Aggressiveness in patients with obsessive-compulsive disorder as assessed by the Implicit Relational Assessment Procedure

Objective: Psychodynamic and cognitive theories postulate a prominent role of aggressiveness in patients with obsessive-compulsive disorder (OCD). Explicit assessment of aggressiveness in OCD has yielded diverging results. The present study aimed to investigate aggressiveness in OCD using the Implicit Relational Assessment Procedure (IRAP). Method: Patients with OCD (n = 59) were compared to non-clinical controls (NCs; n = 31) on an IRAP using self-referential statements and the explicit State-Trait Anger Expression Inventory-II (STAXI-II). During the computer-based IRAP, participants were required to respond as quickly and accurately (“correct” or “incorrect”) to the relation of two presented stimuli (e.g., “I am” + “aggressive”). Results: D_IRAP-Scores for the I am aggressive trial type were significantly higher in NCs compared to the OCD sample (d = 0.73). Patients with OCD scored significantly higher on the Trait Anger scales and the Anger Expression-Out scale of the STAXI-II. The I am aggressive D_IRAP-Score correlated with the overall Trait Anger scale (r = −.33, p = .001) and with the Anger Expression-In scale (r = −0.31, p = .003). Conclusions: Patients with OCD were more ambivalent about their own aggressiveness than NCs. These findings were in line with patients’ explicit aggressiveness.