The impact of parental and individual factors on school refusal: a multiple-mediation model

Abstract

ABSTRACT School refusal in adolescents is a growing issue and has been studied from several angles. Parental psychological control is a known risk factor for school refusal. Several individual factors have been linked to school refusal, including children’s emotion regulation, externalizing, and internalizing behaviours. The current study hypothesized that a child’s emotion regulation, internalizing problems, and externalizing problems mediate the relationship between parental factors and school refusal. Participants enrolled in a residential treatment programme (n=184, 62% female; M age =15.26, SD=1.54) and their parents completed assessments as part of a pre-treatment protocol. The participants’ mean scores for school refusal types 1–4 were 2.08 (SD=1.78), 0.97 (SD=1.34), 2.14 (SD=1.68), and 2.91 (SD=1.46), respectively. Multiple-mediation analysis was performed using the PROCESS macro (Hayes, A. F. (2018). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach (2nd ed.) New York: The Guilford Press). Parental psychological control was related to expressive suppression (b=.24, p=.01) and externalizing problems (b=.36, p=.03), though it was unrelated to cognitive reappraisal and internalizing problems (p>.05). Each model of school refusal was significant, with r2 ranging from .18 to .43 (p<.0001 for all models). Additionally, significant indirect effects were identified for all four models. Results demonstrated a comprehensive mediated model that accounted for up to 43% of the variance in school refusal. Future studies should seek to expand on the comprehensive approach of this model.