Psychological factors, including disagreements with parents, appear to contribute to fatal asthmatic attacks in children, a study in the Journal of the American Medical Association concludes.

Researchers who examined the records of 21 patients who died after being hospitalized for asthma attacks found that medical factors alone did not explain why they died.

"Most of the clinical characteristics previously thought to place patients at greater risk . . . were found as often in the control cases as in the children who died," writes Dr. Robert C. Strunk of the Jewish Center for Immunology and Respiratory Medicine in Denver. "These variables alone did not identify the patients who died, unless there were also psychologic difficulties present.

There are an estimated 2.2 million children with asthma in the United States, according to the National Center for Health Statistics. In 1982, the most recent year for which statistics are available, 180 children died of asthma.

Medical factors that appear to contribute to death included a history of seizures, conflicts between parents and the hospital staff, and sharp reduction in prednisone dosage during hospitalization.

In the children who died, such factors were most often combined with parent-child conflicts, manipulative use of asthma symptoms by the child, and disregard of symptoms by the child.