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Lidz found a striking similarity in the personality configuration and in the type of precipitating emotional trauma in fifteen consecutive cases of hyperthyroidism interviewed on the medical ward of Johns Hopkins Hospital. These patients manifest an intense dependence on the affection of another person, often the mother. Rejection constitutes a major threat to their emotional equilibrium and seems to stem from an unresolved sibling rivalry. They outdo the other children in the family in their devotion to and care of the mother, thus securely binding her to them. Later, by identification with the mother, they manifest an obsessive oversolicitousness toward their own children, and in turn exact the same unswerving devotion. The husband's role is usually a secondary one. He is chosen with a view to implementing the bond to the mother. Infidelity on his part with another woman or his own family is taken as a rejection.
The trauma that appears to precipitate the clinical condition of hyperthyroidism is a disruption of the dominant interpersonal relationship on which the patient's emotional equilibrium rests. Events that terminated or threatened to terminate an essential relationship were found to have occurred immediately prior to the onset of hyperthyroidism in fourteen of the fifteen cases. This study confirms the findings of two prior investigators, Mittelmann and Conrad, and further clarifies the personality configuration of hyperthyroid patients.