Available affiliation theories are unable to explain apparent inconsistencies among studies of affiliation tendencies during stressful situations. A new theory, the utility affiliation theory, was suggested to integrate these data into one theoretical framework. The basic assumption of the theory is that the strength of the affiliation tendency is a function of the extent of perceived benefit and damage that may be caused by being with others. The benefit/damage perception may be affected by three basic variables: the characteristics of the stressful situations, the individual, and the potential affiliates. Using the concepts suggested in the utility theory, the affiliation studies were categorized and reinterpreted. A summary of three studies that were conducted to examine the validity of this theory is given.

This study examined the emotional changes that occur during the trimesters of pregnancy. Two hundred eighty‐two women were asked, one day after giving birth, to indicate at what frequency they had experienced various symptoms during each trimester of pregnancy and to fill out the Repression Sensitization scale (Byrne, Barry, & Nelson, 1963). Results showed that while women's feelings during the first trimester are characterized by symptoms related to physiological changes (e.g., nausea, vomiting, dizziness), during the last trimester anxiety and emotional distress become the most significant symptoms. The level at which these symptoms were experienced was affected by the subject's socioeconomic level, number of previous births (primaparae or multiparae), and her personality type (repressor or sensitizer).

The current dispute regarding the existence of repression has mainly focused on whether people remember or forget trauma. Repression, however, is a multidimensional construct, which, in addition to the memory aspect, consists of pathogenic effects on adjustment and the unconscious. Accordingly, in order to arrive at a more accurate decision regarding the existence of repression, studies relevant to all three areas are reviewed. Moreover, since psychoanalysis regards repression as a key factor in accounting for the development and treatment of neurotic disorders, relevant research from these two domains are also taken into account. This comprehensive evaluation reveals little empirical justification for maintaining the psychoanalytic concept of repression.

Memory for pain after delivery was assessed by means of a verbal rating scale. 238 young women giving birth to healthy babies as a result of spontaneous delivery were asked to rate intensity of pain immediately following delivery. A day or two later, they were asked to remember how much pain they had experienced immediately after delivery. Analysis showed that the recall of pain was fairly accurate, irrespective of personality type, the level of education, and the number of childbirths. The findings provide some support for the reliability of pain reports from memory for a nonpatient population experiencing a rather unique pain experience.

In agreement with Freud (1915aFreud ( , 1915b, patients' unawareness regarding the underlying causes of their behavior seems to be the key to understanding the development and treatment of neurotic disorders. However, Freud's concepts of the unconscious and repression have encountered serious problems that do not allow for their maintenance (see review by Rofe ´, 2008). An additional issue concerns the fact that none of the available theories can integrate the therapeutic effects of various interventions under a single theoretical framework. Both of these issues are addressed in this article by the rational-choice theory of neurosis (RCTN). RCTN maintains that patients consciously and deliberately adopt neurotic disorders when confronted with intolerable levels of stress. Unawareness is created through sophisticated cognitive processes, by which patients forget their own self-involvement. Subsequently, patients develop a self-deceptive belief that rationalizes the neurotic behavior, thereby preserving unawareness. According to this new theory, all therapies exert their effect either by disrupting patients' ability to preserve unawareness, increasing the cost of the symptom, decreasing the patient's emotional distress, or eliminating the stressor.