Conversion Reactions and Psychophysiologic Disorders: A Comparative Study

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Abstract
A chart study of psychosomatic consultations was undertaken in order to compare characteristics of conversions and psychophysiologic diseases. One hundred nine charts were rated according to sixty descriptive, mental status, and psychodynamic factors. The subjectivity of many of these parameters is recognized, but was controlled by cross-checking scorings made by independent raters. Reliability, so measured, proved satisfactory in general but not for certain factors central to psychosomatic theory. Within these limitations, the results showed significant differences between the two classes of disorders in eighteen factors, including reason for referral, type of stress, intelligence, insight and depression. Among the traits traditionally considered distinctive, yet failing to differ in this study, were sex, religion, rural background, education, social class, and sexual adjustment. Psychosomatic theory has evolved from the unitary “unconscious symbolism” model through the very discrete distinctions postulated by Alexander and others. More recent trends, however, minimize the classical taxonomy. These results suggest some re-examination of our descriptive pictures of conversions and psychophysiologic disorders, but also demonstrate enough differences to justify our continuing to regard them as distinct entities.

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