REVIEW
School refusal and anxiety among children and adolescents: A systematic scoping review
Işıl Tekin,
Selami Aydın,
Işıl Tekin
Department of Psychological Counselling and Guidance, Faculty of Education Sciences, Istanbul Medeniyet University, Istanbul, Turkey
Search for more papers by this authorCorresponding Author
Selami Aydın
The Department of English Language Teaching, Faculty of Educational Sciences, Istanbul Medeniyet University, Istanbul, Turkey
Correspondence
Selami Aydın, The Department of English Language Teaching, Faculty of Education Sciences, Istanbul Medeniyet University, Istanbul, Turkey.
Email: [email protected]
Search for more papers by this authorIşıl Tekin,
Selami Aydın,
Işıl Tekin
Department of Psychological Counselling and Guidance, Faculty of Education Sciences, Istanbul Medeniyet University, Istanbul, Turkey
Search for more papers by this authorCorresponding Author
Selami Aydın
The Department of English Language Teaching, Faculty of Educational Sciences, Istanbul Medeniyet University, Istanbul, Turkey
Correspondence
Selami Aydın, The Department of English Language Teaching, Faculty of Education Sciences, Istanbul Medeniyet University, Istanbul, Turkey.
Email: [email protected]
Search for more papers by this authorAbstract
School refusal and anxiety are considerable problems among children and adolescents. While numerous studies were published, no review on the issue has been conducted to holistically reveal the current research results. This study uses a systematic scoping review design and aims to synthesize the results of the current studies on seeking an answer to the relationship between school refusal and anxiety to make recommendations for teachers, school counselors and administrators, and educational researchers for further research. Included studies were designed as qualitative, experimental, correlational, descriptive, or mixed-method, while studies designed as a thematic review, systematic review, and meta-analysis were excluded. The study identified 30 research articles that met the inclusion criteria within this scope. Results showed that anxiety is a prevalent factor associated with school refusal, whereas school refusal is directly and closely related to state and trait anxiety, social anxiety, school anxiety, and separation anxiety. Another finding was that school punishment, bad family functioning, parental depression, and parental anxiety are strong predictors of school refusal.
CONFLICT OF INTEREST
No potential conflict of interest was reported by the authors.
REFERENCES
- Albano, A. M., Mallick, R., Tourian, K., Zhang, H. F., & Kearney, C. (2004). Children and adolescents with social anxiety disorder: School refusal and improvement with venlafaxine ER relative to placebo. European Neuropsychopharmacology, 14(3), 307–308. https://doi.org/10.1016/S0924-977X(04)80390-0
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders ( 5th ed.). American Psychiatric Publishing.
10.1176/appi.books.9780890425596 Google Scholar
- Aydin, S. (2008). An investigation on the language anxiety and fear of negative evaluation among Turkish EFL Learners. Asian EFL Journal, 30(1), 421–444.
- Brandibas, G., Jeunier, B., Clanet, C., & Fourasté, R. (2004). Truancy, school refusal and anxiety. School Psychology International, 25(1), 117–126. https://doi.org/10.1177/0143034304036299
- Buitelaar, J. K., van Andel, H., Duyx, J. H., & van Strien, D. C. (1994). Depressive and anxiety disorders in adolescence: A follow-up of adolescents with school refusal. Acta Paedopsychiatrica, 56(4), 249–253.
- Cooper, J. O., Heron, T. E., & Heward, W. L. (2007). Applied behavior analysis ( 2nd ed.) Pearson.
- Denyer, D., & Tranfield, D. (2009). Producing a systematic review. In D. A. Buchanan & A. Bryman (Eds.), The Sage handbook of organizational research methods (pp. 671–689). Sage.
- Doll, B. (2009). School dropout. In I. B. Weiner, & W. E. Craighead (Eds.). The Corsini encyclopedia of psychology (Vol. 4, p. 825). John Wiley & Sons.
- Doobay, A. F. (2008). School refusal behavior associated with separation anxiety disorder: A cognitive-behavioral approach to treatment. Psychology in the Schools, 45(4), 261–272. https://doi.org/10.1002/pits.20299
- Egger, H. L., Costello, E. J., & Angold, A. (2003). School refusal and psychiatric disorders: A community study. Journal of the American Academy of Child and Adolescent Psychiatry, 42(7), 797–807. https://doi.org/10.1097/01.CHI.0000046865.56865.79
- Eicher, V., Staerklé, C., & Clémence, A. (2014). I want to quit education: A longitudinal study of stress and optimism as predictors of school dropout intention. Journal of Adolescence, 37(7), 1021–1030. https://doi.org/10.1016/j.adolescence.2014.07.007
- Elliott, J. G., & Place, M. (2019). School refusal: Developments in conceptualization and treatment since 2000. Journal of Child Psychology and Psychiatry, 60(1), 4–15. https://doi.org/10.1111/jcpp.12848
- Ellis, R. (1999). The study of second language acquisition. Oxford University Press.
- Erden, S., Şirin-Ayva, A. B., & Tekin, I. (2015). Okul reddinde bilişsel davranışçı terapinin kullanımı: İlkokul ve ortaokul olgu sunumu [Cognitive-behavioral intervention for school refusal: Primary and secondary school case studies]. The Journal of Academic Social Science Studies, 41, 119–129. https://doi.org/10.9761/JASSS3009
10.9761/JASSS3009 Google Scholar
- Fernández-Sogorb, A., Inglés, C. J., Sanmartín, R., Gonzálvez, C., & Vicent, M. (2018). Validation of the visual analogue scale for anxiety-revised and school refusal across anxiety profiles. International Journal of Clinical and Health Psychology, 18(3), 264–272. https://doi.org/10.1016/j.ijchp.2018.07.002
- Fourneret, P., Desombre, H., De Villard, R., & Revol, O. (2001). Interest of propranolol in the treatment of school refusal anxiety: About three clinical observations. L'Encephale, 27(6), 578–584.
- Gallé-Tessonneau, M., Johnsen, D. B., & Keppens, G. (2019). The relationship between mental health and school absenteeism in a community sample of French secondary school students: Four profiles derived from cluster analysis. European Journal of Education and Psychology, 12(1), 77–90. https://doi.org/10.30552/ejep.v12i1.242
- Galli, F., Vegni, E., & Vignoli, A. (2016). A child with headache and anxiety disorder including school refusal. In Headache in children and adolescents (pp. 187–192). Springer.
10.1007/978-3-319-28628-0_33 Google Scholar
- Gómez-Núñez, M. I., García-Fernández, J. M., Vicent, M., Sanmartín, R., Gonzálvez, C., Aparisi-Sierra, D., & Inglés, C. J. (2017). Influencia del rechazo escolar sobre la alta ansiedadante el castigo escolar en educación primaria [Influence of school refusal behaviour on high anxiety of school punishment in primary education]. European Journal of Education and Psychology, 10(2), 68–74. https://doi.org/10.1016/j.ejeps.2017.08.001
- Gonzálvez, C., Díaz-Herrero, Á., Sanmartín, R., Vicent, M., Pérez-Sánchez, A. M., & García-Fernández, J. M. (2019). Identifying risk profiles of school refusal behavior: Differences in social anxiety and family functioning among Spanish adolescents. International Journal of Environmental Research and Public Health, 16, 1–7. https://doi.org/10.3390/ijerph16193731
- Gonzálvez, C., Inglés, C. J., Fernández-Sogorb, A., Sanmartín, R., Vicent, M., & García-Fernández, J. M. (2018a). Profiles derived from the school refusal assessment scale-revised and its relationship to anxiety. Educational Psychology, 40(6), 1–14. https://doi.org/10.1080/01443410.2018.1530734
- Gonzálvez, C., Inglés, C. J., Sanmartín, R., Vicent, M., Fernández-Sogorb, A., & García-Fernández, J. M. (2018b). A cluster analysis of school refusal behavior: Identification of profiles and risk for school anxiety. International Journal of Educational Research, 90, 43–49. https://doi.org/10.1016/j.ijer.2018.05.006
- Gonzálvez, C., Kearney, C. A., Jiménez-Ayala, C. E., Sanmartín, R., Vicent, M., Inglés, C. J., & García-Fernández, J. M. (2018c). Functional profiles of school refusal behavior and their relationship with depression, anxiety, and stress. Psychiatry Research, 269, 1–14. https://doi.org/10.1016/j.psychres.2018.08.069
- Gonzálvez, C., Kearney, C. A., Vicent, M., & Sanmartín, R. (2021). Assessing school attendance problems: A critical systematic review of questionnaires. International Journal of Educational Research, 105, 101702. https://doi.org/10.1016/j.ijer.2020.101702
- Gosschalk, P. O. (2004). Behavioral treatment of acute onset school refusal in a 5-year old girl with separation anxiety disorder. Education and Treatment of Children, 27(2), 150–160.
- Grant, M. J., & Booth, A. (2009). A typology of reviews: An analysis of 14 review types and associated methodologies. Health Information & Libraries Journal, 26(2), 91–108.
- Hansen, C., Sanders, S. L., Massaro, S., & Last, C. G. (1998). Predictors of severity of absenteeism in children with anxiety-based school refusal. Journal of Clinical Child Psychology, 27(3), 246–254. https://doi.org/10.1207/s15374424jccp2703_2
- Harris, J. D., Quatman, C. E., Manring, M. M., Siston, R. A., & Flanigan, D. C. (2014). How to write a systematic review. The American Journal of Sports Medicine, 42(11), 2761–2768.
- Henry, K. L., Knight, K. E., & Thornberry, T. P. (2012). School disengagement as a predictor of dropout, delinquency, and problem substance use during adolescence and early adulthood. Journal of Youth and Adolescence, 41(2), 156–166. https://doi.org/10.1007/s10964-011-9665-3
- Heyne, D., King, N. J., Tonge, B. J., & Cooper, H. (2001). School refusal: Epidemiology and management. Pediatric Drugs, 3(10), 719–732. https://doi.org/10.2165/00128072-200103100-00002
- Heyne, D., Gren-Landell, M., Melvin, G., & Gentle-Genitty, D. (2019). Differentiation between school attendance problems: Why and how? Cognitive and Behavioral Practice, 26(1), 8–34. https://doi.org/10.1016/j.cbpra.2018.03.006
- Heyne, D., Sauter, F. M., Van Widenfelt, B. M., Vermeiren, R., & Westenberg, P. M. (2011). School refusal and anxiety in adolescence: Non-randomized trial of a developmentally sensitive cognitive-behavioral therapy. Journal of Anxiety Disorders, 25(7), 870–878. https://doi.org/10.1016/j.janxdis.2011.04.006
- Hochadel, J., Frölich, J., Wiater, A., Lehmkuhl, G., & Fricke-Oerkermann, L. (2014). Prevalence of sleep problems and relationship between sleep problems and school refusal behavior in school-aged children in children's and parents’ ratings. Psychopathology, 47, 119–126. https://doi.org/10.1159/000345403
- Jones, A. M., & Suveg, C. (2015). Flying under the radar: School reluctance in anxious youth. School Mental Health, 7(3), 212–223. https://doi.org/10.1007/s12310-015-9148-x
- Jones, A. M., West, K. B., & Suveg, C. (2019). Anxiety in the school setting: A framework for evidence-based practice. School Mental Health, 11(1), 4–14. https://doi.org/10.1007/s12310-017-9235-2
- Karlovec, K., Yazdi, K., Rier, U., Marksteiner, J., & Aichhorn, W. (2008). Separation anxiety disorder and school refusal in childhood: Potential risk factors for developing distinct psychiatric disorders? Primary Care Companion to the Journal of Clinical Psychiatry, 10(1), 72–73. https://doi.org/10.4088/PCC.v10n0113c
- Kearney, C. A., & Bensaheb, A. (2006). School absenteeism and school refusal behavior: A review and suggestions for school-based health professionals. The Journal of School Health, 76(1), 3–8. https://doi.org/10.1111/j.1746-1561.2006.00060.x
- Kearney, C. A. (2001). School refusal behaviour in youth: A functional approach to assessment and treatment. American Psychological Association.
10.1037/10426-000 Google Scholar
- Kearney, C. A. (2008a). Helping school refusing children and their parents: A guide for school-based professionals. Oxford University Press.
- Kearney, C. A. (2008b). School absenteeism and school refusal behavior in youth: A contemporary review. Clinical Psychology Review, 28(3), 451–471. https://doi.org/10.1016/j.cpr.2007.07.012
- Kearney, C. A., & Albano, A. M. (2004). The functional profiles of school refusal behavior: Diagnostic aspects. Behavior Modification, 28(1), 147–161. https://doi.org/10.1177/0145445503259263
- Kearney, C. A., & Fornander, M. J. (2018). School refusal behavior and absenteeism. In R. J. R. Levesque (Ed.), Encyclopedia of adolescence ( 2nd ed., pp. 3298–3303). Springer.
10.1007/978-3-319-33228-4_236 Google Scholar
- Kearney, C. A., Chapman, G., & Cook, L. C. (2005). School refusal behavior in young children. International Journal of Behavioral Consultation and Therapy, 1(3), 212–218. https://doi.org/10.1037/h0100746
10.1037/h0100746 Google Scholar
- Kearney, C. A., & Silverman, W. K. (1999). Functionally-based prescriptive and nonprescriptive treatment for children and adolescents with school refusal behavior. Behavior Therapy, 30(4), 673–695. https://doi.org/10.1016/S0005-7894(99)80032-X
- King, N. J., Tonge, B. J., Turner, S., Heyne, D., Pritchard, M., Rollings, S., Young, D., Myerson, N., & Ollendick, T. H. (1999). Brief cognitive-behavioural treatment for anxiety-disordered children exhibiting school refusal. Clinical Psychology & Psychotherapy, 6(1), 39–45. https://doi.org/10.1002/(SICI)1099-0879(199902)6:1≤39::AID-CPP178≥3.0.CO;2-W
- Last, C. G., & Strauss, C. C. (1990). School refusal in anxiety-disordered children and adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 29(1), 31–35. https://doi.org/10.1097/00004583-199001000-00006
- Leary, M. R., & Kowalski, R. M. (1997). Social anxiety. Guilford Press.
- Maric, M., Heyne, D. A., MacKinnon, D. P., Van Widenfelt, B. M., & Westenberg, P. M. (2013). Cognitive mediation of cognitive-behavioural therapy outcomes for anxiety-based school refusal. Behavioural and Cognitive Psychotherapy, 41(5), 549–564. https://doi.org/10.1017/S1352465812000756
- Marin, C. E., Anderson, T., Lebowitz, E. R., & Silverman, W. K. (2019). Parental predictors of school attendance difficulties in children referred to an anxiety disorders clinic. European Journal of Development Psychology, 12, 31–46. https://doi.org/10.30552/ejep.v12i1.239
- McClure, E. B., Brennan, P. A., Hammen, C., & Le Brocque, R. M. (2001). Parental anxiety disorders, child anxiety disorders, and the perceived parent-child relationship in an Australian high-risk sample. Journal of Abnormal Child Psychology, 29(1), 1–10.
- Nayak, A., Sangoi, B., & Nachane, H. (2018). School refusal behavior in Indian children: analysis of clinical profile, psychopathology and development of a best-fit risk assessment model. The Indian Journal of Pediatrics, 85(12), 1073–1078. https://doi.org/10.1007/s12098-018-2631-2
- Overmeyer, S., Blanz, B., Schmidt, M. H., Rose, F., & Schmidbauer, M. (1995). Schulverweigerung: Eine katamnestische untersuchung zu dem diagnostischen konzept von schulphobie und schulangst [School refusal: A follow-up study on the diagnostic concepts of 'school phobia' and 'school anxiety'], Zeitschrift für Kinder-und Jugendpsychiatrie, 23(1), 35–43.
- Peters, M. D., Godfrey, C. M., Khalil, H., McInerney, P., Parker, D., & Soares, C. B. (2015). Guidance for conducting systematic scoping reviews. JBI Evidence Implementation, 13(3), 141–146.
- Renaud, J., Forget, Y., Rousseau, H., Arjane, M., Laurin, G., Lavergne, J., & Simard, H. (2005). First degree relatives anxiety disorders in childhood anxiety disorders related to school refusal compared to anxiety disorders not related to school refusal: Preliminary results. Depression and Anxiety, 22(4), 224–226.
- Rocque, M., Jennings, W. G., Pquero, A. R., Ozkan, T., & Farrington, D. P. (2017). The importance of school attendance: Findings from the Cambridge study in delinquent development on the life-course effects of truancy. Crime and Delinquency, 63, 592–612. https://doi.org/10.1177/0011128716660520
- Sakuta, R., Tazoe, M., Narita, N., Murakami, N., & Nagai, T. (2003). Anxiety in school refusal children with indefinite complaints: Psychological estimation using State-Trait Anxiety Inventory and therapy by serotonin reuptake inhibitors. Brain and Development, 35(5), 394–400.
- Santarossa, A., Nabbijohn, A. N., van der Miesen, A. I., Peragine, D. E., & VanderLaan, D. P. (2019). Separation anxiety and gender variance in a community sample of children. European Child & Adolescent Psychiatry, 28(12), 1629–1643. https://doi.org/10.1007/s00787-019-01319-3
- Seçer, İ., & Ulaş, S. (2020). The mediator role of academic resilience in the relationship of anxiety sensitivity, social and adaptive functioning, and school refusal with school attachment in high school students. Frontiers in Psychology, 11, 1–12. https://doi.org/10.3389/fpsyg.2020.00557
- Sibeoni, J., Orri, M., Podlipski, M. A., Labey, M., Campredon, S., Gerardin, P., & Revah-Levy, A. (2018). The experience of psychiatric care of adolescents with anxiety-based school refusal and of their parents: A qualitative study. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 27(1), 39–49.
- Silove, D., Manicavasagar, V., & Drobny, J. (2002). Associations between juvenile and adult forms of separation anxiety disorder: A study of adult volunteers with histories of school refusal. Journal of Nervous and Mental Disease, 190(6), 413–415. https://doi.org/10.1097/00005053-200206000-00013
- Smith, S. L. (1970). School refusal with anxiety: A review of sixty-three cases. Canadian Psychiatric Association Journal, 15(3), 257–264. https://doi.org/10.1177/070674377001500307
- Spielberger, C. D. (1972). Anxiety: Current trends in theory and research. Academic Press.
- Sutphen, R. D., Ford, J. P., & Flaherty, C. (2010). Truancy interventions: a review of the research literature. Research on Social Work Practice, 20(2), 161–171. https://doi.org/10.1177/1049731509347861
- Tekin, I., Erden, S., Şirin-Ayva, A. B., & Büyüköksüz, E. (2018). The predictors of school refusal: Depression, anxiety, cognitive distortion and attachment. Journal of Human Sciences, 15(3), 1519–1529. https://doi.org/10.14687/jhs.v15i3.5084
10.14687/jhs.v15i3.5084 Google Scholar
- Velting, O. V., Setzer, N. J., & Albano, A. M. (2004). Update on advances in assessment and cognitive-behavioral treatment of anxiety disorders in children and adolescents. Professional Psychology: Research and Practice, 35(1), 42–54. https://doi.org/10.1037/0735-7028.35.1.42
- Viera, A. J., & Garrett, J. M. (2005). Understanding interobserver agreement: The kappa statistic. Fam Med, 37(5), 360–363.
- Voight, M. L., & Hoogenboom, B. J. (2012). Publishing your work in a journal: Understanding the peer review process. International Journal of Sports Physical Therapy, 7(5), 452–460.
- Zebdi, R., & Lignier, B. (2017). Anxiété de séparation et refus scolaire anxieux chez l'enfant: étude de cas [Separation anxiety and anxious school refusal among children: A case study]. Journal de Thérapie Comportementale et Cognitive, 27(4), 165–176. https://doi.org/10.1016/j.jtcc.2017.06.001
10.1016/j.jtcc.2017.06.001 Google Scholar
