). The concept of thought-action fusion suggests a related pathogenic belief that merely imaging something terrible is associated with an inflated sense that one is immoral or will cause harm (Shafran & Rachman, 2004; Shafran, Thordarson, & Rachman, 1996). Clark's cognitive control theory (Clark, 2004; Clark & Purdon, 1993; Purdon & Clark, 2002) argues that the key mechanism for OCD is unrealistic beliefs about the possibility of controlling intrusive thoughts. Although these cognitive theories are captivating, one further issue warrants further serious attention. Because intrusive thoughts appear to be so nearly universal in the population, the question arises, How can this observation be explained? For instance, are such intrusive thoughts just the inevitable "flotsam" of the operation of the mind (Rachman, 1993), or could they have systematic, functional relationships to internal processes and external circumstances? What does it say about the nature of basic human psychological processes that most people report that they are having intrusive negative thoughts at one time or another? …