Psychosomatic Medicine 16:315-326 (1954)
© 1954 American Psychosomatic Society

Specificity of Peptic Ulcer to Intense Oral Conflicts

¹ Topeka State Hospital Topeka, Kansas

Alexander's theory of emotional specificity served as the theoretical background for the present study. With the belief that this theory has not yet been fully validated, a rigorous investigation into the specificity of the conflicts attributed to peptic ulcer was undertaken. It was hypothesized that individuals with peptic ulcer could be differentiated from individuals with non-gastrointestinal psychosomatic disorders in that the former would have an intense conflict over oral-dependent needs (a passive wish to suck or be fed) or oral-aggressive wishes (an aggressive desire to bite or devour).

To test these hypotheses, an experimental group of 20 cases of peptic ulcer and a control group of 20 mixed non-gastrointestinal psychosomatic cases were administered the Rorschach test and the Blacky Pictures. The Rorschach test was not scored in the traditional way, but according to the Affect Index of De Vos, a scoring system based on the content in the Rorschach test and containing categories of oral-dependency and oral-aggression.

A conflict over oral-dependent needs, as measured by the Rorschach and Blacky tests, did not significantly differentiate the two groups. On the measures for a conflict over oral-aggressive wishes, the ulcer group was significantly different from the control group. This difference was significant at a moderate level of confidence, but approximately half the control group scored strong on this conflict. Comparison of the two groups on other hostility or dependency measures in the Rorschach test, as well as other types of conflicts on the Blacky test, did not produce significant differences.

These results suggest the following conclusions:

A conflict over strong oral-dependent needs is not specific to peptic ulcer in the psychosomatic group of diseases.

A conflict over oral-aggressive wishes tends to be more common, intense, and chronic in peptic ulcer patients than in non-gastrointestinal psychosomatic patients.

Some psychosomatic cases other than peptic ulcer have conflicts over oral-aggressive wishes that are just as common, intense, and chronic as in ulcer cases.

This study does not disprove the theory of emotional specificity. The examination of one concrete illustration of a theory is not sufficient. The objection can be made that this particular conflict in peptic ulcer may be erroneous, while the specific conflicts found in the other psychosomatic disorders are still valid. Therefore, further controlled research into these other specific conflicts is necessary before the validity of the theory can be established or denied. Replication of the present study would also be in order. The findings of this investigation, while they cannot strictly prove or disprove the theory of emotional specificity, do strongly suggest that the theory should not yet be taken for granted.

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