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Author:
Little, J. C
Title:
Physical prowes and neurosis: A study of specific vulnerabilty
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PHYSICAL PROWESS AND VEMOSIS
A Stu
in 22ecifto
Vulnorabilitv
Factor
Proross as an Astiological
Threatoned Physical
States in th3 We,
in the Genesis of same Fourotio
"For whera your tres-sure iss, there will
your heart be also. "
Hatthow.. 6.. 21
12.34
Luke
by
il c 1. L=nE
LMMS, 1965
COPY
BEST
AVAILABLE
V
00
ri
qI
ble
print
ity
-i
--
SYNOPSIS
PHYSICALPRaMS AND14M. CSIS A STUDYIN SPBCIPIC VU114MBILM
1, This study arose cut of pilot observations that a =mbor of male
neurotics had placed very high %mluation on poroorwU pýysioal prowess
and devoloped their nourosoo when this was threatened,
2, Furthor and more extensive observations oonfixm this initial
clinical
tut in'rospoot
Vot only in their dovotion to athletioiem
impression,
to'mu. W other variables thase athletic
g=p
nourotion form a distinot
whan compared with male nourotics who havo not boon inolined to
physical activity.
in
is
3o Tho link between athletioiam
male neurotics
common
neurooic
and
in tho literature,
but has roocived little
attention
4ý The outstanding
experience
of tho personality
and previous
charaoteristic
Con-mant
ia the povarty of =urotio
markars.
of the athletic
neurotics
dJLot= "There are no neurocos,
is made on Schneider's
only nourotioso"
5c) "Athletka"
are almost specifically
vulnerablo to threats to their pýyaioal
The converse
immu= to non-plVzior-l 3trasson,
well-boing and relatively
holds for the ron-athletic
wurotios.
is oharacterisad by a high
The emuing neurotic illness
in the athletic
dogras of ao=tio anxiety, but the pattarn of qmptcma is not
discrete to warmnt the term Osynd=ool
sufficiently
7, The pzychopathology of tho condition is disoussodg with special raforanoo
*surprise offoat'
to obseavionality
of the strass, and
of personality,
oultuxal and sooial influonoes.
8, Tho question
"Is high devotion
in itoolf? " is examined,
to pýyslcal
prowees a concealed neurociss
9, Thaso findings provoko a critical
examination of Ruasoll0a qu*z7 "Is
to breakdown-a gonaral charmotoristic .... or is it Gpecific
auseptibUity
to specific conditidna? " and of the quostion rhather neuroses are bamod,on
dotorai=d
oonstitutionaUy
vulnerabilities
or an aptoifio
miltiplo
predisposition,
106 Tha key role of obsossionalitj
of pdreoral#. y. the diffloultics
of
to zpaoifioity
evaluating this variable,
and its relation
of stmas
am disouscod,
11, The study amphasisas that there are three parwators
duration, and relevance to the particular
individual's
and life experience.
ef stress- intensity,
gowtic endortment
to possible
12, Variou3 view* exproo3od In the literaturos,
reforrinS
receive oo=out,, and a n=b, 3r ef
personality,,
origins of tho athletic
the prosont study am evaluated.
pointers arising fr=
differanoes bets-can athlotio
13, Tharc are signific=t
and non-athletio
as measured by the Uudslay
neurotics in Hourotician and ExtravorsioN
Ferzonality
Inventory.
14. Aztbropometric studies reveal significant
and ipportant differo=oa
between the two groups which throw considerable light on tho problea
In term of oompen3ated
and land support to an Adlerian interpretation
irferiority,
15, The possible genctio basic for
of the Athletic
characteristics
some of tho most outatmuUng
Personality
is discussed in detaiL,
Oathlotio'
in
16,, ronew up studios indicate differing
for
neuroses
prognoses
indicates certain
cloro =Jysis
malo'subjedts.
and 'non-atbletic'
features ffbioh distinguish
athletic
neurotics who do badly from those
is diGOUGBOd
who do well. and the significance
of these characteristics
in terms, of the general theory.
17, Some emergent trends apparent in thog as yet,
encephalographic investigations
are reportod,
18. Illustrative
caso histories
an
early stages of electrowith due isserration3.
given,
190 ThrouShout the study omphasis, is placed on the valms of we need for
highly discriminative
stuaics at the present stage of evolution of
disordorso
inquiry into tho nature of psychiatric,
parar-cientific
20.
The results of the stuay have considerable practical
siguifica=e
deflining a discrete nourptio &etiological
oo=only
oonstellation
with in routine
clinical
of these
understanding
indirectly
contributes
in
mot
The study promotes identAfication
practice.
oaaan,, allows one to hazard a progno-3ia,, and
to preventive
psychiatry.
and
21, The study adds to owr gonoral understanding
of the aetiology
of =ur0t: LO
in peaoo tizie,, neurotic
the view that,
breakdown
8tgtoss, and fa*ours
factors,
specific
as a response to highly
proolpiteuing
meaningrullv
is probablv
ivlatod
to the individuals'
constitution,,
more oo=on than
the nourotio
m1adaptation
which ja an eVrocsion
of a general
tondoncy to breakdown undar non-specifio
Even within
the
stressoa,
non-athletio
is quite limitod,
group the range of streanful
experiences
22o The distinction
of Deprivation.
in uphold
betwoon. Neuroses
of Contlict
sad Wcuroao3
23. It in maintained that in general it is just in thogle
9re as of
PvcholosLoal
satisfaotion
whioh are moat valued that maiim=
lJos - "for whera your tregaurc ia, there
vulnombility
will
your
hovxt be also(, "
ACKNOWLEDGEMTS
"No one oan take from us the joy of first
becocting aware of
But if we also demand the
smethings the so-oalled'disoovery,
honour, it oan be utterly spoiled for us, for we are usu&14
it is simpýy unoonaoious conosit not to admit
not the first0',,,,
"
frankly that one is a plagiarist,
(Epigram plegiarised
from
Goetin.
Lawelot Law fttG
in "The Unoonsoious
lxbfora Proud. " 1960) *
-
ill -
ACMOWLEDGFMTS
The clinical
which form the basis for
this
thasis
assessed and recorded by the
items were personally
care,, all
personal
who supervised
but no one can carry
contribution,,
vaouva:
one in enormously indebted
to those colleagues
kept one's original
to those who have already
published
level
forward
help,,
come
given advice and
and through their
enthusiasm at an effective
to the investigation
during tho years when
level
has been threatened
have
interest
continuing
by ever pransing
demands.
Foromost I would like
Martin Roth viho, inspired
to express my deep gratitude
the stuay by indicating
PhellcmanýD of neuroses in athletic
pos3& quostions
Initially
study in a professional
out a scientific
who have variously
and ideas,
with information
clinical
individual
to mwW aspeota of the study* and. at a more personal
work relevant
attantion
at follow
pationts
is an oriGiual
seniss the Investigation
strict
all
the statistics,
calculated
and personally
In this
tests,, personally
and scored the psychological
recorded all. the body measurements,, interviewed
up visita,
are
under his
the authorgs own work" in that the cases wera an
"entirely
author,
studies
fired
and familiarised
on the topic
*menand'in
which require
in me a curiosity
to Professor
the existence
of the
meatings over the years has
an answer.
about the aetiology
It
was he who
of neurotic
me with some of the methods for ur-mvelling
statoo
their!.
mysterlax,
To the late
for
offering
Pnfessor
me a part
G,,R, Hargreaves I am particularly
time Lectureship
indebtod
in the Department of Psychiatry
1;
1
at La3dis Ualvoraity,,
which made it
for me to find
possible
ths tima to
carry out the study over tho throo 7ears during which I held the
To his successor,, Profesao. r Max Hamilton,
appointment,
the forobewwwe
he has shown in his efforts
for
statistics
clinical
must be grateful
for
I oannot single
the University
All mathematical
research workers, )
his
book "Looturos
exoellent
(Ilamilton..
Rmaroh"
Clinioal
to tram fozm me into
as he expounded and advised on the prinoiples
rumerato pbyziciae
out for mention by naw all
of
tha members Of staff
Of
Professor
Officer
of Health
demogmphio
useful
Univarsity
Departmant
porplexing
statistical
for
helpful
of ftford
to pursue s=9
with rigard
information,
of Mathematics
problems.
manuscript
of Sooial
StuUca
to the
and Professor
time
Lead1s,gave me of their
whilo
helped
Of those
to gdngle out Dr. E. Slater,,
time,, unpublished
ways; in ww
of idean takeD PI&OO, Mr.
Grebaniak of the Dopartnent
Bmdahawl, Medical
in various
tests,
ohoioo of pay0hologloal
Parnell
troglodytes
on tIxi Nothodology
who have helped and inspired
R. Wobster and Jdr, L, Lee were partioularly
I rould like
of
1961)
medical contra much cross fortilisation
provided
"a
Department of Psychiatr. V at Leads and of the Poyahiatrio
Unit at St. Jwes'so
active
for
I am grateful
on genetical
with
Dr, Welsh of the Leeds
some partioUarly
who helped
who kindly
by oorrespondecoo
loaned me ang, at the
aspects of n3urosins, and Dr., R. W.
and Dro J. M. Tanner of London who w3ut out of their
of the problems &rIsing
out of the anthropometrio
investigations,
I would like
and
to pay special
tribute
to Dr., S. B. Finlay
of the
way
-v-
of th3 Skin Fola
for
Caliper,,
Officer,,
Hedioal
to
treuble
tlzm,
that
record
not
D
least
for
this
extra
load
Finallys,
for
their
caro
mat only
typed
I
the
would
H. E. G. 68o
cheerful
in
preparing
it
but
to
showed
thank
the
to
way in
Hospital
deal
a great
to
indeed
they
which
of
insisted
them.
Miss
D, Kirby
manuscript
genuine
gone to
I am VGrY (; MtOf'ul
and enthusiastic
was no trouble
like
and ecApalpmont
James's
at St,
have
D, A, Brookes,
the
and aseass
R, J. Stillq
promises
Neurophysiologist
Consultant
Mrs.
Dr,
with
and
investigations,
and other
and hits B, E, G, Recordist,,
also,
to ms their
made available
the anthropometrio
Dr, K, A. Exley,,
but
own results,
no the u3o
twzght
uh,,) not only
to ease the calculations
tables
supplied
to me his
made available
Senior
Haialth Ssrivoa,,
of Lesda Studant
Urdvurvýtly
interest
and for
in
and Wra.
the
the
fact
story
P,
H, Pennock
that
as it
they
unfolded,
GONTEITTS
Page
I
synopsis
Hi
Aolmowleagements
I INTRODUCTICIN
STRESSANDNIMOSIS
0,00
00
1?
reua,, Adler,, Jung,, Mayor
000
0a
Conditioning Theory ,
41
00
a0
Specificity
of Stros6
0
0
co
00
00
ORGANISATION
IN CLINICAL RESEARCH 0
PERCEPTUAL
4)
09
"Splitting
and Imping!,
000
a
Avoidarwo of Perceptual Set
0
006
00
PILOT OBSERVATIONS
-a00.0a
000
0
boum31S
obssi-iationa and HypothcisaB concerning Athletes and
POVEM OF REFEMICE TO NEUROSES
IN ATHLETESIN THE LITZHATURE.
ILLUSTRATIVECASEHISTORIES
0G
4)
000
nUMMUAL
2
3
5
8
13
15
15
17
21
AWD MMODS
27
27
30
31
Selection ana Criteria
000
Dofinition of Athleticism
00
The*Clinioal Investigation: Items Assessedand Reo;rded
MoreDefinitions
0000
4) 00
1311RESULTS
STATISTICAL ANALYSIS
Family and Childhood
a0a00
0
40
0.10
Psychiatric
Illness
Family historY of
Quality of Relationship
Parental Harmony
.0
of
the Single
0
0
0
0
0
4
6
4)
0
0
0
421
Drive
Patient
as
0
&
0
0
0
a
0
durir*
0
0
0
0
a
childhood
0
40
6
a
0
&
0
.0
a
38
38
38
29
41
42
43
43
43
44
44
51
51
52
52
4)
0
0
0
0
0
41
0
0
.
0
0
0
0
during the
0
0
0
0
0
Illrees
d Other Traits'
Woup, ailon'and
Social Claso
Marital and Sexual
900
Marital Status
000.
a
Uarital Ccepatibility
4)
Sexual Relations in the Married Patienta
in Sexual Intercourse
a Satisfaction
b HarmorW/Sex disorepanoy ,.
()
Sexual
a Deterioration
in
Sexual. Attitudes
0
0
to Parents-
Family Size
00aa
Childhood Neurotic Traits "0
Happinessin Childhool0
Childhood Health
00
famlij
Inoidetwe or 3i&Uicant
Par,ontal Deatbis
4)
00
Adult Life
000
Work Record
00.0 Traits
PredominantPersonality
a) Sociability
00a
b Obsessionality
'o 'Nervy' Personality
0
0
0
0
0
.0
0
40
0
0
0
0
0
0
,
0
53
53
54
55
58
58
58
59
59
59
60
61
Pagra
62
62
72
73
Tho nl=sa
0
00
0
Precipitating
Events
0
0a
00
Compannation, Issue
00
0
0
4)
0a
ý at onset of Illness
00
0
0
Age
to Psychiatrist
at referral
6
00
00
Diagnosis
CIA oal Featuregi and Psychiatric
"
,
Fosults
Definitions
and
0
to
a
OF THE CLINICAL IN'VESTIGATICH
SUHMM OF MAJOR"FINDINGS
73
76
76
90
XV QO!.
aWT CK RESTJMS
A,,GH4Z1AL
.0000
Po3silae, Blab in .Case Selection
Mrther
a0
incidence
check on relative
a
4)
of mathlotid
41
0
94
94
00
00
typ o" nour0sis
in nalos
in affecting
Comparisons
Difficulties
0
0
IN THE PRE90BID
B, RELATIVEABSENCEOF NEUROTIC11ARKERS
WERIERCE AND PERSONALITY 0000
a
Family and Childhood.
0
9)
a
Adult Life ,00000
0
IntOr-porsorsal Relationships
4 Marital and Sexual Relationships
5 "Broken Homes,"
;
O
*
l
General Commenton bov Results o0
(6) Bereavement in Chikdhood
Results in the Present Series
a0
0a
4)
9)
4)
0
Critical
Conclusions
0
4)
000
100
100
161
102
1011).
107
103
109
109
109
Digression
000athe Literaturo
Roview'of
96
97
110
C,
a
0
(7) Incidence of Plwisioal'Illuass
in the Family or in Self
during ohildhoo4L
.0
(8)*, Sooial Class ard Neurosis
Compensation Neurosis and Accident Neurosis .
00
0
CQ THE ILTZESS
Q0
0
0a0aa0
(1) Age at Onset of the Neurosis and at the time of
Referral
Psychiatric
.0a
:
Featuras'and Psychiatric
(2) Clinical
Dlagno; is
4)
0
0
0
117
317
3-18
121
123
123
3.26
V FORMULATICOOF
A PSYCHOPATHOLMYOF THE ATHLETES' WELTROSIS
Begreifen
and Verstoben ,000
0
00
Excessive Valuation of PIVaical Prowesa-.A3.1the eggs
in ono basket
a
a
00
tMoholison ard ChurchJ21
0
a0
00
Sbaw
ie
16;
Gv
The goat VbInerable AV: Jung,, COM
mk
o"
-aci,
as
j
lNeuroses of Conflict and of Nprivation
0
00
0
Tho role of Obse3sionality
00
0
0
Go 0
The OSurprisol EfTect
Autonomic Imbalance Panios and ftochondriatifs
"
00 4)
,,
Cultuml and Social Influenoes
,.
0
00
00
Fr6ud we Types of *fturosis
a00
4)
0
4)
00
4)
00
0
129
130
131
132
1Y+
IN
137
139
140
142
i"i;
14 ii
I
S
Fag*
VI IMPOTHETICALQUESTICHIS ATHLETICISMNEUROTIC?
IS EXCLUSIVEAND FANATICALDEVOTICHTO PBYSICALPROWESS
A
CONCEA (SUBCLIHICAL) NEUROSISIN ITSELF?
0C0a
145
VII THEORYOF SPECIFICITY
OF STRESS
How Closely are these hators
Linked?
3.47
e 147
(1) The RemoteAetiology (Constitut: .,,
L04 4,4,4)
0
4)
(2) The immediate Aetiology (Immediate or Proximal
Factor)
precipitating
147
illne;
*
(3) The Romiing Yhlaftntilwa Re;pons; (TY; O Of ]NGur;tiO
s)147
Further Analysis of Specific Vulnerability
149
in Male Neurotics
Was who carry a Double Vulnerability
149
Specificity of Pathological Reactions
156
"
itres;
Differontial
Immunity and Susceptibility
to
and Us
Meaning of an Hzparience for the Individual
157
co
0
"
Personality, Stress,, and Payohiatrio Innesis
163
006
A Review of the Relevant Litei-ature
3.63
0
0
00
CP
Obsessional Personality Traits and Specificity of Stress
Response
166
and
,0,1)
a
000000
Per3ons with Multiple Constitutionally
Determined
Vulnerabilities
167
and persons Specifically Predisposed .
0
Animal Studies
171
co
4)
4)
0
00000
The Uniqueness of the Individual
172
0
,0000
Prediction and the Three Parameters of Stress
173
0
40 0
VOME
VIII
Ix
THE ORIGINS OP ATHLETICISM
PSYCHOLOGICAL
FACTORS 4)
C
40
aa0
co
0
Psychological
Test Results:
YAudsley Personaility
Inventory
IN' and 'B2 Scores in Athletic and lion-Athletio Vourotics
Comment
000
4)
41
41
06aa
.
Athletes,, Neurotioism and Autonomic Lability
00
.
Psychological
Considerations
Psychoanalytic Views on*the Origins of Athletioism
Adler and Compensated Inferiority
,041)00
Distinction
between different
qualities
The Significance
Group Size
of Sibling
Fami2y Tradition
of Athleticism
PUSIQUE AID ATHLETIC PROWESS
0G000
Review of the Literature
Galton:
Plarodity
and
Q
Outstanding
4)
Athletic
of Body-prib
.000
0
4)
186
187
0
a0
0a00
Prowess
Ussomorpby mid Delinquency
0000
Masculinity
Prowess
and Athletic
,0000
Harvard-Studies
00
.0 4P
6000
.
4)
Word Studies
to
0a
9
.0
4)
00
175
0
175
0
175
,
178
0 184
4)
188
4)
189
4)
193
a
193
a
194.
194
0
194
a
194
41 196
0
196
4) 198
0
l .z. L "-i 1ý J
ý,, Q ý.
Page
Anthr..Ipozoopio and Anthroponotrio
Methods
000
Disoriminant Funotion Seale for AndrcSyW
00a
Bocly Index
0
45
0a0
00
40
000
000
Ponderal Index
L. B, U. and BocV Fat
a00
41
0
Rosults in the Present Series
00
00
(1) Tabulation and Anal.*sia of Findings on Applying Tanner's'
Diacriminant Iftwtion
Soales'for
Androgyny
2 1 Rees-Eysenok Index of Body' Build (I, B, y
.
3 Ponderal Index (P, I, )
4 Stature
000
00
40
00
5 Estimate of Loan Body M&,
ss and Body Fat ,
000
aumm
EMENCE FOR OBSESSI(3RALITY
W PFMONALIZY
00
Review - Diffioulties
and Defioiewias
000
00
Note on Further Hental Tests
0
00
4)
Self-Rating
Questionnaire
Test
Gough's Rigidity
00a
060a
FINAL. COMMENT
CR THE ORIGINS OF OVERVALUED
PIMSICAL PROMS IN
THE LIGHT OF THE RESULTSOF THE PSYCHOLOGICAL
TESTSAND OF THE
MTHROPOIWRIC STUDIES
199
200
202
203
203
2.07
26ý
212
212
213
213
215
215
216
216
216
218
IX GENETICALCCKSIDERATICKS
EVIDENCEFOR M HEREDITARYCOMPONXiT
1(3) Extraversion and Neurotioism an Nasured
the Vaudeley Personality
laventory
In 2) Obsessiftial Personality
Traits
Pbycique 'and AndrosM
Vulnerability
Pluridimensional
by
a
223
aa
224
224
225
227
X FOLLOWUP STUDIES
D33TEMCES IN PROGNOSIS
so** o0000
COMMT ONPROGNOSIS
ANDFOLLOWUP STUDY;
4)
229
233
000#
'ýlj'-Differenoei. -b'etw6enAthletic and Non-Athletio Neurotics
.
2 Difference in prognosis within the Athletic Neurotic Group
THERELEVMCEOF THIS STUDYTO COMPENSATION
CLAIMS
000
XX ATHLE,
AND
",ICISM, NEUROSIS
THE ELECTRO-ENCEPHALOGRAM.
'MaturILtyl
of Rooord - Tentative
Report
.,
41
233
237
21+3
244
00&
caRFIDOCH IN
ni
THE FINDINGS,,
246
APPENDIX I
origima
item shoat
f44 Athletic
Neurotics
28 Non-Atbletic
Neurotics
0*R,,
12-17
APP34DIX IX
ease histories
of
f15
26 Athletic-Neurotics
Non-Athletio Neurotics
REFERRICES
1-61
s.
.
62-99
S.
.
R,E.1-13
I
INTRODUCTION
ft I*
STRESS AND NEUROSIS
It
is
a commonplace that
symptoms under
illness
that
certain
It
stress.,
is
exogenous factors
persons
play
What,, however,, are the typos
The list
h=*,,
is
almost
physical
masturbation
loss
increased
with
superiors
ezaaination
failures,
broken
disoLpline,
boredom,
head injurys.
ova could
go on -a
conceivable
type
It
is
genetic
aocial
that,
as not
apparent
a sensitivity
influences
possible
Id
anVor
to group z=e
theme and detaimine
life
these
retirements
people
challenges,,
experiences*
am
scruples
religious
ohallengeo
dayplop
there
must
To what extent
which involve
a
the extent
to which a stress
to the previous
and genatio oorrelates,,
or group of stresses
constitution?
is it
camon
are
and deteming
relates
be
from
derived
the optimum, ages at which these stresses
the personality
-
every
and pbysical
all
bereavements
experience,
in the constitution
of these stresses
operative,,
meaningrully
with
bearings
wbioh includes
of payohologicals.
further
a vulnerability,
battlo
immigration,
pastiche
adolesoenoop
3.033 Of ViSiOno
or. pýmnts,,
engagement,
veritable
symptoms when face
neurotic
child
from
separation
or after
experiencýq,,
responsibili%,
relationshipa
to school,,
during
sexual
genesis.
which are involved?
of stress
- going
neurotio
qua ncn of nourotio
in their
a part
emancipation
marriagel
guilto
of limb,,
di ffioult.
inexhaustible
illness,
a sine
almost
develop
win
*
FREUVSADIMI, JMI(;
focussed a ttention
i=ediate
ignored the. rature
precipitating
inf=tile
in the effort
. it.
developwnt
lie
Tho "ediate
IM
expezIenoep..
claim that it
at which the traumatic
create
levels
and oral
the foundation
This ýTheor.T only bwsoo'283
of subsequent oral
the different
conflicts
Adlerian
symptom fomation
attompts
optimum adjustment
to the. 'social
studied
instinctual
infantile
(Feniohelp'1955),
*
the
of
ego,
of the site
the selection
f'zm
character
has especially
with refereDoe to a theory
for
neurotic
of Oripu Inferioritys
symptoms by Inducing
and psychological
attitudes
and
of
environment in
lives,
which the individual
JungLan tharapy
offers
to radse the middle-aged
self-absorption.
attitudes
explains
to promote relief
are claimed to
and awl
obanctorology
the later
theory
oxawplý,, fixation
for
ways in which those different
influence
sexwa
occurred which dictates
experiewe
of infantile-sexuality
developmerObs, "Psychoanalytic
back
and further
further
the nature and form. of the ensuing neurosis;
at the awl
of
is b"assed
stage of infýntile
is ti,.
of Mental
in disturbances
situation
to traoe the supposed origins
to tho very earliest
. p. ari.
illnegs
neurotio
sexual experience..
Qf the
aiýd signifioame
For the Freudian the roots
eveAt,
and in particular
illness
The FnudiaD
on constitution.
almost exclusjý(4
approach has largely
stýtOB have
on the gonesis, of nourotio
thaories
TjwUtionsl
g--IZM.
a mystical
neurotic
Psychological
holistic
sufferer
'types'
philosopby
of life
above his pathological-
are described
but these
are not specifically
illness
or
to
form
the
Of these,
%be Jbyerian
history
attempts
adjustment
enquiry
balance
sheet
and demonstrates
is unbalanced.,
attractions
in its
tends
longitudinal
study
of factors
physical,
in favour
system it
biological
of
of
and
occur when this
As an explanatory
to be vague and lacking
the
life
of
psychological
how 'reactions'
thorough-going
to pay much
7he field
maladjustment.
genetic,
follmers
situation.
its
with
covering
equilibrium
can be hold
the im. wdiato
of
those-Provoking
ranges widely
e
and Sullivan
a cumulative
against
factors
social
approach
the
and some of the neo-Freudian
L. Aloxander
to the mechanics
attention
initiaton
which
i tsolf
illness
the
of
Adlerians
only
of Karen Homey,
to the situation
ralated
holism,
has real
but in practice
in definition.
CONDITIOTMD
An understanding
Yields
information
more precise
This
and reBponsea
an object
or situation
anxiety.
This
threat
in
during
threatening
to that
the original
so in
in itself
or situation
object
contemporary
respect
emotional
resembles
responaeo
it
object
(stimulus
inappropriate
or situation
At some later
or one which
phobian:
in a. situation
to the original
(U. C. S. )o
or situation
between atimulus
my provoke
to origins
(C, S. ) became conditioned
stimulus
and man
the caBe of irrational
threatening
be traced
which an innocuous
innocuous
some particular
not
the relationshJp
about
is particularly
can frequently
time or place
mechanisms In animals
of conditioning
related
unconditioned
time,
in general
generalization),
of real
exposure
or in
evokes
In higher
the response
aninimls
phenomonon than the simple
the vork
normal
account
stimulus
direct
behavioural
in
#Bonds' are present
together
in
discrete
"the
studies,
fourth
the bondavould
conceptual
and units
is
generalisation,
through
vulnerable
Pavlov's
build
dogs in
is
discussion
sufficiently
of
this
Conditioning
that
the mode of expression
Consider the child
through
anxietya
are almllar6l.
may offer
of neurotic
situations
has beco=
1938).
will
Favlov's
of
'(Thorpe-1956)
may be seen
abnormally
and Jams
For a
(194)o
in some cases
an explanation
manifestations
once establlshedý
for
anxious atate., possibly
pain and anxiety
in no need to
the anxiety
sufficoo
with rheumatic fever,, hospitalined
Joint
there
If
repetition:
one exposure
time and in consequence in a highly
by parental
(Frolov.
flood
ideas
Often. as was the case with
sensitisatione
again
of linIZing
by some process
presumably
individual
phenomenon see Little
theory
Uport.
'which assumed that
of a imilaELtZ
provokative
potent
and,,
(1898) work,, which preceded
discrete
response
stimuli
Of the e.-Esential
rihich
the Leningrad
up a conditioned
aroused
for
previous
physical
are capable
those stimuli
to hava a common theme to which
take into
only
threatening
which
moke readily,,
apparently
not
in its
of response,
the principle
tend to link
Thus several
contras
by
those more co=, lex
one n=t
those of
context,
in Thorndiketo
which viere inherent
familiarised
reaction
complex psychological
the higher
stimuli
a more complex
to the organism
the highly
the abnormal
- response
reactions,,
stimulus
but also
environments
eapecially
physical
is
When con3idoring
of neurcphysiologistoo
and abnormal
to stress
becom linked
the first
aggravated
so firmly
that
.
in later
Another child
experiences
and is short-ternporod
adult,,
situati. on evokes joint
years an anxiety-provoking
and headache,
the latter
attacks
in con3cquoncee WB
Mentification.
maternal
dovelcps
her mother suffors
anxietywhan
and rejecting
through
partly
pain.,
Mie mechanism in
tliese
as an
child,
and the liwking
of anxiety
througJi
to anxiety
vhen provoked
of migraino
cases is a variant
so=
the
streseful,
situationo
classical
conditioned responso for there is no bondingr of response to
stimulus but a strong and lasting
an irrolevant
of the original
of
intoraction
reciprocal
stimulus and re3pon3o. An analysis of such cases offers
an explanation of the choice of sympto-w and to someextent explains the
of the neurosis*
precipitation
Ey,sondc (1960) has maintained
A
and the higher
traita
high
14buroticiam
degrees
of acme of
the results
in considering
of autonomic
lability
of
these observations
this
personalitY
with
associated
on the Maudsley Personality
scores
The relovance
response is
the conaitioned
induced in persons showing introvorted
easily
particularly
that
Inventox"yo
becoma apparent
vill
3tudye
SPECli.PICITY G', SIMEW
To return
to the basic
question
to its
antecedents
and to its
man in
the otreot
knows,, thero
show a tendency
development
of severe
inadequato
of relating
effects,,
every
constitutional
psychopath
symtom34,
nourotices.:
described
upocificany
from an early
any stressful
These patients
(1939),
ago
situation
comprise
variant
one
-'
by Henderson
knows,, and the
psychiatrist
are somo personswho
to break down unaor almost
of neurotic
stress
of-which
the &cup
is
the
The'
every-day
ý
xvith
cliallenges
adaptive
which
in
burden
-a
the strict
isenne.
the undesirable,
in deneral
for
presenting
ýVactice
At the other
critical
'neurotics
help
madical
do not
lie
and invulnerable'psychologically.
if
point
the stress
is
American physiologist
occasion
had its
(the
#breaking
floods)
had also
with
U*S* troops
only
an estimated
attitudes
this
that
at all.
Itought
man has a breaking
every
iapossiblo
is
of
ofwhom
picture
to its
brain
in combat convinced
7% would prove
the observations
that
provided
applied
Tinfortun ately,
to prove.
"Just before his death, Pavlov told an
that
pointt-
found and properly
is hold
(G. Ekstein)
Leningrad
(1958)-
majority
to this
enough,, but
Sargant (1959) rcportso
and the
those vvho are extremly
It
great
personality
and rejecting
1, tho great
confom
the scale
end of
an inferior
see Watts
the
image of the
of nuch personalities
but understandable,
tend to embrace all
society
the pcpular
and to othersp
Por a description
they present
problems
to himself
defeat
of existance
From -such cases derives
mechanisms.
'neurotic'
ingrediont
are an essential
made on this
him that
convinced
the appropriate
and nervous
Grinker
stress
system. "
invulnerable
if
Uas
Expcricnce
(1945)
and Spiegel
exposed
dog
overy
that
to battle
stress
indef initely.
It
of
would
be extremely
the aetiology
with
a constitution
develops
certain
and invulnerable
neurotic
illness.
neurotic
states
nhich
would
the nature
and/or
this
contribute
single
of people
life
that
oxneriences
to one particular
the commonly accepted
further
of
in a group
influences
is vulncrablo
to any of
It
if
gonetic
to any theory
aa a contribution
to demonstrate
of neurosis
in association
only
illuminating
stress
precipitants
to our understanding
stress
could
be
of
of
7
'.
related
meaningfully
alone
activates
to other
indifferently
Professor
susceptibility
this
adverso
the hypothosis
oonditions? "
at
about
this
highly
ono type of
why thin
In Individuals
who reaot
atiorali.
(1953) Poses this
to breakdown a genoral
is
havo brought
damonstrato
vulnerability
co=on
R., Russell
of us -would agree
to specifio
uhich
and vw could
vulnerability,,
specific
stress
to tho factors
"is
key question:
charactoriatio,
the mownts
at) I think most
or is
it
specific
9-
PAMCEPTUALCRGUilSATICEI TH CURICAL
RESEARCH
"SPLU.
"TING AND_.
LUL?IUCr"
are dissatisfied
Ijavy psychiatrist
dinSC03tiC classificationev.
that
definitivo.
obscure differences
state,, " though useful
between groups within
made for. example, when wo: imvestigate
the laxser
(Nayvr Grose, ; 92k
oftirophrenia,
1945) atd sohitophrenifom
19508,1960)9 the lattor
an not
Frogross is
..
four baaic
group.
beyond the triLditional
and identify
Heduna and XdCulloqN
ter=
based on such broad goneralisations
StatiCtios
types of sohisophrenIa
descriptive
such broadly
"I"aohis: ophr-ania,, " "a=iety
as "dopraarjJLRrý,.
aufficiently
payohiatriO
not because they assume tboue divisiorSto
but becauzo, they feel
be invalid,
with trnaitiozal,
now inolýý"
disordera
(LanSfOldt.
the isohisophrenia-Mo
psyohos0a
(SlatOr
(1963ý..
1963),
Beard#
desoribo
Roth
XUoh
araof ýp14epay.
and
,...
the latter
as "one of a group of aMtm&tJLo sohizopl4vnias aecoolatod,
uith
ditease
cerebral
pFoýsis
or exopnous
factors
study defite
Dignificanoo
in schizophrenia.
hiatria
a defiolonoy
at that$
Medicine,
thuo cbaýur"
aetioloay
the fact
It
if' an
*
oacea. px:eaenting
olassifiod
in
that
with
an "annemis" and
thare an mazkytypes of
andý what in of partioular
study 0 that aqr particular
ono a,etiology,
(i961)
of goýd, and. poor progqojýtio
of haom0globin were finally
amemia of different
to this
Simon mdftýt
nosology has been at a Otago oompýrable to that
uhich would obtain in Internal
left
which carx7 a bettýr
than "iai 9pathi 00.50hisophrents.
nn important
P
factors
relevanoe
type of anaemia may have more than
is only when the different
entities
within
tho
p
hava been acrted
broa-Clor pgcupinga
ba mandein linking
Analynis
aetiology,
Unqualifiod
generalisationz
bts generalisations
useful
of familiar
of a host
clinical
about
medical
cardiac
in scienca.
nvocansity
"Anxiety-
about
ca3
and troatmonto
phenomanal prognosis
aro a fundaurental
and rosynt-hosin
ýhat progr(=
vat and cla3aifivl
Statas"
are abcut
vurmors. - r1exiatiam
as
or any othor
which have been subjected
conditions
to
ref Ined a tudy.,
JDr,r Ja Ph Pe Davioz,
to this problem(Davies
attention
and Coles, 1960): "'Ille world of
medicino in made up of #IumPOMOand tsplittero'..
in teaching,
particularly
or ao-matimes out of-an inborn conservatism
of mind, and thoso nho 'split'
Both these attitudes
There in a not unnatural
it,
and force
so=tirias
does not fit
tXter
the -truisms
of
are
tho
=n
are
scientific
thome very
and C014*31 article
always
searching
into
for
is
prewAtarclys
a category
11husdifferences
which
are losto
comes lumping of the fragwnts
all
this.
Illustrates
DavleB
that
gross distortion.
oignificance
Oplitting
circumstances.
the condition
adequate description,,
without
"
numerous entities.
under appropriate
tendency to identify
Thus a compromice
entities.
into
conditions
are excellent
without
highest
be
the
of
may
history
those vho 1.1u7p,
togethor,, as an aid to descrip. tion and meraorising and
conditions
where it
has drawn
an alumnus of our Univeraity,,
reached
the
so=haro
samo and all
investigation
of
clearly*
Shearn
writes:
similarities
"the
into. omller
the
along
men are
diabetes
lu=, ora,
and ccomon
difforontD,
and
(1961)
between
linu
of
epilepay
commenting
u3uallly
caunation
in
11-bo
the
in
on
m. jority
dilBOasO41
lo
The skplittýýrz,,
hand'. dolight
the
other
-on
eynclro.T403.1110Y wclco, -Ae multiple
flumpings'
eviinSs batmen
the study
Via sea here a restricted
the ona seeking
of
the lumpors, are
at present
factseateno
of aqy "trutlh"
the conditions
(nee
Collected
ago
has dcno .little
or note
neurotic
Zia n.-.cd for
aetiological,
Puporso Vol Ile
to tho general
of behaviour
closer
waye
and a
definea
explicitly
Psychiatry.
of contemporary
of
applies
It
react
(conutitutional)
lcnp,
"Psychiatry
typos so far*
an to whether
a person
in
symdrcmen and to
to clinical
is a basio
to external
to kncn- what sort
us "stop
Mayer wrote
1951., ýo 294):
about
may we32 obscure dIfferencen
organiams
Ijet
Adolf
psycliiatx7,
Even 90neralizations
and intelligoncoo
*but me want
and in uhat
for
nub-divisiowe"
analyalm
con3tollations,
that
the search
to the natisfaction
classification
We nood furthor
typO of neurotic, il2nens
class
facing
on the diffeiGntiation
itself
limits
true,
dffferenc=
is univorsal,,
when it
two carmpsoe
1960)e
to the problem
To return
of order
of a
differentiaticna
human thcuoit:
acceptable
in
into
and the other
complomentary
in all
form
only
it
under rhich
(Vvhyt*,
criticso"
is
field
one particular
and unity.,
tendancy present
in particular
statement
in
Yet they represent
of one underlying
stress,
the history
in
have tendod to eplit
thinkers
similarities
order,
between particularne
social
Phich
the
describes
cuthor
domonatrated
expression
tendoncy. - "Awopean
general
It
"in
jhj8
and collocting
the showe"
running
order
"
causation.
and toplitting'
diseases
of collagen
in oubdivIdIng
talking
one particular
rolated
in all
studies
Um reacts
to
observation
stimuli,
of men react
in genarallitice
to nox, ap,
to vhat
sor"M of atz-033S
ana got
to specifics"
to bor.-ax a phraso
of fifl,A
(HOLIP'son
z
ý.
Broad -Ourvc.'M Of OxtOns: LVO pcpulatiors
inforiTation
typical
IqQ+)
do have a place
the
and Brown (1958) which demonstrates
by Garstairs
hoti a largo-meshed not cast wide can only catch the bigger fisho
not cast at atratogic
pointsvill
yzild
.y
Consider for example a
of a general kind uhich is of valua,
study of this sort
for
a different
yeild
A smaller
view of marine life,
the analogy,, there is a need* for s tudiezi under both the lov
or,, to alter
and high powered lenseso
Tbeae authors carried
contrasting
during
For
communitiea.
a five
and a half
being proportionately
Vale
for
men but not for
is
men.
Iliuss
it
will
both In ovora12
botaeon
in
be roallsed
raterig
differring
whan diagnoszs
and in
communities
are analysed
and psyc-hcpaUWI
In
especially
in
When the figures
that
revealed
triose
are broken
difference
a significant
of the Vale
the Vale)
that
morbidity
the relative
- in
this
very
cases aa the group
rates
times*
In both
the
outrwmbered
vary
tremendously,
number3 of men and vom3n,
case., rural
the preponderance
the Rhondda is
by 1.6
vromon pationto
and mining
areaco
"psychoneurosea
of cases of
marked,, both for
the Rhondda the group of male non-miners
as many psychiatric
Valley
outnumber those of the Valo by 4-05 timeas
vvhile Rhondda women outnumberod
communities
Mondda
casc93
womeno
Rhondda wn outpatients
(but
are significant.,
the industrial
of Glamorgan.
it
canes identified
of psychiatric
the differences
year period
down by sen by the authors,,
exists
the total
more numerous in
the rural
oowpared with
canes in two
out a census of psychiatric
yields
of miners
men and %ioman.
twice
prcportionately
and ex-miners,
the
12, -
tines
nino
greater
Hcm m1alcading
inplications
under
groups
total
suicido
or
to ignore
and not
The present
not
would
frcm
tho
and not
to
those
for
for
in
having
author,
to too
for
tho
identify
the
mind
for
ratez
and psychapatIVII
with
paychonouroacs
those
for
inpatiento
many categories,
in
vorked
a rzining
of
one's
with
both
the came patterns
structurc
to
in
"psychoneuroses
cutpatients
sex differences
expenot
social
figures
in
figues
the
conaidering
it
confuso
to muddlo
not
group),
vhen
and hms Irportant
a study,
cano-3 with
(a hoteroacnocus
for
can bo to ganeraliae
consideration
psychiatric
those
It
such
of
the nc-2 miners.
am.-lig
typez
ccmmmity
of
inneas
of psychiatric
cowunity
that
and
ariving
an industrial
of
city.
Car3taira
and Bmin's
broad
certain
would
disordera
Any attempt
gleaning
has criticised.
if
only
co:Vuting
mankind,
infinita
Yvill
eventually
Tho difficultioa
requiredo
range of variables
bo revealed,
in lt, 3alf,,
quite
defined
groups
th3 amount of
(1956)
the bolief
-
that
timo and monoy with
of all
hmnan bohavicrur
enormous benefit
with
in defining
groUps
Irat distinct
Ho Miyte
in Scientism
spend sufficient
Inherant
in
William
tho datas, tho secrets
to analyoo
of certain
more closely
rioo
of rwroalirg
virtue
two adjaoent
to study
faith
the
tho incidence
an astronomical
American
Investigators
machines
in
part
and computing
the currant
sufficient
and interaction
on their
has
study
in men and romen in
have ontalled
J.=ndiatoly
information
of difference
categorios
of psychiatric
sociotiono
opidemiolegical
and mciasuring
apart
from
to
the a3most
the statistical
13
renders inpoosible
complexitys
facilities
that with limited
search for
social
"
or personal
is
It
to a
our enquiries
we confine
there. tho most pathological
the-more obvious correlations
and disruptive
"even
-
of such an ideal
admit that the bugs are appalling.
it3 proponents readily
essential
the attainmant
reactions
existo
. 41aPuner (1949) said of Freud., "He made only one basic mistake:
believed
could be understoodeft
that everything
AVOIDANCECP VMIýll
Constablots
vivid
of his
the conventiona
Thus,
to the phenomena of mental
act
perceptual
Bacon expressed
Francis
not
induced
to be narrowed
practice
to take in
the image of
later
at
a
echoed
could
from
not say that
the fact
prejudice,
It
close
Me
*"
that
(Boller
disorder
by rigid
this
their
in Parasccvo,,
the Universe
date in Baylets
theoretical
4:
"I
the mind Is void
is
has been mants
and enlarged
do not know whether
of knowledge
conceptse
" a sentiment
discovered,
one
do not come so much
It
as that
in full
of
and Lee 1952),
is neCC83ary to throw away onets preconceptions
look
which
to a good examination
the obstacles
of
"The universe
must be stretched
is
vision
the dangers
to sterile
as it
dictum:
a fresh
must bring
of understanding
the understanding
find
and the scientist
Aphorism
reflected
and untra=elled
and guard against
adherence
through
in M=er
leaves
childlike
investigator
down to the limits
up to ncm,, but
that
the artist
world.,
on common ground.
in
'him to break
enabled
time in appreciating
of the natural
themselves
Tj SET
of nature
ob3ervation
green and not brown light*
perception
he
at what Is actually
going
on for,,
in
and have a very
the entire
field
of
14
wdicines,
richness
the atudy of Rmrosis
of theory aUled
has no rival
to poverty
for
diversity
and
of recorded observationuo
cz, -
-I
PT-LiOT 07331MVATITIS
OBSIEWATIOM AND lUP(YjlfrZ7i.',3 CONC!
"MMM
M
Allfg;, ý,
AND MIUROSIS
Some years ago vvhen the author ma working with Professor
Roth
in Newcastle upon Tyne, me observed in the course of day to day clinical
that a saeminfay disproportionate
practice
verc individuals
who in their
high value on their
of ton quite
activities
Among these one recalls
the neurotic
especially
man who entertained
his ward mates with displays$, In which he would flex
every voluntary
minor whose pride
it man that he and his
"marra"
and
There vas the
(mate) consistently
than any team in t-,Iw pit.
more tube of coal per shift
t-,io rounds of golf
independently,,
muscle in the body*
name,,practically
filled
of
-when this prot.,ess was threatenedo
illness
neurotic
malea
had set a very
and attitudes
prowess and had devclcped syupto=
own physical
crippling
neurotic
number of adult
on Saturdays and Sundays to keep f1to
He playad
Following
a
jilip, on the ice on the way to work he hurt his back and became a
7here was the fly
cripplea
neurotic
who developed a severe anxiety
weight boxer,
state which all
in his mid forties.,
but obliterated
the
symptoms of early pulmonary tuberculosis*
krising
goneralisation
from these, and further
was formulated:
illness
when this
is
U1030 who set high
threatened,
athleticiam
but in other
individuals
inight
differ
aspects
an initial
value
to the development
vulnerable
prowess are particularly
observations.,
and moreover.,
of th*ir
from othor
not
previous
males nith
only
on physical
of neurotlu
in
their
personality
neurotic
stateso
these
-
_________________________
-
16The attempt
to confirm
is not synonymous with
point,,
study
does not follow
that
1, formation
of science only if
by observation
it
deductive
absolutely
discovering
vhether
Is true - hypotheses are never directly
directly
It
before
did so:
why call
verifiable,,,
"he had no preconceptions
which certain
of
this
certain
tentative
and other
clinical
will
or not
of the
beccme a part
is
development
-
cr not a hypothesis
verifiable
(if
itself
a statement
and in facts
investigation,,
a scientific
to confirm
of its
is
is not necessary to advance a hypothesis
(Bronmiski
"
Nature.
phenomena of
initially
as:
a hypothesis? )" (Vadder&,ý196o).
it
it
that
be
noted
might
conwncing
sw=arised
consequences which are
Wated by experience and found to be true in fact
necessary for
and the
or experiment thether
"A hypothesis
yields
of a
2o deduotivo elaboration
hypothesis,
thcse consequences occur In fact*
observations
the validity
of investigation
pattern
of a relevant
these pilot
has been foruulated,,
no hypothesis
3.
testing
and
consequeaces,,
fabric
of
to confim
atteapting
At this
hypothesina
the validity
about
the =chanism
and Mazlish.
arect
hypotheons
which underlies
1960). D This
observations
are advanced
studiose
k
Neuton nevor
study
aim
frcm a consideration
to explain
the
of
the phenomena
i-i
-
of tillose prolirdnary
In discussion
athlotess
colleagues
malignant
neuroses
literature
directly
Ono should
is
"Sports
I'staleness
They list
to hide
" have
Injuries,,
they atate,
"
factors.
ask.. "in
but the
Indeedo
scant
in which
in
o=the
Li3tructors,,
book
"trying
including
U-Inessooo
coven
or having
an injur7
he happy at homeoois
ho
type? ""
a vorrying
In "The Disabilities
breakdown,,, othe athlete
are little
relationship
"ft-iiations
to *rheumatismt
from
the normal
psychological
and newspapers
that
etc..,
in
of
Minor
the nature
mechanical
him
he
event. "
future
and allied
time,
so much of the profession's
influences
may affect
rhid-i
have led hundreds
In a discussion
to dincontinueo
or nervaus
that Sports Modicine can make useful
and u=t
Sir
Is in a-hig)21Y
athleticism
mothoda,, and hence performance,
understood
fag
of brain
influences
by supporters
in somo important
Troup (1960) claims
to training
with
psychological
are suggestions
may not succeed
as "a sort
staleness
preoccupied
Ite
state.
suggestible
(Abrahams*1961)
"
Sport.,
of
and Injuries
describes
Abraha=
advorsely
their
and stalencas
such faotors
undiagncood
A:Iolphe
in
caused by psychological
is probably
po3sible,
(1961)
tcpic
at
recall
Training
to this
related
of nourooes
observations
experience
seen in Physical
on training
a chapter
Service
vith
and Armour
Coleson
UTUEMBIA
TO W=OSES IN ATIII::ýTr-3
Ppn. 'ýRU Om
injuries
of athletes
of
theze
ailments-which
efficiency
no mention
the perpetuation
is
of
contributions
and strains
and sportsmen
injuries
and the
represont
the body" and take up
mado ef possible
of these disabilitieso
.13
Moore (1ý60) doom recognise
injuries
sports
anasuggests
the use of aggression
the healing
prolong
can lead to accidents
of inýurics
of
theze
apart,
t'rela
is
syndrome
the
of
trainivia.
This
b=fits
of
prevention
attit.
the
and cure
of
mental
are
deviationse
apart
possible
ODThasis in athletic
steinizus
praossor
of'Sport
sumestea
psydiological
barriero
th*
includes
lattor
tonston,
that
experiments
Dortizindg.
"Car findinjis
in
trau=
of the
held
at L4DuShboroUzh in 19142.
as seemingly,
the
pýaiological
-
tho asaess=nt
support
on paycholOgical
tho meeting
Thus at
Dro Go Cross also
this
on
training
a quality
the urge 'to win and similar
doncribing
cerebral
adverse
in the
and Medicine
has,, in fact., - two'limits
Ostrength'
that
to be of great inportance
perfo=ancoo
of outstanding
Association
the
sportse
some other
idon which are now recognisea
British
in
no hint
direct
from
of
and social
a value
Is
There
stop
abruptly
physical
can have
sport
disturbancee,
the prevoution
with
general
in, the
symptoms
sports=n
rhen
andýautlines
is a gonaral
amliievemnt
in
seen
wheiher
of
that
knnw n; 11 one
are
and sowtimes
concerned
sporto
effects
There
systenm
its primarily
asks
and in
boxing
report
It
psychological
norvous
and
(1959) affirmo
sport
presenting
particularly
and inJurics
acciftn'43
of"over-training
and
regulation
autonomic
effects
untoward
Conflict, 3 over
of tbose conflicts*
as a reault
few
way aggravato
in the case of athletea
Report on Sports Medicine
tively
endocrine
czrdicr, mscularv
factors
of sport:
a psychopathology
The WeILO, Proliminary
injurie3
that psych.ological
of
defined
tpersonalityl
problems*
ard-tho
two aspects
factors
ana
such as
Ura Go Adamson
theme quoted Professor
the thesisaei'that
limit
these
as
objective,
E,,A* WlIer
poycholoaical
of
,
-I
rat, her
than phy3ical
M,iere could
tot--I
br&=
aspects
of sport
those so interested
of "mons sana in corpora
tha doctrine
that
It
the incidence
and not
psychiatri3t
A survey
of the incidzwe
of current
psychiatric
The Journals
topics*
doscribed
as Accident
that
presenting
the
textbooks
of
to a
in athletese
of neurosis
which might
prove
fruitful
is sought on those
are almost equally, void on these issues and what, Is
in fact
Nburosis, is almost Invariably
which the issue is confused by the eVoctation
as a possible
motivation
been referred
initla2ly
conponsationo eg.
to
denies
Astudy is
the present
when inf omation
y1oldo only scrappy speculation
*
devoted
graV
to a dogma which
in male neurotim
of athleticism
and lastly,
can be compatible*
howaver,,
be =Thasized,
should
in
interested
and othern
selected
sano"
and neurosis
athletics
Secondlys,
anaathleticso
be a highly
well
might
to the
in prcportion
see tboso caam.,
not
of
the number of
szall
those doctors
might
f or the poverty
Firstly,,
ray may bo very
dam neurotically
the medical
perception
this
in athletes.
"
of pciTcrmance...
explanations
engaged in sports
number of persons
having
tha limit
alternative
illness
down in
breaking
datormine
be several
to neurotic
reference
people
factors
'
Miller
for a continuing
of financial
to a claim for
for an opinion with respoot
Neurosis"
IMIroy
Lectures
RoCoPo LondonA more general thzme which is widely
phyalcal
illness
has of lowering
3.at*nt
nour-otio and psychotic
illness
eatablishedo-
already
recognised
resistanoo.
tendencies
There in,
is the effect
to the manifestations
or of aggravating
moreover,
in
compensation
the cases having
disability,,
(1961) "Accident
a neurosis
of
mental
the tondoncy of some
&JODC_, ý in'. 1tc"d
Q., Fa
C11&D
DartiXul. rar diSCC1E;
U10 gancral
Sr. 7ptcMz.
ýhiattric
and psyc:hologlcal
physical,
field
vide
extremely
it
To zurmaarino,
in thtý cauzation
the aholo
coaprizen
appears
to
that
PVC: 3-ant
wltbz
stuay of the re !a ti =113p In t--c n
faotor3
vhich
13$
zolcrw.
of dinzase
is an
madioinoo
of psycho3c=tio
the particular
psychiatric
ccc:plex
which is, the subjoct
of this a tudy is one vihich hao not pravicus3,7
ý,
by psychiatrista
in sporta
eithcr
reported
or by thoso intom3ted
becn
madicinco
is a restisricted
2here
botue-en physiqua
to the extent
which hcv*
cf reporting
a ba-aring
It
to Stre&o,,
reatxM
being
the literature
of the clinical
::
'
it
section
that
is
offered
pertaining
literature
cn tho relation-
vhicli
b-., referrod
only
the results
3uppcrt
!a becauze of itn
study-is
cliniczO.
prcuess,
on cuP contouporai-I
and in particular
neu.rosis,,
review
;-,nd atlilotic
introeuctory
In ibis
but grming
thcorles
contribution
as a th-. aiz.
investigaticne
inssuzz
raise
of the Sonesis, or
of ,cS!
Mt2Mic
'V,
ab.UjjZ
_u1n--2:
to thim. 'thoory
It
to 2atere
to anticipato
nece3sary
Cf the stuay
a theory
to this
vi32
In,
ch 1.
that
would be prcr,: xt*t=.
appeot-4 before
roporting
the
to
21
ý
ca
IVE
is appropriate
It
at this
4"m
a(me cases of neurotic
their
athletic
individuals
do not conform
neuroisis-prone
to the
w4o higbly
of
Inaus
In mmW ways these
accepted
generally
histories
oonoept
of the
21 years
with
personality
"A" CaseINo 14.., a senior
the one firm,
In those
be seen that
will
brief
to present
point
as occurring
It
prowess,
CASE HISTORIES.
sales
representative,,
inuess
developed a psychiatric
or consideraMe
intensity
at the age of 37.
life
as
his father
that
reveals
story
amateur footban*r,,
- an enthusiastio
pneumonia when the patient
he enjoyed, a good relationship
with
who died of
a boys, and also with hin. mother,,
was still
who bad a hard task in widowhood bringing
up her family
Is no history
In the family,
He was a bed
traits.
Iram &so 7 to
wetter
of ary payahistrio
to age 73, but otherwise
16 he enjoyed life
at boarding
delIdLopeda keen interest
disorder
showed ra neurotio
sohool,
in sports,
proved a good soholar and
wd healthyq
Always robust
His subsequent marriage was a happy one and their
driving
His personality
latisfaOtoryo
a slightly
perfootionist,
obsesslowl,,
Intelligent
W&s that
bypmanio
ana very oonfident
develop dyspepsia under stress*
of humour.
he was
soolable
outside
was
I go-getter,
but with a tendency to
simoo leaving
played hookey, a gme to whiPh he was fanatioally
and interest
sexual life
of an Onergetio',
Although very rigid
Evez7 weekend in the seas=4
was his only outlet
There
fitness.
proud of his pbysioal
Mutually
(of four.
his work,
he had a sense
sohool,
he W
devoted and whioh
I
22
At the age of 340 he received
from a hookey UU
a blow in the smaU of the back
w4 Witbin a week W&DOXP*rioraiug dizsY SPOUIR
*almost bla0kiV9 Out" and began 'to fear that he might be developing
tumour.
4Loerebral
This r,ýAotlon puao4
ofr in (Jus courae4, At ILge
36 he dropped back from the forvard live to half-back an "I couldn't
stand the paces I was begLoning to got puffed. "
illness
He banpd his heacl in conision
oacurrecl,,
I)Ut W" not co"Ousepc, ýId oarried
developea faintnessv
Kim
on,
vandting. 83ýdaiýdoty
Progressod to a s*TOre. pwdcky mclety
pf pbysloal
Wmax.
of an important
months in this
Perfectly
he van referred
via a mutual aoquaintawa
well,
onjoyiog
golf
ooluUtion
rapiny
hip felt
fears
rowA
In the
perfonwwoo
treatment,
fmw
we after
he bad made an 80% rsooveryj
that he Is nowt three years later,,
wd "kicking
himself
that
he did not take
depression
idth
lWaterioal
at the age of 45*
,.
This mano one of ton siblingat
family
ba suddenly
an& oute home. After
for payabiatrio
3-t up Years avý"
-.
*A".. Case No 2 developed, a reactive
features
wA this
matoh and put up a feeble
some four months of such treatment
Ono lea=
days later
lb evaUd the first
whiph be excuseit himself
state
with another player
state with demoraUsing
Hs booeme Impotent.
competition
next roumil, after
At age 37 the present
atmosphoreq
4ýnjqved goocl hwath.
Life
was brought up in a very happy
was hard due to poverty
but he W"' active
Scmewhat purq up to ths. 'age of 160 tUsbafter
gftw apaos. He vow bappy at sohool ana had pl*vL7 of $**a friends.
Me father
disil
of oamer *ben he was age4L12 Rua his mother of 4
and
to
2
fractured
when he was 25o As a boy he was very interested.
skull
in
and keen on sports,
During the war he enjoye4L lifO
in the Police
big bluff
oheorfqI
Sime-the
war he has had. the one clerical
his married life
He describes
nis
good,
.
footba3.1
we
and said
regular
with
so=what
job,, *
dramatics,
twenty
years. "
club. and
youth
humorous tolerance,
proved
been a
"I've
These activities
would
a week and up to the age of 45 he was still
nights
and tennis
oricket
At age 36 he stayed
football.
and. oooasiovia
for
sports,
away
months foLlowins
six
At age 43L he was sevon weeks off
tonsillectomy.
naive,, extrovert.
an very happy; sex relations
=&tour
widow for
cricket
him out four
playing
his
encourava
wife
activities
sporting
take
and very sociable,,. If
Reserve,, being a
work with
sumps and
lumbago*
before
I first
went.
However., he did not
saw his;
wA demoraliged,
and reep at work if
irritable
wd
he recovered
state
subsequentljy
training,
)
his
was hi&4
tims
missing
he was looking
and has bpen well
of the effoot
has oonfimed
his
After
sime.,
down
He beofte
rotten.
He slept
and ate well
eighteen
months in
this
treatment
he came
During
of age. on his
athletio
symptoms and
he would break
reactive:
at wazt.
the pain
and became dejected
lWaterioal
disPlaying
remarked
IS weeks before
confidence
was not Impaired.
the realities
to accept
and
libido
work for
off
recover
state
arrow
and childish,
throughout
he stWd
Intermittently
His mental
behaviour,
of lumbago. at the age of 459 34 months
blow was an attack
The Mal
fervour
his
pl"ip4
to
coaching
powers
and
ý
Case No I dovolqped a so-fOro amdety
One of four
"I
never
got to know him. "
really
aged 1.6.
his rOl&tiOnabip
siblinga,
He got on very
with
that
summer he plWd
p; Icket..
ycung man,, happily
injury
his
of the crowds,
His personality
of friends
back as he can remember,,
showing,,
the idol
at
the first
- "he' a r.Titten
profescional
promising
or Illness
Ismobill3ation
on television
previously
years
as far
relationship
had plent7
trainer
informed
During
the
and modamtely
at interview
sociable
seemod somewhat
commenoeAsome nine months before referral
his first
tha%
a zkOe
and the parontal
mother
He in an intelligent
married.
whioh. neoessitated
interest
his
when the pat: Lent ff&g
and superfioislo
His illness
sufrerqd
died
footballor
and being
ability
me,, outstanding
vias neutral
The fathor
was an interest
sport
At age 17 he became a proressional
shallow
with Us fathor
As a boy ho 'was happy and stron&.
was hamonious,,
and reoalls
well
otato at tho age of 25.
int. orviev,
for
ýe, told
a young International
off
it
-
ruinad
who underwent
a kick
ovpr,, receiving
In plaster
on the s4de
is
seven weeks. * It
me of seeing
have both
him, "
when he
some time
logo
; rqotured
He 41so mentioned
for
an amputation
a log
of
another
injury
some
proviouslyo
The patient
on returning
to the GQmsat the end of the season after
seven weeks was vary inuoh off form and developedpanicky
lie udk
isthis
disorder
and w=ioýzs self-so, rutizW,
to me, "
He could not play his summer time cricket,
Rv the time I saw him the next footb&U
Ids tmimer
tolA me ".he has just
attend further
after
his. initial.
of heart
cant t happ9n
. 4ý-Zxmý
-
season had oomenosci but
been a passaxWer. "
interview
juat
fears
butis
in
ThJ3 mm djjL not
in fact doing very
in his profossion'.
haVing Pro.,nimably mado a spontaneolls rooovar Y.
.
This is a case whera the man had all his oges in the one baskot.
woll
His wozic his incomes his into roat =d his prestige
q
in the skill
kumledge
of proviouo
"A" Case No 16
anxiety
atate
his childhood
a p=ge
&w to log injuries.
devoloped
engineer,
One
in his make-W,
element of rwomissin
maintananoe
by
an
at the age of 38..
a good rolationship
as very happy; he had plenty
the 2adc" with plenty
fit
nervous, "
mano happy and oontentak
was a tank driver
at football.
was the thipgý"
His. personality
frm
with
and was "one of
at school,, was
his half-sister
of a moderatoly
never nervy and with plenty
1942-46 and "rather
h3 describes
pwrouts;
swimming and running -
He doscribes
was that
both
of frierAs
He did well
of oonfiftneo.
ozd excelled
"from age ten'sport,
"a bit
tragedioa
professional
An a boy he enjoyed
exceptionally
concentrated
expressed through his logs and he was sensitized
that there was also a large
felt
are all
as
obsessional
of friends,
enjoyed it. "
He
He has a good
work record as a meohudoo
His marriage in happy and sexual life
devoloped Impotence during his recant
developing
After
in his mid-tweuties,,.
interested
exclusively
" tolevition
set,
vas satisfactory
he
until
133. so.
back pain whon swimming in his Aray days, while
he had to givo up football,
H3 remainod
In sports however,, and later,,
"I vatoý all
sports
having purchased
evento and nothing
olao;
It
is
" drug with me,"
His work entailed
His firm
ispeoftliced
going. out to lorry
breakdowns, often at nighto
in tyro work end he decoxIbed to x3 with pride
-I
his ability
4.0,
/
to remove and h-andle Vh,33o heavy lorry
tho younger assistant
During Javuaryq 1957 there were fraqwnt
within
a ranp
back an this
cant
tyres
for
was settins
job and within
blcvný, "
Ono night
at the depot,
thaze services
of 40 miles and he admits to "ptting
I didnOt use to -I
Vien
who would &oo=paqy him.. ard also, his ability
vdien changing these hup unwieldy
and strength
uheoln better
vary washed out;
he &trained
a week developed a severe anxiety
his
statz
which pursued a fluotuatILn, 3 course ror two ycors before receiving
specialist
was virtually
attention.
Mtor
treatment
be
symptom-froo.
This maN incidontally,,
w4 recalled
six months of out-patient
was aloo an avid reader of books on sport
Gordon Rlobards in hie autobiogmp1W. danoribing
his
nervous breakdown at the age. of 40 when be was slowing up p1joic allyý
"it
zIngs a bell
in his autobiogmphy
(Sir
"
with me now,
of his period
when he took to his bed for
of "a mall
duodenal ulcer"
Gordon Rioharda (3.955) tells
of demoralisation
weeks irmiadiately
and deprossiou
follo-, dzg the diagposis
at the age of 39 years. )
27 SETXC%IICN )3D
As rao apparent fr=
of thece atblatio
CMMM
tho prelimirmry
nou:rotioa
atudy th3 groat zajority
pilot
are easentiany
construet
group ita tb*ir
tho, follwwing
attitudes
and practices
method of selection
Only neurotio
patients
vdth a PrIMM17 diagnosis
worc L=ludodo
Th=, not orly voro pationts
pationts
or org=io
of affootlVa pzyohocij3.,, gobirophrenia,
the aj; gracmive or inadeqwto
arA men vdth soxual parversiors.
faotor
only boing includedL trhou this
In a patiout
provo33,
was uzod,
(1939).
by
HenUrson
type no dofinod
light
tho athletic
with rogard to physical
oroluded but also payohopath3 of eithor
the lattar
ft=
group vdho ahould diffor
control
a c=parable
reforrod
prJmarily
o,,,
in order to
often with aepresaion aza a degroo of bypochondia3is.
states
state
from =doty
cuffering
0=2
subaaqwutly
with nourotio
to
Subwrma
oympt=3,
"v m rojectodo
DEFnaTion 07 ATROTICISH
rll-zt are the oriteria
to tbo Athletic
betwoon the awi=er,
erector,
thore
(control)
Non-athletio
=a
rugby playor
fills
r,ho oojwj, -)tantly
by whiah male nourotios
oxist
most tub*
o:? coal
atblot-to
murotio
piWoio-sl
prowaa3 Wd PbYG1041 fitnOZO.
of rooreations.
or no Jwlj=tjon
nject
By. contrest
pbyaloal
ia
notivites.,
ovidaUt
the tough
=d
is
that
the miwr
rur=r,
stool
of ths
an overvaluation
OftOU thin
affooting
exertion
abift,,
is
It
What tha patienU
the non=,atbletio
towardz pbyoioal
arq voluntary
per
hzvo in oc=on
prooocuptation
country
ana cross
wide divergano1oz,
group all
famtioal
Mtgh
011
r,
groups?
are allcoatoa
of
an exclusive
and
choico of work end ohoioo
nourotios
frequoutly
hava bad littlo
positivelv
and tend to ignoro =W
20
-
COlmid8ratiOll Of thO, O:rfiOiOEID.
V of thcir
Of the two possible
be to allooate
mid-position
score for
an-individual
on this
tb3 firat
mothods of W. ing atbletloicm,,
this
trait
The other mathaa it, to olimimte
oontizm=,
line-and
has boon adopted in this
mo4ority
Ownbodios.
at a
It
The lutter
appro=h
in tho
has not provad difficult
grouping and in
da-eide the appropriato
of male neurotics-to
along a
point
those vehowould oaoupy a
compare, the extrem8s,
stuay,
would
84
tWClVd
Ora.
V
of
come
male
Caa03
out
comaccutivo
=UrOtiO
praotio*
were eliminated
appropriate
fm
category.,
pr6cedure itiself:
athletioism
the, atudy beomusa of u=ertsinty
Thus the first
ramat
fn=
to the
the selection
diohotomou3 distribution
there in an essentimlly
among male neurotico,
arlsoz
u
(Result
for
NS 1)
An example of the type, of - Owle- eliminated
is tho 043.y going man
Joi=d
zucooss,,
and
'.
with
onjoyment
moacrate
sohool
who,pleyvd gamen,at,
rugby, and, crioket
still
olubs after
leaving
plays ocoasiOml,, orioket
musician,
readak widely, and is involvoil
who taka moderate. -exercise
rustically,
at 30.
appropriate
cohool,, droppecl rugby at 25 wd
in addition
in local
politics.
to their
age but are not
*xA emolusively, davoted ýo physical
ýppear at, p3yohistrio
he is a koen
olirdos. o To. clarify
fIrm
ýhe-anooaticn
a4ta,
which
p@nowa
fitness
Thus porso=
do not often'
tbs. issue further,
the. basic
inýo the two major groups me
(P
in
Appendix
-I
ý
mad*$, is, presented
Tho only-two
athlatio
fCm&18-cazO" m(mutoreci,
aro i=luded
in W
series,,, but .boome of this smaU..==bar no females were
for
tho
oontrol
aelected
group,
=4.
A further
procedure:
at
the
interesting
sur7oying
preotioe
d3coribed
consecutive
male, nour'otio
unit
excluding
pisyohotioa,,
payohopathe
the
following
groupings
this
cases
payoWLatrio
above)
fz=
arlson
hoapital.
gneral
(and
obsorTation
in
=d
soloction
to aWself
referTed
private
consulting
and subnomalis
emerge
as
for
as material
the
IstmV.
Cates=
Vumber of Patignts,
m
Nm=tios
Athletio
44
because of unoort4duty
Cases rejected
12
rep, rding categoz7
Neui.vtips
Non-athlotic
(Coutrol Cason)
UNIVERSITY
OF BRISTOL
28
MEDICINE
TafAL
Thus =ong mae neurotics
outmmbors the non-atbletes
personality
is justifiable
Tbus it
cc) grouped tho athletio
to olaim that
ana "into=edintes"
the male athletio
is a oo=on oondition. prosouting at the psychiatrio
been latherto
oomblued.
type of neurosis
oliDiC Uud bA&
(Raisult Vo2,j)
unrecopisca,
assantiaI27
type of
lTootnote,
Thus we have "o'ba3io
consecutive
of thair
taois
in ths
other
valuation.
assewd
*Footnote:
of plWzioal
to, aeternize
The following
respects*
were considered
arl
This
ohosen from a
who. have been differentiated
investigation-is
obser7ation3l,
rare
seriess,
groups of maurotio3
items
prowess,
lab Initiot
Tho next
whether
these
which,,
following
poasiblo
fruitful
on the
logical
groups
differ
stop
in
the pilot
aouroes
of difference
rooordodo
finding,
that
the factor
of Athletioism,
is
oc=on
in
4
Palo tvurosos,,
disounion
provpkos certain
whiob foUawo lator
the eeria3
in the Thasic)
to nourosis.
vulnembility
for
colleatod
for at timesswith
seems littlp
quantify
with
accurate
record
period;
doubt
oonfidence,,
is being
rosarding
abortap
this
that
kopt
medical
of an
study van tnay
but. in order
is co=oN
bas Improved,
at&Mng
payohiatrio
cases over
thus a check can be mado on the reliability
j
in
tj3io
advanced
study.
and hpavy Olinioal
a accondary oon3iderationa
the condition
now that
speoifio
doubta an to whether
of modical staff
dom=dso apourato repording, of 0450s bop=o
There
tho theoretical
The author has cortsin
of male neurotics
conceoutiva
(in
oboorratio=
of the figurom
TBE.CLINICAL MCMTIGATlai:
ASSESSED
AND 1=011DED
Family
ýW=op--MLW
1,, Fam4,v history
of payobiatric
2. Quality of relationship
illnesses
(mild
and eevere)
with a mothor
bý fathor
3. Parent.al hamoiny
4ýýFamily. also
"(zmmber of isiblinga
c"výn8
infancy)
Childhoca
Childhood nourotio
traits
6. Happiness iii childhood
7o Childhood health
8, Imideme
of 13ignificent
fazily
illwas
during childhood
Bereavement (Pa"ntal)
to
doathe
9. ftrental
b
with analysis of:
an
a one year
IWO
see P.0
IT=
to
Age Of Patient at timo of tho doath
Cause of parental death
Sudderness of parental &-ýath
;g
MATERM ANDMETHMS
3-1
Adult Lifo
10 Worlo.raoord
11, Prodomimmt porsonality
tr&Tt; 3 ospacially
ot) Sociability
b) Obsu3l=lality
12, Oocupation and scoial
Marital
1.2",
MI
-
olacs
SOMT1.1
Marital
14.4irital
statu3
ocapatibility
15, Sex a) flarital
ammal relatiou3
b) Tibethor se=al drivoz affootad
16, in sinslo
patients
during
to opposite
- attitude
the illnoce
sex
The TIlreae
17. Detailed
acooumt of ary poiwibla
the ovwt of the illneas
precipitating
eventa
preceding
16, Compensationissue
19. Ago a) at onsat of Mum
to payohietrist
b) at reforrel
20. Clinical
features
Further It. me
=WxmmýýWqýý
Presence of multiple
episodes or cupposod sensitizing
WORS
It
ia n3o3ovary to dofino
oriteria
diagnosis
and psyoMatrio
c=yorienoa3,,
DKnNITICTIS
s=a
of thaso itema to indicate
tho
by which judgement3 wero made.
Itowt;
11 WERE H100! x
Sovere
syphintrio
Mmais
inoludos
urdoubtod
psyoho3os,,
m3atul
hospital
admiission,,
14il,d psychiatric
ouicide.,
illness
severe
includes
known to have haa a "nervous
breakdown"
to
of relationship
is
-(a)
Ilegative
hoatilitys
Poor -
(++)
overdependent
this
When present
parental
5-, ChIM20
relation3hip
Strong Identification.
affcotýono
' parent -who has been non-possessivt
far
dependent
has not been excessively
I
alhose are specified
significance.
resentment,
excessively
does not necossarily
the other
iup2, v an ideal
passive;
a contribution
SýOred: Yes, No,, Separated,
Neurotic
nor disli1ced.
Parent often unhealthily
and
pwaassive
domineeringe
Fatient
and
at once hostile
dependent*
excessively
harmonys however does izply
childhoodo
symbols:
scoring
appropriate
Parent usually dominant.,, patient
and passively dependent.
be domineering,,
might
one parent
range of rolationshipso,
feeling
expressed towards parentsdislike,
rejectiono
ambivalent
HarmonX
a
and
neutral
Positive#
Plaither Med
towards parent,
Neutral feelings
Indifferencoo
No resentmonto No deep bond.
0
3- Ilrental
with
affectionate
Vo Good ++ = Strong$ healthy
mutual
RespectarA admiratibn
and-on vhom the pationt
Strongly
into
the possible
were devised
categories
normal healthy
Good +=A
as having
(b) mothor
father
to describe
inadequate
11he f 0-nowing
are
hospital
not necessitating
based on a division
judgement
A fjimple
Neutral
relatives
temporamento
ndrvous
particularly
negativo
those caseswhero
or vAiaro a member of the .1"amily is described
admission,
2. Qýallty
alcoholism.
relationship
the presenco
to security
of
in
Divorced.
Traits
and recorded when they arc of any apparent
-
mna 13
Thi:,; ir, soomd in rospowe
do you oonsider that
hilftooiL
IX
Ic
a happy one or
No,
Health
On tha assumption
that
health
rolova=*
to the dovelopment
ajoknocaj;
this
sevare
que3tion. - "Looking back,,
on tho whole your chlildhood v=
not? " Soorea: Yeis, Mizek
T,
to a standard
item
point
childhood
of subsequent
ill
protracted
of discrimination
might
hoelth
wrd
wa3 any history
of
There is
in childhood.
between laboent'
and Opresent' but
a judg3mant rue made an to whether innoss
had seriously
with tho course of physioal,,
or cooial
psychologioal
have z=o
to h*alth
attitudes
whero there
was scorea positive
and ospecivMy
no clear
during
interforea.
aevelopment.
8. nimeas in tb3 Immediate faRdlY, duriU9 ohildhooa. was aliso oonsidered
a posi5ible Morionce
present
when theillness
appropriate
of the mmbors of #w family,
an oppo3od to a modioal,
to stress
experio=ea
porsonality
on the life
Deaths
In a psvohiatrip,,
=a
arA again ms I;Ooro(i
- eppeola3.3,v of a parent - appeared to 1mve
=. orted a strorýS. influouco
Parental
boa3.th cLttituao3
affooting
biator7
it
asoms moro
the age of the p%tient nh*n thS bereavement
as an event of poosible
dovelopments, rather
major importanoe in
than to rooora tho paxvuVa
ap
at
doath.
Tho osuse of death 11.3not a3.vmys aocu=tely
43 danoribecl bý the patient.
to be differontiated
Imown and in rooorded
Sudde=eaz of death is not clearly
from an lunexpeoteaO d3eth, but implies
an
unhoralded
duration
or d1cath af tor a brief
death
in a person vhoso previcas
occurring
to be vithin
considored
of a vlock or two
illness
life
oxpectation
S=o
persons
was
normal limitso
10. Work Record
in a fami3j
a position
jobs,
judging
business
this
cog* contracting
work,
Somemy be conscientio=
itome
frequont
rliore
and doepiy involvea
tdoubtfulel
spent
life
a vwking
is
contribution
from
satisfaction
one trade
'poor'
in thoir
employment but
in porsoma
relationahipo
job
work records
their
have often
records
rcrk
rhero
their
darivo
much
or profeaziom,,
they nor
and neither
their
'good'
and from which
appreciated,,
of Job to the n=t
pl.
time in
Those with
satinfactiono
Ile
Those with
a
changes are to be expectedo
have to keep ohanging cming to difficultiea
and are scored
for
in
are
or
a carver,
pursuina
into-
step
there
and stay
effort
withcut
Others have to change jobs
time.,
IJA
noodod in
care is
Great
they
drift
coployers
one typo
fr=
easily
derive
much
efforts,
§22iabillty
:
tsociablel
Thoue scored
couLpany of their
major
source
really
enjoy
men, regarding
are scored
xho seek cut and enjoy
such social
In life,
and satisfaction
own c=. pany, avoid
ccmpany but are also
Ogood mixers'
Iýt
their
easy mixers
A few cases have been scored
long spells
into
fellow
of enjoyment
those vho prefer
mi=rs.
arc
#sociable;
andIpoor
mi=rst
quite
meeting
are
and are poor
Those viho
to do without
' the differentiation
as a
'Unsociablet
people
as interwdiate.
contont
intercourse
the
is
it
for
Cesontially
35
tO
V-
ýzonal
-"ý-
is
ibin
,
nat an easy item
so there
hiEP-Xy desirable
thtranolvas
Vraits
lack
insight
owitside
v, rjA
two ideal
In
boon acen frequently
obtessional
traits
obte3sional
perannalLty
are as described
which
ibi-lity
is
and lach
314,1*11nr
and diacipline;
fac-)
of
this.
and its
perzistonco
of obstaclezoooDepondabilitys,
ccý'ITILICUOnt-153 In mttcz'
qua.'Llty
of w=th
peri'mmanc-a
thera
and =ach an7A-cty is felt
maintnf,. nado" Ibis
par3r, rzalty
Ifincr
Of morall).
and stabilltya.
profile
daccription
first
io
outlined
anxicnis
only
this
by Janet
'traits
of the
Clinical
or neurasthenic.
are Its
rigidity,,
ob-sca.,
3ional
(1908),,
precision,,
traits
atandards
modified
and jam
oven in the
punctuality,,
thesO standards
slightly
is
and anduxunoo
are high
if
Where
cons cien tivasness
raliability,,
have
the, obaessional
about
its
term
and
and Roth's
of personality
of adaptability;
in
and relatives
Slater
bo
ruald
these patients
in excoss
the merely
typa
way as
Os laprollSionse
in Mayer-Gross,
from
words it
of the character
is a specificity
lacking
features
The oxxt3tanding
of
the assesemant
(1960)0, "There
Paydilatry
Infle::
for
the sa=
Many of
have seemod to be present
Tho basis
rcccrdedo
"
ouch
many with
described
one
-
to the psych la trist
spousco have contributed
in
apprcpriate
interviews,,
at psychiatric
Viat
theirmolves
of failure.
considered
assessing
however,
personalities
term
the
than they do in fact
traits
cut,
"By selecting
observers.
the other
of
is
not rate
and wculd
to cor!ý;ruot
poz.-ibl*
the parscrx-aity
of individuals
is a danger
(1961) has pointed
Ing-ran
societieD
more obse--sicnal
as poss*asing
displayo
in
traits
of sorw obsessional
prosenco
In Westorn
to assesoo
add a
of pernonal
oannot
fr=
ba
the
Aqv a3cessment
of
bias
by his
reserýaticnz,,
to stand
results
3tu-4,7
,
are given
judg=ents
Other
describes
only
pationt
integral
judgementq
c=qcusut
At a later
Scalo
reasonable
stap
in this
these
a self
we
rating
clinical
scale
and Roth2a textbook*
Slator
to be Ozwrvy: l where the
himself
considers
for
with
to. oorrolate
in Vmyer-Gro3o,
outlinad
Is well
of experience
and making due alloinwo
of soma attempts
The patient
traits:
of thooo traits must
munt be preparec4
Gough's Rigidity
&Vdnst
based on crIteria
pro2enoa,
interpretation.
and subjoctive
ena aeapoe
but any psychiatrist
of thoir
awaro of the reality
I. -
th, 3 prozorma
be subjective,
of necessity
XQ
himsel. f as, a lworriorO
this
is
oozzidared
au
of obssssiovmlityý,
is &core& as:
Ilaxital. 22Matibil
1, Happi marriaga a
2. ficutml
unhappy., or spouse unfaithfta
or durlsij tho illrabB
beforo
150 Sex Rolatilors
.
scored QacodQwhou sex lifaý is coxmidered no=sl.
wbatever ito
vatiofying
Scores:
24pod'
3.6, Tz singlo
Attitude
freq=noy.
+; in&UTerqut
to opposite
=U enjoya their
zax is
= 0; 9poorta
Soored as. - Osoodl if
towards the oppoaits
compwW., Those with
of or indifferenoo
as 'Poor. '
or variable
gationts
bAS P031tiVO ýexupl roelinse
fear
and mutua32y
the pationt
ýex and seeks out
sexual inhibition3
to women or homosexual foolinp
and a=Jeties,,
are soored
37
;'
In
ozcq.,)o wh3ro
of murotio
thora
illhaalth,
bea
boon
1.1117-tan
cao
tha aggeat oaiuzatof the first
-At ,Iik. 0 It
attLok
1,9
rooorded.
Turc,har iteme
Unclor thin
Il-lvding tl'-OrO U ; %Ordad arT tondonoy to rapgated
brorltdo=,,
n9urotio
thaulp,h r-cit provohirj;
relovacco
individuml
Ulness
to thi
and also argr sIgniffoent
naurotio
illno-vis
pryohopatholoCr
to Vas typ, j of situation
at a latar
data.
past axparltmeei) rhioh,
at tho time,, qpp ar to lisve
.c:
in having unduly e3witiced
tho
which prooipitatoa
tho firal
UTS
1g, Me
STATISTICAL
Than
and all
for
all
are band
r*SUlt3
28 non-athlotic
this
cass3s
ou
A-RALY0313
datim on mU 44 athlotio
neurotios.
is
statod.
ZAIRY
muntion
Wwra the date is tot
(seo Appendix
oomplatod
1),
AN%DCHnDHOCD
FAMILY HISTOff OF PSYCHIATRICILMIESS
Atuotio
vourotica
Seven mental illress
7 (17rp)
Mad merr.al illucce
8 (14.5%)
non-athletio
INsurotioa
6 (22%)
3.6 (6%)
for
Negative family history
innese
taoutai
Eaw
26 (63fa)
8 (30%)
a
Based on infomation
in 41 out of 44 athlatio
thaso oasoo for whioh infomation
in iufanoy).,
Based on info=ation
(one
of'
nourotics
is laoking is a man who was adopted
in 27 out of 28 non-athlotio
naumtics.
27
41
maurotios,,
non-athletio
jjXLLj
athietio
AL0,1V
.
Pa
Severe mutta illnes 0 X2 = 0,,278 1 df
Wd rental
liogativo
illuess
blatory
any iacratal Mness
X2 = 11.25
1 df
P=
X2.m 7.44
1 df
P..c
raurotion
INot'sigai0sut
001
highly
Vory
.
siflamoant
for
<,
lV.
Z
IM.
ýOl
-ViODAficant
ýRý
2 LUýVýTff 02 REIATIM481UP IROPARUNTi, InolucUng
&Eoptod as ohildren.
of patients
++ w Very good
Key:
and "parent-i"
etop-pawzU
I
desirable
+a Good
0i
1Iotro.
Negative
Ic
om
a Ovýr proteoted
undoeirable
= Strongly
(D)
ambivalent
infacoy
during
died
Parent
patient's
a
known.
othervice*never
WS)
or
by
$bad'
'Good'
replaoed
mother
stop mo,
s,
durlug ohildhood
a, Nother
Quainy
0++ +
Athletio
or Heiation =p
(++)
(D)
lj
30 3 k3- 1312
Wourotict;
There is oray one aaopting
(mls).
haaaing
the
undar
463201
pareu+.,
parents,
istap
anaowvtwo
way:
lion-athletio
X2
Decirable
I
33 (75%)
Nourotios
12 (113%)
jisurotics
7.54.1
df
a
P
40.1
bota-,
ara best aMaly3ad in ths following
-- -- -% A ýws%aub. &. &
Athletio
28
10 2
Tbase dita
44
11
16
33
12
lion-athlatio Neurotios
(14/3) Totca
Hi,
-AS
ý
--%
uwýý
- ý. f --
-IL. A-
Unla3irmble
-
Total
11
44
16
28
Sifmlf cant-
b, rmthor
Quauty of Relationship
(D)
Athle41-flo Neuroties
**
(6 -7
28
9
tiork--athlotio
tio=tiob
i%
Quality
Desirable
Athletic
lieurotics
Hon-athletio
Neurotics
Z" m 6.79
1 dt
Total
0.1
21
44
z9
ö
jý
28
of Relationship
Utdosirable
Total
28(63.5%)
16
44
9(32,'%o)
19
28
p=<
Highu
nigELnoant
Pol
41.
PAREUTAL HARMCKY
of Parental
Quality
I
HSM02XI Diaba=orgr Sep=uted/
Divorced
Marriage
Totals
One parent Not
known
died
Athletic
Neurotics
33
2
4
1
44
16
3
4
0
28
Non-athlatio
Rourotieo
Th3 ethlatio
nourotio
for whIch th*rs
group" In ordor to zvduas the
bmolcetod with the "unfavourable
observod difforonos
is
io no infowation
tbus:
I
Unfavoumble
Favourable
(Patient as a ohild know (Patient never
. ha=ouy b4trman parents)
experiono'ecl barmonioua Varental
Total
marriaor)
AthlotiO
IN*UrDtiOS
Tion-athlotio
X2 a 2.5
1 df
33 QVO
n
44
16
12.
28
Not aimkf i0aut
P =>ol
Thera ic a trend in favour of more athletes
exporionoing
parental
ha=onyo
Azajyjjjj3
parents
of thoso who experienoo
who vare harmoniously
married
Cood relation3hips
(this
with both
is a combination
of. items
2ag 2b exd 3)
Vo. with I"ul3,v
denix-ablo puvntal
Atblatio
Ifeurotios
Noný-athlstio
X2 u T, 51* 1 4f
No. laoking faV
desirable panntal
influanoe
22 (50%)
22
5 (18%)
23
Total
.
P =4., 01 Hidlk
BLVA110ant
28_1
42-
E
it 2.MFAYýq"V-L«'LZ.
Tht total
of tho siblinas
is dofJno.d an tho "Sibling
vfho survived
grcup 3ise, "
Humlbnr, i of
Sibling Group Athletio
Sizo
ivfaw, 7 plu3 the patient
Ppi+imr. +n
'Non-athlotio
Naurotioz
Feurotios
3
Total
7
10
2
3
4
6
5
6
7
2
2
21
6
0
2
2
12
5
4
9
10
2
2
2
-2
Total
-28Peurotics
Athlatio
Kean SiblinS
c-rcup ýias
9.59
Becauso of the skowed distribution
nourotio
thO "t"
13 inapplioable,
Two VariableD
XV70alO & bi9blY.
4 02
,,
HigHL
which
with
tho long
U41
variance
at the era of
in tbia
group
Ho-,wozthe
me'thu& of Copp.ari. eon of
ZdPVicant
dWerenoao
nigifiam-4
Approeoh-od in a different
high proportion
4.07
eroup and the Oxtr=a
the athletio
t*Dt
Neurotics
4.45
3oO
(Difforanoo betwoen meano1.4.5)
Varianoo
Pa
Non,-athletio
my,, a gUnoo 4t the tabloo
of larSs families
can be tabulat, 3d tb=:
in the Sýbletlo
reveals
neurOtiO groull)
4-3
sman romoy
Tc-tal
Larga F=Ily
(Sibling
FYoup 1-3) (Sibling gmup 4-12-j
Athlotio
22 (50%)
22
.
Nourotims
7 (25%)
21
von-athlotio
I df
X2 = 1ý.45
P
05
'.
44
SIEMýa6snt
-28
ronult
MWITOOD,
TRUTS
CHMHOOD WWROTTO
prVeent
Athletio
Nourotion
Non-.athletio
12 (27,
32
44
17 (60.5%)
3.1
28
e,.Ol W-dazsilgMamut
I (1ý
I?- W.71?5
Total
Absent
011AMMESSOIN CHnDHOOD
Uixod
Happy
Athlatio
35 (79.5%)
llourotion
X2 = 12.09
OOD
8 (IMP)
12 (43%)
Tionm-athlotio
.1
2 df P =<, 01
Hi
.4
.
rlWtllLvti0f,
44 (10V.52)
',*)
28 (10CY,
oi&mflcant
Sipiffoantly
3ýnpairad.
3 (7%)
44
3.9 (60o%)
9 (32,5Wo)
28
Iffpalred
in ormotbird
rzýlxotlois).
.1
df
Toýl-
41 (9X00
IWalth jjj3tUILo=t3Ly
T, 03
T!Dtal
11,
noll-atblotio
(Childhood
6 (21. 5%)
-
10 (35ý,%,
Goott
Athletlo
unhappy
P=/,
M&)joOl
2.191LIOMI
of uon=athletio
r41
VCIDI-EIVPý 0?
ItnuLSURARG
M.
Wourction
Athlotic
yen
No
4. M)
40
14 (50%)
lion-athlotio
(Prollont
1 d;? P
Tatca
14
in 50% of tb* non-athlotio
X2 z; 15,,26
11-11
.
28
nsumtioo)
0,,001 VaM hiffýU slic-TIficant
(MYNTAL)
EMM.
"AMEMPT
NUMM
OP PARIIITAL DMUS
Mother
Athletio
No. with mother
dead
11o, with mothor
dlive
22
9
nourotiofs
Noz-atbletio
In tho. two casoo in the athletio
no irx0mutiong
order
to
reduce
the
Ux0mc=
U3
difference,
cms
aturotio
bincloted
"iro
T-bw
ths
data
Igot
Total
20
knorn
2
44
19
0
23
Smup wharo thero Ju
with
th*
lalives'
in
roaft:
Mother
Desa
Atblatia
22 (5Vo)
Nourotion
9
Nor.
-atlastio
X2 = 21,21
Alive
1 df
Paý.
(32,110)
Total
22
19
02 lict 0ýp
anýlfinant
28
Fathor
Wo. vith father
dead
Wo. with father
alive
24
Athletio Nourotics
19
irfomation
44
14
Won-athletic
The one case in the athletio
Not
TOW
knom
28
0
group of whom there is no
neurotio
Is braoketed with the falivD11, in order to reduce th.
difforanooo.
TI=3, tý
results
read:
Father
O-WAMPOWSO-0
DoQA
Athletio
Wourotiots
20
44
14 (5c%).
14
28
Thus there in no SiSmificaut
sigrdnoant.
difference
Groups with. respeot to survival
Non-&thletio
Totoa
24(5%, )
is not statistioally
T.his aiffer6noo
Alive
between the Athletic
and
a mother and father
at
the time of referral.
In view of the age discrepancy
of xvferral
(mean age: athletpo
would expect that
for
if
parental
between the two grmps
40.3 yvars,
controls
death incidemce were oquany
the
two
between
groupa there would bag if
age
of parental
deaths' In the oldor
in the figuros.
ýý6
arUtbin&
at ti=
yem)a
one
djL4tjjLbUtOgL
come oxisgs
age group, a trend V,41oh Jo appmut
We do not know the &gas at whioh parantal
deaths oocur
in comparable DOXIIal groups,, atd can OnV wW there In w significant
dUVeranoo between the two gro
a under sotutiM.
46At
(b) AGE (W P&r'IZI'T AT TM
Patient 15 ap
at time of
doath.
parental
OF PARMA
Athletic
Motber
DEATH
N=bar
of vationts
wourotics
Ron-athletio
-I-E Eber
Fat4or,
Neurotics
Father
I
55 1
50 - 54
45 7- 14.9
2
40 - 44
2
1
35 - 39.
34
30-
4
2
25 - 29
8
3
2
20 - 24
3
4
1
15 - 19
2
4
2
10 - 14
1
3
2
2
3
3
22
24
14-
3
5-9
4
07
Total
Anowins
owTon for
for the manor
mmbers in the =a-athletio
ago at death of :Cather Correspond Oozely.
asath
in
th.
of
mother
of
of
ags
poaIdul;
25
atl,,. tiL.
gmp,, tb*
Thore !Ls a
in the ago rvzp
29, but owing to the mmll =zmbers in each range this is unlikely
to be siplfýOýUto
on ths whole tho fathers
groupso
(lie earlier
than the mothars in both
47 1maing a parent
.
LmA,visf.a of numbars of yationts
1ý ana bofore tho aq
Out. of tho total
bororc tho VE, r
.0O:
0:?
of 44 Athletio
1.1curotion and 28 Pon-athletio
Wourotion,
3 patiento (6, E%)lost fathor by death before age of
Athletio
11=t0tica
lion-atbletio
Uvuroti6s
2
(4.4%)
"
mother
"n
6
(13. M
"
fethor
"0
3
(6.49)
0 mother 0"
3 Patiento
(1'0. )%) lost
Wo
ef tather
"34
by death Pefore age of
mother 11
0
2
The Sreatest
father
5t
So ". 5
a
(21.4%)
father "
14
(7.2%)
mother "
14
observed dIffaMaos
betwoeU tho groups ic in "death
before the aso (Wý14,11
Býfore Patlvrýt aged 14
Father died
Athlotio
Neurotics
X2 = A748
.
It
6
lqev=tJLoo
ron-athletic
Father
ronowo
df
that
P
ourvind
Total
38
44
22
28
NOt
CUMMOsmt
o5.
tbs lesser
differencoo
a; v zpt alpiflLoant,
49
-, -9
()
I
to not momi
-!
plu,
-In ovoxy
T1,1110
*
ocourivil durlw,?,l2a.
ýX:
2111-1
mt R
_0
1. Mnthor
Oudaxna
Neurotics
Athlotio
lo tic
Rloa-ath.
C.
2.7
11
12
lIcuxxv,GleLes
U.hlo, tio
.
4
11
rion-atblotio
At.,V..Gtic UOUTutics
Fon-atIllotle
"
10
YGA-10QO,Tcotjýon X?- = lýJ. 5
in both groupt.
Rc;ushly
13
1VP=4,
ic in rziipert
gror-test
d3»ffiro=o
Athlatio
Z011ro.t.103 t*r;o thirds
non-athlotio
nourotica
aon. Thosoalffe: mnooz
aue,
RAjML&Js 21M
howovcr.,
wora w-moctod,
waro su,0.6an whilo
op ti-jo
do r"o' oa.
a7Da
/
in
-,,he
wc.ro
ppro cc
,h
WhOrOLMOVII, aa rolportod OY
This is lwzTm In 37 out of 46 Qacco of parceiml
dca,,
ths In tho
Athlotio
Vourotio3 and 23 cat of 23 aaoon in the rvon-evhlstio
rouratio
rroup.
II
Tho
h,
ac"a"
h
th
in
tlia
02
l,
MO.,
Za
17hýz
3
4..2
14 ,
,
of thn dmtha
omly cm th-Ira
> -3
ab-Crut1,.
rtlf
rzxddon,,,a-nd aba%il;half
Trure
2
j,
49
ý.
1 -
1,
Venrotion
Athletic
ftmfta=*40ý
II-ther
Total
Fathor
Coronazy
Chronic
on
Caraiovascular Heart Diseiaa,
*
3
Ccoplications
Phlebitis
of
Thrombo3ic
Heart
neext
Cardizo
Coronary
Stroko
chr on-IQ Rhaunatio
' bisouse
NeZrt
Angina
Heart
Haart
Stroke
Heart
Angim
Mal,ignant
10
16
Canoor
Cancer 'lower
Way
Cerebral
tumour
In broast
Grmth
Cancer
throat
Brain tumour
Cancer
3
ReopiratOZ7
Cancer atoxach
1918 flu. epidomio
5
Pneumonia
Bronehopno=onia
T, B.
Result of war
jps6ins 1919.4
fraotare
1
Acaidont
Othor
Thyroid
Mtodsnal ulcer
Suioldo
Poriotonitis
appencuoitia,
Acute Abdominal (D. O.Tj
Cirrhomis
of liver
Killed
by horce 1
Skull
5
2
on
6
37
0
iý4. wrvýw
th1Mt1i
11Ii
---
Tot*I
Father
Mother
Wdioy4soular
f
Hdart
Heart
stroke
Hoart
Ansins
Cerebral
Heart
(died
after
opqration)
fimemorrhap
Coronaz7
Coror-arl - ocrebral
Haemorrhago
Canoor
Comer
Canoer,
R03piratoq
T. B.
TAB.
Browhopneumoida Pneumonia
on
ohronio tn=bjUa
Bronohitis
-2,
Awident
Rotor aociaeut
Road aooident
other
Gravea Discaso
Virus
Enoophalitis
Late effeau
Eaoephalitis
3
2
2
Chronio duodenal
uloer'
ar
2
Causoo of Parental
Ilourotios
Athletio
cardievesoular
Doath.3
lion-athletio Wourotion
10 (434%)
9 (39%)
8 (21.5%)
3_43%)
(13.5%)
(22%)
mallgrant
Respiratory
.5
Acoident
2
2
Otlwr
6 (16%)
4 W%)
23
37
Thore
figures
are to major
to be observed
wA the
are small.
The results
aspeots
disompancien
death
of parental
the athletio
neurotio
Investiga#ons
these
of all
ncý oipMoant
reveal
and the non-athletio
into
various
between
differenoes,
neurotio
groups,
ADIJLT--L-M
10.
(.+)
Athletic
fieurotios
6
a worL- rooord.
sub-oatepries
analysis
-
aged 20,, had bar omployment
amd bas been too short
a time in work to"establish
The above data am re-Zmupea
are so man:
28
2
are Taot inoludecl in this
Ono Ja a housewife and the ofter,,
Total
42
5
37.
Tbe two femae, patientis
Defivit-1-ýJ-.
'Poor
-
Nomp-athletio
broken by inusba
or Impairea
Doubtful
Good
an the mmbera ih
52 Definitely
Doubtful
good
or Poor
Total
Athlotio Wourotics
37(W),
42
Non-at-laetic
20(7le
28
X2 = 3008 1 af Pm>
/,
-05 el
is not signifioant,
Tho, clifferenoo
work record In the athletic
tovmrds a better
level
higb
show
a
groups
in 88% of the athletic
nourotio
but a trend is appannt
neurotic
group, Both
WL stabilit7,,
of work efficiency
prosent
and 71.5% of the non--athlotio
neurotics
group.
ýa.. PREDOXMAHT PMSCKAL=.
-T-RMS
(a) Sooiabilitv
Pý
Sooiable
AtUatio
Neurotiop
won.-athletio
Tho non-athlatio
with
13ooiablef
L---I
3-1
-for. mhominfo=ation
I.Neurotics
Iffon-athletic
.
72
7
Tot
6
0
44
16
1
-28
Is luking
Is bmaketed
in order to lesson the O=erenoo,
Sooiable
Athlatio.
Unaociable
1 dfo. P
Upsooiable
Total
6
44
16
28
38(86%)
.
12(1+3%)
lfojxýMUNZ
sielfigent
I
(b) Cbecior1y
Extra=
Ikurotios
Athletic
1,hrked
Abdorate
-5)
A
1,10
421
inf c=tioa
to docroaco
vKOt obse3sicn-all
4-s,,lam'dqg
Athle tic neurotics
35(WA)
Non-athlotic
3.6(57;1-)
(c)
tLar"t
Imis
is
and relates
P<
-05
braclwtcd
with
28_
Not obsessional
Total
9
44
28
13orsmiality
of the patient"s
a self-rating
particularly
oquAted wit'l
otmesDiOlmli"Yo
VetIrOtiCS
ron-a thle tic
Vw athlete
in order
for
personality
premorbid
to &Wmess.. lack of conf iftnoo
Uiwa mho only reported
tNervy'
0
Significant
to anxiety,
Athlotic
is
12
tho difforer=:
Obsesciod'al
X2 = 4-14
Total
44
35
16
r1he case in which
?
18
ý12
Non-athletio
Ab3ont
are excluded as this
Mrvy
Not nervy
?
Total
8
35
1
44.
10
18
01
28
whom, information
to decrease
I*orrlarf
and pronerezza
4
tho difference.
lacking
-
13 bracUted
with
is
1
-Not
Norvy
Mnwotics
Athlotic
9(20igý*)
"
Non-athietic
X2 = 2, 05
*
1 df
(d)
in favaur
of lam
Otbar recorded
3 patients
traita
porsonality
nervousness
wsm very
patient
Aick
was q7,
the Athletic
mood swings.
tampered
prudish
temperamant,,
and stubborn.
in
and paranoid
regarding
4J+ Athletic
of
five
patlent3s
terperede
Neurotic
hypomanic.
nli&htly
chronically
depressive
personality.
" nouraesthenic
It adventurou3
aggreasive
touchy and aggrossive
gaick
attitudes.
had a slightly
and caa quick
Eon-athletic
"a
his
som,
one was parencid.
vas
include:
cptim-istic.
auspicloiI3
10"
in
and naive.
had mild
3.
28
hypommnic.
wero slightly
2
1 pationt
iß
J*uroticn
91
out
J#4
grcrap.
Athletic
1
.
35
NO-t Simirioaut
Therv is a trend
mourotic
.
)
10(35-.r-57,;
Total
nerri
te ý,p cred and aW; ressivý
defensively
agamssive
hypomnic
55
Out of the 28 Non-atblatic
hnomanic
and eno slightly
pervonalitles
patients
bv Social
Analwis
Ite,, 3a are s=3.1
porconality.
class
Neurosis
Social Clasm
III
5
1
Neurotics
Athletic
aggrer,. -,-jvo
IIAND-SWIQ
AT
of
xTore four
cQn bo drann,
mmbara and no S*naral conclusions
Tna
thore
31
IV
v
Total
5
1
43+1 istudent
not ol=mifled
6
2
Non-athletic
13
6
28
1
'Or-Population of Ueda
4,650 23,486 100,089122,
23,499
174,
oo6
v26O1
1
,
Males: :L951 conaus
At tho timo of publication
not ava.4LUbloo
figurps
is reasonable,
It
IMere havc not been any mjor
based on tho 1961 oemus am
hmover,
indus*Jal
to asumme that in thin
changes over the paat decade
t
in
henoe
no
ezpectea
chif
socia3. clAss dis tributicm.
and
fiLmas are for
Conparing
nourotic3-
rnales,, occupied and ravired,,
the
riw=s
observea
neurotic
and non-athletic
for
210 consus
aged 15 and over.
social
groups, vrith
claw
in
tho athletic
the, incidonoo
of social
from which theýsampjes were drawn, a discrepancy
the
in
population
clasm
Class I.II ( ce* HIsta; gr=. t P. 57 )
,
for
Cigurea
thOsO
nourotiO patlants only rapresent
:
Although
emarps
ref, arrals
in Social
to one psychiatrist
detemine
to
purposes
logitimato
city
in the o4y. it' is useful
the r.atio, por 100,000 populatiou
comparicomo
for
the
oompamtive
iu oraer to elTeot
of "corroo-tod"
Tablo
HID29Vourotio
irold. erxqkL
SooLal
CU33,
Out-patient Beforra3.3 to one Poychiactrist
PoEula,tion
each Class,
-in
per 100,,000
Social class
I
Athletic
I
11surotiou 21.5*
Won-athletio
imiaence
CIZ33 1
4.25*
31.0
22.5
43.00 26,0
13.0
271.01 4,25*
be soon frm
will
v
21.5
of 1. or 2 patient
Based on very rAmll figures
It
IV
the histogr=
and tables ttw..t wb3reas tho
and non-athletes'is
of athletse
higher
and a lovmr
thw
than expooted
As the n=bera
of theý Chi. sqwrod
in Sooial
test
in Scoil
expected. proportion
proporti,
equal in Soojel
approximately
13: IV =cl If therO in a #sorepawy
prOdUO03 a rather
per class
Cl.,, I, n-I
of athletic
oU of non-athietio
usurotios
murotica,
qlassea, I vza V aro so Gpall,,
the 0148ces are re-groupad
for
tho, puxposes
thýw:
Sooial Class
111
11
Athietio
Neurotios
Von-sthletio
7-'" r. 4-:76
This
b7 aocial.
.9.
t=ud
2 df
Bl%Ow3thOrO U
sipificance
dir, proportionately
h6l
31
8
13
Total
43
7
28
difforecoe
DO signifioant
groups,
in Sociza Class nl
high inoidonco
of nou-athlatio
V
I Ilot sigEaLioant
of tbgý two neurotic
class
to=rds
iaoide=o
P=/.,.
6
IV
typo
of athletio
neuro3is,
H=sver,
in tho dit!, trlbjtion
thora
j3 & atro r-9
in which there
typo naumais
is a
and a lower
I
Grr
L
/20
L
ilt-
A/A
- OCT
$
II
. 60
4
I
-40
-20
I
ýOC)AL
CL-Ass
IMITAL
END SMUAL
MARITAL STATUS
Number of patients
mariviecl in both
Married
Athletio
a
arc
singlo-
Total
36
lieuroties
44
19
Non-athletio
9
28
Percentage Marriod
Athletio
82% at MS= ags 40.3 yeara
lieurotics
67,5% at moan aV '3406 'years,
lion-athlatio
Thora is no signMoant
difforunce
two, M, ýps but there io.,.a trend
betwaon tha
statisticallY
tovarcls more. athýjetscs' being Farried,,
14,,, lWaTAL C01.51ATIBILITY
.
Atal Ha=on-v in thoze who are marrioa.
11ýppy Woutral
Unhappy inc,
av6rced
-ok.
36
31
Ath1ptio
8
Won-athlotio
rrihst f4auraft
2.
a-ra rearouned
9.
baimpai a, of
19
mmbnrEt-!
fmall
Neutral. or unbappy
3on-atbletic
VP:.
11.67.
3-1,
''
(, 001. LaMhi&IX
'3.
The divorce.
represents
rato:
Thorp
an Inoidenoo
i. s one diyorced
of divorce
Tdtal
36
31(861,:
Athletio'Nourotics
X2
Total no,
"mirried
of
.
19
sigrAficant.
patient
in, 'each group which
c. 4% in 55 marrAlagas,
i
15pSF.TUAL REUTIMS IN THE MAPURIED
PATIERTS
(a) P. aim of. Sp6tiafaoýýon in, Se=al. interpourso
of nourosia,
bofore
onset
lsoxual latmourso
Athletic
%
Satisfactory.
Unisatioraotor
2
7
2
12_
1
6.
1
INeurotics
lion-atbletio
The 'query'
Total
36
1 .
19
to mirdmiao the differenoo:
came are rodistrlbut94
Sexual Intezvourso
Athletio
Satis; ýotory.
-Unzatizfaotory
Total
27( 75A"
9
36
6
19
Nearotios
lion-Lthletic
NO DISELI: 10=t
dirrarenoo
I WMW
(b) Humber with diisoreparpy between. mari tal ha=ony
,
for
interooures
X
sexual
rating.
isatisfaoto!
Athlotlo
ana
Feurotics
Marital
Sexwl
bamony rating:
-++0-000+0
rating:
satiefaotion
There is a. disorepanoy in six out of 3ý marriages
Won-athlotio
Marital
Sexual
(16.5%).
hamorv
0--
+
rating:
satisfaotion.
isting:
in. eight
......
out of 3.9 marriages
It wi3l be noted thats papeoially
'unhappy'
are
iýto
maw
group.,
satiafaotion,
0*
Neurotics
There ics a disorepe=y
kj6,
ratin4
in their
00
(42%).
ýn tha iaon-athletio'vaurotio
marriage claim
oexual
4()
(o).
Ilumber in iihom Semml Drive
Deterioratecl
durinR
Illu3ss
Sexual Interoouroo
Deterioration
Athletio
Ifeumtics
No Daterioration
21
10
for
whoreez, the total
is
the. athlefio
neurotic
number cxf' married
due to one oa3o who married
divorced
during
deterioration
the illnesss
ot sexual
waakeninS. effoot
lost
rofraired
as ron-atbletic
rotioed
the 10 non-athlotio
ýLlresdy had a totally
satisfaotion.
if; J4'
is 36. - This discrepanoy
i1jress
during
and ow - case' who
cases,
tho iI. Imez
only, one. pationt
intoroctwoo
under tha Impaot of the illnesa,
that-of
group in tIAs Ublo
thuss, Jn t).,,*Bo tw
he w3aken himself,
murotice
19-
pi4ionts
rela. tionahips
of aexwl
1
duzlng, hia
Out Pf. the 34 athlotes
relevant,
Total
2
lion-at4letio
'Ito total
?
tho . issue
is
not
idoas
expressed
About twica as marW pthiatio
umzatisfaoýox7
reporting
s=ua.
life
neurotics
in isexual perfoxmamo
ýut aýgaipzt this
neurotics
of the
delibomtoly
and one cue
dzterioration
of
mu3t be oat tho faot
no doterioration,,
and t=
threa
had only partial
By. cozpardmoN OUIY one OaBOamongthe atblotov...
rapprtina no deterioratio n*9had a coxwa Jiro whioh was eltort of
Dati3faOtOZ7o ThU3. Gliminating th.050 casca in whwii tho ue7.tMi life
Ij bacome worso than it
oould no-';
in Sexual
Deterioration
wazo tho figures
Intemourcowhere
Fresont
Athletio
Neurotiov
21
thorp
read:
in
rocm for
Abs,3rt
10
Doterioration
Total
2
Won-athlotio
.1
33
16
-
TX we rediztrilbute
6i,
tho 'quarien'
reads:
to lessen the difforanoe
Deterioration
Absont
Prount
21
Feurotioa
Athletic
8 (50%)
Non-athlotio
do not show any #gnificant
These results
two nourotio
Total
12
33
8
16
difforemo
nine sinMXe patients
out of 28 non-athlotio
shows that thsrO aM two siU910 athletio
single non-athletio
Attituda
murotioc,
rourotios
over 30, and four
rourotios
of SinLle Patiento to. tha ý2MCzjta Sox...
Neurotics
Wegative
TOtal
3
8
Von-athletio
The figures
differecaso
ara maU
and
Amalyais by ag3
nourotios over 30.
Positive
Athletic
botwoon the
groups.
16,, srxuAL ATTiTuDEs OF SINGLE.
-PATIMS'
There an eight single patient- out of 44 athletic
I
thig
and tbore is obviously. ýo signifimut
C-
C'
Tffi..ý 1f OFA
R303'
OF MY POSSIBLEE
17. DETAMSDACCOUNT
PREOVITATING RMTS PRECEDING
THE CESETOF TIM ILLNESS
of, tha 4ifforance
Awayoi3
to whether
according
neurotics
to physical
beturven tho athlatio
the Mnasis
and non-atblotio
by a throat
vas precipitated
well-being
Direot
Threat
to Physioal
In Part
P=sent
Al'ong
In ýw==ter
Present
Total
threat.
23
9
12
44.
2
1
25
28
lion-athlotic
X2 = 26.33 2 df
Hot
by
preoipitated
physioal
Athletic, fouroticis
WoU!! ýqi Lng
P=<.
001 VOEXhisuz
of o&3*s the precipitating
SiLnifioant
factors
are multiple
thia
-
oocurs in two wuys:
1, A parsoma
may have a paries
of aone yeam,
period
2. For wW one attack
of similar
eaoh having
ita
own preoipitating
more than cn) preaipitating
thoso ocoroa a* I in part procir.,itatod
V a non-phyalcal.
additiowl],
athletio
neurotion
preol. pitated
throat:
so scored, *
by non-phyrloal
breakdo=3
neurotio
this
over a
ovent,
factor
may be presont.
thoro is
by pbysioul threat'
ooourroa in oj&t
out of nine
W tho twelve athle-14pianourotic
cana
stroomcs,, in three ocses the stro, 38 113
multiploo
Cns can itemise the, tdial =mber of preoipitating
with
the reurotio
epimodoz in the athletio
faotor3 assooiated
and non-athlotio
groups:
Ltatea by
Ono of the 9 athletic
nou; atics soored 'in
PMOJLP:
-Part
beCaU30
the
6treasl
proolpitating'faotor
vw4san awamness
physical
than
booause,
there
ratImr.
wore precipitants:
g=ee
at
of
slowing
of
bath*p"hysioal and non-Vayoical. charaoter.
12hun there
era record3d:
66 PraDiPiUting
oVentis in 44 athletio
it
40
Table:
Analpic
"
ndurotics
28 non athletic
ana. olansification
of preeipitating
events
in 72 male
neurotics:
:E ljo
itarts.
zical. Praoi
(in
being
the
23
laml
sole
Boir-j; lo An Wimlysis of'
non-PhYs.
3tressoa,,
3.? ozr3os) or par, t (in
44 athletio
9 ca3oa) preoipitant
in 21 out of tho
neurotics,
of 37 non-pbjoioal
2. An analysic
stressaa being ths solo
in 2.5 of the 28 non-athletio
procipitant
1ý
nourotio
casels,
Athletic
Bourotion
flon-athletio
Neurotics
6
7
2, Stress related to sexual or
r1exital relationships
3
7
3. Death c
"'nasr*
419
7
3110
1,
Strss3
work: this
inolucles i1norease in work tempo,
increased re3ponsibility,
failure
to adapt to chanV (mostly a3300iated YrIth rigid perfootiord=)
Total
related to
in friends or. memb..
of family group
ef 1,92,93
4, Corflict
wer
18
ambivalent role
re: Mother
Father
(2757o)
0
0
24
3)4
1
5" Conflict
oT arZrassion/submission
(Ina,
family
militarl
outside
discipline)
0
3
6. Threatoned break up of famil, %'
group,, including children's
from
home,
separation
marriages,,
moving house
5
3
7., Examinationfr-Llure
0
1
0
2
8" No clear prooipitating
event
Total of 4-05j6970
Total
(i-, Oa all
Of 1-8
ncu-PhYsiOal
stresses)
Stress of direct
threats
to p.Vsioal
toing
won
Grand total
LPitatiV9
0; P-"Oc:
evOPtB
5 (7.5%)
13 (32. %,)
23 (34. %,)
37 (92.5j"o)
43 (65%)
3 (7.5%)
66 (10%)
40
There were OnlY two cases in whieh there was no apparent
praoipitating
eventO
(60%)
(100%)
f.
r
,
Cament:
1, Considoring
non-plkysictl
stream
other non-phyideal
single
Thus it
groups.
for
sooounting
in both the athletic
illmoss
39% of non-PhYsioal
27% in the non-athletio
nourotio
related
to work associated
related
to sexual
rigid
with
males that
of:
the ton-
firstly
deaths
no,,wOtiO3,,
athletic
is
perfectionism.,
and non-athletio
as the most common,,
in the
Secondly,,
win
tho co=omest
neurotic
are comprised
str3,3303
group.
3U
nourotio
&roup or among friends
groupst it
exceed in importance
that itoz
can ba said of all
in the family
end innesses
in boti
cnlyt
2 arA 3 considerably
to murotic
preoipitazta
ZLijoal
stroscoa
oombimd =d
prooipitaUt
non-pbysloel
nourotic
It
tho three iteza
be aeon that
an
thm
t1ho factor
and
of stress
and thirdly,
stress
relatio=hipa,
andmarital
for
the
throe
of
stross
combined
nOp
groupa
account
above
Lhe
.
illnoaa
in
7E%
in
the
of
suoh
stressos
murotic
of
athletio
precipitation
65%
in the non-athletio
and
neurotics
2,, Considering
the total
65% of all
3. Of t.he )f4 athletic
jrjollýbejrg
neurotics
in
neurotics
physically
tho athletic
groups this
analysis
strossful
factors-
nourotio
of
group and. only
in 72. V%a,
there was a threat
as a prooipitating,
factor,
in both
neurotics.
in 10.7% there
a precipitating
that
revoals
atro3com
the non-atbletic
present
faotom
prooipitating
Zý61ovant strme3,
oon3titutes
7-55 in
all
neurotics,,
was a throat
faotor,
to physical
Of tho 28 non-athletio
to physical
wall-baing
present
as
23`-311,5fýiU211SYSIB
of
aU
-ýT-
ractors,
A.Caso
Precipitating
dt A..
thletle
raotors
Neurotics
HowDooreil as
personal
"pb
oal throat"
injury
to an1do
I
lUror
2
Attack of lumbago
D9volopint
4.
5
of Hernia
Fainted in oin=a at moment in
ths film of amputaltion of haro's
legsjlador).
Pationt is keen
footballor
'Influenza
Xothor s serious Ulroas
mare=3
that he himself
Advice to have operation
parotid tumour
id
32
of
throat
Present alono
Minor
Present alona
Minor
Pre 156
ent alone
Idnor
Present with
other factors
Indiraot
Present- alona*
Hinor'
Vot prosont
Three cumulative events:
lumbago
Sciatiod
and
--I.
2. flospitalised
With slipped
diso
3. Nata
pain
lllr=3
of ralative
house (? relevant)
seioritj
physical
and
(aet
37)
old
vmwing
7
Asnozament of
Prasent alona
Moderato
Present alone
Mnor
for
in the
Not present
I=reagod wozk load and stroes
of =Wbing sick wifetuo w4 seeing,
month
to children over a
period
not present
Aet 41 - for a your consolous
lovod
fitnose,
lolling
at
muoh
of
.
&otive sports
Present with
other factors
19,2016 a*norvoua spoll. after
Recontly:
operation.
nasal
1,ý Dental extraction
2, Fractured metaoarpal
3. Biýton by Alsatian dog
Attaok of ,i*
5 nusitio
.
of family dettha
ta,zo number 6
,
,
=4
Present with
other faa#r3
Unor
Cumulation of
I
ainor episode a
= Uodarsto
Faotr
Precipt3tt
13
14.
15
16
3.7
18
19
20
Fab#lo
? Ewephalitis
How scorad as
personal
"PhyZioul tbroat"
(ml2d)
Present alone
Two episodes of minor
injuries
on hockey fiela:
1. Blow on býak from ball
2.6nision
idth anothor
I plapr
Pxýuýant4oýo
Losving satisfaotion
of
lbgu3,ar Amy We for poor
grade employmOnt
Not present
Hart hio baok after
ev work
liftiug
1. Blow in gmin frcm
(baokfira)
hancUp
startins
2. Ostootomy for efTeot. 3 of
above
iviifele infiael#y
2,7celing
forhis
not
J6
strorgenough
Azoo-ac-moal.
sovority
p4pAC&I
1,1 ýMnor
a
i
1prosent
alono
Mnor
Present alove
Major
Preaeut vdth
othor feetors
Minor
Roaarato
1.0amed as chilcl bacl heart
kIqO
* ovidenoD tor
diceaso
this - iatrogensais)
for
throut
Minor
..,
1. liospýtaUsed ? ooronary novor establislascl
2. Cametý) work in a strange Present vdth
town
othe'r faotois
2. Askea to return
c9l
Presont alone
rapeat
ý', Coronary thrombosis
Vary-marvous after each opis I ido
21
T=rease of york. t=po
and 'rbzp'onsibiýity
ýot
.
prewitt,
22
dDath and
Irither's
own.'marriage
failura'of
Rot present
23
? influenza
P. M.
lanUxl&r favar
7, rr,,.
Proaant alom
MaJor
1
-",I
CO.,
34
W.
0.
i
procipitating
Hor soorod
as
parsonal
threat
ph7sical
Factors
I
Ascea=ont
severity
physloal
Fraoturad spin! D,, f emur
fall
foot
in
a
ana
Prosent
blone
114 or
25
FIrmatureafemur
Present
alow
Major
26
Carain=a
(&at 38)
Present
alono
Major
24
21
28
10.9
(Female patient)
1. Ait 22 told had ztrairod
heart (No evidence iatrogenic)
2. -Fathar-in-la: W'dying of, and
fath--3r died of hearb disea3o
,
3. Told by q. P. had high
blood prossure
Presont with
otbor faotors
Minor
in Rugby
1. Minor injuries
field.
in
2, Threat of illneS3
immadiato fami3, v
Prozent with
other faoto=
X-1m,
or
(azt
illno3a
Hothar's
cf nur3inS
and strain
fir3t
lenoed
30
31
32
33
of lung
illress,
in
his
70)
her -
ever a=. or-
f=i3,
y
Omot of perobptive
deafteas
and tinnitus
ear
right
Vot
precont
in
to
injury
1. Kild
development
testioles
with
of hydroccele
2, Oparation,
on
hydroooele
Present
alone
Minor
Present
alone
Hoderate
leg wound War-time
pain
severe chronic
2. Inareaeda
work
rasponsibility
Presant
with
fa6tors
other
tuo months of
frcii
death
uwle'D
thrombo31D
coronary
not
1.
within
proson-1,
MJor
of
of
throat
Cauo
34
36
ý7
.
Procipitating
How soored as
perpOna
physical
threat,
Ameament of
sovority of
physical threa
Attack of acute rhe=at6id
arthritis
at ago 19
Present alone
Major
Coneussodat work
Precent alono
Moderate
Impotence ard qjaculatiO
precoox on att=pting
soxual relations
IIftraaent
Attackýof Iflul.
Increased
work responzibil. ity and
disturbed relationsh#
Prenont with
(Pemalspatient)
with
59
Fawtors,
cuporiors
other f aotor. 3.
17incr
Break up of daughter's
marriage
Not prosen't
39
Separation from home
Not present
1A
Hdi3pit'Alleatiou'vith
mild
kidney infection.
Prolapsed
diso
Ant6veitebral
Presont alone
Moderate
'Strained back muscles in
injury at work.,
Present aloifte
Hinor
Major
42
Pulmonary tubaroulooic
Present alone
43
Trouble in sister's
Moved house.
marriage.
Overlooked for promotion
Not prosent
4ttmok of Influenza
Presout alone
44
B:
In the, Non-athlotic
Neurotics
1
Ilona dateotd d,
Not present
2
Cardiac death of stopfather and rearrousal of
la-lZont oblieation
and. deep
bond to mother
Not present
v
Hinor
Case
I
210,
3
If
5
6
7
8
9
10
11'
Precipitating
Paotora
Hovr coorod a3
personal
-.
threat
physical
Feared istraiwd heart
following cross co=U7,
=, n in Army i=ediataly
after
being in bad one month with
Tlu$
IPresent
alone
Inorea3ed work rasponsibility
and break up of establiahed
praotices at. the faotory
Wot present
Ambivalent bond to mother
Not preadni
Multiple: Sexual frustration,
inoreasea worries at work,,
friction with busineso partner
who subsequantly soauoed
'patientgo wife,, Cardiac death
ýTiot prezent
of friend aet 45
LWifo Ie death.,.12Y-ns=on:La
A faint? Plus offoot of
subsequent caraiao investigations vhich revealed an
septal'defeot
atrial
Sudden ooronary death of
oousin and threatened broak
up of older son's marriage
Confliot ro aggression
Ydien ohallengod to fight
Very insidious onset over
17 yeirs linkoa with childhood experiOnoes of
dominating mother
12
1. Marriage n years
2, 'Sexual fra3tration
13
Strong ramily hiBtory of
stomaoh trouble and brother's
for
Prognoatioutions
9100mY
ationt on this theme
identifioation
with
apparent
family patý6rn)
Prosent with
other faotor3
Present
alono
Assas=aut of
severity'of
p4yeical threat
moaorato
en
m
Moderate
Moderate
I'lot present
C
ot precont
a
Not prosex.
1,
6 years Not present
presont
OttGo
Faotorz
Fvýc-i,pitatint;
H"Ouveorad
P.o psraoiW.
pýysioal throut
14-
Not-ligr' s death
Tiot Precout
15
Amy #80ýplipo
Not preiso'nt
16
Sexual
Wt#le:
inarital
frumtratioN
dichamozW... work iitress,,
fath3rla death, I`rieiýdlc
death
Vot present
? Bmtherl a Prison
aeublancofor hoinosoxuMlity
110t present,
17
18
.19
lbsUy related to eirkieties
Iand respoUaibillUea,
at
r,v I"k
..
yather=ln-3ý*. ' a ppionary
20
Favolation
22
23
a
a
of Impotenoe
Vot presont
a
Not present
a
Rooont case of oarainqma in
f&mily. Veceint's*tross and
worr at ro rk'
rtustration
of stressful
r.mrrjago ard ambivalence re
Vot present
a
(Urfioulties
Vot present
a
Severe mousles in his child'4'.
ý
1
yeaxýi
y'ear and
ren ae,
not present
1widjous onsot ? leaving
-11ollool for work.
Ambivalonce re. parents-
Hot present
increased to*po an(I
at vork
responsibility
I)o,by's Illness
(Hjrzbhcpr6j3'3
disease)
father now in tinancial
25
piwaoid.
'Not prevent
in iar4iea
21
'I Not present
'13F.013mmat
Isoverity
S
Vot. pres6nt
P-6
2.7
Itarriago
Pot present
26
'Irailure in ixamination;
a#iety
ovaroon3cientioui
"icork.
I
re'.
Vot present
a
of
of
thzpat
1, Thrmfto
Athletic
Neurqtýco
Won-athletio
Nouzmtic is
23'
2
12--
25
44
28
Present uloýoý
Present vdth othar moupýysicai faotoiý
Not progow",
Total
Threat to phyaical
athletic
waU-being
not present
neurotics.
neurotics aind'92.5%Of =n-athletic
2, Estimate of SoveriUorf
at all- in 27. %., of
Threat tO EMB_Ioal W-en-boing
VaJo.- Voclerate Mnor
a. In tho 32 ýAthlotio
"116urotics
6
I
towoot
''17 (50)
1
b, Iii the'3 Itbil-tthletiO
,
,
#Ountion
Rumber with injurloS
Total
32
3
in 32 Atblotio
Ifeurotics
w 12
:L8. compsSATIM ISSUE
Tbig wvo p; erg4t in none of the non-athletio
00:nplioatad
Caso 17
(&at 45)
tj: O pipture,
in only th=o
neurotics
of tha-athlotiG
and
raurotion:
Co#ensaý: Lon claim in ýUrst illwas
at ago 35 but not in
(WoOid)illneziý
ilth
ons'et at ago 41
present.
C=PenssltiOn Olalm s0ttl. Ocl soon after'o=.
2, caso 25
(aot 62) 'at age
et of inliecs
clAlm outatanding for sovoral yeaia fr=
Cv.00 4.1
'compmation
ilad
fa.
iger_co',
'claim
ma*g3.
xiw..'pi6vad,, *
&t -age
onset
.-'
1911'
Afal
of DitTerencos at:
Analyzis
a, Aý2 at onset of illnass
b. AG2 at referral
-
'to Ltjm hiatrist
Hean age at onset of U-Ineas in 44 athletic
Man ap
n3urOtion f1ii36-36 yýam
omet. of ill. nows In 28 non-athlotic
It
t. teat p iz 40.01 2A21
b,,..Vean.age..at referral
Mean app at retprral
ci, =ifio=t
to, psychiatrist
in 44 athletic
to psychiat;
in 28 nor, -athietio
Ut
= 29J2 Vara
nau=tios
wurotjLcfj = 40.3 years
neurotios
34.61
yeara.
=
t, teat p= <0.05 IUMM-0ant
the above clata it
Furthor,,. fr=
betre-en Us onset of tho Muoss
Thus, because the athletic
neurotioss,
treatment
is
a clus
will
e, the
be seen that
of Us
the groupa
quite
4
eo groat
payohiatrio
the non-athletio
at the
as it
time
is
of
at. onset
in
thO OuiPv-tient
neurotios
ilýO
illnOZ3.,
Onset Of
VU10
34and =der
are aged
at the onset.
of
mV provide
'0113,5tand at Presmtation
mmrosis
of the athletio
for
are referred
of symptomn than
not
aP
to the notiology
5.29 years
tetween
the age, differaws
for
ion
p,-esonta4;
3.95 years
nourotios
duration
a shorter
the mor_ndurat: Lon
in..
and reforral
licurotion
lion-athletio
after
timt
Vourotion
Athletio
treatment
fonows
dopartment,,
for
66% are aged 35 and over
Of the nOn-athletio
Further,
nourotio
group
49.75P` of the
40
the
time
to
and
over
at
of
roforral
a
are,
aged
rourOtion
&thletio
81.75
the
non-athl"LO nIDurOtiGGare aged 39 and
of
while
p,3ychifatricts,
(Sco
)
HistOgr=ls
the
time
of poychiatrio raferral.
at
P. 74 ana75,
'urZer
F-]
.-
--
10
4
ol
10-lY
2S'-Il
36-3v 301
4,f-"
aa-a rcý,j a- 4, j 0"0,
f-S
4 4' at ý.t&=
No,
t..
ý
oitktt
'1
p
jo.. 24 2_ý72j 30-39
Cl,,,t
e
00
11
I
T
-
_I
Va
7A
z-
4ci
9
lit
&/9
2f
.
4L
C,ILL 4;
20
10
3t,
2y 2; -27 -
tý
4;
(c-)
^J,
r4,
ýme
FFATURM-AWD'PSYCHIA-TRUG
DIAMOSIS
20ý, MMICAL
I)erinitions
Depreasion
P,paotivotType
to be suffering
Cases oonziaorea
in this
not inolude(I
:Lj=adjMt3
Ondoganoua deproasion
whon present,
The most important
quality.
has bo.en the reactivity
differentiation
fleeting
to be a labilev
from
in which dopression
study,
of a difforant
essentIally.
in'this
texma used:
of SOM3Olinical
depressioN.
influences,
enviromental
wore
wa5
criterion
it
of 'the mood,
v aryirig,
appropiTatolat'vith
Diurnal
mood'variation
used
tended
the
and Carly
been
hve.
present.
not
weizing
Phobio Anxcietv
is
T
Ihis
(1959a
by
Roth
used
the t,o=
(1959)
19 62)'t King and Little
aversion
Patijological
trains,,
'V=iety
serrad
is
often
to
Pt
easy
surrounded
away suddenly
a fear
is most frequently
pation-ts
is
to dosoribe
ovOrah'olmins
:Eb is
by strangers
of fainting
involvod
noraally
often
The
and croudo.
to be
- O. g" 't 'edting
Tbe cc=on,. thPM.8. seems, to
'where it
is
to ozaselfo
attontion
not
There
foolish,
', Tho,
the pymptome, becomo,
and is
a docoription
of brief
durations,
- one t-jpo of. explosion
confinod'vd-Ithin
thus to the pa tiont
buses,
notably,
and hence appearing
to dzfina
end app,rahanuion
arenas
in a situation
drarzing
without
an experience,
;h an anxiety
bou.,
"ds tompamriliq-
is
in aI bus quoue,
difficult
a little
fear
ahurahea,,
waiting
to describe
and. placou
is : rom he-mo ths worse
the patient
This
situations
shops,
if
aggravated
in, a shop or standing
be olle of being
-further
large
(1964b)
and Littlo
to certain
oiWm, %3,, oafess
1959b 1960),, *Harper and Roth
Jeopardising
limito
used bý
of-
of affect,
bursta, ito'
tho entira
process
-77 of adzptatiom.
A spoculative
is tho focal
&=lo&y
OPUOPSYwhich mv7 on
oconsiom explode into a grand mal seizuzv,
jjUOohonclriasi3.
-
Mochondriacal
"In the a=ioty
with hypochondriacal
neurotic
symptcms are somatio in nature,
a=ioty
prooccup? t ion, 3., tj,10
but by tho f. -raqponoy of their
they
promote a conse of uneasy awarenaar, of bo&I.1y f=tion,,,,,
reourranoe
never to be coýnplcteiy swpcen,,that evon though no
belief,
to
a
allied
pIW13ioal abnormality
boon discoverek
ha3 yet
OnO daY it
(1960).
Roth
Slater"and
Uayor-Gross,,
W,,
.
hypoohondriacal
Although the adjeotivo
high p=bar
signifio=tly
doftoo
oh
%Thi.
belief
prociso
of athletio
dofinition.
in the pr,evance of serious
ld
taYlaoicuttly
ha,
boon
kZ3
so
and
that
,.
"cl"31
the tora
Ross (1937)
two caaea
of
dolu3ional
to
refers
foar
of
may develop
Obsoasionals
th3:iomboai*,j or malignant
Sometim3a these
*Poohondriaais,
into
fears
tho irrationality
is. a diagaostio
illwas
with
p.-Osontg birarro
liypoohonrie_oal
of
which
fear.
diseasa"
resolved
of
are unshakemblo
there
of the fears
be 1:1efs,
in
a
aspecta
with
arA escantiaj]ýr
uhich
and d ascribes
psychotherapy,
dinoama
of a ruminative
if
bean Used.
MUM03,
readily
a particular
is,
has
GoronaI7
state,,
a quasi
intemittentlyo
are,, moreovers
doluslo=1
insight
stranucu, 31y
resiateclo
Againp mwW with a=ie ty states
tiona
maneesta.
oonoopt
in the fr. 0a of evidonoe to th, 3 contrar v
disoase as part
bat frecruently
it
to a
some cases the preoccupation
physioal
"phobias
cyphilis
has been applial
neurotics
in
be. "-
will
fearfully
hyperfunotion.
of autenomiq
interpret
as mptoms
the
of discasev
41
if,
v
&U.
ep,pecj.
after physical oxmination, they are sant aray to
having
"nothing
the
the matter on ez=inatioe
of
riadle
solve
suffering fr=
yet atill
the symptoma. If the phyaioal exonination is
f03.1owedby a straightforward
of the meohanismsof anxiety
explamtion
apes
insult
vftich
not
produotion
symptom
ana
thiWcine; the fear of physioal
illw3s
hel.d belief
W' no insight
anl whioh doos not vielci
tmaitioxua
by
Slatair
noted
ag w--s
n-3uro'tjos
tetweon
the two.
(;onfining
(1943)
in his
to
physical
23
non-athietio
tha
of
Hyp ooho ndri a3ig
and obzesBions
allocation
about
diceace
of a=ioty
present
of a oase to a
a mixod neurotic
war-time
studies
In general
these
Patients
depres3ions
with
th-3 tOrM la=iGtY'
,a
psyphologioal orieing
b2tb,,
I%V
and reaOtive
a=iety
v;hioh he
of pbyj3:LOaj
ý.nd empi ana tion,
.
in the
group.,
in the Sorvioes,
atates
tensiont
in
diffiOultY
diagno3tic
into
with
VEMOTIC ILLNESS
OF
The initial
illjOS3.
from Misinterpretation
disealse
feara
from
arising
of
P-nd
CLINICAL Fl?ýý
preoccupation
to thq influenoe
from phobias
to bo differentiated
is thj3
has boon used to dosoribo
in the precenoe of phyclioal
a
reassuianoo*
remom.
and
ime3tigation
a logioal
wJJ3. usu&Uy vubsido,
who has severe s=atio
the mantal state of a patient
a firmly
ths patient'
study the term lkrpoohond#aais'
In this
and
to a mental
experience
27 of the 44 athletic
naurotic
of male
suffer
a good deal
of overlapping
by the patient
neurotics
from
and the
experience
recognised
pioture,
te=
to be of
(63. V.,) and 19
(67%)
experienced
group
one or other or
m
2,. Racotiva-41,,
jps cbPrOz3iOn is GOGILIn 14- (31.5%) of the vAliletio
rmd 12
naurotice
cf the non-atlaotio
neurotics.
3. A=ie: týr7Te-jýsionwWor
Reaotive-type.
of the atblotio
(86%)
24
ancl
of tho non-athletic
neurotics
Anxie. ty-Tension
Whare. neither
diagnosis
the prineipal
Or Reaotive-type
D-sprefision
Won-athletio
aro zesn
2
Phobic Anxioty
Dopers omlis
2
Phobic A=jety
with
Deporoomaliiation
atign
(4 Cates)
lieurotion
phobic Amdetj
awe
neurotics,
is:
(10 Cuses)
lleurotio3
AthlsU6
Dopression is seen in 34 (77%)
2
bypochond-riasis
Ob3mional
Neurosis
1
Hypoohondriasia/Hysteria,
Loss of oonfidenoo
conflict
1
Hysteria
and
Panios
A-
Table of Clinical
Ibntal
Featureq (a)
Phenm3ona Athletio
fleurotiois
Anxiety7tomion
'Mental'
Phenomena.
% 19on-ethletio
lieurotio. 5
% X21
cU
p,_
Silgliriow
27
63.5
19
67
34
314
3.2
43 1 1.25
'0-3
vaso
2ý. 5
5
18
1-25
(0-3
14.s.
13.5
2
7
10
a
.
Obvioua3,
v
N. S.
Reaotivo-type
Depression
Phobio Anxicty and/
13
Deparamaisation
or
6
Waterioal spptow
Obsen3ional
Irritabfaity
-Agstossion
Panio Attaaks
and
5
3.1.5
6
13-5
14
.
1.,
31-5 10
7.
-
"'0.3
25 2,29
1ý0,2
25 1.49
",0.3 *
IT.S.
0 9.121 1vOO2 H
.
K.00391
S.(FX)*
lo-mat
(yx)
corrao-tion
Ari&lvais-of
.
Atbletdo
"ozqoatod
"Achar's
and/or
distribution
:,".xmot
Weulvtloa
= :L.,I?
a. e of Clinioil
1 df.
lows
than
ýCest"
is,
Yatoo
u&34. 0
of Tonpion ana A=iety
llov:--avAetio
X2
io
I
oithor,
P=<.
A=: Loty
Tension
22'
8
13
9
3 Not singicant-
Foatums (b) lphyoioa3. ' Phonomona
Athletio
Neuratiou
g,-.
1yajoal PrAnomer-a
1, Number Tdthout wW phjsioal
2-0 Number vdth plVvioal oomplaint
bý-,.,full insight into its
psyohological o#gIns
Iluieber vdib obsessionA
(inSightful)
proooeupation
121'health
physiCal
Tber'efore rx=ber without
'
of qbyaical'illuosS'.
with
emy fear
x, = 90;
.
13
8
3
6
1
0
17,08.5%)
14 (50%)
1 df p. =<5. Not ei&zd-floarýt
Number Tdth -Cardiao Neurosis
az 'Orly PlWeidal 004luint
Fich3rs
Non-athletic
'Nourotios
"Exaot Test"
5, Number with severe somatio
fears
of
'
gr6as
preocc4ýd6n;
Iphy#oal ill heat h; narksa
,
but
hypochonariacal attitudes
exoluding puro cardiso neurosis
6. Number with quasi delusional
hyppr.chondria6al boliofs'.
.
Fishor3 I'Mmot Test"
(21.5, e4)
26
P
<. 06.113t v,
12. (2ro)
08Mt.
2 (7%)
5 (3.1%)
P=<.
15ý Not cjf2A: ric&nt
81
Atl,,.lctio
liourotica
Therefore (A) (5 +
Won-athletio
Peurotiots
17 (38. Z.,)
8.736 :L df P=<,
(B) (4 +5+
x
ol
Hi
A
19 (44%)
2
1.55
1 df
P=<,,
ant
8 (28%)
3 Not simifioant
Thuo:
!!p Differancas
icant Inter
1. si
The statistically
siamifioant
difTeranoes
between the
clinically
two groups are a highar. 1noiaerae. of pmdo &,t-uaoks in the athletio
neurotics,
arA of Bovere,,,somatio PrOO00u;atiOn of hypoohondria0al
(pxolUding
cardiao
neuro3U),
Five athletio neurotics displWd
beliefs
type
a pher. =enon
not
quasi dolusioral hypoobonariaoal
seen in the non-athletic
nourotion,
2, Trjrd3
Additionally
( leval
a study of the figuras
show thaso trencia:
<,,
2)
15
P
of
=>.
Neurotion
Athletic
There were more cases with:
phob.io anxiatY/dePsrzOnalisation,
Oeoocupations
OSMPt=s aud 30matic
hySterical
Non-ataletio
Pý-
of all
kinan.
Neurptios
Tbare were more oases with:
irmitability
Symptoms,,
roaotive-type
and aggrossioN
do,proesion,.
ab3cnoo of aW fear
obsessiorga
of phyr :Loa,
illness, ý,
The non-athletios
signs
not
seen in
also OOMPlain Of a GrOuP of sirmptoms and display
the at*etio
neurotics
viz:
Athletic
llorb-ýathlotýo
uburutiosý
-Nourotios
LOS of con?1danoe
2
self-consoious
Eardly
3
2
uPset
consojouri
Yealings
couniot
3
of inferýorlty
Diseatisfaotion
with
301f
introspeo tive
2
Withdrawn
2
21
as ird,,rospective
These mv bo reprded
phenomona.
that. whereas there -is no significant
It in of interest
in the number of casep showing prooooupation
(though the athletio,
whore this
this),
r,araiao wurosis
group
neurotio
neurotics
experience
in non-athletio
murs,
in six out of eight
the fom
taken
is
aifference
ill
with physioal
health#
a trend toWards an exoe4l,3 of
neurotice
it
oases (75,rfa) while
a nonp-oardiao
takes
th3 rorm (e
in the athletia
bypoohondriani3
in 17 out
(9
Vp).
3,9
CS533
of
plsyqhosis
one athletic
payohosio
further
two ycars
athletic
neurotic
(A,: L4,),
neurotic
illne3ss,
Another
after
with
oneirophrenia
tho resolution
suddenly
developed
developed
a classical
endogenow
depression
neurotic
(A. 10).
of the orig: Lu&l n9urosis.
t-hreO months after
patient,
neurotic
seven months afterthe
patient
(A. 21) developed a manic dopresisive
illness
cleared
the
onset
endogenous
A
of -the
depression
as a clear
out attack
and a year
later
present3d
=
t
Ono other Athletic
patient
and complained of "a
3.o,3t insight
cor head.,,"
neurotic
This aelusionlea
63 -
All
were athletio
of 1Q4 of the altbletic
severe depersonalioation
round the outsida
of 72 malo neurotioB
during
m=ifestations
DaurOtiOs aud this
neurotic
of
but ba made a full
SUSPiciOn Of cohisophnnin,
(A.
'Thuni,
28).
out of a total
rooovory
up period.
with
halo of jelly
to a
Oubsoquontly developed psyohotio
1ýV
4
the four ye=3
MPMants
follow.
an inoidence
group,,
I
Similarities
Features
Anziety
easentiall
and tension
or reaotive
depression
two thiras
of g1l
= detyp
of the symptom O=plox,
as part
of the Mrafle
Athletic
Neurotics
Clinical
Features
Depressecl, anxiouso d=oralisa'd,
depersonAisedo Cardiac nauroiis'
2,
groups:
of a13. the 04090 haa
quarters
Data on the Features
Caso
Vo
in both
in approximately
ware pres3nt
Over thmo
both
in
groups,
casca
tension,,
.Z
in inoidonco
similar
I
Diagazie
slightly
A=iety
state
Dejected,, domoralizods reactive depression,
hystarical
irritable,,
panics,
very
A=Jety and
hy3terical
state
(a) 10 pars:
tends to onr, irTitable,
easily fatigued
(a) Low grade
a=ietar stato
(b)
dhest paiuip a=ýGýy ++,, reactive
depression,
weepys bypcchon&riaoml,
panics.
mura3sthenia,
Severe unremitting
panics
phobic
amdoty,
wealmeas of lego. ITo emrMr.
Anxioty
+
concentrate
Unable
acute
(b)'Xi-med. neurotic
state with bypoýchonariazio
Phobic
state
anxiety
to
Anxiety
(+ D. S, )
84Caso
Clinical
IWo
OW-000
Fwature3
Great fear, of having Physical
:L111,303o Meai0al
iatropnio
investigations
and surgical
-,,
leacl to I=rea3ing
factor
PMAO,,
"Back not stron%"-narvousnesso
inZ=ni&
ana general
Diasnosis
A=iGtY
IstatO a24
bypochondri4sic
Anxiety
state
hypoohondrincis
8.
Very severe exodety,, phobic ar=iety.
Severe quasiDepersonalisation,
foar of cancer, Hysterical,
delusional
importunate*
childish,,
Mxodl muratio
definito
state;.
hypoohondriasis.
9.
transient
Claustrophobia,
a=iot: r sympto=,,
hysterical,
phobic a=ie. ty, slight
aspersonalisation.
EizOd rwurotic
state
10.
Hysterical panic attacks
him
leave
might
at fear rife
vith
ýM) Hysterical
state
b) 7/12 later 2nd6ganous
depression
attack
(a) 18/12 later
oneirophrenia
n.
Acute panic
attacks.
12*
"strain
Severe temzion
and
stato,
Obsessional
"
chooking
and
weakness.
fears
of illness.
Acute anziety
state
A=jety
stgte
tension
+++
Obsessiona
ar,
symptom's
13o
Reaclaothoson exertion,
vague. dizziness.
(Consultant Veurologist*-, N. A. D. )
14.
leading
faintnesis
(a) An:ciety,
vomiting,
illnasn.
fear
of
to paidos and
physioal
(b) 3/12 later
suddonly features'of'
depression
severe
endogenous
moderately
15.
16.
(e.
health
ideas
g.
ro,
Quasi delusional
'(Corizultant
log
left
properly)
oan't use
V. A. Do')
Ileurologist:
Tension,, anxiety.
A=iety
state
Jý=ioty
Stato with
hypoohondriecal
features.
B'Wogon=3
d-oProssion
aymptomatio
bypoehondriaois
Armiety
state
I\
85
=
Caae
NO
Clinical
Featuros
DJaMoaJj%_
3.7.
I=ong=uz3, v severo pain in log eter
18.
Anxiety, panics regarding health. a=doua Anxiety state with
.
Multiplo
severe
symptoms,
somatio
self scrutiny.
hypochonriazin
hyponobonrincis.
seVere
19.
Anxious, depressed. latroganesis.
Phobic ýnxiety/daparzonmUsation,
Phobic anxioty/
doperponalimation
state
20,
Fhobio wwdoty. Azxieýy
Phobic wudety state
Anxiety ++
21
Suicidal thou$ite and depression
Reaotive deproazion
(Hanio dopresaive
psychoais 2 yearz
'later)
22,
VM severe am=iety. Phobic a=iQ ty +,+
Rmiriitive and compulsive phaviizom"
roaotive doprouaian,
M=& state:
Very sovoro phobic
6=iety. Deactivo
doprosalon,
hal murozis
Obaeasio,
934o
Weakness,,=roxiap
apathy, loas of
intero3t, Not depressed,
? Waurotio state. A32
pbysical investigations
N.A,,D. (Consultant
Physiciin)
247p
.Burning stomaohi foot pain, hoacl
hynitdripal
di6,
fears
'
will
pains, *
attitude.
ffyýtorioal
hyPObhdZdriP. 313
25,
feam of
dyaptoea, fatigue,,
Dizzinns,,
heart di3caca loading
on to reactivo
6omatio
*
Pýin'jn
depressimi,
anrAqtjez,,
hips
"ell
if
ovejýo
ana
ra3jts.
abdomen,
(Consultant
Pbyzioian D. A. D. )
A=iety
Irritabl
o. tonae, deprossivo rýminationz
'
*
his
aeath,,
religious
r=in,;.
regarding
fears
will attack
obsessional
atiozw,,
wife and childxOn
Severe roaotive ty-P3
dop'r6ssion witli
tenilon, andLobs3asional
fears'.
Panicky breathless
Phobic a=iety.
Severe
i
headeohes.
Ten3ion.,
attacks.
cardiac neurosis.
Phobic a=iety
Amdety stato
'26.
27.
injury
and ontootomyo Tonsionle=ioty
Amxiety state
atate
antl
-W-
Cano
28.
M.Woal
Fomturan
Dimosis
sleeplessness, hoadackws, Can't
ýaýas. P=ios.
conoentrate, auicibl
fear of caneer. Deparconalisation
,in
delusional
to=rj
-bizarre
ciesoribea
Anxiety istate
doporconalization
(quasi delusional)
leeding to suepicion of sohimcphronia.
29,,
Insomnia., w3aping, anorgia,
bursting
fear of Li3wdty,,
in
to
30,,
head
waight lose,,
in haad,, tension
bowildorod
-
and stomach
A=Joty
state
- OlinS3
wife.
joint pains.,
Hervoue, tonze,, tinnituo,,
obost pains, mimb=33'in ciao of hevA,
insomnia,
fear
fainting,,
oe
parasthoniao,,
fear of thrombosis. 'Dolu sional belief tbat
he is
riddled
vdth
Quasi dolusional
hypoohondriazis,,
long, -standing.
V. D.
31
Deprossed,, suioidal,,
32.
fools faint
LeSp collapsing,
- panics.
Sick headaches - groat*anxie%
insomnia
(CoroUtant
Physician
W.L. D. )
35o
Depersonalisation'o
Headachs++ A=iety
irritable,
and routive
depression ýdth
stomaeh'sýcho, nausea 5 'broken
oon3tIpation,,
(Consultant
hypoehonriacal
N. A. D.
Pbyzician
aleep.
*
behaviour
features,
DriuldnG., associated
Yrith abusive
Pears of cerebral
attempts.
and suicide
Hjpochondriaona.
thrombosis.
No phobic
a=iety
Anxiety
state
Hypochondiaoal
Depersona. lisation
Otate
featuros,,
Do:pression,, hystorioal
phobic =iety/depersotalization
35.
Hoadachas ++, pain3 azd loss of powor
in a=a, can't oorcentrato,, exhauntak
doprescod,,
inscmula,, choking, irritable,,
fears will fall.
36.
Worry ragarding
insomnia
37.
Severe phobic am:ioty
impotence,, blushing,
Phobic anxiety/
deporsoi4lisation.
Mixod dopression
hysteria.
and
A=ioty
and
hypoohonriasin,
Reactive dapressiona
Anxiety state
Phobic &=ioty
(;linical
Poaturas
Diarmosis
3B.
phobic aradety/dopersomlisation,,
a=loty
and crises of pozio. Loss of woight,,
reaotiva deproasion.
39.
Loos of confidence, violent
dizzy's listless,
headaches,
morose
Phobio anxiety and
roaotive doproasiou
Anxiety a tate
40.1
Irritablo,
panic, dejectea, ftmoraliaod,
excessively worried regarding
aggreuive,,
kidney troyble (genuine)
Sovore a=ioty
state
vith hypoohondriaisis
41.
Der-Aarallued, back pain ++,, depressod,,, lost;
body symptoms .++
insomnia,
or =Ight,,
F.Daotiv, 3
Amdety.
dopresSion
421.
omatio symptoms ++ Insomnia,
state ++
43.
Obseadional.fear or choking when eating.,
tension,
phobic anxiety/depersonalisation.,
anxiety,, panio., tingling in nookepigastric,
sensations.
ul
44--
worx7 re.
Tension, --'ýVjjsgroMl sleept aw-cating attacks
'loas of confidonea, no .fears of physical
illness.
Ron-athletio
2.rnxietyq reeotive
d,epression, Sox-atic
prooocupation ++
Mixed ob305SiOUaI
neurosis'and phobic
u=iotvaepomnuization.
Anziety
A=Jety
(ttnajon
strto)
neurotics
no pbysioal
2.
Hypoohondriacis
(compenwaluou case)
fears)
thoughts,, no pbysical
Depressionp
suioidal
donial
symptoms,, unhappy tho, 41;hts regarding
fooling
inferior.
life
full
and
of
doprossion
reaotive
'I Wogenous
mood
)
P.
swins'(W.
(a)
(b)
Amdety (oarcliao neurosis)
Obsessional murosis
Cardiac I; euro3i*
Ob3essional fears
of hatming
mother
Cardiao Veuroz;is,, cbpersonalisation
tension - (a) psychological:
sudden spells of depression.
(b) physical:
stomach flatulence,
(full
insight,,
not
vomiting.
occasional
ill)
physically
A=iet. v. Cexdiao neurosis
Dapainouili3ation.
ft=joty,
A=dety
state
(. N. P, )
Diamoals
Obeassiowd Preoccupation
and nasal muao3z'
Dizzy,, palpitations.
disease
Ath
balcLiace
foura of heart
Obaossional
(but little
nourcsis
- insight)
iety ++ (cardiao
t=:
.
-neurosis)
Depersomlication,
dizzzyq,
phobic tt=ictys,
headaches, fear of passin, -, out,, irritable
upset.
ard easily
Phobic a=iety/'
depersonalisation
r=de ty *
81,
Iýysterical,,
seoldngq dePrestsed,
attwntion.
Anxiety ++, terme,, cardiao neurosis.
Icy
in baok
feelings
worried about
'; evere hysterio2l
',,
Wasi
state.
raciety
e-olusional
comatio
'ard
preocoupations
obaossional
ruminatioru--
9.
Can't cop3. istomach cramps. Hysteriloal
Phobic amdoty,
ýrasentation*
fIxed phobio
and byeteria
Conflict
10.
Loss of ooeidorme,
3.1.
&oossive amdot,.ý rqgarding
blushint(venr
circ=aoribod
12.
deprorned,, domoralined,
Ineowda,
withdramý
bolief
noso*out of shape
quasi dol4sional
irritable,
stomach'acho.
aggressive,
)
'(Comultant
N.
A,
D.
ourcoon
13.
Retohing and vomiting
anticipation"(oxprossaa
U. Iness).
pbysioal
14.
regarding
cooial
neurosis)
Bluching
(N. P. )
nourosis
IUod
state
? parar-oid roaotion
Vdth awdoty.
"u-miet,
dissatisfaction
Soing
amdety
Conflict
rourovits
undar stross of mW
no fearn of
tansiona autism,,
Inertia,,
life
is
and
way
self
with
and
ate-to
(N. P. )
Unolautified
neurotic
Aate (. N. P. )
'
Gro3s loss of confidenoo,
aomatio a=iety
tiembles
dy#toms,
++,, fear of crowds,,
suppmased aggrossion ++
13evere
a=Iety
,
(somatic)
16ý
Maotive dopression,, tenslon,, can't
intsommia,,
initial
introisconoontrate.,
peotion,, anoreXiao
Armiety
17o
depre3sion,,
ten3ion,,
A=ioty,
reactive
, lack or ponfid6noe,
? lator
qggresaive,,
featurois of andogenous depnision
stmte
Amdety stato
3tate
(II. P. )
(N, P. )
ca.,30
Dia
Inc,
ma-dety., depressLon, tension,, in3omnia,
aggressive suspioiou3 attitudes,, cttaoks of
taobyaarUa (insight that this lattor is
pajohologiocaly induced)
190
20.
21,
Amziety,, obsessional feara regarding beart,,
irritable.
depressed,
nourosia,
oardiac
WorTied rogarding
narried
impotence
aince
inner anxiety,,
Attaoks of exhaustion,
Ansomnia, self Conscious and Self &mare,
(insightful)
fears
nlit_ýht obsessional
but
health
no scmatio
ýe,
: Sazzting
prooocupations.
osill
Chrordo a=iety
(. N. P. )
A=iety
state
(oardiao
nouroEis)
foatures
obseseicnal
Psychogonic
-
Arxiety
state with
featuros
obsessional
(Ii. p. )
22,
lack of onorgy, run aom,
'go oonfidenoe,,
tightness * in ohodtv
Ins=, -da,, oan9 t relax,
illness,
fears
of
somatio
pains,,
t3tomach
hypoohondrimeal. attitudoB. 9
Anxiety
state
hypochordricoal
features
23,,
!, osu of confiderme, reactive depreasioN
fears Of malzing mistako,
lrritability,,
3light obsessioral checking, No 3omatio
prýooouputions.
Reactive deprossiou,
A=ioty
YrIth obse'asiomi
ecatures (W. P. )
Sovero ourdiao
"-urosis,,
part
Latrognic
and
Anxiety a tato
(oanUao nourosis)
lRoc*tiTo depression
(N. P. )
25.
Lou of oonfideroo,
easily
upoot,,
depressiTo mools and suioidal
unsottled,
fealings
and gortures
26.
Tension,, insomnia, nightmares., obsesaional
ovorwaekins,, conMiotz regarding goals
ar.1 identity
Oonfliot-tension
(V.
)
P.
state,
F-7o
Bmoiing rountment and moods of
embivalews regarding wife - violenoe
irittable,
3uioidal ideas., stcmach pains
(Consultant Physician N. A. D. )
Conflict
++ with
3toma0h 13ýMptous
Tension in head and loge., insomnia,, loss
of confidenoe, clapressed,, obsessional
fears will make mistakes, I year provon
D,,U,
Arzriety statev
obaessional features
? Atypiona dndogerous
type depression *
28,
* No-S. In 17,1wosof
non-atbletio
do2ressiont
of oiviogo=3
SUNTM
naurotj, c,,,,, a SuSpiclon
but in nono Tr,%,
a thic
OF 741,701PODEGS
OF THE CLINIM
cllagrzzis
is
presont
substantiated,,
37WESTIGATIM
(The iteias tsl)cd in capital a are thoso in Wnioh a signifioant
has been dcaonstrated between the t1fo nq.arotic groups)
difference
xhle Nourotials
Jýudly
hl3tox7
xantal
illnen
Athletics
lion-athlol-,
27%
22%
ios
car-08
of severe
FAWIY fr. "jTOff OF MILD
IMMTAL ILLNESE
14.5
N. S.
V.ZH--2
Is.
M-PTIVE HISTORY BPOR
1AMILLAL METAL ILL HFALTH
H. 8
IZUILITY W PMATICUSHIP TO
MOTHERDESIRABLE
QUILL=
Paronlail
Or, RELATIONSHIP TO
F,kTIZR DESIRABTZ4
H
ha=czV
YULLY DMIRIM
13
5Vo
E PARENTAL
rl
3."
I.,
-SS-
SIZE. LUIGE SIBLING
Yl=j"
TICUP '. (4 - 12)
,,,MrDlY07J ITET31MICTRAITS
MPROMS
w),
,
=HOOD
211 CJ,
CM111100D MWH
Y ILINESS r'URMG CHILDHOM, 9%
Y,
JX,E,
:F.
LA
LOa
H&S.
HLSL
His
U-sx.
Ný-
71Icm
Athletics
ýathqr
Parental Deaths 1 Mother doad
It
2. Ago at parental aeath
mother
mother
father
1ý, SUddeIM335 of parental doaths
5. bauses of p3,rental deaths
woric record
Pon-athle tic a
50%5
55%
father
3. Loss o:C parent by death
before ag,30 5 and V+
Male Ilourotica
32%
a
WIS.
50ý
Do siSnUicent
diftorance
No significuit.
differencea
Do significant
Do significant
difference
difference
Hose
pail
SOCIABILMY PIUSMT
vH
Ms
PPMMIT '.
OBSESSICNALITY
111D.
"Nervy" parsonality
20.5%
Be
'
000U.0atiOn and Social
rarital
Si&nifioano(l
Vo signif-ioant
difference.
Trend towards disproportionately
high inoidonce of athletic
neurotics
in Social Class III
ClaD3
atutua., Percontaga marriod
8,2%
67.5%
MjU1jTALHMMOWYM THOSEPARRIM
se-xual Iatoroourse
patiOnt3)
(marri ed
Gati0f&OtOr.
Y'
Dotorloration
in s= Orive
during a3urosio
ttitudo
Aw
opposito
of tI
Box
single
to tha
Diiscropa=y in marital ha=OzW/
rating3 -6
ser" satisfaotion
75%
63,5%
'amall numbers no significant
differenge
out of 36 marriagas
8 out of '19 mýýagos
V. S.
16. %, -Athlatio
42%, -lion-atbletia
92
We
ltc: m.
Athletic
Tieurotics
lion-athletic
sigmoa=o
Tho
itating
.,,.
1, MSICAL
Strossoc
TIMAT PPMENT
2. PHYSICAL STRESSISPS A
OF ALL STIMSSRS
PROPORTICU
DMGT
(in
2&.Xla
M.
12a=,
249
THREATTO PHrSICAL W=
the athletio
3.14on-physioal
BlMiG SIGNIFICANTLY GREATER
M THE ATHLETIC
GROUP V. H. Sgroup the coverity of pýycical streas is orai major in 2ý%)
stresse32 aX
.
compriaecl of
a. proportion
in
deaths and illnosses
family group
39%
271%
b, Proportion comprised of
in
death3 and illnesses
fazily ýgroup,, vork stresa.,
and soxuzI and marital
problems
7E%
6Z3
C240%lzatiOn QAiMOý
c=ponsation
ia3u.e Pl7esent
rAl
0 hm,
ffl
AS,a16E2 OP 1=Esß
ä6, J6 Mar. a
BEA14AGE AT REFERRALTO
PSYCHIATRIST
go 35 and over at onset
At onset
o'
of illum
Aso Wand under at onset
Of inness,
At
roferral
go 40 and over at
to p'sychiatrist
rxvferral
go D9 and under at
to
r,, ferral
payohiatriat
29,J2, Z2ars
ýA-,61
.
21.75%
33%
78.2%
1+9.75%
18.25%
50,2, W
81-75,51o
His*
MmloNeurotics,
Non-athletic
Item
Athletic
Si
ficeM09-
do Clinie2l FOaturOOancl
Diaeosis
P=hiatric
t*nsion present
lo IL-miaty aWor
2o R.',,aotiv3-tYp0
dOPr9s3iOn
2
1
and/o-- present
3o
67%
63,5%
WIS,
311
Mo
4.9PAVIC ATTACKS
31,
5. Thoz* without =Y fear Of
physical illreso.
38..'X%
AHAS.
6. Those with cardiac neurosis
an only pbysidal complaint
21. %
HIS.
7e,,
P
MIS.
7. THOSETRIf SEVM SOMIC
pREOCCUPA-TIMS(EXCLUDING
VEUROSI61ý
CARDIAC
38.5%
8, Thoso with severe SOMatic
(including
prooooupations
iiTý
nsuros
oarUao
M ia
44%
(In
it
WIS,
takes the tora
those vritil sovore somatio preocoapation
of 'a
(75%)
in
6
8
'
Is
non-ýathlotio
of
cam,
=1
oiýt
of
a
wurosis
cardian
(90%)
19
17
in
bypochondriasis
out of
of athletic
oases)
non-cardiao
9, psychotic
manifestatio'ns
devoloped in
lC%
Wil
(5o5% of the total
male nourotica)
of 72
95
RY10 and Mmil ton (1962),
Ryle*s
practice,
the G,,P. by neurotic
this
considered
is possible
"
factor
In a provious
accounted for
to a peyohiatrist
atudy of aault
The relative
differInS
served is urbanisod.,
industeLos
in their
ocnaus of psychiatric
"It
oonoludeo
and
readier
"
Vale.
from
the
men.
cases in contrasting
community.
The authora,
(predominantly
factora.
vary in
of tho looal
class within
reveraed
(mining)
industrial
wore refei-ved
the
and
to psychiatric
In tho former (.P
ý0.00:L)
that men from the Rhondda.have been
with the minor fo=s
as to whether this
mental disorders
and geographic
and Brown (1958)
Ihu-ther,, Carstairs
appoars thereforo
to pre3ant
an opinion
by social
four times more frequontly
clinics
outpationt
the
and consider3
The rature
or affluento
communities that male patients
agricultural
in South Wales,
variability
in social
the distribution
(1962),
iiare
ty
oo=uni.
- seo
for
to the deeraO to which the area
according
indu3trialised
dictate
mav woll
Ryle (1960)
in the criteria
of the tTm typos of neurocia mV well
of the Pountry,
in
Sroundao
source of biaz lios
distribution
parts
to this
of
of the cases,
vvide divergence
among general praotitionors
choice is often made on irrational
aelootion
wurotios
ten percent
noarly
Kar,sol (1963) also draws attention
The other possible
somo positiVe
of neurosis
because of his intorost
Rammley and Loudon (1962) disoovered
referral
tho high incidonoo
that
has wourred
patients
illness,
paychological
"it
consider
for
acoouvting
of mental dil3order than have the
cautiously,
reflects
do not ca=it
a higher
psyohonsurosis
irzidenco
themsolvea to
of these mildor
and psychopatby)
in tb**
in
1
in cada
I-To alabi
that
)5 -
tho corolusionz
must hold good for eve.rj human cowunity
fr=
industrial
similar
urban industrialized
communities elsowhere.
of the payobiatrio
colleague(Dr.
consultant
,rho as my late
Sonior
Calmity
FlothOs
in
and
in
grappling
J.
medical
with
the area.
and
Syndromo (Phobic
st&ff,, ' pervina
in
1962)
Anxiety/DepersonaliBution
at his
pressnt
-
Syndrome)
hoopital
post,
of 900,000,,
of mental
ow
cases in malets
these
a population
problem
For ex=ple,
co=ur4oationp
was interested
Registrar
illness,
was sti3j
the pgy0hosels,
*
dopartmenta.
1.964. Dr MtEhesyopc rt3 that
.
it)
bOgi=ing
Iza
3
inoroauin,
in
B. Hu&boz,, porsonal
tho most praBaing
the Outpattent
is
servico3
had
seen no ca3e of either
-
females
vibars a =all
in
apply to
thc. *jr ir-oidenoo bocau3o the whole nouronia problem is hidden
by t1w natura
4
and
in malea in
Soma payohiqtr: Lsta may not aca these typos of nouronis
undorrate
atj4y
to tho Argontin3
in the North of England, and may well
a large
city
from Bali
Thay aro ba3ed, on finding3
to Koulcona
Ifew Yoex City
rcaohrwd in tho prosent
now, that tho houpitalls
to
of both
0,33 ex=ploa
moaaal
staff
t-ypou of nourosis
d,3partm-3nts.
in the outpationt
.
M3 TIM, REWIVE
l R
FUR;M.
INOMMOE
OF ATFJL? 117.Typr,, FLIn. OSTS.
-CIMCK
An a further
soan fr=
now pationts
Solecting
hospital#
o=o
cr#erit
esposoially
oheek a very oarafta
has boon kept O:r all
vibaltever couroo during týs year 1964.
the neurotic
as private
register
males aeon by myself
PEýticutc
and on dmioiliary
no cUtpationts
viziU,
in
urA applying
foatures
i.
e.. oliminatiu$
-
any males with
p3yobotic
calogencus dopreasion
- psyohopethy,
oubnormality
and ai; 7
tho
reforrecl
primarily
bocouco Of marital
the disti: #utign
parvo. raions,
ý"n
AU Uale IR,
ý.-urotioq
*as
U
six
hationts.
nov
Doo=ber
Intermediato
3
6
of 1904,
13 (3v?)
Total
Th9so*==ber3
6 (18,1)
aro: cma:Ll,, amd'although
in
the earlier
ap
predominate
nct
that
the
to
vion
support
largor
tho athletic
in males about equally
among male neurotics
18
6
15
11+(42ia") 33 (IOC%)
do
personaitiol3
atbletio
serios,,
8.
tli3 figurog
type. neurosis
3.ond
ies a comon
rep reacutod with non-athletic
oasee
clefizod as abovo,,
DIMCULTIES
Mi BT-nCTMG COMRIS(Ila
these findingo,
1.1aving obtainod
neurotioo,,
Total
roomalities
months
Sooond six months
a.ignifioan.
-12
1"Non-atblotio"
of "1964
condition
or
as follows:
"Athletioll
Personalities
First
or oexual difficultiofl
t. difforenoois
exist
one acka with
azýd havine, aamonstrated
that
between the two major. groupo of male
what othor
duta
thaso
filuung
in its
entirity
C=
ba
oompared and contrasted?
To disouss the relevant
entail
an exhaustive
ana opiniona
roferenoes
rolev=oe
relating
involved
literature
survey o'-'- the whole field
to tha actioloMr
woulcl
of published
of neurotic
statoo.
here have been ohosen for thair
flnding3
The
patticular
to the prob3-SM3
raisea.
In th3 absonoe,, so yetq. cý a oompamblO 3tUdy or matchea "nomaisn,
one only
bac irAireat
evids=e
rogarding
tha i=idauoe
of the racorded
ga
-
in
variables
tho male population.
inferenoes
drawing
Groat,- oaution
about "nomals"
frcm population
one in ago,, struoturo.,
from the present
One might exPeot certain
=alfmro to be obtainable
fr=
mu3t bo examisod
oomparable factual
d=ographio
differing
s=ples
sox., habitat
in
.
ate,
&atz of a definitivo
Purther
surveys,
advice was
sought from a Demographarq Profee3or Grabniok of the Dopartment of
Stud'O's,
SOG'al
Ur4vOr31ty
c):r LOOdz,
in the areas where direct
that
&3 the criteria
in almost every case from those used in this
is due to the inadequacy of info=ation
this
been forthcoming
of parents
given moref6raight
does this
particularly
refer
comparisona
Likewise,
there
appropriate
of the
Loods oity
r. ot yet
available
agos or of the
at the time
In some instances,,
but it
is hoped that
when the projeoted
unaertaken,
in my work which might have
regard
rogardin$
losing
n6tional
aivorce
by sooial
to enquirioc
figures
the ages
olassp
into
class
family
parents
at different
ages.
for
numbers married
at
at these
rates
ages... The analySia
based or, the 1961 Consus, iz
of YaIting,
rough: L7 comparable figures
statistion
the investigation,,
analym.ed by age ana social
stics
with
are no oomparablo
population
of data differ
In s=e cacoso
recearoh,
at the time of planning
of the population
and the proportion
size
the
usoful
to :rinci
birthdatos,
at death and their
to yield
of 80100tion
to the lack of infomation
The search for p9pulatiouptati,
fails
disappointad
comparisons are sought.. demographic
am not very helpful
statistics
Om iß P- little
of muoh higher
survey of morzal males
could be calculated,
validity
will
be forthooming
drawn from thq 3=0 community
Fýý
5p -
-
1=,','o'mation
about the more oubtle
to pýronta.,
relationships
in personalitys
,
traits
obseasional
bamorys
ato. j may be sought in poyebologico-Uy
studieip,,
but. onoo aSEdn,,. groat
abou7ids in information
Tho literature
suoh
to
spaoific
of, 30hizophroi4a
:C,5,mvae nauntios
sub-group
for
study
chorm there
Tiras, what may b.s specifically
in wealtby Vimose
innass
tho Ineidonce
illnoas.,
in mixed groups
reactions
nsoanot
in adult
are indeed
relor=t,
marital
interpretation,
to-the
of many
It
in
naocs3ary
to the aetiolo6y
it) not =cessarily
pcy&. qpatha
of neurotio
in
oe,,
ocx-.unity
what Is of rolova=o
illnossoo
or dplinquenU_or
this
for
oalled
of Psychiatrio
ýho antocedonts
to the gensais
rD: LOV=t
this..
pr depreasive
Furthernorog
n..3uroj$ia.
,ubich
about
oriontatea
regarding
in the antecodents.
variables
The qatte
is
oaution
influences
pophaI6, gleal
zvlovant
to
of meas ana
weezzarily
nalga,
be
even vdthin.
marked differonoo3,
aotiolooy
of nourotic
in 1906., or even moro vmeatby Her Yoriwm in
296.0, may only rel. ato in a vo.ry sonorra vv to tha aoticioSy of neurotio
the
industrial
in
mle
predcmi=ntly
skined
population
cW
an
worker
stater,
oity
in Englav4 at. tba pro3ont time,
14th thOsO r"01301'"tiOng in mind, TO CrO in a Position
general
information
whore
oompaxisquo
associated
trith. tho athletic
is available
and non-athletio
to dmir
between th
Majo =Urotic
by
in
"no.
boon
th.
has
h=d
otherz
rocorded
mcaSn
-,,
on
3
Ono
what
n=uroticvo
on the other.
variable*
V
groupg;,, Ona
and
TEE PORMOILSIT)
EXPIMMICE
B,
MID PERSMALITY OF ATHLWIC TIMMOTIGSo
Thv firist
whereas
the antaceaents
tho
reculto
the
non-athletic
is
that
of the neurosis-prono
concept
tj2is
is
not
so in the
crwp,
athletio
As a =plenentery
for
in
illnems
to marCr variablea,
respect
with
parnonality
of the =urotlo
to týe videly-held
approximato
group
to ba. dra-va from
conoluclon.
gororal
are and social
the seme oriteria,
using
vp,rjables
know how oloacly
the athletic
(The ftxther
at larga.
history
have a fauily
to
plo=ed
survoy
is
indicated
tho inoidenco
this
Until
now under
of mild mental illnuess,
Mr-ess
at an.
matohad
Cancrul
of tho
and quality
ia donos, wo do not
a=e
really
to tho male population
way - Jumary,
that Ir.,;; of athletio
of severe montal llluosa,,
history
a s=ple,,
males d=-wn from the
Group approximate
study
history
Th..
) family
is
07-aaaq of "noz=10
o.-eer, to datoraino
in
population,
it
study
1965),
neurotic
oanos
14.5% havo a femUy
6Y,,.
have
family
no
cmd
>
history
of =ntzl
ARD CHnDHOOD
The qvzliV
We
of fmily
75,e,.hsA a desirable
fevoureole:
11ada de3irable
ralation-ship
childhood
appears to be
with th3 moth-3r; 63*5%
ralationchip
with tho father,
with both parents,
relationships
during
50% enjoyed good
who themselvos uore ha=onioualy
carried.
wero without neurotic tmit3
baok on their
ill-health
childhood
in childhooa
4,0 a happy timep
in chUdhood and 79,5% look
Only 7,Ooex? arionoed
and,, in only 9% war, tbare vmy Mussa
significant
in parents
I,, ,-
auring
Choir ohildhood
soricus
anough to di. -,Mlt
the eourzo of fam:Lly
life,
these roaspeoto, with the exooption
In all
(JV
innew, in
firat
in the non-athletio)
and 22,1%
in the athletic
Au-. 9.
of severe mental
background in more
and chil4reý), q th-3 earlier
favourable., in marýyirmtanoes to a'higbly
of "fully
imiacnoo
family group. (grandparonts,, unoles,, au-Ats,,paronts,,
wiaer
couains,, Ablines
degreo,, -than in the
significant
With the powsible exception of the 5V,,Oincidence
group,
zon-athletio
olf a similar
tha athletic
docirable parental influonoe"
group may won
o.pproaoh the no= for the male population as a'rholo,, or enjoy an even
more fevourablo childhood onviroment,
ni ADITLTLIFE
2
in W
A good worlic record is present
with the high inoide=o
in conjunction
pernonality
prosent
level,,
the
above
of sinilar
in varying
link
for
in an urban-industriel
community, and
and obcoasionalitys
co in tho caea
71. %,, good work rooord,, 57%obsessionaL
"acciabloll
as
mted
vmro
Smup
ll, Zo vmre sliak-tly
#
themaelvos
as
r3gardod
in
ansessocl a3
group in vrhioh
is repeatod in the non-atbletie
86%of tho atbletio
thinD
may well ba
the male pcpulaticu
are both ; owar, ýhough only slenificantly
nobisessionalitya"
of
j3. lnsr, a2and
degree3 in 801o. 'Ilds figure
between vork. rooord
independont variables,,
behaviour.
ana
in tho
role in the astiology,
play a significant
the figuron
class
be considered
night
of obsessional, traits
asýesaed by the e=9 oriteria,
age and social
Tho observed
and this
most
bypcoanic in teriperawnt.
"nervy*
way
arq
caseis,
in
in their
before
onI. y vory
attitud3a
only 20jj
the on3ot cf the murotio
mitor
dogree.
.
1:,, 3NTERPM-l- I
&REL
Whatever might be the validity
ill=sa
of murotio
aotiolo&y
neurosis
whioh,, in this
roferred
to the payehiatrist,
Rustiell
Professor
Sullivans,.
tor
d
&dvoaat4-,
that
psychoemlysiag
in interpersonal
(1962)
Davis
theory
pay0hoanalytio
and that
disturba=es
in
The patterns
of behaviour
i's I;UPP06042, in
ý
lifoo"
and adult
,11
e-tra-family
it, this
with
personal
study
relationships
but prImarily
d13tUrbaUOOZof interpersonal
vory subtle ordero
outside
this.
group aoute inness
relatiorwhips,,
&cuto
parents
to whioh theso
relationships
in
tho athletio
male neuroses
to"tho
vJoffpoizt,,
illnese
in a disturba=o
does not ariso
out of a threat
relationships
of a
a3'suaptions
during
early
give
rise
.
in. ehildhood,,
to good intrz-f=ily
in the athletio
cut
arises
disturýanoes
points
of
of
disoxqor; s originatein
and sibs
the family
t"a
of all
lies
illness
nervous, and montal
relationshipa
the evidenoe
to acoopt
Me of tho most important
that
the
and in the tradition
'others..
the esson0a
of montal
is
for
drawS attention
amongst
relationships,
for
is difficult
ovor half
study,, improsents
in such relationshipso
All
it
as a thole
views as having major ralovamo
psyohoanalytio
crisis
of Freudian theory
group.
out of orim
to phyeical
chilc1hood.
roour,,
it
adolesconoo
and
Furth=ore,
in auoh
prowess.
prasent must be of a
PaV
il-I
:tLý-
,-
i
VARVAJ, MD SEXUAL REUTICEISM"PS
theox-y would olaim that
AG.
ain,, pr.yohoarx23rt1oal
in mouroacs is a dicturb=oo
and othor w2c. djustments
of infantilo
In lator
parpotuated
in cezuel
U apparout that
in tho athletio
marital
ha=owj
=rried
at a Man ý60 of 40.3 yeara,
exista
dicordor
life,
horo It
In the nouroces studied
noxuality
tho primary
a high dogres of
Vot only an
group.
but marital
W
ham- cry is pr03OUt in
86, fj of thoso married, in whom 7% clelmod caticfaction
in a*,-.ual
-4,
It is ourely most
intoreourzo boforo th3 on3pt of tho innoss,
important
not to blur
tho,se of the inneas
doterioxation
the diotinotion
itsolf,
for
during
indicate
Ln only tvo catos whore libido
oenfirming
tho gomrally
Both thono
married,
catiafaotion
datoriorated
in
in tho athlotio
that
during a neurotic
murotiom,,
is presout
thic
from that
accoptod opinion
(moa.n ago 10,4.6) havo becazo happily
bimopq
mari-14ca
zm-rrjoaj,
of the jllrwcjzI,
differont
doteriorato
Turming to the non-athletio
lio
of Vp of all marriad athlotes,
before the orset
comonly
the cauces of th* illrean
group, in thoso in whomaax?
ja
not aiGnifioantly
Nora
doolinod vma thore any exproscion of
inoidewo
an
athlatea
vmro
caea3
lw,d been the rulo
that
coxual diffioultios
o:V sexual intorcourso.
feara regarding mmakeningoffeots
in tho non-ath)xtio
oocurrod in Ckl of casoo,, which
to an ansumption that
findin3a
tho
whervan
cc-jusal
&nd zarftmanoc
the courso of tha lattar,,
in soxual. yotonoy or desire
migh-b lpad inoautiously
501'eqa fit; =
botween promorbid phonomem and
cc=,-a3. djair-O
illnoss,
only 8 out of 28 pationta
Amone thote
in only 42% -a
who hava
differe=e
fl-cm th,..
Orl --
-I
v.,thletio
raurotios
vOlUohis hl&ly
vignificant
in tho two gmpa:
demonstrato
cescoisted
In th3 majority
elifficultios,
whatover
Tho divorea
of oazoa in oither
may be the intorpersonal
group
illnoms
nourotio
is
verie&
not
ge=al
vritla marital
in
dofoots
Emrital
for
Vp
55
in
Is
marriegoo
rate
about
In both- tba athletio
tho Uttar,,
-there
cf marital
tho
th* wholo rparles
are
gmupa,, 'but
nourotio
and non-atbletio
a &4,1sorcp=cy
cases d=o=trating
oapooigIly
botwoon
the marriaga,,
in the rcon-athletio
(14o).
Smup
satisfaction
for
here,,
occur3
rhoreas
L
con
cbffer-anoc
,.
in tbi! B mcae group tho
" in tho
is towards "uthappy marriagm and so.-mal satisfaction,
dicoroyarzy
by Roth (1960) suffering
;?emalc3 stuaied
largely
low"
Lvely
an opinion
wea n)lat:
totally,
iss
r1chole
nave
worc
more subtle
marital
+.h=
mhý jVzaity
relationsWýpa
phobio
sm.
-mally
oonfirmed by thoir
spou*05, but
FASId$
further
with
a
:
1613frigid
or c,aocud obildbirtho
These GtUd'-ICSindioate
to naurosic,,
from the very oc,=on
"the
fallproll
don
-,
propor.
of
marriago
-
a=: jet7/d*parsc=lisationztAte:;
first
the
in
harmorg, and of so=al
8
it,
out of 3.9 marriagan
This GOO=
follorinj;
neurotics
(i. eotwo divoroes).
of 72 yetionts
tiagree
in this
68. %,
SroLT.
ron-athletio
in
to
prodisposition
by the male pationts
displayad
tho form*
that
in marriago
sexual vatiataotIon
75%. non-athlatio
neurotics
athletic
These results
in
in th* olaims for
differonao
Ffowavar,, there is no
slanifioant,,
that
ha=orW =d
the relationchips
satinfactory
betmen
zer=2
vulnerability
relationships
aft
imSirOdo
hSTO
V
ma.
w3
of the f=11y,,
displayed
in tbiB
ohildhood
and, mc.,
rital
exparjenoe3
and
study may ba Ompared vdth the findings
(1951)
Woodsido
in their
atia
of 1131atzr
in tho urban mrki"
It=
ga
Slater
study c:r marriage
ralation4hips
class in-Londono
vxA Woodside's tables
b3longing to neurotic
compariacna are possible
and control
can be extreated
figures
(non-nourotio)
group a
for',
Where
these are tabulated,
MUS
CHLY (Peroentage3)
Slater & Woodside
Controls
pmeent Series
Neuroses'
Slater
Woodside
(norl-Peurotio)
Athletio
74
.
79.5
43
73
93
60
15
27,5
60
45
16
13-
13
21.4.
3.4
7
61
75
Non-athletio
Neurotios
1. Childhood
2. Goodbodily hee.1tj
In childhood
3. Ilervoua truits
. in chUdhood
Bofors aot
By deathv
'1, Losu of father
2, LoEs of mother
Puivntal relatim
happy
15hip
6,, Simiticant
parantal illnots
durding chilldhood
7. jjittle: Mppy marrane
V.-Inýeutral/unhiLppy
56
48
9
50
86
42
8,91c. tor &, woodamov
happy
al
a)
narrie
28
(a)
b.
+ average or
catipfaotory
65
war ýý
slator and Woodmida's series: "OaY a little
of 'tho p arents
,
"
hialth',
This
',
aijdation-h ag'Improved a
roM3onab4'&o
oajcrjed
I.-Ator in'myý. Sarftv.
for tho differant
U-,Uii(; allora=eo
ucod by tho inv9stientoro,,
oritoria
London
that
working olacs population,, all marriod,, atudiod
a
and aooopting
frem a Leedo population in 1961 in v&= only 8C%
in 1951,, in differvnt
M
in
olassoo
sooial
are
IV and V.,, and in WhomapproximatelY Ma
interesting
be
oompariisow
some
oan
nevertheless,,
made,
are married,,
The Most striking is that the athletio neurotios approximate to
Slater and Woodsides' oontrol La. normal group,,.ancl the non-athletio
neurotios resemble Slater and Woodsides' neurotio gr*up,,
it will be seen that with the exooption of "nervous traits
whiahs in Slater's
oUldhook"
in my seeLes inoludos
nourotio
series
rOI.QtiOnShip3 than Slater
traits,
and Woodaides' "normals"
the mother beforo
in an enviroment
of parentia
and mora. oontmot
positively
the athletic
onv:Lx%)Ment wd
emotional
have
bettor
happy,
and
more
more are
losing
Of
Chance
means marked zervousness,, and
many very mild neurotic
favourable
more
enjoy
group
in
ioe,, in childhood
thoy have only half
health;
they roach tha age of lit,
hamorV.
with more pareAts fit
the
moro live
and won,,
happy marxiagwi,,
neurot103 are cmtmotod from the total
once the athletic
10,
II.
I..
-..
in
the
remaining
nort-atbletio
nourot103,,
my
serioa,,
neurotics
zaaae
of
pool
Conversely,
are less often happy arA more often
Slater'
with
compared
a neurotics
nervous as ah4dron,,
have mom freTiontly
before
the age of Uft and possibly
The pýycioal
age ;k
health
In childhood,
lost
less often
the father
contract
and inoidewe
by death
ýappjv marriageo,,
of loss; of father
is 4bout the same for both groups, ana the nou-stbletio
favourable
mom
a
enjoy
Only
of hamonioun parental
influonoe
marriageso
vith
respect
to a high3r
before
nwaroticis
inoidanoo
aegmo the followinS
aamo
Thoug'a not oora;,ardblo in tbi
figums
are also of intemat:
Mae
Nourotios
Xelo
1"Bout
Series
Relation3hip
Father
undesimblo uith
Mother
In rW groups..
In Slater
and Woodside's
ill
groupo
group of neurotiots
extmatod
is
not.
father
wd
Howover,, In all
for malen a higher
that wy be arawn from all
in many reopeots the euvirorment
that
it
both
:Lnolclonao
with the father.
rolstioiýship
Tho ganaral inforenoe
Tor
is
thore exiat3
uo=aljs
3.7%
15%
3%
the diswýýpamy
giroupn inaluding
of undssirable
Neurotics
Controlo
Relationahip
with parent3
Father
inoluding INother
unsatisfa6tory
orual. or inhuman parenta
tour
68%
57%
36*%
25%
Slater =d
Woodside Kaloo
nother.
won-stiaotic
Atbletio
is above nomal,
from male nourotion
these, comparisons
anI stability
and that
of the athletic
onýe this
group in
+.Iw romminder (non-atbletio
nourotion)
have
haa
ions
favourable
lose
the
a
and
stables,
mholo,, even
on
are,,
onviro=out,
than a mixed group of male neurotlos,
(1951)
that "unhappiness
dictum
a
Slatar
associated
t"s
later
vdth neurosis
neurotic
life
in lat6r
life"
male in the sense that
is (almys)
assooiated
in tho o'hildhood home was
does not hold for
one cannot say that
the athlotioneurosis
in
with unhappiness in tho ohildhood
h=ao
-
BRcrm
0
10"I
-
limm
(1951-Page
170od3ide
39) - "A brokon home is usually
and
Slater
regarded as one of tho most Iraportant
a tondonoy to nourosis
in adult
oauzes of childish
life,
"
nouroziz,,
(1957) in a
Stain and Sklan-)ff
survey of an Edinburgh suburb,, found that f=ilioz
and
with a choolobildren
rate of 1%, "broken h=oaoft
had en overall
TLO70 rAlec, in mr total serios (75r, married) are of an age to
be the parents
(o. 40o) and tho sopamtion
2 in 55 marriages
rate
(chndl*33)
hais remarriýd,
in life
will
the high level
aooounta for
,eroluzion
it
not to beca=o
of brokon hcmes,
melntemnoo
of the married
of paychopathe 9.md delinquents
tho stability
rate
The inoidonos
of the p1ronts
in their
ohildron
Om speculatea
In thaze male neurotic
of obseasionality
the tenacious
patientis
)
those marriagea produoa a high netwocia rate
wb,athor
is only
is zd3L,, (Ono further
were dmwu up and ono of the divoroad
origl. u &I figures
if
so far
mte
r-Ourotio - 17o.17.,, has soparatod from his wife ainoo the
non-athletio
later
but the divoroo
of schoolohildren,
Tho
state,
ia almoat oortain
pationta
to affoot
of the ohosen sroup,
of brokpa hcmea oaused by divozve or gepamtion
of these male nourotios
in as rollows:
ITO. of
pationta
I
Pareata of
Athletio
Neurotioa
I
DivoraG whon pationt
I
Separation
1
when patient
aot
adult
Divorce
Separation
Total broken marriages
(Parents of patients)
aet
Ilo information
dso.
Patients
regarding
No. of
Pr.tiontB
i
so
ParaMU
Of ZOU-
1
Separation whan patient
.3
DivOrce
Veurotiqs
Athlatio
I.
aot 13
No infmation
patient's
ago
Separation
resaxans
Total broken marriagav
(Parenta of patients)
TIras,, there is no evidenoa to =9603t
hc=3
than in the urban population
as a wholo,,
E =ULTS
COIMZT M JABOV.
GEHML
2,oth (1963)
"
nourotio,
it
stetemqnt
if
sc)nsa
mako,3
in
wed
two sonses and often
in
s=o
word is
variable
the illzas3l
the jnzadaqLmta)
- of Syse=k9s
end, this
cloud3
situation
the fact
personality.
#
but
in oo=onlv
u3od
that
disorder
"
depressive
it
can bo
caxwot
chronio
traitv
Secondly,,
of a
the
In somo
of an illness.
be distinguished
neurotic
in most cacos
personality
that
is u3o6L an a description
"Houroticiam.
(the
are not
contradiotiono
realication
the qýmptoa, complez
the parsonal4ty
betwoon
ba
premorbia.
made
can
e. g., anxioty-prone
any clear
aro
of the
ns2r'OtiOB
the word ': wv=tic'
Firstly,,
used. to describe
th,
3 ninorit7,
oazess,
fr=
without
tho3o two contexts.
por3onaUty
that
4
"Thom
The results
stanars ia an nbsurd
af, it
one socepto
9
diot=,
Paradox - "Jý03t =10
study poa.o. 02
This
(1923)
" svhnoider
no nouranoss,. oray =Urotios.
a f=ouz
Schnoider'
has oritioieed
pre, zont oll. rjoal
3 of broken
of thene groups of male nourotios
in either
is higher
in. ohildhood
the inolder
that
personality,,
a oloar
diatinotion
and psychiatric
perzo-wmlity,
obsessional
ayqptcr-ý-
hydterioal
porsorwaity,,
depressive,
per3onality,,
CMd hyStorioal
ObSMiMal
frm
au well
as quantity
oortoopt
of ncurc3is
0a
fo=or.
ovolving
frcm
on tho other
aid.
differing
pMtoms
This
I= nd$, anxietyl
diffora
view
in Suality
frcm
the
Meycri=
the constitution,
BEREAVEM.
'MaT 314 CHILDHOOD
.,
IMNSULTS314 THF, PRESTVT SERIESI
Batman the two malo nourotle.
wore ob3cryed
in
the incidence
in the
tha
patients
of
agc3
the
Seneral
for
social
Incurance
Life
or patornal
are no rolovant
=parizons
the assooiation
borearement
and the subsoquent
dovolopment
ýospita-l
prsydhistrio
DIGRESSICU
ý
lw.
Tho scotion
tho
importance
Mu3trates
of soWdng
relationabips
is
cf particular
concerned
the
with
field
this
relative
are loose
or include
tho
aspects
"In
mental
inness
thesis
to
for
it
where
hotorogoneous
ooncopts
13 narrowed
opeoific
down to an
Tl=j3,, attempt3
in
streose3
of th. 030 studios
illuminating
of the PrOblemo
non.
onlightening
of enquiry
sterility
in tSOMO
sohoolohilclron.
but as this
is
of tho
parental
from
of no=al
it
analyeed
for
innsss,,
praotioe,,
studios
emerge when the enquiry
the
to
question
answer
ono
available,,
the statistics
of mental
assooiatio=
heed:Lng_, and conversely
Witch
For
betwoon oarly
a digression,
specific
and definition*
c: w broad
analysis
followa
vex7 clearly
criteria
under
vhIch
occurred,
deaths
States
ganaral
and from
patients,,
the literature
review
the
havo been dravm from
oontrols.
tho
Compmy have boca used ao a baaio
When invoctigating
fstudies,
deathe, 'or in
statiatios
In the United
age and aex.
classp
metropolitan
of maternal
two groups when theso
there
population
differoncla
groups no aignific=t
later
life
to rind
asgooiatod
1-ooba 91,1-1to
1,.
vlAc),.v
r,, Opl,
betvican larls
rýsZ=iv, ýtion
qujr&qýjQz:
T-dum
tp
bo at I
holnfv- I vould
zlom
to
tha
wich
of moth,
ýr ani
"
0:? 114,
,,
nsa
fal-, hor by desth
al, tb, -ý
problp=a
in each
end the lalvor (lavolop-mcut- of za,,ý,
di
fermale
In
L=Vc3
in
ciril
pt;
malo
fe
nw-ýc-IcVetatcr.
rant
GCOICLI 010.
-Snoa
A CR-RIVAL PUNYB37
',
hnz
derabl.
r,--cn
ett.
-ention
43.
con,
i
111racemt
ac,,3003-ction
pc:salblo
be-lw-Tv, th,,ý wzp,on-loras
-=
"Ir,
chililhool
.
(1,927)
f0brahai'a
cvrzidar. ý,.d that
liable
rm
Vý.
Ojv
nor
1.035
.
ona or mom
of
leAor in lifla,
ýs
of r, ýmtvl illml,
W, tbllý
who oufTorad Doze t=zva
al."ildron
ptatie=
in
found
l
ar,,,,
ljfo,
In
thM
tb. 3t
In 21G
loss bv dnth
suf"Lorinr, 'Orcný
a ýzarent bo-fore
h-ia lost
or
Ufa.
to dovolop malancholia in latar
B,rovii (19(, 1) stutllocl tho 1=10, =100 Of
pationts
on th--
tho asa Of
l
2157
19.,,
in
pationt., miatterclAnC,
with
compama
,5
curgorL)s.
further
(1951.,,
has
3.956)
coutrIlint-ked
vraU
s
Lcao in saldoophmnlo.
.
In thia
1
ara
3o=w.
pOr,
of
Z
(Ign
'I;3Tloal
tho
omse in
ir,
somm dolent
In
choca to join
tho
r
rat, ý a1mrso an m.-meas 0.0ý.the
"Lv, a group thoy
of nooka
nv). c
cm& ocr4tilhevional
for
Tlia
"0
incV,
',
Thost
DAFý,
c-noo of pp.ychonin
-Idio
nav.-OL
nonaa das c of
h4 "ýhz"r
chorýn that
ovarz-ALl p3ychoxto
%hathar
tho, U. S, Ilairy.
mo-le popuilatiou
par,"Mital.
s-".UOloz on carli
cf
for
M0,100,, ar'd tL'(,'
sctio crOx-.r,, orZU=ry
Onal GIVI-p
all
atanid- out unfawoura"blar
r.:Ull
reesn'd
t
.0a
acrior,
factc, rz as ccmý?
*.th otb!., r paychotic
araa v-,.
31.
y.
OtIliz,
-Intem.
thare
9;=
fowicr
ý-In
Fzx'rJ (1949) Occ'.
Pz'rlra thmo Lrrou,?
a C.-! cont., 015 with
nsur ralat,. 1ran.
"moutly achizophranicill'"
1683 Stato 110-'Pite- patlouto,
p,*.rloa for materral bareavoment with regard to the evontual
wxýýW-xm
oriticia
to the a3o of oleht,
develoymor-t of p33rohozis rms prior
(19501)
r,o-,Y'Lb,
,sinoo Us originul
v
on the
extanAvoly
yn-itten
and Io33
ty
olzzraotsr.
"
d-eath
Thia
role
of
topic
is
of
the
critically
its
(Bowlby 1946) has
contribution
doprivation,,
maternal
in
and otherwise,,
1v-a*8OdzMO, nt
-A
formation
of
in
revivead
effects.
proportion
live
a cignificantly
homes With their
fora, sr ralv. their
rith
7. q% heve lost
lovor
fether
proportion
these figures
the moth,)r t7 death and
that
of the
to each otbzr,,
p=nts
tho fathor,
tho mother by aiath
aro
or are dead,
ef the dolincpant
have lozt
lovmr
a cowiderably
Moro of ths daAinrponta,
Vs 3. Xfo havo lost
tho uon-,Aolinciuont, ýbo.
lost
Rat*=41
boya dravm from
own imothsr,, and that
th*i. r fathem,
te ocrputed fr=
of
in a group of delinquont
havo
bson
divoxpod,,
nover
marrietl
or
zuted
aapa.
c=
isoparation
"affootionleas
tho
I'Voprivation
boys, o=; uroa with a matched gzvuy of non-deli; icrnnt
tho same nalehbourhooýp that
due to
" (V. H. 6.19642. ).
Glueck and Gluaok (1950) have a=onstmted
It
The number of
deaths b-3foro tlAa ago vas not abnomal,
&atamml
Care
chored that tha
boys
Of
amd 12% havo
by doath,
SQv tables pop* 89 vaid 90 in C-lucok & Gluok, 1950)
3:n aotuml rmbera:
1" jTOt-hfLr
Delinglient
.
boyp
lion dalinouent
mothor olive
460
483
doad
40
17
500
500
roth3r
X? = 9.84 ldf
P=<, al
boys
J-0- r.,
ýmýx,
ý,
60
r-d
r dý.,
500
500
cif P
bo.73j,
ill
ai,,ýaiflaaut
a j1I.Cilly
of fathar
loos
og'
ijct not
1,slatod
lnaraaýod
tli-ore j"3
vrit'a
ino-idonoe
of loas
of, moth-or thrmi,,, rh do.ntll
thmug', "i do.ath,, mhioh miCht
to lalvor
'of
to c1ausl y
well
zubsocsizont dolinquo, "my cver. in tho abo,-,moý:
i
of othor ixaMuonooz,
Tu-,,
-.,%drmrto noravotle
,,
illunn,
covoral
(195,22) otudled 500 yation-to
departioul. - of' a( Sonora! hnpltal:
di"-ordor, "
cr I.-,arjonality
C,aýivnuiva
diaorlora,
"
to-Ing w-w-l-udod..
Ath
C(r-jparcd
rml tlio &3rlaz inollAaaa "Jeca thnm 117,
Z oil mn,
500 coxiltrolog =tchvl.
:Vcr
cc. and ocol
al- -
dormwý010,-,imn2 and mourcloe. eal,
hirher
A sioLlfloamtly
lmd lozt
contmIn
attonfUn'r'. tho rmychilltxixý
".HO;
M-TM-rOsuffeVII .s from,
3-v,
frQm the
sý.,Ilcatod
havo tW-ort publishvd,
otuaios
proportion
tho fallho
tr
beftra
Of PJtjcvýjts
(is
m--4-Clainr!,- tho aSo of 10
yo3rz,
01ri,1jOr4 t0
-by
U,10 '7:LCT«''llat
4
"Cal'ly
1033
of
tho
m0-4ýer
of' puzychialoric abnorm-cAity in r-ourot-le p.atiolats. 0
2r
nt
b--twcon
dll
vaa
tirm,
cr
looo
of
mother,
of th, p
T'ho
ctu-61-Y
in
ol'
17-a
uts anc, ccnt =I,,
Eý a"toa
srvuý,?
VaD
fi5arar,
Caprc.,
dicorexro
caivor,
=id
sna
j,o,.1rotica, poriorazaity
f
domm
or cc%.
,unLrez
o: ý
Gro nt,.t
113
(1949) found that in mountio oolloge stuacnto tilo lnoidcrioc
Ik; li=
douthe did not Wfor
of parontal
from that
algaifioantly
in
reportod
coutrolo,
(1952),
founti tba inoidenco of parorit&a toraavcoont
at al
Oltw=
in roumis
inoroggod.
not ciGniýic=tjy
(1960)
Undoma=
Bvxry and
stuaiod 947 psychiatrio
iscon in privat4L praotioc,
a 10 yonr yeriok
* These patients'.
Geneml Hazpital,
395 Malos)
CC:2par,jcozs
and six
Ccmpany statictioz
These authors
old
in the UM
found that
POPulsti0u,
patients
The loss
whoso mothers
bereavemcnts
for
(P =<. 05), - there
of thz mother
Voyohonsurotion
:rU,sUrS=9
their
social
is
auring
have died,
a jurked
nothing
liko
childhood
hiOh BhOWth&t
b,,f. re tj,, ý ýkUd 1,
iLnd pE,.
VOho3o=tios
Hovmver,
if,
th3 z=bor
this
sex difference
pook in
is mora ec=on
thO M310 =d
of =10
tha n=bor
with
reach a peciz before
(12%) than among males (-Plo) C..f.
Stati3tiO3ST;
bareavomant =ong
,,thr
oontrasted
patiento
of
"
is
fccalo
inoidenoo
and ooouomio stataa,, and
in psyOhor.,,,,urotjL0j,
mothera
Incuranoo
Varied from 2,8 to 8,0% in
for maternal
(P r- <
oOl) -
Idfa
p&rtj3 O:r t-ae United E;tates',
the death of the
is more froquent
who have lost
3 3;aara
of the
atudies
ap,,
ddLearders,
or payohov=atic
tho Matropolitan
io. remarkably const=t.
Qxiormalg populations
a,jtormi
yublithed
ratos,, ths figures
cl,.suSing m-artality
famalo
from
but "when converted for
tl,. ese serics
patients
maurosis
ar 103a of mother in childhood
The inoid2noo
tl=
female (552 females',
in pormal sahooloILUdran, in differant
boroave=nt
f-Ave years
figuran
wore made with
ovor
we at the jhgj)SObu,33Otg1
predominantly
from either
waro cuffering
patients
of
appears:
the aGo of
the ohart
for
males,
in women
Metropolitan
female
Lifo
combined
figure
3,14cm
for losis of mother in obildhood is 5*5% and that 16.7% of the population
,
United
have
lost
Stetom
the
one or both parents before the ago of 18
of
(metropolitan
Life InsurawokC&AVaror
The death rate for fathers
that for
*1944)o
follows
the nonsal population*
differanoe
in my stuays no signifloant
bereavenants
of parental
at different
Th vW all-mala
groups,
approximates closelY
lose of father
in Boston);
ages in tba two male tour-Otio
and UnAemawls
reggirecl
an
( whioh
non-athletion
figures
for male mourotics
age 14 in double this
before
in
times
three
non-athlates,
as
great
ani
population
loce of mother by death
Nd 74% for
athletes
to B&M
in ahown between the Inoident
of nsurotio3:
series
before age U is 69E%for
vzonwl'
whioh is more nearly
a pattorn
Figures
figure
for
for
athletes
a oomparable
in order to assena the general
releyawe
findiWo
the
of
I
Peterson (1961) studied 291 JoelandIo patients
iDOludOd 160 "P6YchOnOuV0tiO PatiOutg*
states$, phobiax,
disorders
11
patients
and
ompulgiong,
traits.
with psychopathic
deaths (not analysed for
inoidamoo of parental
death) indicated
made up of payohoasathenio
reaotionesobsessive
oormrsion
in IL group which
psyvhogoxwa
The &=aysjLs of the
ago of patient
fava the population
so marked variation
amxisty
at time of
an a whole,
Is
perhops. not Burprisingo
which
aspects of those studies
several
methodological
groun".
hma: Lng are sounk
firAinp
instamess,
Although
an
open to question
the control
there &rLse x4mervatione
beoguile of defects
the studies
in the conception
procedures
in accepting
on
wA statistical
some of the
of the research.
lack the degree of speoifioity.
In several
whiah is an underlying
theme of 'this -thesis*" --Mii-Norton0a stu47, potential sex
an
-aifferanoell
.
randexanals
overall figures indioate a relationship
overlooked. umand
they demonstrate
ho"Verthat
analysis,
only on oloser
it is
by death and adult swurosis.
between early maternal deprivation
a striking
sex
aifferenoeo
different
ASLIjIl in seyoral. studies,,
(1949)
Barry
study. sogo
for
together
"State
500 patients
"
Norton:
g0hisophrenion;
to provide
different
quite
947 patients
suffering
including
neurosis
Parther
analysis
delinquent
The term implies
deathpj, aeparatiON
parental
of the Glusoks'
- mostly
or personality
or payohoomatio
disorder,
"
the oonoopt of the "broken home"
a hoterogeneoun. group of situations
divorce,,
imprisoment
(1950). findings
boys lose often make their
to a signifioant
Patients
likely
three
are
whioh
groups
-
Bowlýj and others have oritioined
loose,
too
being
as
are grouped
Barry and Umdemam (1960) olte
results,
from"ofther
Hospital
entitips
with"psychoneurosis
and under IC% of depressives"
disorder
nosological
reveals
homes with their
degree, this. is assooiated
and desertion.
that not oay
mothers,
do
but that
with loss of mother through
death
FitzGerald
(1948),, Madow and Hardy (l947)
(1944)
find
MoGregor
and
that death of the mother and subsequent development of nourosin
Howeverjo theyinolude
d9gligration
novena
types of family
"broken homes." so that in this
distuption
respect
are related.
under the general
the studies
lack
spikPifloity,
The paw
by.. E&rlo and Earle (1961) again strikiney
the valu; b of a disoriminating
analysis
of results:
illustratan
Out of 1,423
i,
76
they found 100 who had boon separated
patients
psychiatric
mothor for more than nix months in the first
Thus defined,, early
name sample,
to a diagnosis
related
brokon
work record,,
schooL'
to having
Among the sep"ted
was 27% compared, vith
b,etwoen maternal
bysterioal
y
possib3,
except
ostjor,oriels
the vw7ing
Rooognising olearly
of deprivation
oiroumstames
two groups:
payohOlogioul
eto,
oritioJoe
diotgLtea by jhe
intc
and thoce in whm
separation,
assooiated
Thuss, they oonoluas that
diagnosis
Up&ot
There was no signifi0ant
in not the oause of the assooiation
later
a
and
diaguolstio
of other
of cono0iousneasp
was t7 death;
in death oases,, whioh were sipUioautly
depression,
iwiderioe
on the ohudl,, tbe 100 caess war's divided
edeprivation. was from other oauses - divorce,
aftissioU
personality
Thera was no, relationship
dissociation
thoss in whom deprivation
mental hospital
of sociopathic
2.9% In the ,non-s. eparatod.
and the relative.
or industrial
reformatory
group,,, the prevalence
deprivation
was significantly
and to broken marriage,,
personality
been In prisong.
A
age and sox drawn from the
deprivation
maternal
of sociopathic
of life.
six ysers
matched for
oomparison výs made with controls
from the
inheritame
inegitimaoy,
differenoe
with a diagnosis
from unstable
between early
maternal
of
parents
deprivation
These authors
of nooLopathio personalI4.
exoept
also
the loose oonoept of the Obroken home. 2
*.In 00.nBidGring aný comparing the results of
]Bowlby (1962) sumarises:
.
born
in
be
that
is
it
mind
concerned not only
each
must
the v&Aous studies
difrorelat
&
with
kind of pationts,.. but often
differput
&nd at
times in the paýtiantls
witil
lifp,, w
a different
kirA
of Iosa
1A7-,
ME
between 1035 of mother by doath cud of the wider
The relationship
influences ooming under the gOnOral heading of. "brokon home" on the one
himd. and of Us development of soolopathio
to be fairly
body of
that loss of a parent
levidenoe
with a diagiosis of depression.
in assooiated
U tho loss of father
It
or mother or both whioh is oritical,
deprivation
be
to
& vital
appearn
III&nAl
g..
&IW fom
dovelopmput
of neurosis
in Norton's
study
dqatlý
suo
Of Rental
illuesse
There is little
Bow1by's
holds
contention
would provoke
This promising
fioM
in particularly
in females
at an early
that
gpod that
dolinquenoy.
later
of mother
age is
that
maternal
or so4opathio
of researoh oans
with
the experience
signifiotutly
where "deprivationr
"early
asscoiatod
on1y.
In tbare. awl evidence
evidenoe
the age or eight
experienoe.
loss
In neurosess, -ýýe early
only
in early
is not olear whothor
In cohisophrenia,, a; ain the lose of the mother before
the later
soeu-
estab; UWL,
well
There Is a giv"
it
on the other,
personality
of
with
ascooiated
seant"death"
if
deprivation
lose
and,, if
parsonality,.
for further
severe,
definitive
studies,
INCIDENCECP SIGNMCMT PHYSICAL ILMESS IN
THE'lOAMILYOR IN SMY DMUNG CHILDHOOD
The results
or morstbletics
significant
is present
show childhood
health
=4. in only
of athlptio
innoss. in. the raugv
in 5C%,Or non-athletion
to have been impaired
in one third
nourotiog.
grmy -, in parents in ove,7 case .
and or4
9% or jLtblatio
neurotics.
"a
Cc,
6
Iud19r.
1
S,Ssoný-011or
c=,
ext -, VuzL :e aio
his
fever
botwoor, rhumatio
by SjhilbrinS
deftnef!
r. con4ition
and "pro=zncss
I. e. cathanim
noth-orle
r, qSmr.dccj a,,) mwdfostation-3
vw
rathor
Ija4 poor haelth
eightli
rith
thoir
werkizig
rh1oh
ability.
diaoo-zuging
tha outlook - for
of the P=Vnt$
cf
about
are
thowevoro
he elth
the rooorl, of parantal
Mazonably
onjoyea
it
ilou&
tb-wa to wrok,
re=ittel
or dWbillty,
good hoalthD
whilo
over
ow
The Luthors,,
writing
in 1951,, e4ld that
bom
50 or 60 yamrs egro Is
athlotic-nourotio
Iýattar
im vastly
horovor,
woro not.,
over
tho. futuro
th=
this.
of
and "4ypophmnla"
sorl. cusky intorforocl
of tho 12oalth of adults
vior
dsoade later
ailment
devolorzout
or nw.=sizi,
of tho parea-, x
Votroepootive
he3lth
Tbzza conditions
by sono ohronio
impaired
*&a yet
(1947).
which,
as.-miation
' and Q3
:in ohildhood.,
health
than a quartor,,
a ViSiflount
linfootion!
disesno
and inoroaso
oonatitution
oc=onoing
of mental
about half
good';
core
to
(1951),
Ia
Wocdaido
aerie3
and
siator
bot
HO found
dizordor.
to neurotio
limbility
"early
moy &-mcam a person's
in ctaflly life
Muou;
that
ia a brig#tcr
period
a prolon&va
atudiccl
Tho fioxca
for
1.6ho
the
Certaimly
one,
patients
if
in Loob
a
ron-athletio
t1w mo.
CIS AITID 1,1171,
MIQSTIS
tetwo-sn GohisOPh"olda 6nd 60cia
Tho ralation3hip
catabliah, 3d.
Th3 sooial
praedm= and Hollingshoad
for
rategs
ti., cir
murcsis
ability
d=or, strated
ralative
claos distribution
(1957) in tbzir
for
troatmento
a ;str. Lking comeotion
is lese cortalb,
Ncmzhavonstudy found hiabor
in the upper olaceoc,, a ftndinL;
to pq
propordon
of =uroslz
clt, 30 iG =- 3.1
Holling3hoad
whioh probably
and Redlioh
bet"wean 010,3o position
mirrorn
(1958)
ztd the
of vzmmcia and peychoolo-O In olassoe I and I: [
-119 6t, of Pationto are nourotvi c,
.1%
lC%, a diffeivntial
v
45%, class IV 2v", and olass v
,
significant
at the o, l% level of
Clrze III
distritution
Th3 authors point out this this may ro:rloot ability
protability,
Neurosis in this oontoxt inoludes cati-sooial
yny for treatment,
2=, r.turity
ru=tions,
oharaoter wuracia
to
and
and payohosomatic raeotions,, so
oura must be exeroicad when oomparine with other studios,
11ounieat jý (3-957) in a aurvoy in New Yoex City fowad "simple nourotio
"RUXiety
111M983" Leo
tmit
lowast
typee
" to be tw1oo an oc=on-
fornation.
shovre in figurea
pattern
ar. opposito
i1i tba highest
L-gae n3urozes
fjnUnS7CTfe=
othor
i.
statua.
Sencral
males i,, e, highoist
tba
com-pared with
of ell
in
is a dieproportionaloly
tb3r*
social
clace
a striking
V ond although
oomparison
3bview
Statistical
claccifioa
lower
the
oc,
in Bawdand-,
j
pmotioe
inoidame
of nouromin
with
of Enslrtna
low inoiderze
the fiVares
thoze
of an
are small
published
in
and Wales Suppl=ant
thin
tho Regintraion mental
1934 - 56 (H. U. S. O. ; 960) ancl 1957 - 58 (H. U. S. O. 1961).
In each revi6v
&Cni-esion
rates
the relevant
par million
(th*
diaSnO: 3tiO grOuP3
year,,
sooial
drarm fr=
for
espcoially
the higýnsst
or per3onality
oluzzo
In zV ceriez,
Gmarm.1's
with
Ivarled
tba higher the inoidenot.
Logan (1960)
in
Tho inoidanoo
invercely
of swurocis
tj,, e class
lk-alth
).
2%.
and
olaas
sooial
by u=atication
Pymptona unoompli6ated
distributed
taton
according
=let
data are publishod
in Table
aged 20 and ovor by social
era ba-sed on tho h=o
to, tho social
class
M. 10 as
class
in
for
caoh
population
proportio=
at
the 3.951
120-ý
diagno3tio
The rclovcmt
a111 fox="
whioh
to bo distinelichad
is
under
of nourotloB
males,
p3yollonourotic
Tho figumý
in
soratiiV
comparicon
othAr
dinorderso"
the present
O=luding
dozipatedt
gimpl;
Thus,
istudy,, tide
psychopathy
JD npeyehon3ýur'ODig
liko
General's
Crolx.)Oi953
'
F3yohowuroooz,,
all ko=
1(4.2(ýl
repmont3
4view
of, Bngland & Wales
Not stated parcont
of-total
atatod.
17
294 260 407
5.3.
99
198 498
3.6
1955 215 246 339 331 514
4.3
1954 2.55 2A
1956 23,6 24
315 294 J+94
6,0
1957 262 252 324 326 509
it
this
psychovaurotic
lihich
in zzles
Illness
Is at variance
Tho *zPl8A4tiOU
hospital
being
few
a
Y
Orj..
=urotio
illnons
or goverity
for
might
Iov
inoidenoo
be that
in social
that foroos
hospital
in
social
Genoral's
fig=3
of naurcso*
the prosent
ad-Atted,
ola33
in social
This
zarieo
sugge3ta-sither
V In malo3 13 predominantly
admissions
Gongralls
class V
figuCei,
class
thoro
V,
are for
ware outpatienta,
that
of a quality
or that admission is sought
It, doen cast somo doubt on the vide3, v
from the k3gistrar
of
in tho pra3,ent sorie3vhere
tho Registrar
whorvas
subsequoutlY
th* h1ghost incidence
ocoura cozzistently
with tho fýndiW
7
admizzlon,,
sooleJ. r4asora.
derived
bo seen that
will
diaproportionatpýy.,
is
a
:
jjentýj
series
ancl subnormality,
Statiatical
Soolal Clasn
Year
ii
xiý
Fr=
the
uro:
Rosiatrar
Dias=stio
this
from
intelligance
and
behnviour
,,,
.0
"Chamotor
group for
tb,%t cooial
hold vio ..
)
ola3a Vproducoo
O-en
an
csomt-le
tr'.,& 10I.
'Výwgm,
Eurca far zy outpatlerrt
rmer-tal ho.%niW
acmn in 11-thece
V rovId
*lass
4"
zars.ez to ptz-Alel
tY4
a6musion
bo about 9 or 10 patient3
tho tý
imoieonzao in
in oach Smwp Inotead
of the
or"00 Otgerved.
In r. surroy
Hom-le
c-4"Xent,%l Fcapital
Pra--%tice fm London
(5.
Vjb)
593
3,,
dic5wsel
t
15,9
tbc,,
Of
B*.
',
n
a62ittiol
am
oay
Mvcalc
(44.2 %) ara dl&..?,
nosý3dv.=loty
of
roproreato
em awraep armual admicalon mate cf Q per millinn
of 161, &t an avanga
a,,-
q2,,,Wj* eav disobarEed
Thwj) Lcmpllal
rw=ýotlc
=av
age for
-.4thin
This
statea.
wn over tho
9,,
0,,
B.
39
S.
ra
yac.
of
admim3lon
first
one y-oar,
e&rsiselon in only nooorczry
in a -rery mill
pebionxt3- onutlon must bo *:,-.,
*rojzod
from
In
tho
oboorratim
mcao
U,
ýurogjs
,
proportion
in V,3a,)rjj3jr.,
c about
maclo on thL3 amall and selected
S=UP
COWERSATIM NEUROSISRqD ALCnmrmp.
N=10=3
Tz the prosert
aeriis
vris there mW queetion
out cý )44 athletic
0.? a o=, penzation
tho onmot of the cond:Uion
In only omo =a
In this
:Li may
injux-j
Mneir
dilsorlbta
for
evideme
bils tWInp
wn qqW-ýPn bomaec
tha patiint
of 12 cmaaz of mumUc
th3 Hilroy
in a laree
Sorioz
o? an outstanU%
antitled
"Aopidtint
of patiGrv'tc
alai=
for
Tie
folllowjnS
dizabllfty
em outmtmUn,, r corrT.en.as-tim
Lootarez
soon
waa memn.
oultOtAmding eXtex four Y%-o=,
om of irbom vas thors
(7.0.361) in
thma
in oni tho oladn raterzed
olalm-
yeara bzforp
fivo
there a olalm still
studys
in *nly
in another ths plaim W43 vottled
to an oploodo cfx yzars
arter
murotlas,,
01olm,
14r.
-mais"
primarl. 3,y reforml
oompor,,,3atior,
f07,10-,;jn,
ýq
ineuitrUl,
road or other lnjxwy whero such a claim, van appropriate*
Opinioms aro exprmacd as to tho motivation
studigm ah", ing a speedy return
of the, nOurCr,,
v:)# follam
tv,
to. work in a:Lmoj3t&31 cases after
Sattlemanto
Althaigh
follow
trifling
vicrrantir.
my figures
injur7
in aomv ton
g a ccap*nsation
bw at rork
in uo=
must be vulnmrable
tb* fact
ara mull,,
claim$
that crippling
in tho absonoo of circumtanws
domonstraton
that
other
of those who do make such a claim.
bafore
tho injury
iu, 4,Ur*d in such wayu develop
neurotic
v: Tactation
-of financial
of nourotic
o.naptomatology in Injured
I
gain
nsuroses can
is not
I, % self
Cviaent
reactions,
It
factors
might wall
That ouch porsons
for
not; al].
Is clear
MM
that
tho
tho on3,y causa of th* parp*tuation
man,
3.23
m
THE
AM
AT 0-=
There in a istatlAtically
AND Fýý
difference
significant
between tha two
grovil:
No"-athletio
Na=Ucs
404
Wba-athletio Neurotics
Two out of every three a2actio
nmwotics
Aipproximately
Uln(aso
the
onset of
2942
r,=roti(m
Athletic
Moan age at presentatlon
to psychiatrist
36o36 yea=
N*woti(m
Athletic
Meanage at cneot
four
you-s
34.6
ar* agod 35 or over at the
out of *"ry
five
nom-athietiogs
tho
34
at
under
onseto
or
are aged,
tho aboonm of evideno* of prsvious
in
to
inioga
wisdom
view with suspicion
03.
a,00eptea
widely
or netwotic
fact
Inness
age bf the patioutc,
Inoreasing
with
know about the age incidence
cif neurotic
it
instability
neurotio
diagnosis
a primary
Vhat do we in
"Neurotic
illnoss?
but
In
are
any
ap,,
conconest
adoloscoma
at
may ocew
o0ownt
(1957) In their
paper "The Age for
that mmV neuroses have their
beginnings
baforo
the 30's in equally
prcminente
Umo
rhe decline
.
after
reactions
ana ear3,V a&at
life,
(1962).
"
to
them
than
Henderson and Batchelor
mu.
Wmen are more prone
Shepherd and arusubarg
is
NOWOMB,
the ago of 35authors
ask some
to
this
which
scus
questions
presont
study
offers
trommly
yertiLuent
,07.
to
know
the
dMerencee
botween
none
like
neuroaea
would
answergs
I
begiming
in the oarly
tvanties
Do they cefor any clinical
and thoao begiming
charactorists?
in the middle thirt,
Do theY have different
630
duratiom?
ow124
Is
In the circums tancea surroumUng
a difference
there
tho beginning
cc
"
f
a symptom ormatlon?
data
Their
the
for
peak
incidence
prevalence
even
course
ties
characteris
of
as tiologye
the
In
a further
Figures,
adulthood
untreatedo"
the
age
group
affected
(Kessel,
and
article
the
data.
for
I. Matients
39 Years#
S-E,
pgydhoneurotios
rates
for
or
Attention
to
"aght
yeila
Is
decline
a rising
the
rising
in
naxwosas
mass
maturity,
a parallel
a rapid
the
In
early
There
thirties,
then
have
must
a
special
nz an tion
inf
of
derived
the whole
to mental
wilh
from
gawral
derived
from
young
regarding
dooline
of
the
in
figures
dooreagg with
increacing
ageo
first
tho majority
both
range*
somas in young
Norris
Age "cifio,
aul
In
(1959)
gives
2Eevalence
Shepherd 1962)
adult
the peak for
of a group representing
shows
of male
male outpattentis
Joeft
Reports
of prevalenoe
admission
a peak In carly
%be peak for
for
g9t
General's
l*v*1
(Kesisel
off
Is
However,, the data
in 1,ondon.
by 50A at age 50.3h
that
maintained
life
adalt
for
thereaftere"
demonstrating
Is
Registrar
the 30 - 6D year
hospitals
it
practicoo
a peak p2:MMjcnce
In Buck
the inpatient
at 40 Y*ar$
neurosis
Oo9*9 an the mean age for
outpatients
fallen
has
and
1962)
Shaphard
to be at age 40,, and a high
Mj*x
over
maintained
"Thus
yo=s
females*
ana
and
the
tho
for
twenties
In
and a progressive
the peak for
than
fortico,
the
m1gland, and Wales "reveal
for
is
the
association
by
exWorted
diwing
in
*met
9o#
traditional
the
later
neuroses.
recognised
of
of
rather
Into
continuing
prevalence
a peaking
being
males
and
prevalence
limited
suggest
life
resemble
and a
Is at age 30
first
attendancs
approximately
half
m
K00801 (3.96D)found In Soneral praotica
of &U =10 USUrotic outpatient.
a rise
from youth to early
In prevalence
The curvo for man 1.8 couparativoly
high plateau
relatively
flat
but no nutgoggant
adulthood,
that for v=cn
vhzroas
d601111()*
ahMg &
betivean tbz Wadle yoarg of 35 to 55 ygam.
correspond broadly
findings
125 aw
2haza
to those of rAý&= (1953). pry (1957) w1d rqjO
(1959)0
2beso (3oWlcx Observations
s,ttitudes
of general practitioners
co=mmlty
at large
lVationt
to soma extent
2harm mv three populations
a hjgýay
vho ara
the Oonrmva
(see Ramuslay and Loudom*1962) and ft
to umwoticso
neurotics
help to explsln
or neurotiout
ard &tyq: Lmj
avacatciL
SrOW =a
mal3t2y yotmgo
2e out patlbnt
,
newotic
refermle
who are mostly young amts
OAS" with
6%
tely
spontamoun racowry rate bytthe third ymr af tar cmat
apprc3d
(mällzog am mateeig59)
3o The 3C%of nowatics
vdth a poor progumls who are dlacharged from
oow=nIty
they create an omran
virtually
untreatable*
care of these chronic
and intractable
2he present
qAnicu
inproasion
Watts$ (1958) has
neurotics
with
an chronic
publichedi- a p"r
and
on tho
who present- amra
to the general praotitioner,,
problem
study of male neuroses provides
Intersomml
no qjvjdqnM
to xWort
t1w
returdea gsubjscts cu the cue hand,,
constitutionaa
tendoncy to the devalqxamt
%he findings
of nourosis
In the. commmity,
(1961.
)
"infantile
that
MAges
of
and subjects
particular
MountIng up year by year In the
or are never referredo
outpatients
varlAnta
m the other show a
of noup0aig, in rgi&Uw age. n
of
thli-
study
point
(mean age 40! 3 years)
for
acute
neuroses
to a relAtiv,
In a groV
31y hJ&
e4p &t referna
reprenanting
aboat
baU.
- 126.
of
-I.
th3 msaa neurot1cm rho firdt'attend
with Rmol
variance
a
Min
poycbLatriat.
and Shoph*x& firdingo
QmorZ =10
to at
in
outpatients
Bucklngbamahlre,, where the peak incid(m. co is at 30 years
of age.
here with an induatri, 62/urban Versue rural
dealing
Class M
lion
hospital
hISMy reprooentcd
In rural
artar.
(Registrar
about the Incidonce
r. A=
In Social
Rat*3 fOr =11tal
to bo greater
In tamw
General 1960) but the f; Lgu=s tell
than
us littlo
113juss In the commadty,
lot Dmwotio
QRUM
diffiPronce?
in the 00=tz7?
admimalon have lona been recognized
Are we
AND-EMIATRIC
MMICS15
Henderson ard Batchelor (1962) express the cpinlon (P- 187 - 8) that
if the main neuratic
types
reaction
have no hard
hysteria
netwools,
anxiety
gram
each
., q
are hold In camon - anxiety
syVtwa
change so mich that
time
and moos
showing admixtures
the claasicil
exhibit
which
I&zyvr,, Gross,, Slater
of prgoise
classification
and Slater
and Slater
loraihough
anxiety
now it
It
atat*
kinds
both
of
of neurotic
muroacts,
A given
emaplaeo,,
within
of on3,v we
to diapose
be foundo
in
The diagnostic
Again Skottaffe (1953) states:
into
to the diffimltl-
neat
nosologioal
in wartime
cX male naurctics
from hysteria,,
"it
patient
the majority
grmTs
ct patients
faded
is conventiowl
catesorism,
Rothts studies
and thay are not mutuany
cc the phobio-anxioty
oxausivo.
deproolmlicat:
OUtitieS
states
from a
an suffering
into
eyaptoms
on* anothar,
to subOU13131:
ry
Into
four
groupso. oThese are ayndrweas, rather
poychcdourouss
defined
case mW som*-
the subtypese"
of
one naurotic
certain
commonar than thoso
are
ana Roth (1960) draw atUkution
disorders
and in
now In another:
cue group,
oyaptom
(19411.) In a study
and another
could
for
cC neurotic
-was possible
boundaries"
and obsossional
falls
features
and fa3t
than sharply
ts
jou statq
roprellent
"
127
ý
ca-3 cloar
recent attempt
yravimsly
undstocteds
to delineate
a spoolfic
from out of tho confusing
clinicca
pyr4rcme,
patterns
of nowotlo
reactions*
study the author must confeas to diseppointment
in the prccont
in
tho
in
11o,,
group
athletic
reaction
syndrow
I
tansiol-in the incidence ct anxiety,
to that soon in the non-athletic
did not cmerge.
a ciear
similar
type deprossion,
and roactiva
(c. f,
lattsr
udystkWdes"
prooont
hysterical
and depart-onalimtIOns
the
in
kjA&S
ataetic
813.
obaessicnAl
Those dikferences
incidence
and 841 of the
of the fa=r
higher
'and mwe rcactive
nsuroticu:
of physical
inoidanc*
*cr phobic anxiety
oyaptams and somatic preocOUPatiorm CC
GMUMOS Irritability
fear
of
&4d abetuca
in 7g
Eyeenck 1944)
Oert-ain tronds are apparent -a
higher
that
introspective
and aggression,,
Illms
in tbo non-athletic
are not statistically
of panic attacks
type d4proscion,
neurot1w*
as are the
signIfIcanthumover,
and of laodhondria3is
experienco
in the athletic
growo
Is defin8d in the Oxford EngLish Djct: Lw&ry as ul. path.
*Syndr=**
concurrence
nyWtmso"
of eaveral
qMtomn
T120 conc=(Ruca
zuffjLQj6-.-jt). y constant
in a discaae;
of 13ynpta=
to justify
in
Uia oth: L*tio
feattkras
lead
the
may
clinician
cortain
in
tho
Logioal
essenoo
reaction
inchanisms
gotio:
statO
anVor
reaotivo
ThIl 8tudY Is a d6mOmtrati=
lmdIng
to a broadly similar
garAral
modioilw whqre a partiodar
grow
in not
the use ce the term syndrameo Itus,
0.1inical
jo an a.n3d*tY
a act of such conc=wnt
although
to suepect a particmUr
In the majority
of cases
dopreanion.
cf too difforoat
and resuit,
Parallols
cUnj()&j
astiological
pathways
aro encamterod in
gyndranO W
d1svolcp as tbo
128
of disparate
and result
of a variety
0-ventu,ally
convorge in activating
the
clinical
provoke
-which
certain
pattern;
point
clinical
features
in others
this
of 'which
cauzal acquonces,, an
the physio-pathological
mochaniams
phenomena of that isyndrcmae In some conditionsmay be associated
is not so.
with a partIcular
In passing,,
direct
in
the
and
obvious
of convorgance
it
astiological
may be said that
target
for
thoraperutic
the
attacko
V
LC.
&WUTIM
OF
07, A PSYCHOPATHMOGY
ATELIM
NBMOSn
129
A POPMRATICITOF THE,P033ME PSYCHOLOGICAL
IMCHAMSMS,
UND
TRR
DEM, jOMMT OF THS NEMOTIC STATESIN TEE ATiffsrT
BEGREIPM AND ýTýMJM
AzV att=pt
as fran4y
regardai
cf
to oonistruct
tho ; h3=iona
This
NoverthOlesz,,
conjectural.
obsex"ved- cart be partiolly
bgy thoara with
tams
a pavohopatholoSy
an empathic
'Vorstzhen',,
ability,,
s.
of Vico
and Gcmto to bo of a difTerent
ccmPreh4nsion,,
'Begnifen't
bias
thq
of interpretations
nat-M
ottarverao
other
that
Pa.scal
"coometrio,
sojourn
creeps
,
It
in
sooi4
that
Mazligh
"The heart hu
there
Antioipating
ita, reasons that
types
of underatanding
learned,
to which
by
the
-
from his
geometry
and
RoucaeAu he Ooiýod the fwaw
reason knows notole
ýrorowgLj
and
(1960))o
Having nc"hitted
the me-%wag of thig
spproach I fat),
to b3 gainod by the fo.13-.
owing opooulationa,,
les3
be
may
trowh3rou3
the probl=atiO
It
of
axt more in
woro tTO spirits
having
was a realm
form
to be repoatable
different
spirit"
the times
investigation.
likely
there
that
and
cinos
based an 'Verstehen'
which are leas
whpn he deolarea
llfe,,,
in psychological
from tho more unual
to scientific
inD and finAinS3
did,
not, apply,
muthomatics
phrases
order
and tho "intuitive
spirit"
botwoon cartain
of kAm-an behaviour
was in a sense to these
roferrad.
t1w lir4tz
has boon rooognised
applicable
Subjective
these cases must be
undoratood
appreciation
r4sation.
for
than a suppocedly
oharaoter
is not PY-intention
of its
"A personal
scientific
one which conceals
stag* to oonsider
obsessionality
=d
is
intorprotation
hiaden ass=ptio-, w. " (Wbyte, 1960),,
at this
faOtOrG
as athletioiems
ZuOll.
Of
for
C=OthinS
tha root
sooiability
personaUty
tmits;
spri"s
as
I
130
will
oontinlý my discussion
difference
A strildng
referral
to ths final
in the
is
and a variety
have been demonstratpcl, ý By contrast,,
oo=emes
at
in the lats
uoually
the time
30's
the ago at onset
In the non-athlotio
groups,
below 30 years,,
in the causal chain,
between
apparent
two male neurotic
is
or-set
age at
linka
th*
.
and they
the mean
of precipitating
nourosic
are
in
ancl at
situations
the athletic
just
on averap
group
ovor 40
Of referrala
]ZCE§SW.fl ZALTJ
LT ICN OF MUM,
MM. 38.
IN CH BASXBTg
ALL THE
Not only h,as. the prooipitant.
been a threat
to physipal
prowess and
in
but
in
Impressed
by
the
being
maxW
so
oasejs,,.
one
relatively
wall
this
of
nature
in the.: ý&;ority.
04Y estimated
as =Jor.
stsaina,,
*I
wan gotting,
".
nj
oouldn't
ptýýf94 easily,,
keep paoo, with
"I
often
dropped
the younger
Theas mou have booome extremely
only admitted
baokfrom
is
of these
the final
prowens.
14ter thirties
that
breakdown
in retrospeot
the forward
to ouch throats
OUDS wOll Digh ozolusiVe,
tho,v havý plaosa on physio4l
threat
lino,, "
It
is because thin
they bao=o
praoisely
valUatiOn
bogins
ability
no payohologioally
expCoodo
Disoul0ing
in this
MY firAIZP
fielde,
in
other
vmrking
"A 1030 v.? physical
tý*
-
ohapo, "
vulnerable
becaucle Of ths sm0*15sivs,
in 03
repeated observation
year or two proceeding
of, an, awareness overthe
of am ýmpsirmontof. k physioal
to decli=
of the threat
in 25% of the 32 cases in whoma pbv#oal
Ono was atruok,. by the oft
wss present,,
patients
in whom the severity
minor.
study with
solf-raferrinS
comItaut
colleagaes
commout would eften
prmmse, would. not partioularly
bo mtft:
worry ma; my uj&tmam
1,-
131
be
Inaiments,
"
demonstrating the point th&t it
M=017
would
WILi0h :Lt. most valued by MW particular
attribUtO
WMA of
person which beo=*a
in wcm@Nin Yhom-perton
pjXr4ýoal appp"nqe
olearly
or zotual
and sexual attraotivarden
provide
fiold...
for an opinion
booome preocoupied with a "naggine
from ohildhood
ezperimos
apparent
tile
end sooonUy,,
compiouously
beautiful
wcmm with
beina
partioular:
37 :intelligent,,
a3ithsr,
Me
or aoompliýhod,,
satiefsotions
the f4mtioal
were bouna up in
allegecl
statýs
inaJoats that their
particular
to the onotionia bonft within
VIC
AIM CmImEELL
Perbapý tbý jýost insp "4
.
to valuation:
Sho had
surgeon.
There wre
3=0
abcut
saggims was not
g1he wag,, IW &Uy sta=lurdq.
few other
attributea
wittyj,
athlete
.
to x-cocamend her,
wam-h3artaa,
an
her prestige
obarming
and
tho one attribute,
Roth's demorAstmtions of the preoipitatftg
commonphobýo. a=bty
rolated
Tbare were, howeve.
r. two TdtO
fimtlv
prosent:
to the observer
souroas
oase domonstratos
.
wbiah vould malce her nowitive
doubtless aggravating her awdetioo,
outstandirs
morm potent
by a pla3tio
round the eyes,,
of
99T in bar husband's sexual ardour was
bar appears ce,, and a falling
features
As olosely
to be hiably
impairment
Oiw particular
the tbame that vulnorability
C. aged 3% was referred
evident
of th*38*IV03
tbr6atened
in
the physical
of appr3hencion
very
the
maxlz= exposwro,
Physiosa prowess amd stamina do not anear
vaued
is th&t
which partioular;
fiold
taotom
y.. affeot
of the vaI7
young mamýed w=sz,
of valuation/vu3morability
relttas
tho oloss family group (Roth. 1960) co
fmm a nin-nodloal
if
adizarce, -'The 'ýUiihg av6ut'_bAhS ecdd al gardes id that
you aro Sooa at them you onjoy playing
them you forget
th=v
your problems in the playing
a kind of I=ppIna3P;,,
ex-d if
of them and theraby
And if
grzes has boon li. fe for
playing
you, 11fo in a sen3a comes to an en4, prematurely,
livinC:,,
o:V the mind suoh as it
if
you don' go pga,,
Indeed, it
alv ninety,
vou
-7
apý
achievo
But when you get to z1aale ago you bocomo too old
to play gmas &Ind bappinozo, ondo,
the Ilfa
you onjoy playina
But if,
ais in my oazoq
isp ban boen your rrval lifo,
you can GO on
to tho fun,,
gets fullor
or almost to tho full.
I till
as you grow older. " Sir &rold
(1961)
Iioho1ron
Lcmarelevant,, but of into. ract is winoton chruohill'a
Napolom have run seven, miles
aoross country
bamed
on mwW yea='
agporience,,
(t95O),
We
observation
at A;wterlitz?...
observation,,
ere rApt uou&12,v supoessful
qual=oaýions
on seming
officara
raiim
In my
with hiGh athlotio
offioem
in the highor
v. brai! u, but have these men "died"
of brains
"Could
ran1m. " Churchill
tha old controversy
in H=3. d Hiobolson's
aenso
in MiMe'aga?
THE YOST
NERABLr%AGE
-WI;
Forty yoaris of ag3 is regarded by mary aa a difficult
being tbo threshold
in a man's life,,
after
the pre3ent
r=iet7
atatoo
non-professional
quiok-wittod
personAity.
coudaarablo,
verica
of miaae
W,
wis*or&okor,,
He Me a hyperaotivo,
the yorkshire
He r4a in buziness for
physical
point
Ow WON On0ountered
was closed$ Present. od with a savere paniokv
I bad tho advantage Of knowing thia
a.a.tting.
dividin
emarEV and otmj=(,
wir7 little
OqLjivalent
hims*lf
man fomerly
mans, a
O:e tba typical
in a BMUed
in a
Gooknoy
job dezanding
I vaa at a loss to explain
hia
133
"
for
illr-socs,
nourotic
the anteoedents did not isugp3t
Then) was no history
individuAl,
of an injury
of hic older boy made him "feel
old. "
key
that
the
hie
was provided
wife
with
His age seemed
wa3 at a xubiseqaent interview
It
to
had
he
a
pieoen
suddenýy
go-.
-
on hill 40th birthday, ',
breakfast
after
or Illusas,
oompwW of his younger son, an
to have s=e bearing for he preferreathe
that
a neurosis-prone
aboýxt the ohanged egatem of valuos and the need to
juni; has writtep
Woo
demanft
to
the
of
adddle
adept
in "The. ShILdowLine" - "one goes on.
Joseph Com-aa write$
still
too, Vp,. on
left
be
too,
awt
youth,,
region of early
In tho Scottish
Field
(196I)s, a reference
tiole
The
f
400
ar,
the a& 0.
torise
with
gnater
problems of this
psychological
to the exaggerated reaction
(25
betym, en juventus.
period
p"eas
insight
of life
viriljLtc&3
WA xwnins
important
very
is not trug
which form. & familiar
background
".On the borderline
(40
55
years)
-
the man
However,, we also see neuroses of
lif.
of
e; man starts
doo.
ourva
oanUng
the
a juvenia,
"
than R;idw (1953) on the nox2al
and virdaitais
.
throuSh a grave orisia,
around
is SIM05t an
In the forties,
soon in the athletep,
Itp years)
orisis
a psychological
that ooU&pse wen the oumble
for
high
talent
men
of
GIPOrisucO
No or.0 has written
is made to C. H, Grieves, tho
which G, B, S, used to insist
do la quaran
obligatOr
often
oontinues"..,.
the
behind, " ConroA (1925).D
poets vho ýPPIWOAUY passed throu4h
Soottish
that
one
wamýug,
abeaci
Wmclowlim
ono. per,08jV83
And the times,
to fail,
he reaohais only a faigneci
often,,. however,, one cees - arA this
is
(n.
b.
"
This
that
nature
Inny
of
nervous
appetr.
symptoma
a
-
of V
controls
who aro mostly younger)
so that we may think
134 -
I-
we era dealing
with
a naurosis.
in rellgicn,,
renewed interest
between th3 older
tim-
and rising
Previously..,
changes...
of talent
remined. unrealized
an
0
peroGiV03
9130no
people on their
suddonly
that
often
rmain
way to fýll
It
so.
perspective
the
of life
is an obliSatory
later
on,, have
for
affliction
(Gofp
)
ity,
"
G,
B.
S,
ýzstu;
betwoon the begiming
in pýyohjo
enrosses-itglolf
of, further
tho urge to. and possibility
for
perceived
before us was uaimitod...
rrom the oonMiot
(Wýioh
al5o
agoýng
riseas and
one Lis standing
which ono. hoped to be able to realiao
and will
- not
of spýritual
of death the entire
the time stretching.
o,Muoh oan be unaerstooit
biclo. gical
are. nouroses
Death is
generation,
and with the perception
Ponsibilities
controls
I@mko goeo on to a discussion
nerwouis symiptcm) .
first
" (n. b..
of
funotions),,
wd
development in the realm of spirit
"
sma,
and
of ,
RiWw Iýsts
as one.of the t7p:Loal cordltioiýs
of. the aisturbanoo:
*the boooming oonsoicus of the dsOlinO Of Pbarsical powar,
of giving
up such aotivities
ws aports,, mountaineerlng,,
The U6088alty
eto,,
often
hurts
deePlYD"
(1959)
Tor3lo
wrjtýug
inter
am ssW3,,
alla.
it
in
what
not
prwalso
q
the payohological
of men o,vir
waso"
forty
Reforring
*=W
-
of the miane
problww
resent
the raot
to the relationships
develop betwasn the middle aged man and, the Orl of half
..
beginning
the
the
"
to
of
&galng
woopt.
prooofse..
refused
the developusut
of bWpoohondrisoul attitudes
bodily
his
ag@ing and
pzvoesses am letting
"he fools
that
professor
thair
which may
his age - "he has
As a baokground to
he is prematurely
him doun. "
NEUROSM3,
CP gCKPLICT-ANDOF DEPRIVATIM
Dant.9 - HM
aPcl
(1960) has introduoed
a usoftl
4
oorceptual
135 -
-
betwoon typc3
diatimtion
cituatiow
awiromental
arouna
tendencin
13idividual
from
the
romova
Ina
3er-r*
to a nfwsl isituation
in the face
an element of loss,
entmil
upon whioh
with a stross
cal; ed dogriv
otýto
(b)
cuid
MWs .
stat*
tion,
Thos*
stat*a. *
rawtiow
nourotio
all
is ozzooiatod
with a stress
different
Deemto bo ectentlally
inocm-73atibla
to wbich he its adapted =d
stimuli
the latter
BUSSO,
3t that
studios
(0, ) +,hoy siMu3. t=OouSly
to bohavo in
hia b.3havicur is dePs,ýdcntpoootho. fomer
I
ow"'IM
calle-A
Hindags
undue Strogsa ir
provide
in the LwUvidual
"Dr.
of nourcais:
to adapt
of a oballauge
for
aa o.Templified
ex=ple
by the i=tUl'q
YO=6 W== Who tGOOMOD
OMOtiOMalY Cl13turbod on maMirsa:
w
life
but
týIS
to
to
damazdal
is
ad&Pý
OnlY
married
and
so..,
wt
nml
Shl
hu3 lost
of bar childhood
tho comfort and geouriV
hcmg and relgtioýuhip,
woman.Vao, pathologically
chooks the safety of bar fir3t-boM
_
(1956) as. tho co=oneut
dezoribod by Viclie.
resotion
of
r*urotio
Th3 obaos3iozal
so cloalig
is- not only
the p-jorperlum,
and. inoreasea personal
of lifo
livingp,
of
code
veverLtwlesap
MrO
battling
=
whiohinoluded
ýhe. oczocpt
zome. ýItuatione
linkad
6,nd alwayis
prospaot
:LrAu3trjzI
diggstarliý
retirment
deprivation
where the elperionca
entitled
altor=tive
a "Tr=ition
a u3eful
in a, major
State"
tbzeo
state3
one.
element,,
and tho
are fouiid,
by Tyhurat
(1957)
of being in a state
Thia author ineta=cs
and the short-lived
a not
indopandonoo.
aul
satiefsotions,
until
oircumstv=os
to anothero"
This oonoopt is similar
is
of loot
zýd insooUritj,
and psychplogipal
fraA
one situation
eoing
of freedom
olemant
of a uoiaroaia'of
of auffering
teen
has
Such a VzOuM
j, 80 "tha sooial
a laret
mode
of an altered
but is ralinquiching
responsibilitioB,,
the need to fina
with
of a period
Twith the challenge
follcwing
of
migration
and
oivilian
to KU11s: "The Otate of streac
may bo
136
w
but it
an dbstra3tio4,,
oan perhaps be rogardod as a proooas or Change during
now adaptation
which a
in reached,, "
The oowept. or deprivation
to suoh diverse
oonditions
finanoial
from parents,
retirement#
oatýstrophe,,
Illpelsoa,,
to sovore disabling
is implicit
The OOMCAth=9
this
that
much
.
lost; of
if
in a patient
and status
anoguntered by Abe athlatio
to a loss of part
reaOtIon
for
problem
ralejrazýt
"
Pprffcn?
0038atiýn
as part
g;tageq
t#9 An"ýU4
of a role
"Oriclo"
ana external
raprgaýisaýioms
fam
&!ad
his social
arm
nook
life
and recreational
It
is a bereavement
Lirdemann (1944) has fomulatod
of 44037a9tion
tr=aition
with
another
the
emotionally
more or losis
neoeissarily
sudaor.
arises
490ý O.
VO;O,, wd the stro33ftl
for mwiy individuals
wolff
chopping my right
to the lose of previous
"The Deea for
HO
ýýug
roprvgrsý:
holLtual
is like
work, has mount- so
the reo? zýtly bereaved an "what do I do now? What now gcal do I
ilý f'013 'Of t4ý3
d8riný
suaden e. g. coroncu7 thrcmUbsis,
Image of the self,
of oneself
and adaptation
maiý,, with the cormopent
to,
threshola,
a.,
middle
ge,.
replan
the
of
on
develop
ard
acooptable
now
a
fk-rA
bo applied
bereavement,
or. vision,
Ia remark:
me,
I
Tbace comoapta have obvious: -rolovame
j, &tjsfaatioms
can readily
marriago,
loss
emputatioN
pspcoially
_prostigo
statea
and divoroe, of parents during
as separation
udolesoent. em.
apo#ation
ojAldhood.,
off
and tranpition
at oartain
situation
in so far as it naoo3sitate3
lifib
booome3
intra-individual
whioh do not belpng to the garsenall
of
ive
"
resPOIlq0s.
adjust.
(1960), maintains that m= Is threatened when growthdevolopmeut
of individual
.
4ao,p&rdy to survival
of calf
proclivities
an blookedo, a*&a well as by
and kin and to opporhmities
for
prooreation,
-137 at two faotozz
hint
Thoso obeor-fatiom
beariuS on the oaUSation of the nourotio
role
the our pr#o
of obsecolortAity,
...
THE ROLECP OBSESSIMMY
It
.
it
inoidme'
tho
know
we
tho3c who go on pýýno
(X? the athletiq
atbletio
life
runs. into
hi&
týsse. peo
e with
meohanioal
sonseq move on in
tba realities
into
many of thoso
tho moohanim
attitude
doqoo
and also
lino
cituatim,
their
llelthar'ao
partioularly
It
30'a
their
boaring
is
on tho mcoh-aniam
the singlemindedno-as
delay
oncetho
adaptation
the work being
further
ana
used in the
amy from
andl further
In tho ppychotherapoutio
pa#O. nt&fJLrs. t maIx.
e rwa. prpgresc
undorl*ng
but one might
demands a chmige of direotion
of inertis.,
a at-mighl
changing
into
in pronotina,
Life
diffioultiels.
their
of their
a part
athletio
as a whole,
has a direot
trait
thio
migký,. jp; q
the neurosis'p
muoh zeal
with
p"s
to propoumd that
and paraistance
in athletes
of obaesslomli=
experien0o,
of. such traitvin
lower than this,
is comiderably
-I
the
poored as lextromeD,
of, perconality
&s a wholo j4dgea by tho is=e oi-ltoria,,
i as that
sere47 hazard
...
O=hanga
of the tmumatia
effoot
I
We do not know the inoidonco
Onodoratot
tho majo p?.p4stion..
reasonabla
traits
obsoosional
oxhibit
Imarked2-and
of
in tho athletes:
rawtions
(BC%)
be
high
that
of th*
a very.
perconta, go
noted
wiU
neurotics
in
uppear to havo a direbt
rhich
insiCht
ýhpy
g&in
when
prodloament.
THE SUMIME ETnCT
maW or ths patiente
aotivities
from an e"
date thoi. rý jpy in athletioo,
ase-9 Ibm
an& innesso
oports
and plw3ioal
havo a lif. 0 lopg. fo,ar of., ana sbam
They have boon fit
contmot with., 'ýoýpitals
that in a ite of, or bemwo of mila sonsitisiý
lo
ancl haalW
e=criences
; or co
along
3.38
ý
they come to believe
the
of. thig
in on4
group. ims hsalth
bonded during.
fool
Ia yaradifle,,
livo
on oan avomp
that.
diotateS
reported
oontinue
this
with
same rpport
Ons cannot$. 0.XQOPt in very
Thull, in this
group not on4
at
the overpreoious
Deýtk
family.
and family
psychological
a complete
walysis.
groups
as
to an advanood age and
than. tho. corrospondinOuLle
out that
pointa
most university
Marienoe
and oo=on
exoeptional
be an
oiroumstames,
but
valued ver7 hi*ay,
illness
been
h%d rarely
it
OrA noes tho samemechanismat play in Roth's young
t4roatenea.
risk,
a veritable
suoh urni ual
the sport
ia athletloism
bereaTownts
ýanily
follow.
iLowzi
break
U9
who
wcijj2
, within
that
university,
the
t4a
tilme
tho.
onset
of.
neurotic
to
of
up
serlous;
obildhood
OnSOs lifoo
all
*
during
in the famil. 7 group to. whom they
also
on 1"ving
sports
stop pnotising
aportsmon,
is
Note that
ýTýy move on into
six. or. seven y.eara IoWr
(W, H. 0,1959)0
population
atblete
ski-era
illness
obildhood.
ýt
although.
diStawe
long
lpiwdsh
for
impaired
cignificantly
9$
thore
in
signifloant
was
oWj
and
were emotionally
inviclato.
themselves ph7dioally
WA threats
iproup nover. proviouslY
inness,
surprise
oomo not. as accepted
- exaggerating
that bereavements. ".nooes3itate
hsbýtuýl.
ad4uptife
of
the
arps-ml
to
that ftereaq
envisaged
an being
sufferings-
iseue
the
to health
but as
in LiDftmaviýla
whiph do not belong
reorSudsations
ýmopozseB."
#. tba lmon-atb.3-0#0.
tba
-rtourOtLOO.
Illness
in Childhood seem ezecissive an& hence mi ght
fom4y,
parsonal
and
.f
1..1ý,.. It ", , .. t.
.
WI...
-.
during
by
Isolating
in
deperdonoo
tho
actiology.
#xA
croating
part
play a.
It
is of intereat
the oritloal
phases of the davelopmwit
of attituden
in
the
such
atbletio
rty
of
cxpsýionoe
Pv
tho very
.V,
maligno
wd bobaviour
reaotio=,
group may be equally
I.
139
"
In thone vfao brealt
of treating
I
to
sq;y Wý
replue
"V,,
hobbios'and
the
as
suoh
Th3 more sooiable
gentle plWdo4
are fortunate
liave b3on aotiv*ly
or injury
Preliminary
Rep.opt qp. SpQrt3,. Heaioinc
This prazents
vAdoh forcea
when avortlagn
IFWWof those men
up to tho Uie
puz-ýUU3 right
draws attoution
in tho cardiovasoularo
to tho
a of
of ýporto
ondoorino ancl nervous
of autonomic, rogaUhr,.
Rnftloulft.
the auSmenting afroot
diaturbar. osis in. the izdtiat. ion an& perpetuation
of
-tho
of suali o=atio
of sMtcm
spirca
formatioll and e-Exi(Dtyoe4d Of. aggmyating tho. somatio prooompatiou
are '50
-
abMMNZ atER traLningo
Orto oan readi3, v appreoiato
tvioal
of
The W.H*O, (; P59)
irAotivity,
of the relativp3, y few known untowoxd effoots
'one
with aMtcme
ago,
thera rzy woll bo a p1Waleal
thoa into
and sometimes disturbapoes
aystwý
to thoir
appývpriato
in acme oases,
IU onargetio
the illness
overtraining
antietaotion3.
3 AUD-MMMIDRIASIS
Immediate "40tiolog3r
e4ýjpd.
work and havo not
work ýy cubstituto
reomations
Adddd to tha poychol-oßýcal streance
ýthý
thier
impre3,3ion
sav0d, by thoir. frioMý4ps.
niBw.
NcE
mimoirro
ccm.J)p1'QUtto
' aM,;Ln ona ban tho
retiment,,
mop., w4p. have ovarvaluoa
obsossional
th=elves
prepared
down efter
of th.013ý3ýtio
rhiob
oymPt=atoloMr. in this alreacV very health.
body-oomoolLous
The
and
gmupe
ordsoo of panio,, w1doh 4ra not
oc)s=oiow
e:VerivXwQ& ty the nonf-athletiol, maYhave thoir
high dCgrev of cutonoxio
the re6rszoa
Thaae are. apsoViative
1ý the W.H. O. Paport to, phvloal
training
of
oafloaticm
doea not allow for
be
ftt
L;
of payohOlogioal
m:
for
imbalarcoo
no roason,
origin,
ýp this
oripir
reflections
diaturbamea
the poarsibility
for keen athletoa
oonjeaturad
for
on abMt
týat. thaaa'ýX-Vt=a
do not suddenly istop
13 the cyndroac of ovortraiminm
another faact
of
ý -
-L,
murosia?
athlotoO3
CULTURALLND S-00MLA INFLUENCES
Tho p p3ent
work., and rolated
.
of &Voiding
adviedbility
dcpqv4enciOG,,.
we
"Nam
of
in
sgra
family
oldor
facing
in
whic h are
a
is
foroaight,
himzelf
totanyydloa
; tandards, and, expectation
tbxm cu-t- loss
isecura foraboa=
and death
the life
for
itself
ftpendis
health
for, tho p4jority
bo
to
qz. e0tek
noý
era
nepte
such uncomon disasters
of longerlife
antastropba,,
awj tondowy
an
but only
of adverae fortune,
the b*tter
malre u,3 moro complaotnt
!4P in an onviromment
of poverty,
many, 1; not. ýor m*3t,, as gobbes
1
brutish
nast7,,
and abortob
---o"poor,
of &. h:Lsh level
toil,
many on. plWaical.
is
ran cannot be
in, advanced countries,,
advanced countries,
economically
of those
ýaq for
of the, WW,?
aid Mainte=nce
tioc
or rork
tormination
or fimnoial
brouebt
strong
plVsloal
tcý the dovelc; mont of a d9p rivation
A prerýýqite
In less
r4qnl life
tho
limit3
tho
to caotional
out the poscibility
of live
health
.
olings,.
provoss,,.
for
valm-bions
vulnerablo,
with
and often abrupt,
adequatoly
improved oircumstazoes
irlionntly
arVý_porzon
for
4eath of a child
Pptimist
and ýxoluoive
can bo. pushod, bayond
rif; idly
of a heavy fall..
Do'tho
a0hiovemont
particular
ana bo=U': Lr. inevitablo
th* moat Mivo
de3bribed
in
which
or to phyaioal
pcabora
to pievaro
disease
erebs
an ideal
who lacking
bjjna=s3O,. =putationa,
..
of excoesivo
senoll
the prospoot
Datisfaotiona
expoted,
tho a4cytion,
AýW pqxýaonq and
tr4ita,
obsosaicnal
is
oorpore,
modamUou.,
rith
PA#icu3.
OuSBOSt th's
studiess,
such th#,
high
of satisfaction
for
attitudes
example
tba lovOl
India,,
with
of inviolability,,
tho
although
of , mitrition
sick=sa
is
and fulfilmant
3tandardýs of pby4ical.
ovezVday eoquaiUtanoe
to. opýimistie
nouroA
lifo
aul
fitz-3as
end death
and few
.
141
=
e32oughsurvivo
boyoud the middle thirties
type nourosis
athietio
for
-the
be a oommondi3order
wM
likely
unftr
preaeut oonditions,
the SiecondWorld Vlar and were tho
after
the
of
study of working class marriage by Slator
giýy4sot
tho inoidezoe
neurotics
it
to be their
thAt w&$ Orilý &nd rOlOntleall"
oivi34cations
the individuaa
than in the present
In our gmnd-
who attained, majority
his nibs on the way and. probably
believed
pwrents
ago,,
3-if*
studiedL only. 15 y"Falater,
was fortunato
day# the child
(1951)
Woodside
wA
in the parents was much hi&r
of ill-hoalth
of athletic
fathergs
half
the
1951 - 1.960,was 414 YearS (-L=O,t 3.96311 1373
dOOOO
In ýhoise who re=494 maturity
series
that
for malps in InUa,,, oaloulýLtcd from oomaus date
of life
The wcp.ootation
to make it
one Pýrent,
is often but M
losing
"Even a. few generati6ne
duty to. prepare their
(MoCalmn
without
children
for
a
1954) but "in !zodam Western
equipped to meet or ocunter
"
630.
str,
Ths
athletes
imurosis'
lowered moz-bidity and mortality
and relative
into
Forbaps the trend win
essay "The-Rio
2033 he goes the rise
inareacing
equ&lity.
for prestige
striving
r. tbleticiam
levels
contingent
on the
I with medical prog=45
a5SOOI&tOc.
affluenoe-..
Will. more men fall
satirical
is Yet another disorder
the sthlOtiO
tmP in. the futuav?
be -&s Michael Young (1958) predicts in his
the
of/Heiritooracy, " Retrospeotina as from the year
Of the now inteneotual.
of qpportunitY
aristocracy
and promotion by merit
throuiSh nonintenbotual
inoreasingly.
following
resulting
altomatives
booomes tha pabulum of t ho masses,
they
ýhoy
Mythoo,,
what
and,
got
me0deda
i3l thO
among which
"The lower
the
Yytho3
of
clullell
ýveododo
hig*y
Thoy
almost
plWsio&l..
ezeut
esteemed
&obiov.
as
as
we
of
Lvooujarity. ý.
q,
I
142
tho upper
one might enquire,, in the light
levol
previous
to
to the experience
adjust
and drive
-disability
It
of coronary
thrombosia,,
- on physical
th=solvos
to an almost
tho-oonaeptual
Thme
of mourobod.
(traumatio)
in life?.,
through boing. boßotten bv ito
their
osusationo
that
=a=er
if
tather
sax=2
of tho libido
fi=tion
to you:
put
into
/P.
this
and frustmtion
situation,
349. "The. comfliat
libido,
the
wbioh
deprived
3
datrimontal
dcor, a baby 0CM9 &bout
juto
mother?
Aß reigUeß
a series
within
- aro roprenonted
Vou prefer
in suah a
At ona
of the other,
havo
fallen
woula
a(who)
and howovor oarefuny
in
in
t6lx
At ths other ena there aro the oaces. -.. (who)
heqa cocapea fening
or that
vritina,
snd CxpCrjO=O,, or. jf
oc=titution
haa Merionoea
:Livaj3 ]=a Won cholterea.
of Froudge
coozz to M* no more cwwiblo
there is more oý tho on* thoro is lea;
tlay
whatever
aW caoug
t4=
of cortain
jj3mogs fan
tho
tho
ro.
extreme
cazon.
a.
scale
of
end
,
woula oartainly
frcm his
er co=oiv. ca by itz
instamoaa of mourctio
faotors
two
tb3
which
it#
Thin di3. o=a
I might
than another
ca. the whole
botween
Aro they the :jjavjLUb3. O
or the produot
constitution
evorianoes
by
doath.
disti=ticn
"Aro wuroaots exogavoun or andoLmnout inwacoa?
result
up"
(Proud 1916-17: Proud 1912): Vol XVI p. 346:
rolev=q
of a partioular
"fold
diotated
Ciujoidal
O.Mtraota
tho
zon who fail
in the light
end murosas of conflict
into
atudy,
and oithor
activity
to comider
OOtiology
of this
of thoso
(V LMOSn
deprivatiou
of
nouroD03
are of particular
attitudes
FRMD AND TYM
is interoating
ths
on
ViOW3
to athlqtio
the limitation.
to accept
or refuse
their
of aaherenoe
of the rasulta
III
if
thair
livo3
haeLnot brOught
"
Ic oonjured up by fruptratioN
of astisfactions,
is driven
as a remat. of
to look for
other
arouso diaploaauro
u,nd paths,. q(vifilch)
objooto
a voto is impoaodo...
pqrsomliV,,
nothat
substit4te
satisfaction-
P, 350:
Tho oymptoms are tho, frosh
"For an external
fr=tratiOn
to becom pathogenia
moot intelligible
prooipitatinS.
tho entornal. factor
"In
the first
diffIcultion
type,, what is prominent
typo the subject
lova Wa3 catiefiod.
falls
cau3a is an attur ,pt
to fulf, 11 the
in
the sopond typo the aoo3nt faII3
cl.
-,
wor3.
first
as fxv. stration,
by n
"
worla,
P. 233-* "The second type of preoilpitating
inte=al
ard
io to be soon
in Sonoral te=3
so leng, ea his nocil for
in tim extorml
unuumountablO'
diecovorablo
cauaa of an onact of nourooin
wbioh may to docarlbed
was Iwalthy
object
real
an intem&I
ba'addod to it, "
=at
Tjw subject
or
which I=s booome nooeasary owing to the fact
Vol XII p., 231: "The most obvicus. ' the most easily
in
of ths
"
of fructration.
frmtration
in Ono part
113. fr=
arainst
of rpali: tZ. 11
_demanda
is a change in the oxtorml
on an internal
an experionoo;
change,
Tm tho
in tho 13000natvyo it
is from a devolopmental proooan. "
Thus
T
frcm
In
;t sense
-tho
come of thoso outli=d
oxtromes
loadod)
of neurosis-prono
the bigbly
however,, considors-tho
viow3
ex proued
In this
thasic.
diapute
with
as to-th3
various
oxtent
iendogonoual
to bo sterile.
go-zoser.ous' or
duo
to
nouroaps
--'onviromputal
substitute
Ggtiýft@ti=
frustration
so far ramovod
proud djj; tjnguj, 5jla,5 two lo: Lar
. tho hi6bly
parsonlity
in7lanerable,
byprouaarenot
nanerabla
(oons titutionaL,.
shmaos.in botmon,
Ho.
to which a wurogsis 4.s
.
Furthari,
ho diatinsuishat,
and the failuro
frOM thoce in which tb3 frustration
to aoblOVO
is "intoma
-
3.0.
Ho choorca to d#"6zizo
the cloment of conflia" t
tipea.. of neuropis
both
wis,hqa while
champions certain
without
oo=eqaont,
of
of the persomaity
opposob -thom and fonds them off,,
another part
there can be no nouropes, "(Co3looted
such a conflial
of
to pravious-levols
reMasion
Thip'. in a3l neurosets 11one part
fixation.
libidinal
with
in his intorpretation
Papers Vol XVI
349).
Thore is oor4ira
even if
neurosis.
Vs comoelement of oozifliot
is onlY in t4o attompt
it
stwhat phall
i aý nowr
ýn w
doprivaýion
for'inberent
in
or satisfaotion
course
that
in favour
thO deprivation
itself
deprivation
arw2ytio4
,Viish,3d.
ropresents
tho mcessity
of another.
neurocos om=t
It
be aaoquatoly
n , l.
quostion
nt or
of relinquishing
in tha muthorlis
explained
ow
oonteation
or underatood
if one careo to assumet4it týý fvýotor pf atýaotioizm
terms of oonfliat.
in
is
an anawor to po
th,, rý i,,
nouroi.
conmioý
ohojoe
to fird
in a deprivation
a libidinal
fixation
then ono coulci interpret
tho
and devolopment of symptoms in sexualime4L payoho-
cxpo.riomo
t.emp. of fniatra#on,,
.-
j
oozftict
rogroccion
if
-
one so
vi
HYPOTH
M CAL QUESTICHIS
ATHLETICISH NEUROTIC
DEVOTICNTO PINSICAL PROWESS
IS EXCLUSIVEMD FAITATTGAL
A CalOMLLM
(SUBCLINIC.41) 14BUROSIS
ni ITSELP?
1. The pilot
between athloticism
GUS98sted an acsooiation
observations
in
certain miles.
ne;
xrosis
gna
2. A mor.0 e7,tOn3ivO p#idy wea carried
The rosults
a more chance association.
respect
with
to a r=ber
nnlo
murotio
of other variables.
us abo4t tho
study tall
of this
batýTeen athletici=
of the association
=3
rap not.
and non-athlatio
Cý ýJae results
4,, Wbat G=-a c0twidOrztlOn
nature
chow it
ahmm,that the athletic
3,- it was further
diffor
groups
out to detelmine whether this
There are throe,
and neurosis?
possibMtion:
(1): Theue people. have been neurotic
Postulato
to
tho surface
xploaes
e;
which
of 'Inýiddle
the threshold
If 'this
Co=ent:
excess
of familly,
years,
before
the sý4option
to Support
this
oný)
in
manifestations
of tho
4ofence,.
(b)
tho famny
the patient
The finUngs
on
in
(a)
come eridonoo
during
little
of
the early
the earliost
provide
an
years
evidence
iiew.
doveloM
lator
in cW2dhooa and is i=edlatel
development
by
the
of athletioism
ocapen3ated
Again, there ic no incUoation
relationshipap
to- find
expect
'would
of neurot: Lo :ILlIn3so aWor
relationships'Within
neurosis
po,stul'ate
the
ago,,
incidenoe
or. of neurotic.
and the
Whon the dofence is. threatored
vmra the exple=tiou
interpirsonal
disturbad
out life
hits bacona compensatory aofence against
development of uthletici=
nourosis
throu
or events of obildhood
as a wurotio
frcm the f=117
equivalent,
history,
fmily
an to why any nauros: LD ChOUld dOV03,
@p.
3.46The evidenoe favoura the view that
there are alternative
in
of athletioism
w2vatling
and roWing families
Genius"),
(q) competitive
axA the temporal
within
the large
aevelopmelit is oontinpnt
to certqim.
be constructed
to explain
condition
difficulties.
sibling
ia only
stresses.
the oausal
neurotics
strongly
but does not asoessarily
two theoAes
support the
on the pro-existing
in the serse that -it
A meaningful
sequence.
group.
of the first
of the manifestations
which, in itselfs,
a vulnerability
"neurotiol
.
combine in the champion
(1869)
in "%redit=7
by
Galton.
recorded
driven
relationship
the nourotio
athletioism
pro-nourotio
genetically
(b) family
determined),
The absence of evidence in favour
Postulate(3):
life,
the development of athletioism
( (a) and (b) probably
tradition
view
for
explanations
(a) pbysique (in part possibly
that
these men,hava lea a neurosis-free
arise
can
pophopathology
Thus,, athleticiam
from'earlier
creates
is
a
VII
THEOlff OP SPWIPICITY OF STFMB
r-That whioh in most useftl
In praotloo
in more corraot
Pmnois Pmoon. Nov=
in thaory, "
Orgm=
11 IV.
"There is a hierachy of facts, - some have no roach; thoy toroh us
Tba sciontiot-'Itho
has asoortainoa them has leamod
nothing but themselves.
fact,,
but
andl has not boacm* moro capable of foroseoing now facts,,
a
nothing
suoh factsq it seems come once, but are not destinod to reappoar,
There ara, on the othar hand,, faata of great yiold;
each of them
teaches u3 a now
and ainco a GhoLoo mu3t be mado,, it is to thome that
"
the scientist
should devote hl=elf,
Honri
Poineare. #4 Tho Foundatiow
sciancoo
of
147
=
HOWCLOSEPYARE THESEFACTORSLINKED ?-
I
(CCKBwTU_Igi)
(1)
THE'IUWOTB AtTIMOGY
(2)
THE 330MIATE
(3)
TM INSUING ULADMVM-TMPCKSB
ARTIOLOGY (IMMIATE
This work'is
OR,PROXIM
(VME
02 NEmoric-nims)
BuVtit3. ea "A Study in Spealfio
The
pre-morbid
-
interaotion
by
ba
tha
must
the
intUvidual
oonstitute3
Secondly- The iýmediate
booome
has
vulner4ble
which
by a speoifio
bgr and large
Tim,
re3pona
and enviromontal
the remoto
aetiologloal
or proximal
stimulus
into
a neurotic
v tO phy31Cal
unfavourab3,
referred
aetiolodcal
ThiE#j
to threat3
are
but do not
of atimull
to Mlain
this
factor
vulnerab4ity
is in some studies
(1961) indicates
This group of stimuli
constitutes
there an
objections
the immediate
faalor,
- consideration
tho ensuing maladaptation
specific?
to others.
the non-athletic
while
variety
The immediate precipitating
term,
aispeet v&ioh U only
thregt3,
to as stress -but as Pickering
to using this
been
to the constitution
rolatod
situations,
A. pisychopathol. o,gy can be copstructod
in the athletic.
hu
faotor
group re3porid unfavourably
by a
rsaoticn
on
factor
aid is not responsive
situation
the athletio
influomes
preoip#ating
in one partioular
prowess but not to other
to phyaioal
triggered
of genatio
Basically,
croated as it
or constitution
in a male grou p to bo l2voifiegLIZ
Umonstrate&
activated
personality
"
Vlanerability.
,
three oor-oopts have b9on analysed:
Firs#Z
PRECIPITATING FACTCR)
in this
must be given to the nature
presenting
study,, although
in the con3equent neurotic
reaction
as a clinical
certain
olit4oal
in the athletic
and pattern
disorder.
To this
of
also
features
are presont
group,
which 9ým not
in the. neuroses of the ndn-atbletjo
present
euMpiently
a definite
to constituto
consistent
BUbjaCt3,, thoiso aro not
Although for complete intellectual
syndromo.
one would have hoped
satisfaction
to be able to represent the process schematically thus:
constitution
10
x MPT*"B"
Neurotic
reaction
"C" and
constitution
"Z"
* IFT Ox"
Neurotic
-)
reaotion
"z"
in. fact
.
wbut eserges is:
cOUStitution *A"
'Neurotic reaction "R"
010 x 3P7 "Y"
C;onstitution
IPjF
x IPY "Bu and
factor)
Immediate precipitating
If we introduce more immediatoly meaningfta symbols:
A+
= Athletic
A-
U Non-athletio, personality
Personality
GN+ = Personality
with high general neurotioism
low
P+
a Pblaical. preoipitating
factor
a Non-physical precipitating
if
factor
Neurotio.
reaotion
a
the formula can be reconstruated tirtm:
Constitution
for
GN-)
(A-
GNt)
x
,
it. has, been-demonatrated
the factor
intra
(A+
for
pme.ral
and_extra-famUy
IPF
Result
P+
.-Pý-- -
"X
that wbere the factor
nourotioism
personal
for
athletician
its low as revealed by family
reutionships,
neurotic
traits
is high
history,
in 0hildhood
149
ý
and in obAt
nouroticiem.
lifos,
are in#arzoly
the family
inside
and -in marital
in the quality
rofleotod
will
have been. notea
preoipitant
(7-570o
in the athletio
health)
Scmo interesting
anteceaents
throat
6morgo if
to physioal
for
this
G=up 11: The 12 atbletio
asuo=ant
sol
NOT=
only throe of whom.=
of tho neurosis)
in whoia the no.urosis
by. ýLtbreat
of go R-plX
was
typ 0.
made up of
supra)12 subjeats
tho
c=ot
(o) Group 1V(v Infra)23
The 23 athletic
a
is rocordad in th*ýtlbla
an
PaGa 150
(b) a group of 9 in whom both'phypioal
Gr!o'UP IV:
to ths
aro:
44 atbletio"nourotios
prýoedocl
(a)
is-direoted
antooodonts of tho 23 athlet, -,-'tho
porsonalltici-(in,
pproonal, itles
(a) Group ll(,!
threat
who broke do-,m following
subjects
of 19 variables
28 non-athlotio
The totea
boing
wall
274% developed a swurotic
a p4ysiCal. throat present as a prolpitant
Group In:
group tho,
threat was the sole apparont',procipitant,
incidence
prýq#ltated-
TIEUROTICS
of the 'appropriate
a scrut#q
typo'on; y ancl (b)
-The
The four gmups uned for
ýThs
rolationships
quoh a threat,,
subjoots in whoma p4pical
GrOUP; :
the inoiaenoo
of these 12 athletic
percentage
been a threat
is lose oomploto,
facts
of a non-phyploal
M L=
whereas in t1m- non-athlotio
rarely
group,
in the absenco'of
illneos
that
has vory
i=ediate
(i. e. to Physical
of porsonal
during childhood,
FURTHERANALYSIS OF SPECIFIC VUMERABILM
It
Tho aagroos, of
relationships.
I
of
the
and, non-pbysioal
throats
nouro3in.
SUNCOU
_perzonalitieo
the sole precipitant,,
-in whom a physical
throat
was
!iý
150=
TABY1,71.
Athl*tes,
No with pbysioal throat
32
as precioitant
Wo.without physioal
thrent as preoipitant
12
.
Total
Paroantage incidence
"06
physical threat only-- 23
z4o. with pbyzical ana
.
p ohologioal throat ="
73+
Total
-ago=
44
.
I
Grouio.1
ýonThe ,W n
Group 3.1
Gnoýu Ill
t_ 7 677 E,1t
T 9 2
a es
Total
athletic
without
physical
precipitant
nourotias
Group 1V
TEM23
44. Athlotio
group-
athletes
with
Ybysical
precipitant
only
Fami]Z Histo
22
60
30.'
16,5
25
58.5
17
14.5
63
43
32
57
58
58
75
75
63
75
78
. 65
70
18
33
50
55
43
66
79.5
82-65
39.5
40
72,5
85
bevere
MOUOTUM83
Mild mental illness
Clear for mental
Healthy relationmother
ship withfather
Parental hamorq
Above combined as*
." totally favourable
pai-ental influence. "
18
23
55
Childhood
Happy
Abavzoe of nOUrotl:o
traits
'Goodhealth in*
.childhood*
Family health good
during *childhood
60
91
93
96
50
91
91
91
Large Si ling
roup
(4 and *-, r7d4j
'
ýk
'G6od wor re oord
Sociable
Obamional
Ilot preAoilay "nervyO
25
71.5
43
57
64,5
34
75
66
83.5
66'
50
M
86
80
79.5
57
91
91.5
83
91
L
I
Peraentage married
(Ha=ozW.
or
miivied tg1exual
satisfaction.
67o5
42
75
89
82
86
83
84
'68,,5
75
75
68.5
151
it
be seen fma
will
into
praoipitated
(12 patients)
for
table
ill
health
relationships.
2. They lie
Aeurotio. family
history,
"nervyness"
sociability
wham the possible
"d
physical
Proportion
wd harmonious marital
position
with re3peot to
to molLher., fully
de3irable
groups,
3. They closely
married.
the 23 athletio
to comparo them with
events
nou-pbgsloall
Comparing oblumn 2 with
strikingly
ef personality,
of relationship
precipitating
with no complicating
threat,
vdth respept to
of pazvnts duri, rmgchildhood,,
in an intermediate
quality
soon
resemble
enough,
"t 13 #tensting-
fonoving
bet-woen the figures
in the hir $h incidenzo or neurotic obildhoocl tmits,
and
.
(a=iety
the figures are small
Although
pronesess) as adulta,,
t1le trend is clear
stbletio
rou&ly
hsppiýnecs in ohild. hpo4s, size of sibling
relationships,,
non-athletes
is a pma3l one
groups i. o. they are atypical
ani innen
powental harmony, obisesuional Units
vrork record,
lies
I.... They res.ex-ble the athletes
pbsonoo of childhood
par,ental
threat
of the il3moob approach the pattern
the anteceaents
in the non-athletio:
o of athletoo
Crou,,,
althoughthe
of 19 variablo3
ancl non-athletio
athletic
in that
that
by a mon-phypioal
neurosic
the inoidonce
tho total
athletos
this
are
13010]:Z, physical
vM
be seen that
axe loss
in those rho break down
am &ifferout
demonstrated that
threats
"courotio"
This is revealed if
the fomer,,
thin
ths more. speoifio
tba. lower are the indices
ýho figures
28
from
the
non-athlatio
columns,
a pbysical
an& it
is
the vulnerability
to
of general neuroticism.
are read from left
neurotics
the
vrithin
a nolm-ptWeicalt and. thasp who bimak down following
The lattor
(ie.
threats
threats),
column 4 it
group the antooodents
in
patiOnts
to right
in each
through the 12 athlotics
who
152
ý
break clown after
for
streets - to the figures
non-pbysical
the combined
44 athletes and on to the 23 athletes who are the most physically
"generally
and the least
vulnerable
Comment* The figures,
being small for. each group, the faot that a
trend emerges is quite
general
"
nourctio.
tho throo fa.otors conoerned with family
history
in the table
(Po 3-50) thOlnoidenoe
consistently
thrqugh the groups, Tdth the exception
flattens
off
(family
health
is totally
consis tent
Thus the athletic
by non-pbyoical
solely
neurotios
other
('seerigures"p.
threats
physical
father,,
to
and
to-their.
score highest
athlotioi=
and the beat childhood
family
illness
sooiabilityl
during
of all
They have the highest
they were least
se=al
s4tisfaotion
Ithe
group size)
but
the trend
"nervy"
is precipitated
analysed here,
healtby
for:
At tho
in whom the precipitant
relationship
relationships
to mother
with parental
free from neurotic
rooord with an absence of significant
57% oome from sibling
oUldhood.,
ourve .
3.1 variables
of a happy childhood
health
high
marital
a
such
group shows
aohieving
poraonalitips
incidence
traits
ba=ony,
cargy a modarate general
of these healtby
combination
or decrea3es
resemble the non-athletio
more olosely.
as reveapiL by thp variable;
harmorW,,.have the hiffiest
we upwards,
remaining
in whom tho illueaw..
and of the scale the athletic
is solely
001URMS
of parental
ard sibling
but
153 and 154).
personalities
and in addition
vulnerability
neurotio
In tU
th*
inoream
-, in two Jwtancos,,
during o4ldhood
to the trend,
does not, nm counter
aoroIS3
of eaoh variable
hamomy in marTiage an.d obseesiomalty,
Mmess,
of psychiatrio
reaaing horizontally
of the remaining 16 variable5
emerges for
No gemeral pattern
remarkable.
incidence
groups of four
of good work record and
before the onset of the illnesso
inoidence,
in marriage
No
and in none is the proportion
so high.
-153-
Z%cir
ol
I
'1411*7
Ilf
i
4, h.4"
,
2T Ell
ýM-k,
pj
7It,
WIN,
-254-
cý'tc,e,
ýLz,
d--
4 -
let
re-,.
Cecýi-zt1
t.
L.
e4-
h...4
//
I'
6c
0
*0
3-0
20
----
-
---
-
---
Yl
thrOugh the athletic-Twurotic
between
Uffer'Grices
the
the
these
athletic
graphs
show
clearly
groups
rourOtLOS.
groupý and the non-athletic
neurotic
Is
inconsistent
are
trerm
the
It. B. Ven where
15!.;
VUMERABILIff
MALES WHOCPIW A DOUBTLE
The forzula
pr; poaad above, then,, is not cbmpleto without
a double vulnembility
a mixod group oarrying
Plus tbo'r
atbl eticiam
it
group
Profoacor
threatis
Miobaux (1963).
that
Firatly,,
MusBcon
in
to one type of threat
health
ppro.onal plVaical
of Roychio'
of individtukl
OýIy -
a non-phyaloal
threat,
Finally;
male neuroiioa
non-.athletio
to physical
ity
health..
and like
employnout atres3es,
who, aevelop
peXtoralition
of.: g?ýeml
theso individuals
coifstitutional
are exolusively
threat,
and prowoss.
often a minor one,
elbeit
SeCondly that less
but in whom
who are not only-athletio
cidgrees of general
ca=7 a double vulnerability-
individisalo
vulnerabil.
of athletic
the ýIýall y aooej!ý ea. ILWcos
.
..
is also evidenoe of varying
threats
ýndorstwading
an
the majority
oo-mmorI7 ono -seeo ýaale neurotios
thare
GNOx pý
has re-emphai5ised. that. -the effoot
are very low and-tlýat
neuroticicm
to tbair
(A+
in this
in males from the above data?
vulnerability
vulnorablo
would appaar. that
to trauma. Mmt generallisationB can we jau, 09 about
vulnerability
V= .02io
of their
whiCh am mol3t potent:.
AthOUt
bo
tr, aums cann t
undorstOod
irffvidusa
,
Umcý It
g0n"O"GurOUO:
is non-pbysical
by virtua
introduoing
but usually
rour'otioism;.
break down following
at tho other oxtremothere
vho', tith
faw exceptions*,. are wt
They oazW a. hirA*degree
the mixe.A group moist f: reqwntly
sexual difficulties,,
f=ily
theca
are entirely
affeoted,. by
of general neurotic
break down fon? wing
boreavement and fami1y
illnesso
The goneralisation
are goneraWnourotic"
vu3merability
to thnata,
is established
that in the "athletic"
the olearer. is the speoifio
to phyaical
won being,,
the less ýhqy
arA- exolusivo
-156 SPEODWITY (10 PATHOLOGICAL
RW-.
CTXCtIS
mental illneas
cowidering
aa a wholo and ý=--Dsyohotic
to what extent
tba basio
aajustmut'of
it
to prodiat
haa said
Confucius,
thcým far
akarýq"
to
r&at
-
quaction
of a person' a lifo
possitle
disordor
cluory ie an. extenpion
Th#
one to another?
in
bý maintained
faotor-s- hýd the result=t.
pmoipit&tJmS
kmaledge
can it
biotary,
how hi
resipma
wM
*.Men' s nature p aro '4iko;
Knowing a person' a habito
Istimulus.
the
oT
word
oo
p3.&,
profOrs
nspaoific
stimulus
04
tbzt
atate
Volpo (1961) likovdae
situations"
"lovA"
(v..
).
s.
istatow
but it
13 thO altomtion
tt"ernu
aituation?
habit3'that
his
carry
reactions?
tallm
acaut"'. 40
aicl-aingle
o:ý more ocý*lox
of the rourotio
atimulus
(1960) doanitiLcu..
=PPcnzd
"
aituationa.
"the
gstzto of, -
can bezt-be rovqrded va a procoss of'
JLs roaohod. 11 Hera the word in taing
ana ig; virtU43, v synomynaus v;ith
TyW
too
Solye (3.960) alGO U0013tho 'word" stre as* to' dogorib*
WOlff (1953) usen torms definod in moohamicjýad
13 UO 13tiMaU3 or imterval
t1w interaction
can ona predict
and "dofinoablo
Whioh a now adaptqtlon
of the cri=i=.
tlioir
as a desoription
pattern'
tha
to
renation
clazoribe
used
"tramsition
is
an intimto
and habit'p;
traits
0 wbioh. suggoots a sipple
may t6 an abstraction,
'olmnSo durivg
baving
of pvthologýoal
to tba corXusion betwoon the ideaa
beoozýOsevidant, in J=Qjj
T116ocousion
stress
Istimuluo
evontz,,
psyohologioal
tvlated
in tho popiqar uaeago of the vorcl. I straac,, I imcl is!
and reaotion
the tem
the flold
to a eiven
it
"
constitution,
aro speoifically
extont,,
Personality
Pickering (1961) dmw3 attention
of ptiaalus
into
that
inuaissol
between external
or deformation
environmental
agant,, 1111treas" j$
onvirommout and ergaui=,
in tba organion
t lat
and notmih"
-071SU030
3.57
When considering
of ter=
a variety
organizas
1.33put:
experiential
impossible
prozinentl,
ba'iiiod
to avoid
to describe
or
pattern'
stimulus
the result.
behaviour
reactive
and Istrossor.
be used to describe.
in
can thus
stimulus,
' 'precipitant'
'threat.
it
complox abnomal
1
the
stimulus
the litarature
on this
the use of the word IstraBsl*wbioh
y in the title
and text
situation'
or freaponael
'Reaction'
Reviewing
in higher
-of the. Vpropriate
can
topic
figures
usually
studiaso
DL! FMIUTJ A IMMUNITYAND SUSCEPTIBILITY TO STRESS
AND THENEMING OF AN EVEEMCE TORTHE 3NDIMUAL
(ig5g)
Reia
agree with
One oa=ot'but
J=odiate
and their
stresses
individual
t4are exist
..
cli3tribution
of differential
iuW
"For
state3,,
giTon cituation
relev=o,.
d.ifferences
introauaing a aisouissionof
who,
h4n býen grossly
quaceptibility
Yet the
to stress,
in susceptibility
ignorda in
"
LO
tr:.
research.
pfiyohic,
MwW authors
(sio)
Istre3s
oan only be understood
conceptual.
its
individurl
P. 6. "Animal
experimentalists
differontial
immunity
to the organization
both
tho organisatign
havo demonstrated
the noxious
of a given
foru
This,
to ativas
mature
organism
of stress,
in turn,, its a fmotion.
I.Vorge-iiised,
porsonality
and vultembility
Orge.nism to a particular
and
w4ah oonoovva the
situation
to itself,
model of that -must. includo
rA3d to understand
(1950) in "Stress
"Ot given by ovento but by the organiem6
of events in relation
in
the
vhioh
may
of
to the mcparienoo and
Tbus, Vlokers
DJL*orxl6r" p. 5: "The stressful
PAYQUELtristoooooo. -13
interpretation
in relation
of the individual.
swooptibilities
psychintrio
have k-ightlY CZPhSLB13ed,but in a very -geuerul. way, that
of experience.
th*, gonatio
in
of a given
basis
stress
"
for
anis, ls. " P, 10.
and the. vulnerability
"
and aEV
"We
in relation
of a given
so 158 -
(1960. lbid
Wolff
makes them aname the natun) of thre4to, " p. 20:
individual
because of Inborn or early
a discussion
Following
diseason in concentration
therefore,
seems clears
"Since
we cannot
(1961)s
stimulus
his
"this
Past
experience
stregs
is likely
pattern
vho experiences
his
related
and/or experiential
moanir4;fý,
been so neglected
future
concentrated
an appreciation
expeotationse
is that
nor
influences,
it.
" p.
128:
the pasts
Mo1wring
in
terms cf
"
and constitution
and that this
yihy then has this
field
of
In part this Its due to the
oases Which has traditionally
on other antooodant factors
of the rolownoo
by reason
the procipitating
to personality
in clinical
studies?
enquiry
inquiry In neurotic
slant - of psychotherapautic
attention
of certain
describeds"
to the individual
are saying in effect
to be specifically
or in
the present
ba measured but only
is moaningful
is psychologically
relationship
In
either
are built
on which
by genetic
&a diotated
can never
these autlwm
What all
tho individual
measure meanings
psychological
of dicappearanoc
"Every evbnt Is only a stres3or
1t has for
stressors
rosponseso"
burdens do not haioo equal aigniffoanoe,,
ibid p*124 considers,
the meaning vftch.
In such cases$
response. "
ovoko -the same adaptive
Hills,
by
"it
he
raturn.
concludoss
subeaquent
camps.and their
that all
"SOMOpecplo
&larming to most peoplee
(191+7)
Groen's
reports
of
the
threatened
feel
benign circumatanoes may evoke inappropriate
ostensibly
of
differences,
acquirod
which are not at an
circumstances
do an
"The meaning of the StIrM334 for
po 18):
of the Imediatoly
to the exclusion
otrossful
of
situation
tho development of symptom*
preceding
Although relativelv
hen not been entirely
negleat*dj,
the theme of differential
susceptibility
4; nored. by any means, but In very few instances
has
-I
it
pormonalityp
Precipitant
IU thO field
defino
profiles
throo factors
all
speaýX.jw, 11y: pro-viouo
and rcaotioll.
CIf PSYchomomatic medicino., eff ortS have boon mada to
of pernonality
eogo Alexandor
hw
to link
promod possible
cl=acteriutla
disevoo syncIrculoo
of apecific
(1930) and hia co-workera., Dunbar (3.943).,
and attention
been cUsamnto the obaervation
that
threat
one type of psychological
i3vz-coptible
will
persons
indifforonco
symptwnz but react with
vith
to
rcapand
to o thora *
TAnford Rees (1960) In a discuzoicra of the proolpitation
disorders
and allied
,"practically
points
týpoo
all
of Stismal.
p2syed a prcciipi ta ting role
in
both
to the extraerdinary
and situntiono
In m,ndom ca= icz
ý
He findzýtouovcr,
soxeso"
that
vary
variation
in
response
(1960)
individualoo
to
the
a3.r3o emphasizes
the
result
end
sama
O
VrOvOj-,
d,,,,,,ons tratea
that
by trio accretion
:Eo not selyo
:Lu=ing
rather
w.anifoutations
uzwlly
of certain
hore emphaoising
than eplittiM?
as otro=ful
or poychological
at
tha phynicien
to strecsitil
in
migirl,
yeam
it
(traum.,
In a-rathor
of StrOzOorb
ji-as bacn apply
infeclolon,
ateraotyped
such az 4*0,, T, 11, and ccrticold-U.
the expcnso
of differoncea
can differentiate
infectlorw
varletY
of
extensivo
an
of
toran.
or
asont
varictY
of sta-casorz
hermoncs
agar, and
times.
honty
tho body reacts
'
may show torked
different
at
the loot
similarities
datermino from the clinical
thz respomez
an oxtraordlnary
"During
-
etc).,
doucribad
an individual
In remponao to a variaty
I.ntoxi. cationas, nervous stirmil
manner,
strozo
that
of atirmlants:
in general
Albo,
s3=0
di-mraity
of matlimatics of all
kinds.,
thoy
mhother
a-11
j
of
ara
tjmu3.
phycical
13
mmrkedly betwoon
of anthm,"
the clinical
and intoxications
and
infectivo
the
the
natura
of
phOn=Ona
"
160
When Sutherland
(196D) Erpeaka of "tho experience
of anxiety
and
the enormous range of stivuli
which can arouse it" he Jz referring
"normal aludety"
and not the pathological
anxiety
responso.
(191+9) has written
Wittkower
or the threat
includes
uLvally
of illness
including
the sUtement
unduly
cAse material
about
this
athletic
their
health"
arA lcos
is certainly
male subjects
ira my series
but
to illman
cf reaotion
of 3jMbsv and
Individuald
the dAta from
are
the Original
iB based are not advanced,
description
profile
The personality
torm
and Introspective
conclusion
Is suggested in this
linkage
blindness
"self-centred
concerned
on vhich
in general
to
cf personality,
A triple
and reacti, ----,ý
from that seen in the
I
very different
stressor
who dovelcp anxiety
states
following
uch threats*
disorders
in psychosomatic
reactions,
Hamilton
(1955) to his book "Psychoascmatics" P-205-.
Is
difficulty
specific
faotp
that
in vpite
of repeated
for
type of personality
the descriptions
of the strongest
these conditions
alternation,,
the precipitating
factors.
Hamilton instances
there
exists
a
ir.
disorders
types are monotonously alike*
they tend to occur together#
problem of specificity
"The moist obvious
p3ychosomatic
that cue of the mcst iMortant
is that
and summary of
made that
advocates of the theor7 of specifio
in the dame individuale"
the fundawntal
claims
each particular
of the different
insistent
he is equally
from conclusive
are in general far
than quote the conclusion
better
do
not
could
and one
and
between antecedents,, precipitants
of the inter-relation
Studies
One
types Is Halliday$
characteristics
yet
of
in Succession Or
pe 208; "Others have tried
not in the predisposition
to place
but In
"
the study by Gracc and Graham (1952) vho demonstrated
-i6i
.;
the
of different
onzot
gpecific
emotional
Migraino
to occur
after
individuals
maximal
activation
autonomic
relaxation
showed that
JLnvestigation
the
during
the widely
in
with
of mental
for
effort
however., after
or
a careful
tend to reepond with
the same physiological
various
tendency
recognised
a period
Bateman and Van Lahn (1953)
liscays
strain,
including
states
In ansociation
reactiom
psychosomatic
a pattern
of
"Ekatevery
function
strosso"
Adolf
in his
1byer
teaching
conatantly
aralysing
the actiological
setiology
apparent in many cases of psychiatric
to rate
the different
that
so
the key role
Vmarely vulnerable
tbIs
ignores
of the final
a sudden stap-like
devcloPmOnt Of the neurotic
d strengthened*
gLv.
syrVtomtological.
Conceptiml
definition,
modelwhose
is overlookedo
so ftoquantly
and of how it
variety
so generalised
the total
(ROth
"every
of situations
individual
by a limited
as, to be of very
little
1963)
could be. modifica
than the rigid
in its
and prezente
Is matched
comprehensiveness
involves
school and took a
personality
too far
probablywent
Thus the statement
to a very great
is
studying
a
v;hich went to the
nosology of the Kraepelinjan
This reabtion
setting*
which transforms
He sought Dome framework much more elastic
vieVoint
cow. rehensive
importance
than 'a process of evolution.
Constitution
however
of the g)TPtCM OoWl=- but
that the onset of the disorder
change rather
the multiple
aetiological
invalid.,
interest was in the study of the factors
wyarls
types"
into a neurotic
of
He faije4-
factor.,
precl: pitating
the "form of evolution"
with
the fact
illness.
to their
according
personality
Meyer is preoccupied
and demonstrated
constellation,
factors
the importance
emphasised
only
environmental
us vith
by its
is capable
a
lack
of
of reacting
number of reaction
value
in practice.
It
162 -
A-
doos suggest that. in Mayor's vievi there is
nature of *, a provocative situation
In a Smat mwW stuaies
;is hold
that
there
is
nothing
c3.oar in many instances
whether
the pmlbility
dofines,
psychological
unitary
kind
of different
9maculine
precise
its
of it
being
emsentially
to say about
individuals.,
Adler
many manifestations
Ivantal
"no allpificance
or
to be of
In the reactions
as Ooz%= Inferiority,
one theory
in
ideas on poosible
mcprossed clear
together an *actual
but were Ulmx&t
conflicts'
not
Jung
stress
all
to a.-Vlain
(13'elaChrzAnoNoId93-959)- 115grouped neuraeathenia,
kOPodiondriasis
been absent,,
the differences
inferiority'
is
disturbanoe,
of psychiatrio
It was Fraud vho first
considers
uses ouch concepts
and 'compensated
protest'
It
altogetherg
has been overlookedo
present
and has little
of the 1=061ate
has in fact
specificity
but
typos
relevance
it
illneasex,
of psychiatric
the nature
qbout
possible
whether
about the
Wcific
In arq mental illaws.
of tho actiology
and many ignore
precipitant
nothing
in the mind. "
neurosic. "
a=iety
specific
neurosis
camen
and
Thege-were not oaxweabv
to be Siz4)IO physical
processes having
They arose in Preudos Cpinion through damed
up sexvxa anirgyo
Paronozi
&a Ophysioneurcols'
n*urosis
points
(19081 elaborated
out"that
Proud
thou&t
on Proud's
in
contrast
that
fmmulatim
to
he could
by referring
6psychonvurogin.
to actual
1 Foremezi
deduce the diroct
cause cf
neuroses from the natuxv of tho neurotic syMt(:
M; a Mixture Of
s"toms vas considered to be basod on 0aetiologleal b:Londing," Here
we
soo an attempt to link specific clinical patterns with itowdiate
aetiologima
cartain
factor8l
iactual
thug coitus interruptUs
nourosiaot
is regarded as a specific
precipitmt
of
Vi-. Ud it; alao
Infantile
tho
enouing
thore
cannot
raurotic
pormonulitles
the present
Slater
(1961)
of Rothle; vicmon ulth
of
of the
:W gancrally
recow4uccl
in -whom cych a d5stinction
cmgSpraticts
of pro-
out that
kkyaterical
displayed
displn. Vc-d
Tho'fen-t-wos
hm pointof'.
n-mrotica
:Ll.vas baforo onq.crýoncod anxio ty or doprossicn
:Ln the majority
A. Y
in hie
cuatinction
Athe r1mority.
tho athletic
series
It
nOt necen-m=Ily
=v
traits,
in
I
oyaptovs. hava previously
hyaterical
Lth
-v;
In
cezes ara
illnoss
porso=lity
traits,
lrre2. cv=t.
thouc
with
occur
of
the qucaiv
-thuo cormideration
is uguallv
arc chrcnio
:in ml aout-- .=aroVjc
crjmting
and illneca,
poracnality
be mado,, but
oventa
He ma-kca no clear
structiwo.
prccipit=t
that
trawmatic
at uhich
personality
batrican
g-jyst=
apacdfic
zo=lity
to cor=3. aAo tho otaao
In hlia aita-zpta
not all
pamomlity
hzvo never
in
thair
to any unuzual degree,, ana
phobic auxiety
and dcparsonalisation
theso
are novel c.,tporionces
ss
IMý, IL-0-F
Aw
A REV
_MLý
,
Mayer!,- Grow, Slatcr aDd Rota' (:L9(*) awnmriso contoLVorary vieva
to
praoipltatinZ
rappect
i
vild,
"There ia littlo
, -137:
hou
ývýterical
of
,
sort
any
,
,:)oychojogical
J,nteresting
Gross
:raotor
et-al
that is Opecific
impczed at=in,,
consider
always
oventop P-=e phpical
factora
th-...y are
exceptions
is marly
Cauzos
The sudcaen breakdowne.
Oxaoso
under
occur
oo. co. ormy
and physical
(1960)
about the precipitating
A.
illnms.
of charply
a%usoain variou; 3 f orm3 of nouroti_c Illwan:
11a rim
play a role
of a varied
(p. 128)
Odlioad by Slator
t1ut
of a pzycholoZical
"both
in aetJo3. caV; Lut -witi-I s;,Omo
and non-specific
In anxi0tv
kinds*
and so= poydrioloe1=1.11
(1961):
ptates
kind*"
"the
Vmyar,,
precipitating,
in
diain
1a3
t
a
o othe
cf
rMOY tWito the Hoyarian view
16ý
-
of tbeme In peace,, mrmual straina
last
the
on
LB aO a rule
strainý
prec4it3ting
Hm*ver,
for
vhen
a do3res
tt
The stresses
Imune
be
way
sub 0-loot
distmas
little
obsessional
states
the
underline
authors
invokina
likely
to some sltmtions
T=n, but liable
average
:L:Lttle
to feel
cf'mind,.
a factor
this
Althouah
part; Lqxlnr
'wlthoUt
&..a anor, &noa is
mde
iiia' leas
neurotio
apecific
is
section
relevunoo
uh: LQ%put3
or a situation
rapponsibillty,,
or cal-ftdont
self
rolianoo.
the prozont
to
states
that
and those vith
a yrecipitating
luore co=on
Off'Oving
out
4V
to study
factor
but not
experionces
in the former,
siEpificmnt3,
v co.
LOgic&2 OVIanation
PCYChO:
the structuro
in
of attitudc
psychotic
of
spptamo
statot
1%%ving
states,,
vho had
pcwsontilities
obsessional
cmipared with, 00 non-obsesisicMI
overt gomial traumatic
to a chango ()r
an increaso
absesmiemi
obsessional
a SOMAS of sme nork-obseasional prlmx7
93 reitients
atudy.
1t
excluded frcm the istudy persons with
anxiety
*Vern onalitle's
a demana on fle3dbility
(1957) in a study of 150 primary
Pollitt
devalcycl
Imblim,
ce-establishea
Gau3o ma3t
consideriM
kind
"thaso
be
demana
Titus,,
atressen my
adaptation
cxr a
-to
a ro2A=tion
in the
which vmaa
to., obsevalonal
reference-
of considerable
an tbo
foxm,
to produco a=iaty
in situation
mciety
"
siPific=004"
"may take a apecific.
persona3l't-aes
obseamicnal
n, ana the
are uno
of relativoly
tho
of all
excosaive emphasis baing Uid
ccmas to pbsessLona3. states
of specificity:
reaction-a'in
loacple,
demnds an appreciation
that have exhaustea his rcaervaa,, without
-fa,otora
.
of *, e mauls atato
"an evaluatien
thal;
occurring
in
dcEcastr-atza in
ccutro3.8 (rxurot4ýCand
paychotic).
were sýgpjfjcant3. y mcwe ectmon aa
and that death cC a near relative
'7h*
author.
for
these
tba pro morbid
4ý
cautirue3, y ralrains
findinplP
personal; Lty,
and did
lhere
vas
from
not cat
in 0 UnL.
,
3.65
boUrcen oboassional
Myor-Gross
themselves
in
the aBroly
are
involutional
depressive
with
conditions"
predominant
(1959 (a),
Roth
the phobic
in
in incidoncelfrom
or sudden illness
danger
family
group
specific
"physical
assaults
touchy
and sensitiva*
of any klnd,,
illness
on the patient's
"no more than a spark
associated
in
self
with
(37,ý),
in
a combination
not
Uiese
bereavement
highlights
again
personality
The predisposed
physical
or acuta
to the security
only
but is
obsessional
deafness,
precipitants
illness
threats
The precipitants
barrel.
the
results
group and include
study
specifico
esteem. "
the pcodor
which
the immediate
vulnerabilitys
are moderately
reactions
is
personality
viz..
is
vulnerability
Paranoid
traits,
(1.15%)o This
theme of maximum valuation/maximum
neurotic
and clarity
characteristically
(34%) and a number of other
to the patient
out
most commonly soon in young
or friend
relative
a rather
states,
and"vaguer
elegance
those seen in a control
in a close
the overvalued
with
states
obsessional
They point
obsessional
constellation
displays
roach
and hypochondriasis.
the aetiological
and moderate
"
neurosis,
anxiety
muraosthenia
anxiety/depersonalisation
of im:maturity
differ
states,
womeno The personality
married
to frank
liable
196o) has demonstrated
relationships
specific
they usually
or nouraesthonic.
not only
in
are
the obmescional. personality
about
anxious
these personalities
but also
of
a specificity
to
are likely
qualities
neurotic
nyuptomst
obsessional
syVtow
of parsonalityoooowhosa
the obsessional
There is
is lacking
that
but in
norml,,
degreco
extreme
sort
of
"Compulsive
P- 152 state:
in a particular
flourish
which
(1960)
at al
and the devolopmont
personality
the
one ;Lnwhibh
trait. 09
paranoid
recorded
are limited
defects,
isolation,
'key events'
" (iýayer-Groas
are considered
at al
1960, p.
3.68).
- -166(1954) In a 3tudY, a 38 c=aa
arad lAigh
&Unaata
of three groWs of neurotics
from tho wan scores
Tho antecedent3 diffor
syndromoo
a clear-cut
studied
by other workers - Slater
yayar. Grcep at al (1949)and Roos (1949) ., with respect
better
higher
school record,
vith
and more patients
SiWdficmtly
intelliganoo,
"unstable
more patient
and hypochoarincal
personality
narvosa
of ancrexia
more prcvIous
(1943),,
to a eignificantlY
111nans,
psychiatric
pcrsom3ity*"
in the anoroxia
traits;
It
group ishowed obscissional
aignificantly
leas vere anxiety
prono
and I'stabloo"
Tho commonest precipitant,
rather
as "disturbanco
loosely
obeas,sional
traits
soon in 3-1 out of 38 callos,
in interpersonal
CC PersOrmlitY
For
relaticnehipse"
th's fiX=5
url*,'
Ob3casional
Subjoct
Authority
Is described
of personality
(1954)
Kay ana Loigh
slatar
(1943)
vlayer-Grown
Jjnford
38 Cases
ot al
(1949)
(1959
Reca
2., 000 neurotic
soldiers
201 neurotic
officers
between a partiollaLng streass,
of I)ergonality
obscssiowaiV?
than the hysterias
2z
CP. STPýFss
Xm
10
cne sces that there a correlation
consti-tutica
and an cnsulngýpattern
are frequ=tly
20%
sorvicamomon
IRUTS OH) spr-,Ciplom
Tn so many of lhaso studios
.
,3cioitat:
nervoua
anorexia
2,, 000 neurotic
OBSEWIPML ffl2LA=
established
of
traits
In.
pr=imnt,
ArO L'PO]20k'B dPUVI'dcD
ct eyoptems,
Ja spocificity
traLts
obsessional
to
related
MGM 8P'Oci!riC813-Y vulTl'*"Oblo
t1w
the
emle?
and
of
other
at
and poyolwpathe
Mater
Mayer-GrOscs,
above
of
Sývcn
Uzax-j
,3u,
a
profile,,
()r porcowlity
anj Reth1c; aralple
Ike
may be
týi1-
-I
11hero is littlo
recalled;
of hysterical
that ic aj-.
)*oifio
illnesspoooin
anxiety
almys
but
be immum to some situations
distress
people'little
The separate
in
clinical
obsessional
fron
highly
favour
of
driving
this
Jz=diate
adjust
conatitution
In
whose life
to a variety
which
to what extent'in
exhibitu
Pro found
histories
nmerous
the widespread
discrete
ji, inally,
three
mon in -,-,YzrtLm; *,
thow
under
studies
Mjo firat
diseWBIGUe
in
inwhich
In
the
the
but not all.
and savore
a succession
to
constitut-
of failures
are we dealing
with
to
a
vuln, =-abilitics,
specific
and
based on i5tiarilus
vulnerability
from one or more spaciflo
MOXF119=
an prominent
Inadequates
to what extent
to eacapo
evidence
by some authoraq
present
pracdpitants
by any moans,, f or
clear
occplaint2
including
and
which porabne
rcaot-lons
is again
described
ar eas of vulnerability?
jLaM-VU
COj-ZTMjO-VjMg-DET
AM MZM
avoidance
payehosomatic
those,
of strasse-a.
arising
go,. 0raligation
may
on the high
laid
2ho case vilth
Is not, entirely
precipýtants
Indeed*
is
provc'; Cing situations
of many vho suffer
newotio3,
nearly
cau3a mout
and rpeolfic
ezphazis
phobic
In frequently
persistenou
varied
subject
Roth., and by
by Pollitt,
traltse
develop
Tho Issue
a tressful
be very
three
personality
anxiety
viewo
rigid
which
others
by L&ntifiablo
and In all
personality
specific
personality
Ional
described
antitica
of obsessional
with
"the
is
of mindo"
two of the stadies,,
incidence
in
anxious
caur=
factor
ting
states
obaossional
feel
are shomn to be precipitated
JAL&
tho precipita.
states
kind, "ooooin
of a psychological
about tho precipitating
R' BS
JVJA_110ý
PMM ME
are
referred
to,
two st-, ILUes are
orising
of
frm
particulex
expcrienoe
ralovanoo
with
to
th. -a
168
Slater (1943) studied 2$,000 murotic soldiers.
"the ir-ttmerable
factors
external
which -aay actually
do not roally
lend themselves to amalysis.,
(3.943) viries
than in nomal
peaco-tims
the atrasses of tar,, compardtively
from family
separation
nIxx the remdnder
were far fr=
low level
It
should
hard life
and these subjeots
that
With 0103or awaysi3
as oompa-redwith others
hvsteria
by military
e=ept
stre3a"
wmaia.
(mostly
average of our material
reactive
oonditiono
which
of precipit=ts
These vhO
soldiers.
states
a=ioty
the ps7chogenio factors
for
to
muroses
associated
one diagnoatic
thoy ware especially
frequent
group
in
"
tenae=y
'Organio
ie.
groups
bogiw
apecificity
to produce
a=dety
symdrom-esand states
amcioty. atates), q cormpomitore
to a no=alj,
of the patients,
fr. equonoy vdth some definite
special
own urlmppium),
has a special
d Partioularly
a-,,
atrass
that
half
from the other3 so that tro
show no predilection
(who make their
"Mili-Itary
with
str9zs,,,,,
with advar3e home situation3
kinds and physical
such a beterog3raity
to the other
contrast
in military
psyahopatb. 3
in the army,,
must be regarded as being of a very
of the case material
3hOWthOUS01VOSas associated
preaipitation
wid di3cipline
group of 2,, 000 naurotio
a mixod
break dcrxn with eace are distinguisbad
emerge., ThU3 "in
They were most co=only
"
adaptability,,
ig POr-haPsnOt OurPrising
in
so in the prosent
played a part in naarly
clearly
of oon3titutioml
emerge.
"
breakaora his ocourxvd under military
owrous,,
W present
but more euily
material,
a breakdo=
precipitate
and hozeq home worriaA of vrri*ua
Thsas factors
in-health,
Ho oonoluaed that
healtby
population
to which t1my, are burdened with the signs of constitutional
naarly
eywtcms,,
preoipitated
than the
in the extent
predisposition,
"
,2i-r,ao ai; ioa. st tvo &Lspamte
1.
Ma co=titutionally
StrS, 53fUl
life
often
circumstances,,
araiety
constitutional
states,
that
family
experiences,,
anayestriotpd
these amdev
jitato
fau
severity,
"military
obsessional,,
clearly
PriMCJp&XYaetorsima
34vk
ard pa
is less marked '"in a=i8ty,,,
In a further
a unitar y kind
anxiety
history,
is more important
traLts
in the neuroses
Ibut the form of the
preasposition,
that
varied
ordar),,
quantitively
The diagnostic
the association
disorders.
'was mom oloselv
associated
of one kind,
one another and
with
this basic
to whioh they h2d been subjeote&.
types of enviromment had a preferential
symptons, others minor stateis of depression,,
I.
hypoohondrisoal'pzvoooup.atioit,
but was not of
to stress
groups faded Into
"
of breaVlown in
with the fom
doprcsSLve and bypgohon.driaoal
than to the type of stress
eventua3. J=apaoitsting
the
Furthermore.,
vulimerabUity.
(in
Oicj states.
to neurosis
th,,j naturo of the. zMt=s
But "certain
family
ud
Sone men were hi&hýy susceptible
others to anothor. b
persorwlity
in
(1944)
Slater
Slater
qoncluae that "the
paper,,
&rA
liability
constitutional
is
the antsocdent'
by coustitu tionsi
paraonality
hysterioal
This
sound.
and healtýy
612aPIBYOhOPatbiGsthan in the 1SUdogemomStates,
$later
whom the
towards tim dystbymio end of the goale.
OThe form of the. -exogenous stress
XOWILOZI,is Btill
in
&a
relationahipis
in the nwrotio
of
by the more restriotecl
relatively
the more benign
a variety
and
stress"
is
and perzonal,
more speoific
down under
pýmcipitatod
predisposition
my findings
with
of no great
designated
group of precipitants
aword
who break
pradispozod
2. a group,, mostly
qrp"nt
Uxzupo ard dofimd. -
effect
producing
others
again a
In general,, minor expreasiow of the
..
neurosiswere found in the previous historyo"
Thoic
v.athor-z favour
th3 view '&. at murotio
to be du3 to a number of distinot
nomal.
"In
'variation,
to one extreme, "
specifio
with
respeot
breaking
stresses,
the man who would be liable
to show a oonatitutional*
In this
kInd.
Howaver.. "the
of *men who were likely
as the laws
showed minor
deficianoies
wwuld expeot
to find
of different
suzoeptibi2ity
tnes
multifaOtorial
genetic
constitution
following
taotoris
a part
timo those vales
of universal
carrying
and frequency
illwas
bypothesis.
Thus one
breakdown
occurý----
of ýd Mae. and olinical
,
ýa peace time unusual
.
in peace time the first
group,
study supports
a theory of
in the pr3disposition
Le,
those vdth a relatively
to develop anxiety
liable
to
states
stress.
break do= in excess.
intensity
than
(vq)
out
th3 most co=ou
who am particularly
a epeoific
In conditions
neurotic
war-tino
playing
of stre8s,,
who
"
show that
in the Slaters'
breakdown) are in faot
neurotic
norml
rarity
rath3r
only,,,,
of a mixture
As Yhyer.-Oross. et. al (1960) have pointed
are uncommon,,bat my studies
lime
one line
along
glyndromes of a pure IWpa. would be in 4 minority,
strains
.
(whose relative
intensity
to break down iýý. r istroms
of different
a nmber
defioioncy
a mixture
among men of constitutional
the average
of 9banae would COW91. one to Postulates
along
those who showed an extreme
to a
to certain
the requirad.
reaohed
symptoms of a apeoific
would be thosep
fix=
deviation
he would be more susooptiblO
down wInn this
majority
to
eaoh of them zUbJeot
qualitiesq
anZ- one ql! ýRty
be
likelv
would
-
neurosis
WCOXY
is
vulnerabiliW
=W
and varied
stress
constitutionally
in
mr
as exparionaed
determinscl vulllsrabilitiOs
In peace time vdwn general gtrea3es an
it
is the apeoifioally
in excess -a
firAing
predisposea
of lawor
nales vho devolop
v&ioh is not in accord vith
Slator's
(1944)
2,000
is
oms
or
by
MaGregor
is
cmd
tud:
time
r
r.,
war
The third
in males.
of-neuro3is
inoident
to 'the group,, "but the variety
peculiar.
smal. "
wam relativeily
PlAysioal
traumata
had never had,
spite
or had lost
an interest in
(one wonder3 Just how "athletic"
physical
rather
that
these wer.e. likely
oommente&
it
is,, inoidentally,,
AVIM
as other
life,
factors..
Onlistaeut,
were iýx this
to discýpline
! i% of all
of stress
:Listed.
pap4ation,
breakdowns, though
It
could be
to be the two most oomon ctresses
of interast
that in much current
of mental illnesses,,
soourity,,. pbysioal
prominently
of 0-1viliau
by soldiers,
immediate proo.ipitants
femily
-stage
gmes or sports be:ror*
betweon them for
only ocmpi4sing two of the aims tnes
evoomtered
in lifis,
ware those who d.,La, reaot Adv(WAOXYto
Boredom and. reaotion
speoif: LOS,aoqouutftg
had had
proportion
the Covaitions
in war time
as. important
were not
trama, ).
of then in
caum
of proolpitating
or at-soma- isolate&
continu*u3ly
in
continued
rovealed no speoifio
large
a
group,
As in the Slaterov
eyaptoias before enlistment
but had mostly
of the prooipitauts
An dý*cis
in
health
investigation
bereavement wd threats
and pbysioal
dangor figure
into
to
more.
Výan do somml traumata,
STUDIES
of respomse lieps at tho root of m=h
The oonoopt of specifiCity
investigati.
or leartnek
on into
animal behaviour,, whether the resporce be instizotual
One hate
at the cal-Grame. rOlu'Dt=t
to
Sufficient
house.
from
t-hU
treasure
say
vast
game
noxual or pathologioalo
to piok partioular
that whoreas it
may be true that,
of resporso has been largely
an Raia saysv thO those or Opeoitioity
ignorod
in psyohiatric
it
researoh
iS P(3rbaPs
t ",
tho owatral
v of behavioural
in aninals.
obsex7ation
and mparimont
&bound
booko and jou=alz/in
to suoh co'ncept3 as
reforonoe
t=t
Appropriate
and learned
inatiuctual
stereotyped
and extinotioN
establishment
sonsor.y difjorimination,,
Under oontrolled
stivAug.
1ýV.,
jltim4u3
In so jauoh work on hum=
value.,
iddob
which give rice
throw
light
on for
aocept that for
rat or jaokdaw wM
there is a touftnoy
oituation
and '"inhuman, "
There is
perteps
a long Christianý
which emphasises the individuality
te=s
mechanistic
is an affront
det9rmUdst; 3,, or in the fink]
and personal
an well
is likely
O=plgxity
of man.
a4 di.fferpnoes
are prepared to
husauistics,
harvest,,
of hman experionce
one
tradition
Ta see his behaviour iu
Whather wo are ardent
the play of free will'
choice
approach, 3eeking similarities,
between the responses of #dividuv2s,
to reap a rich
imfluenoes
approach a$ too "cold"
and shorter
allow for
the scohanistio
responsibility,,
this
to human dignity.
analysis
i. 13MOBB"
OOm*Sto tbO humsu
When it
to, reguA
not without
CaBOBi3l the
of single
euviromental.
another,
exists
illuess,," &ýa,at. the
Investigators
of.. genctio-aud
behave muoh IU*
tanAtory
oauses of mantal
queurotic
group,,
psyphopathologLets.
a given pattern
"the
studies
are
and maoh=istio,,
to broad genayallsational,
exasple
respoweis,
oxperinents
an unwcplored
indiddualistio
other extrane the bigbly
of the early
dateministic
bebaviour,
or "the. causes of the haterogenous
tradition
--thoir
signalso
and ambivalent,
and repeatable
oonductecl and the approaoh, is fravUy
.
OF THE INDIVIDUAL
THE UNIQUENESS
their
and sjtuatjowý,
- objeots
generalisation
def1mitive
oonditiona
betwoon those studies
situations,
coding and ocrapression of isonsory messages, the
of paroeption,
mack.wdos
stimulus-roupome
is one which
We must not boggle ovorm=h at, the immenao
and behaviour;
there are pattem
rmudzkg
173
through
we look for
If
tho t=g1s
theu.
Koestler (1961+)believos the viow of manwhioh mduces him to the status
true - but. only up-to a point, "
of a oon6tioned automaton, to be Oaopressingly
Mo3t of the time am is
poles
of his
illness
man in not displaying
experienoe and attributec
' nen4roSis., he is,, Devertheless..
and origimaity
are opposite
fundamentally
of the
some of the coetent
diatate
W
Although
originality.
displa7ing.
tha stereotyped
of his. group to a stock situation.
reaction
predictable
Habit
nature,
In r-surotic
individual
of habits.
a slave
and
he is more
In this
of an automaton than a unique inilividual.
PARANTERSOF STRESS
PREDICTICKARD THE T'
emphasises that
atuý.
_This
possibly predicting
(1)ýthp
to amaý
(2)
JIght
auration
that
the outoome for
(oýf.
intensity
of the stress,,
Ot thO i3ldividuall
Observing friends,,
in aralyZing
in the event of certain
it
an individual,,
(3) its
but one anist consider
and
is not suffiOieut
Ivalpe's (196U)Haira=by
is probable
mighbours
situation,
a stressful
only
of Amxieti8a)
relevame
and
iu tbO
vulnerabilities.
and acquaintawes
one ha3 been, able to predict
type of neurotic
happouirgs a particular
illnoss
would develop and. must comfeas to a feeling
of intelleotual
t=pered
on, more than one oooasionp both with
vith
sympatbyq when proved correct
phqblc aradety/depersomlication
reispoofto
bas boon surprised.
inthe
outpatient's
states
department
dependent young married wqmm develop a reactive
deparaomliGation
rasolves
after
'the death of her mother.
the Puzzle - the womm does wt
with famny
deperAGDOYsform an eascntial
display
grAtirioatiODO
and athletes'
at seeing
OrAo
uouývsea,
an immature
and
depression without
A perzowl#7
anaysis
the obgg3giorga traitgj,
prarequi#ts
for
the aevolomelit
pbi(lh
of
174.
'
Syndr=o.
Roth's Calmdty
Ono can even on occasiorz
and "intuitive"
astuteness
atage of an interview,,
at a cortain.
or registrar,,
on a basis of broad goneralisationa,,
work out for we are predicting
sound, do not,, in tb3 nature of biological
though statistically
th3 doeme of certainty
carry
may be linkod
personality
evidence
with
Wor do ire know in what wV
poasible
range of ensuing
quary "Is
think
WI
specificity
to
niurotio
situations,
both
Syn1romo
dozoribed
by Roth,,
the
tho
both
and of
only
to
groups
d3privation,
most valued,
there
or
the
evidanoe
a threat
in
Suffioiont
to tho
related
Ritohie
described
in
of
of
time,
peace
two
neuroses
-
with
certain
rigidity
deprivation,
which
in
to
features
what
neurotic
all
the
present
series
tho
and
constellation
to
the
failure
are
characteristic,
and inflexibility
of
married
speoific,
and s,7=ptom
respoot
Calamity
of young
highly
both
common
very
the
3TO of
nearly
here
men - aro
precipitant
though
of
or in it
at the m=ont,,
COMMOD03t nourosis
an Incidence
specificity
syndrome,
the hypothesis
deprivation
probably
illness
In
is
is
xvply to Profo3sor
Certainly
personility,,
failing
a definite
"
neurosis
neurotic
respect
latter
establish
In
oc=oneat
in
fo=or
is
essentially
assessed
c.-A tho'athletes
woman),,
is
conditions?
1964(b)
of
to breakdcnm a gan3ral ohvxaoteriatiog
or uswould
specific
iic=
traits
Rhioh are involved.
of precipitant
to givo a partial
ausooptibility
specific
soienees',
we have not
factors
the antecedent
studies,,
of obsessional
specificity
stimulus
agree
mo3t
(Little
the presenoo
which
symptom cemplexes.
Wo are in a position
Rusalles
that
to identify
fully
yet
in the physical
experienced
are hints
there
Although
what is going
outlining
This of course do03 not alVaY3
history,
to cmerg3 next in the patioutte
a note to a student
by slipping
underatanding,,
evidence of
provide
has
of
personality,
come to
bo