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Reflex neurovascular dystrophy (RND) presents as pain in an extremity with associated autonomic dysfunction (cool and/or cyanotic skin, swelling, and marked limitation of function). In adults with RND there is almost always a precipitating event, whereas in children a precipitating factor has been identified in only half the cases. There have been references to a possible psychological component of RND in children; this study reports psychological findings in 21 children with the condition.
Child-parental enmeshment (defined as "inappropriate closeness and involvement of the child in parental affairs and vice versa") was observed in all cases. Fifteen families were close, with high levels of cohesion, expression, and organization and low lev…