Neurosis and marital interaction. I. Personality and symptoms.

Abstract

1. A group of 6o male patients, receiving out-patient treatment for neurosis or personality disorder, together with their wives, have been examined by means of conjoint interviews supplemented by psychometric tests: the 6o couples represented 87 per cent of those approached. A control series of normal pairs were similarly examined: they represented 63 per cent of couples identified as suitable for the study. 2. The patient and control couples were found to be well-matched in a variety of back ground variables. 3. The patients' wives scored significantly higher than the control wives on clinical ratings of incapacity due to impaired health, and on the M-R section of the C.M.I.: they also had higher scores on the M.P.I.N scale and the total C.M.I. Similarly they had a significantly higher number of previous psychiatric illnesses. 4. The patient `status' of the husbands appeared to be about as important as their level of illness as a correlate of the illness among the(patients') wives. 5. The effects of duration of marriage upon the health of the patients' wives proved difficult to examine, since the most disturbed husbands appeared to be those with the shorter marriages. Nevertheless, when compared with the controls, an increasing level of disability as rated clinically was demonstrated among the patients' wives. The C.M.I. data also showed a tendency to relatively increased scores in the later years of marriage. No trends emerged for the M.P.I.N scale. 6. It was predicted from earlier studies that the interspouse correlations (i) in the early years of marriage would be lower in the patient pairs than the controls; (ii) in later years of marriage would progressively rise among the patient pairs but decline among the controls, and (iii) in the groups considered irrespective of duration of marriage, would be approximately equal. The first and third of these hypotheses were supported on most of the measures used. 7. Since early in marriage the patients' wives did not differ significantly from the controls on any measure of pathology, and since the husband-wife correlations at that time were approximately zero (or even negative) it was concluded that the study failed to confirm the assortative mating hypothesis. Conversely, the increasing differentiation of the patients' spouses from the controls on several indices of illness was considered to be more in accordance with an interactional model of pathogenesis. 8. A number of methodological problems were briefly reviewed, including the difficulties of specifying and measuring the relevant duration of any putative pathological interaction.