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Psychosomatic Medicine 26:576-591 (1964)
© 1964 American Psychosomatic Society

Relationship Between Psychological Defenses and Mean Urinary 17-Hydroxycorticosteroid Excretion Rates

I. A Predictive Study of Parents of Fatally Ill Children

CARL T. WOLFF M.D.1, STANFORD B. FRIEDMAN M.D.1, MYRON A. HOFER M.D.2, and JOHN W. MASON M.D.2

1 Adult Psychiatry Branch, Clinical Investigations, National Institute of Mental Health, National Institutes of Health, U.S. Public Health Service, Bethesda, Md., Department of Neuroendocrinology, Division of Neuropsychiatry, Walter Reed Army Institute of Research, Walter Reed Army Medical Center, Washington, D. C.; (C.T.W.) Department of Psychiatry, State University of New York, Downstate Medical Center, 450 Clarkson Ave., Brooklyn S, N. Y. (S.B.F.) Departmentof Pediatrics and Psychiatry, University of Rochester Medical Center, Rochester, N. Y.
2 Adult Psychiatry Branch, Clinical Investigations, National Institute of Mental Health, National Institutes of Health, U.S. Public Health Service, Bethesda, Md., Department of Neuroendocrinology, Division of Neuropsychiatry, Walter Reed Army Institute of Research, Walter Reed Army Medical Center, Washington, D. C.

Thirty-one parents of children suffering from fatal illnesses were studied psychologically. Urinary 17-hydroxycorticosteroid (17-OHCS) levels were measured concurrently. Throughout the extended crisis, these parents had characteristic mean 17-OHCS excretion rates along the continuum from high to low excretion.

The hypothesis was tested that the more effectively a parent defends against the threat of loss, the lower will be his mean 17-OHCS excretion rate. Criteria for "effective" defense were derived. Each parent was interviewed, and a prediction of the mean 17-OHCS excretion rate was made according to the criteria and independently of the endocrine data. The methods of interviewing and predicting are briefly described.

The results indicated significant correlation between the predictions and the mean 17-OHCS excretion rates. The 17-OHCS and psychologic data of a representative high and a representative low excretor are presented.

The authors suggest that these chronic differences between individuals in mean 17-OHCS excretion rates and effectiveness of defense are importantly related aspects of the individual's response to threat.




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