Psychosomatic Medicine 26:592-609 (1964)
© 1964 American Psychosomatic Society

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

II. Methodologic and Theoretical Considerations

¹ Adult Psychiatry Branch, Clinical Investigations, National Institute of Mental Health, National Institutes of Health, U.S. Public Health Service, Bethesda, Md. and Department of Neuroendocrinology, Division of Neuropsychiatry, Walter Reed Army Institute of Research, Walter Reed Army Medical Center, Washington, D. C.; Department of Psychiatry, State University of New York, Downstate Medical Center, 450 Clarkson Avenue, Brooklyn 3, N. Y.
² Adult Psychiatry Branch, Clinical Investigations, National Institute of Mental Health, National Institutes of Health, U.S. Public Health Service, Bethesda, Md. and Department of Neuroendocrinology, Division of Neuropsychiatry, Walter Reed Army Institute of Research, Walter Reed Army Medical Center, Washington, D. C.

The previous paper reported that it was possible to predict the mean urinary 17-hydroxycorticosteroid (17-OHCS) excretion rates of parents of fatally ill children on the basis of an evaluation of the effectiveness of their defenses.

This report presents in detail the methods used to make predictions. The criteria of effective defense and the interviewing methods are described, and the process of predicting and the problems related to it are discussed.

Using the described methods, a second independent interviewer was able to replicate the predictive success of the first interviewer.

Three case reports are presented, each illustrating a theoretical point relating to the hypothesis that the more effectively a parent defends against the threat of loss, the lower will be his mean 17-OHCS excretion rate. Each case also illustrates a problem relating to the method of evaluation of defenses on the basis of behavioral data.