Situational influences on verbal affective expression of psychosomatic and psychoneurotic patients

Group comparisons between psychosomatic and psychoneurotic patients using the Gottschalk-Gleser method of speech content analysis are presented. Two matched patient groups (N = 40 each) were discriminated on the basis of anxiety and hostility scores derived from verbal samples collected during psychoanalytically conducted first interviews. A concordance with clinical classification was reached in 79.75 per cent of cases, with psychosomatic patients exhibiting lower affect scores. These results could not be replicated in a comparison between 92 psychoneurotic and 56 psychosomatic patients based upon verbal samples produced in responses to a request to narrate a dramatic life episode (standard instruction). Percentage of correctly classified cases was 62.84 in the second study. Factor structures derived from affective variables showed more similarity between independent samples of psychoneurotic than between samples of psychosomatic patients across both exploration situations (interview and standard instruction). A major factor exhibiting high loadings from guilt anxiety and ambivalent hostility was evinced, being more important in psychoneurotics. These results are discussed against the background of the alexithymia notion. Methodological considerations pertaining to diagnostic applications of the Gottschalk-Gleser content analysis are presented.