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Psychosomatic Medicine 12:362-376 (1950)
© 1950 American Psychosomatic Society
1 Allan Memorial Institute of Psychiatry and McGill University, Montreal, Canada
Three individual case studies were undertaken in the interview situation in order to provide data supplementary to the data from group (cross-sectional) studies, bearing on the principle of symptom specificity.
Observations from present individual case studies are in line with predictions based on results from the group studies. "Subclinical" disturbances in critical symptom areas were noted in response to stress of interview, and in response to discussions of life situations distressing to the patient. These disturbances appeared to be specific in the sense of reflecting lowered threshold for disturbance in bodily areas associated with the symptom in question. Continuous study, particularly of one case, afforded the kind of repeated day-to-day study which established the consistency of the phenomenon.
Such findings constitute evidence for specificity of association between symptoms and physiologic mechanisms, and thus support the principle of "symptom specificity" which states that the particular physiologic mechanism of a somatic complaint is specifically susceptible to activation by stressful experience.
Individual case study of the sort employed here appears to be a promising method for providing detailed accounts of symptom mechanisms. The present study has revealed striking differences in mechanism (particularly with regard to temporal features) in 2 cases where end results in the form of symptoms were quite similar. The study has indicated that although 2 patients may both present a similar tensional symptom, the temporal aspects of the chain of physiologic events leading to elicitation and subsidence of the symptom may be quite different from case to case. This suggests that further detailed study of a larger number of cases may reveal hitherto unexpected differences in symptom mechanisms in cases with similar symptoms.
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