Sherry D D, Weisman R
Department of Pediatrics, University of Washington, Seattle.
Pediatrics. 1988 Apr;81(4):572-8.
Psychosocial factors in 21 families with children affected by reflex neurovascular dystrophy were studied. Each family was interviewed and given a battery of standardized psychologic tests. Two distinct types of families were identified. Fifteen families showed high internal cohesion, expressiveness, and organization and low levels of conflict. Six families showed high overt conflict with low levels of family cohesion, expressiveness, and organization. In all families parental enmeshment with the patient was present. Marital discord was present in 12 families. Thirteen patients had significant school problems (ten had learning disabilities). Although most of the children were described as especially bright, only four had above average intelligence test scores. Four had a history of sexual abuse. The patients and their mothers perceived the health problem as significantly worse than did children with arthritis from whom similar scores had been obtained. Possible role models with similar symptoms were reported by ten patients. These data support the concept that childhood reflex neurovascular dystrophy is frequently a stress-related disease; the therapeutic approach to treating these children and their families must take these psychosocial factors into account.
对21个有患反射性交感神经营养不良症子女的家庭中的社会心理因素进行了研究。对每个家庭进行了访谈，并进行了一系列标准化心理测试。识别出两种不同类型的家庭。15个家庭表现出高度的内部凝聚力、表达能力和组织性，冲突水平较低。6个家庭表现出高度的公开冲突，家庭凝聚力、表达能力和组织性水平较低。所有家庭中都存在父母与患者过度纠缠的情况。12个家庭存在婚姻不和。13名患者存在严重的学校问题（10名有学习障碍）。尽管大多数孩子被描述为特别聪明，但只有4名孩子的智力测试成绩高于平均水平。4名有性虐待史。与获得相似分数的患关节炎儿童相比，患者及其母亲认为健康问题严重得多。10名患者报告了有类似症状的可能榜样。这些数据支持了儿童反射性交感神经营养不良症通常是一种与压力相关疾病的概念；治疗这些儿童及其家庭的治疗方法必须考虑到这些社会心理因素。
