Conversion Disorder and Multiple Chemical Sensitivity: A Comparative Study of Psychological Defense Strategies

Abstract

This study compared psychological defensive strategies in two groups of patients with multiple chemical sensitivity (n=10) and conversion disorder (n = 10) by means of the projective perceptual Defense Mechanism Test. We attempted to create a model for personality assessment based on the test data of prior patients, in which new patients could successively be tested. The overall results indicated that it was possible to separate the clinical groups significantly from a control group and from each other. In comparison to the controls, the clinical groups were characterized by patterns that were more nonemotionally adapted as well by a lateness of perception, but the ways in which the clinical groups maintained this difference were not the same. The multiple chemical sensitivity group was characterized above all by blocking maneuvers, while the main defensive strategy of the conversion disorder group was distortion of content.

Get full access to this article

View all access options for this article.

References

Acklin

M. W.

Bernat

T. E.

(1987) Depression, alexithymia, and pain prone disorder: A Rorschach study. Journal of Personality Assessment, 51, 462–479.

American Psychiatric Association. (1987) Diagnostic and statistical manual of mental disorders. (3rd ed., Rev.) Washington. DC Author.

American Psychiatric Association. (1994) Diagnostic and statistical manual of mental disorders. (4th ed.) Washington, DC: Author.

Bach

De Zwaan

Achard

Nutzinger

D. O.

Mitchell

J. E.

(1994) Alexithymia: Relationship to personality disorders. Comprehensive Psychiatry, 35, 239–243.

Bash

K. W.

(1986) Psychosomatic diseases and the Rorschach test. Journal of Personality Assessment, 50, 350–357.

Binzer

(1998) Motor conversion disorder: Clinical characteristics an outcome among patients with medically unexplained loss of motor function. Unpublished doctoral dissertation, Departments of Psychiatry and Neurology, Univer. of Umeå, Sweden.

Binzer

Andersen

P. M.

Kullgren

(1997) Clinical characteristics of patients with motor disabilities due to Conversion Disorder—a prospective control group study. Journal of Neurology and Psychiatry, 63, 83–88.

Binzer

Eisenmann

(1999) Childhood experiences and personality traits in patients with motor conversion symptoms. Acta Psychiatrica Scandinavica, 4, 288–295.

Binzer

Eisenmann

Kullgren

(1998) Illness behaviour in the acute phase of motor disability in neurological disease and in Conversion Disorder: A comparative study. Journal of Psychosomatic Research, 44, 657–666.

10.

Binzer

Kullgren

(1996) Conversion symptoms: What can we learn from previous studies? Nordic Journal of Psychiatry, 50, 143–152.

11.

Black

D. W.

(1993) Environmental illness and misdiagnosis-a growing problem. Regulatory Toxicology and Pharmacology, 18, 23–31.

12.

Black

E. W.

Rathe

Goldstein

R. B.

(1990) Environmental illness: A controlled study of 26 subjects with “20th century disease.” Journal of the American Medical Association, 264,3166–3170.

13.

Costa

P. T.

Jr. McCrae

R. R.

(1987) Neuroticism, somatic complaints and disease: Is the bark worse than the bite? Journal of Personality, 55, 299–315.

14.

Cramer

R. D.

Bunce

J. D.

Patterson

D. E.

(1988) Crossvalidation, bootstrapping, and Partial Least Squares compared with multiple regression in conventional QSAR studies. Quantitative Structure-Activity Relationships, 7, 18–25.

15.

Demers-Desrosiers

L. A.

(1985) Empirical journey into the measurement of symbolic function as a dimension of alexithymia. Psychotherapy and Psychosomatics, 44, 65–71.

16.

Derogatis

L. R.

(1975) SCL-90R: Administration, scoring and procedure manual. Baltimore, MD: Clinical Psychometric Research.

17.

Engel

G. L.

(1959) Psychogenic pain and the pain-prone patient. American Journal of Medicine, June, 899–918.

18.

Eriksson

Johansson

Wold

(1996) QSAR model validation. Presented at the 7th International Workshop on QSAR in Environmental Science, Helsingör, Denmark, 24–28 June 1996. Pensacola, FL: SETAC.

19.

Fenichel

(1982) The psychoanalytic theory of neurosis. Suffolk, UK: Routledge & Kegan Paul.

20.

Fiedler

Kipen

(1997) Chemical sensitivity: The scientific literature. Environmental Health Perspectives, 105(Suppl. 2), 899–918.

21.

Fiedler

Kipen

H. M.

Deluca

Kelly-McNeil

Natelson

(1996) A controlled comparison of Multiple Chemical Sensitivities and Chronic Fatigue Syndrome. Psychosomatic Medicine, 58, 38–49.

22.

Ford

C. V.

Folks

D. G.

(1985) Conversion disorders: An overview. Psychosomatics, 26, 371–383.

23.

Fransson

Sundbom

Hägglöf

(1998) A comparative study of adolescents in psychiatric care assessed by the Defense Mechanism Test (DMT) and the DSM-IV classification system. Nordic Journal of Psychiatry, 52, 527–536.

24.

Göthe

C-J.

Molin

Nilsson

C-G.

(1995) The Environmental Somatization Syndrome. Psychosomatics, 36, 1–11.

25.

Grafman

Schwartz

Dale

J. K.

(1993) Analysis of neuropsychological functioning in patients with CFS. Journal of Neurology, Neurosurgery, and Psychiatry, 56, 684–689.

26.

Hennincsson

Sundbom

(1996) Defensive characteristics in individuals with amalgam illness as measured by the percept-genetic method Defense Mechanism Test. Acta Odontologica Scandinavica, 54, 176–181.

27.

Hennincsson

Sundbom

Armelius

B-A

Erdberg

(2000) PLS model building: A multivariate approach to personality test data. Scandinavian Journal of Psychology.

28.

Höskuldsson

(1996) Predictions methods in science and technology. Vol. 1. Basic theory. Denmark: Thor.

29.

Johnson

D. E.

(1998) Applied multivariate methods for data analysts. Pacific Grove, CA: Brooks/Cole.

30.

Kirmayer

L. J.

Robbins

J. M.

Paris

(1994) Somatoform disorders: Personality and the social matrix of somatic distress. Journal of Abnormal Psychology, 103, 125–136.

31.

Kragh

(1985) DMT manual. Stockholm: Swedish Psychology International AB.

32.

Lindforss

Marqvardsen

Olsson

Henningsson

(1994) Effekter på hälsan efrer avlägsnandet av amalgamfyllningar. Tandläkartidningen, 86, 205–211.

33.

Marty

De M'Uzan

David

(1963) L'investigation psychosomatique. Paris: Presses Univeritaires de France.

34.

McDougall

(1974) The psychosoma and the psychoanalytic process. International Review of Psychoanalysis, 1, 437–459.

35.

Merskey

(1990) Conversion symptoms revised. Seminars in Neurology, 10, 221–228.

36.

Ross

G. H.

(1992) Treatment options in Multiple Chemical Sensitivity. Toxicology and Industrial Health, 8, 87–94.

37.

Rubino

I. A.

Verucci

Savino

M. L.

Hadjichristos

Saraceni

Hadjichristos

(1996) Percept-genetic codings of defense in chronic schizophrenia. Perceptual and Motor Skills, 82,483–493.

38.

Savaggio

J. E.

(1994) Psychological aspects of “environmental illness,” “multiple chemical sensitivity” and “building related illness.” Journal of Allergy and Clinical Immunology, 94, 366–370.’

39.

Sharma

(1996) Applied multivariate techniques. New York: Wiley.

40.

Sifneos

P. E.

(1973) The prevalence of alexithymic characteristics in psychosomatic patients. Psychotherapy and Psychosomatics, 22, 255–262.

41.

Sifneos

P. E.

(1975) Problems of psychotherapy of patients with alexithymic characteristics and physical disease. Psychotherapy and Psychosomatics, 26, 65–70.

42.

Simon

G. E.

Daniell

Stockbridge

Claypoole

Rosenstock

(1993) Immunologic, psychological, and neuropsychological factors in Multiple Chemical Sensitivity: A controlled study. Annals of Internal Medicine, 19, 97–103.

43.

Ståhle

Wold

(1988) Multivariate data analysis and experimental design in biomedical research. Progress in Medicinal Chemistry, 25, 290–338.

44.

Sundbom

(1992) Borderline psychopathology and the Defense Mechanism Test. Unpublished doctoral dissertation, Department of Applied Psychology, Univer. of Umeå, Sweden.

45.

Sundbom

Binzer

Kullgren

(1999) Psychological defensive strategies according to Defense Mechanism Test among patients with severe Conversion Disorder. Psychotherapy Research, 9, 194–208.

46.

Sundbom

Bodlund

(1999) Prediction of outcome in transsexualism by means of the Defense Mechanism Test and multivariate modeling: A pilot study. Perceptual and Motor Skills, 88, 3–20.

47.

Taylor

G. J.

Doody

(1985) Verbal measures of alexithymia: What do they measure? Psychotherapy and Psychosomatics, 43, 32–37.

48.

Wagner

E. E. A.

Williams

(1975) Comparison of Rorschach anatomy responses from psychosomatic outpatients and a matched group of psychiatric controls. Perceptual and Motor Skills, 40, 483–486.

49.

Watson

Pennbaker

J. W.

(1989) Health complaints, stress, and distress: Exploring the central role of negative affectivity. Psychological Review, 96, 234–254.

50.

Wold

Albano

Dunn

Esbensen

Hellberg

Johansson

Sjöström

(1983) Pattern recognition; finding and using regularities in multivariate data. In Martens

Russwurm

(Eds.), Food research and data analysis. London: Applied Science. 147–188.

51.

Wold

Sjöström

(1987) Letters to the editor: Comments on a recent evaluation of the SIMCA method. Journal of Chemometrics, 2, 243–245.