Cognitive distortions and emotion dysregulation in the association between intermittent explosive disorder symptom severity and violent behaviour

Abstract Background Intermittent explosive disorder (IED) symptoms are reliably associated with aggressive and violent outcomes, yet the mechanistic architecture linking affective dyscontrol to behavioural expression remains inadequately specified. This study interrogated whether cognitive distortions and emotion dysregulation operate as parallel or sequentially organised processes in the IED–violence pathway, and whether these structural relations exhibit gender-differentiated patterning. Methods A demographically heterogeneous UK general-population sample ( N = 791; age range 19–81 years) recruited via Prolific. Cross-sectional survey design with validated multi-dimensional assessment of IED symptom severity, aggression-supportive cognitive distortions, emotion dysregulation, trait impulsivity, and violent behaviour frequency. Competing mediation architectures (parallel vs. serial) were evaluated using bias-corrected bootstrapped inference. Trait impulsivity was modelled as an exogenous covariate. Gender moderation was examined via interaction terms. Sensitivity analyses included robust regression and cross-validation. Results IED symptom severity demonstrated a robust zero-order association with violent behaviour ( r = .58). In the parallel mediation model, cognitive distortions emerged as the only significant mediator of the IED–violence association; the indirect effect through emotion dysregulation was not significant, and the hypothesised sequential cognitive-to-affective pathway was not supported. Gender moderated the direct IED–violence association, with males showing a stronger association than females. Conclusions These findings challenge purely affect-centric accounts of explosive aggression by demonstrating that maladaptive cognitive appraisals, rather than emotion regulation deficits, account for unique indirect associations between IED symptoms and violence, particularly among men. Results reposition aggression-supportive cognitions as a theoretically and clinically prioritised target for violence risk formulation and intervention in populations characterised by impulsive anger dyscontrol.