Adler R H, Zlot S, Hürny C, Minder C
Psychother Psychosom Med Psychol. 1989 Jun;39(6):209-18.
Engel's hypothesis of pain-prone patients having a distinct pattern of developmental psychosocial experiences was tested in a controlled design including four groups of 20 patients each: a) psychogenic pain, b) organic pain, c) psychogenic bodily symptoms, d) organic disease. On admission an open-ended interview, including childhood experiences was tape-recorded. Measures were taken to minimize observer-bias. Patients in group a) had, compared to the other groups, significantly increased prevalence of: "Parents, verbally and/or physically abusive of each other", "parents, abusive of the child", "child, deflecting aggression from one parent to the other onto himself", "parents, who suffered from illnesses/-pain", "parent of the same gender as the patient suffering from pain", "pain of patient and parent in the same location", "number of operations in adulthood", "disturbance of interpersonal relationships", and "disturbance of work life". Factor analysis produced two factors explaining 73% of the variance in group a): F1 ("Brutality-Overcompensation") was related to "duration of pain", F2 ("Submission-Inhibition") to "number of operations, accidents" in adulthood.
恩格尔提出的易患疼痛患者具有独特的发展性心理社会经历模式这一假说，在一项对照设计中进行了检验，该设计包括四组，每组20名患者：a）心因性疼痛，b）器质性疼痛，c）心因性躯体症状，d）器质性疾病。入院时，进行了一次开放式访谈，包括童年经历，并进行了录音。采取了措施以尽量减少观察者偏差。与其他组相比，a组患者中“父母在言语和/或身体上相互虐待”“父母虐待孩子”“孩子将一方父母的攻击转移到另一方父母并施加于自身”“父母患有疾病/疼痛”“与患病患者性别相同的父母”“患者和父母在同一部位疼痛”“成年期手术次数”“人际关系障碍”以及“工作生活障碍”的患病率显著增加。因子分析产生了两个因子，解释了a组73%的方差：F1（“残忍-过度补偿”）与“疼痛持续时间”相关，F2（“顺从-抑制”）与成年期“手术次数、事故次数”相关。
