Identifying Risk Profiles of School Refusal Behavior: Differences in Social Anxiety and Family Functioning Among Spanish Adolescents.

Carolina Gonzálvez,Ricardo Sanmartín,Ángela Díaz-Herrero,María Vicent,Antonio M Pérez-Sánchez,José M García-Fernández

doi:10.3390/ijerph16193731

Abstract

School attendance problems negatively affect students’ development. This study attempted to identify different school refusal behavior profiles and to examine their relationship with three dimensions of social anxiety (fear of negative evaluation, social avoidance and distress in new situations, and social avoidance and distress that is experienced more generally in the company of peers) and the perception of family functioning. Participants included 1842 Spanish adolescents (53% girls) aged 15–18 years (M = 16.43; SD = 1.05). The School Refusal Assessment Scale—Revised (SRAS-R), the Social Anxiety Scale for Adolescents (SAS-A), and the Family APGAR Scale (APGAR: Adaptation, Partnership, Growth, Affection, and Resolve) were administered. Latent class analysis revealed four school refusal behavior profiles: non-school refusal behavior, high school refusal behavior, moderately low school refusal behavior, and moderately high school refusal behavior. Analyses of variance (ANOVA) indicated that adolescents’ with the profile of high school refusal behavior showed higher scores in all the subscales of social anxiety. In contrast, the non-school refusal behavior group revealed higher scores in the perception of good family functioning, whereas the high school refusal behavior profile obtained the lowest scores in this scale. These findings suggest that students who reject school are at a higher risk of developing social anxiety problems and manifesting family conflicts. These students should be prioritized in order to attend to their needs, promoting self-help to overcome social anxiety and family problems with the purpose of preventing school refusal behaviors.

Highlights

School refusal behavior (SRB) is understood as a broad term that includes students who refuse to attend school or show persistent difficulties in remaining in class that may or may not be behaviors based on anxiety [1]
Latent class analyses differentiated four groups of adolescents with SRB, which was a result of the different combinations of dimensions of the School Refusal Assessment Scale—Revised (SRAS-R) (ANA, ESE, PA, and PTR)
This study verified the existence of different groups of students with SRB: those with non-school refusal behavior, high school refusal behavior, moderately low school refusal behavior, and moderately high school refusal behavior

Summary

Introduction

School refusal behavior (SRB) is understood as a broad term that includes students who refuse to attend school or show persistent difficulties in remaining in class that may or may not be behaviors based on anxiety [1]. In addition to the high incidence rates, SRB is considered a major problem associated with numerous negative consequences for young people, such as behavioral disorders [3]; lower academic achievement [4,5]; significant psychopathology; most commonly, depression and anxiety [6]; involvement in pre-criminal behavior and the consumption of substances such as alcohol and drugs [7]; and, on occasion, even school dropout [8]. In terms of the public health impact, these findings warn about the association between school absenteeism and risk behaviors, Int. J. Public Health 2019, 16, 3731; doi:10.3390/ijerph16193731 www.mdpi.com/journal/ijerph

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