Confirmatory Factor Analysis of the School Refusal Assessment Scale-Revised: Child and Parent Versions

The School Refusal Assessment Scale-Revised (SRAS-R) is an instrument designed to evaluate the relative strength of four functional conditions of school refusal behavior in youth. Although previous work has shown the scale's child and parent versions to show good reliability, verification of the SRAS-R factor structure remains necessary. The present study investigated administrations of the child and parent versions of the SRAS-R (SRAS-R-C and SRAS-R-P) using confirmatory factor analysis. For both measures, four-factor models were supported following the removal of two SRAS-R-C and three SRAS-R-P items. Three-factor and two-factor models for each SRAS-R version were not supported. Ramifications of these results for use of the SRAS-R are discussed.     

Psychometric Properties and Clinical Utility of the School Refusal Assessment Scale in a Multiethnic Sample

Kearney and Silverman (1993) developed the School Refusal Assessment Scale (SRAS) to assess the function of and to prescribe treatment for school refusal behavior. The present investigation examined the psychometric properties and clinical utility of the SRAS in a multiethnic sample. Participants were 30 children and their mothers who were identified as school refusers after an initial screening. Results indicated that scales measuring negatively reinforced school refusal were intercorrelated, whereas scales measuring positively reinforced school refusal were not. Concurrent validity of dimensional and categorical scoring algorithms was examined. Although parent–child agreement was relatively low, validity analyses suggested that each reporter contributed important information. Clinical implications and areas for future research were discussed.     

Confirmatory Analyses of the School Refusal Assessment Scale-Revised: Replication and Extension to a Truancy Sample

School absenteeism and school refusal behavior are prevalent and serious issues for youth, but few measures have been developed specifically for this population. The School Refusal Assessment Scale-Revised (child and parent versions) provides clinicians with a profile of the relative strength of four functions or maintaining variables regarding school refusal behavior. The scales have been previously tested largely on clinical samples in outpatient treatment settings, however. This study examined 216 youth with primary school refusal behavior and their parent/guardian referred to a community-based truancy court or truancy diversion setting for problematic absenteeism. The four-factor structure of the scales (Kearney Journal of Psychopathology and Behavioral Assessment 24:235–245, 2002a; Journal of Psychopathology and Behavioral Assessment 28:139–144, 2006) was supported via confirmatory factor analysis and specific functions were associated with specific symptom sets as predicted. The results help extend the generalizability of the scales to youths and their families who are more ethnically diverse and referred to a legal process.     

日本拒绝上学概念的演变和原因探讨

拒绝上学指学生不是由于家庭贫困或生病,而是由于某种心理、情绪、身体或社会的原因而不去学校的现象。欧美最早进行研究,日本进行了五十多年的研究。该文介绍日本此现象的称呼从“学校恐怖症”、“拒绝上学”到“不去上学”的演变;日本学者从家庭、学校、社会方面对此现象进行的归因;拒绝上学的行为机制,如分离焦虑、情绪障碍、家庭关系不良;还介绍了日本教育部使用的小泉英二的分类。最后提示该现象在我国发展的可能性     

Profiles of emotional intelligence and demotivation to attend school in Chilean adolescents

The aim of this study was twofold: to identify different emotional intelligence (EI) profiles and to verify possible statistically significant differences in school refusal factors that result in a demotivation to attend school. Participants were 2362 Chilean adolescents aged from 13 to 17 (M?=?15.25; SD?=?1.33), who completed the Trait Meta-Mood Scale-24 (TMMS-24) and the School Refusal Assessment Scale-Revised (SRAS-R). Cluster analysis identified four EI profiles: high scores in repair and low in attention, high scores in attention and low in clarity and repair, low EI and high EI. Students with high scores in attention and low in repair scored higher in the first three factors of the SRAS-R, whereas in the fourth factor of the SRAS-R, students with high EI had significantly higher scores. Emotional regulation seems to be one of the determinant factors to prevent the appearance of school refusal. Based on these findings, we recommend that EI training be a part of future programs to overcome school attendance demotivation issues.     

Developmentally Sensitive Cognitive Behavioral Therapy for Adolescent School Refusal: Rationale and Case Illustration

School refusal can be difficult to treat and the poorest treatment response is observed among older school refusers. This poor response may be explained, in part, by the impact of developmental transitions and tasks upon the young person, their family, and the treatment process. This paper describes and illustrates the @school program, a cognitive behavioral therapy (CBT) designed to promote developmental sensitivity when planning and delivering treatment for adolescent school refusal. Treatment is modularized and it incorporates progress reviews, fostering a planned yet flexible approach to CBT. The treatment is illustrated in the case of Allison, a 16-year-old female presenting with major depressive disorder and generalized anxiety disorder. A case formulation guided the selection, sequencing, and pacing of modules targeting predisposing, precipitating, perpetuating, and protective factors. Treatment comprised 16 sessions with Allison (interventions addressing depression, anxiety, and school attendance) and 15 concurrent sessions with her mother (strategies to facilitate an adolescent’s school attendance), including two sessions with Allison and mother together (family communication and problem solving to reduce parent–adolescent conflict). Two treatment-related consultations were also conducted with Allison’s homeroom teacher. Allison’s school attendance improved during the course of treatment. By post-treatment, there was a decrease in internalizing behavior, an increase in self-efficacy, and remission of depressive disorder and anxiety disorder. Clinically significant treatment gains were maintained at 2-month follow-up. Factors influencing outcome may include those inherent to the @school program together with less specific factors. Special consideration is given to parents’ use of both authoritative and autonomy-granting approaches when helping an adolescent to attend school.     

Intensive (Daily) Behavior Therapy for School Refusal: A Multiple Baseline Case Series

The following multiple baseline case series examines school refusal behavior in 4 male adolescents. School refusal symptom presentation was ascertained utilizing a functional analysis from the School Refusal Assessment Scale (Kearney, 2002). For the majority of cases, treatment was conducted within a 15-session intensive format over a 3-week period. Treatment elements included cognitive-behavioral therapy with the adolescent, parent training sessions, or a combination of these strategies. Treatment was effective for 3 of 4 cases in the short term. At 3-year follow-up, all 3 of the acute treatment responders had switched to alternative educational programs, although parents rated them as significantly improved and less impaired compared to pretreatment. Obstacles to treatment, and recommendations for program improvement, are discussed.     

Psychological Factors Behind Truancy,School Phobia,and School Refusal: A Literature Study

Truancy is a problem that normally leads to treatment interventions within different organizations. Within these organizations different perspectives on the causes and consequences of the above problem can be found. The purpose of this literature study is to map out and describe the current state of research within the fields of school refusal, truancy, and school phobia. The investigation was carried out in the form of a systematic review of the relevant research literature. Research shows that approximately 90% of all young people who refuse to go to school have some form of psychiatric diagnosis.     

Assertive Behavior and Likeability in Elementary School Boys

The present study investigated the social impact of assertive versus nonassertive behavior in fourth- and fifth-grade boys. Subjects viewed eight videotaped scenes, each depicting a different ten year old male model handling a situation in which commendatory or refusal assertion or nonassertion was required. Subjects then evaluated each model based upon their viewing of the role-plays. In addition, the Children's Assertive Behavior Scale (CABS) and a sociometric measure were adminsitered. Results suggest that assertive behavior is valued by elementary school boys. The implications of this finding for the study and training of assertive behavior in children are discussed.     

Emerging School Refusal: A School-Based Framework for Identifying Early Signs and Risk Factors

A student’s academic and social-emotional development is increasingly jeopardized with mounting absence from school. School refusal (SR) is one type of school attendance problem (SAP) that is often associated with absence from school. Once established, it can sometimes be difficult to treat. To prevent established SR and associated problems, indicators of emerging SR and risk for SR should be efficiently identified and acted upon. Risk factors are often discussed in relation to SAPs generally rather than considering risk for specific types of attendance problems. Based on literature review, this paper provides an account of the likely signs and risks for emerging SR. A school-based framework is provided to support school personnel and parents in working together to identify these signs and risks. Several challenges associated with the implementation of the framework are discussed.     

Developing an Online Early Detection System for School Attendance Problems: Results From a Research-Community Partnership

School refusal and other school attendance problems are vexing problems for school-aged youth, families, school personnel, and clinicians. However, few resources exist to detect problematic attendance. The current report describes three steps of a research-community partnership to develop an early identification program to detect youth at risk for problematic attendance. First, a survey was conducted to estimate the scope and cost of school refusal across grades K–12. School administrators estimated relatively few youth exhibiting significant school refusal (missing 5 or more days per year) but estimated the costs associated with services for these youth to be very high (mean cost of in-district programs: $94,052; mean cost of out-of-district placements: $496,657). Second, elementary school counselors were tasked with tracking absenteeism among at-risk youth using an online attendance tracking prototype. Counselors identified a high number of youth who showed elevated absences, lates, or early departures (17.2% of enrolled students), and counselor ratings were significantly related to whether the student (a) had received an individualized education plan or 504 plan, (b) had a sibling with similar attendance problems, (c) was older, or (d) had divorced or separated parents. In a final step, counselor feedback was sought and revisions were incorporated in the attendance tracker. Findings reinforce the prevalence and cost of school attendance problems, provide guidance for using technology to monitor attendance and related indices (tardies, early departures), and direct attention to youth factors that may be useful in identifying youth at risk for poor attendance.     

校园霸凌行为问卷的编制

目的:从贵州省青少年校园霸凌行为的实际出发,以大样本为基础,遵循心理测量学的方法编制《校园霸凌行为问卷》。方法:经理论建模、题库建设编制初测问卷,以3923名学生为被试进行项目分析和探索性因子分析; 以3899名被试进行信度检验及验证性因子分析,形成最终问卷。结果:问卷由7个一阶因子和2个二阶因子组成,共40个题项。问卷及各维度的内部一致性系数在0.7～0.927之间,重测信度在0.291～0.49之间,结构效度良好,与OBVQ-V和MBVS的相关分别为0.646和0.726。结论:本研究探索、发现并整合创新了反映当代校园霸凌治理难点的“恶整霸凌”; 问卷信效度良好,可作为国内青少年校园霸凌行为的有效测量工具。     

Developments in Classification,Identification, and Intervention for School Refusal and Other Attendance Problems: Introduction to the Special Series

The literature on school attendance problems (SAPs) is diverse and sometimes confusing, but it is also promising. This special series presents seven articles and a discussion that attest to the diversity, complexity, and exciting developments associated with SAPs. While some articles focus on school refusal in particular, others have relevance for school refusal, truancy, and other types of SAPs. Collectively, the seven articles provide direction in thinking about two key questions: (1) How can SAPs best be classified and identified?; and (2) Which innovative approaches can be applied when a SAP is severe, chronic, and/or complex? In this way the series has direct relevance for Tiers 1 and 3 of the Response to Intervention model for managing school absenteeism (Kearney & Graczyk, 2014). Three innovative treatment programs presented in this series illustrate ways in which mental health interventions and educational interventions can be combined to address Tier 3 SAPs. The discussion article presents thought-provoking reflections on the topics covered in the seven articles and on the gaps in practice and research in the field of SAPs. You are invited to critically and creatively respond to the ideas offered in this series.     

Modular Treatment for Children and Adolescents With Problematic School Absenteeism: Development and Description of a Program in Germany

Problematic school absenteeism is defined as absence from school occurring with a clinical-level mental disorder. It represents a higher-order term for school refusal, school truancy, and the combination thereof and is associated with an increased risk for school dropout, prolonged mental disorders, and unemployment. This article describes the manualized modular treatment of problematic school absenteeism (MT) by a multiprofessional team. The manual was developed to target a broad spectrum of mental disorders characterized by internalizing but also externalizing behavior. The therapeutic focus is on the reintegration into school and on the cognitive behavioral treatment of the mental disorder. The MT is based on a multilevel model of problematic school absenteeism. The treatment is informed by an extensive case-conceptualization and addresses motivational aspects by offering a low-threshold therapeutic design and motivational interviewing. Core interventions are represented in four modules: cognitive behavioral therapy, family counseling, school counseling, and a psychoeducational physical exercise program. A case vignette provides an illustration of the treatment and the specific graduated approach for school reintegration. The current modular approach is discussed in relation to other cognitive-behavioral manuals targeting a broad spectrum of mental disorders or school refusal.     

父母因素、抵制效能感与青少年新媒介依赖行为的关系

以500名青少年手机拥有者为被试,采用问卷调查法考察青少年新媒介依赖(包括网络和手机依赖)的特点,并探讨父母因素和抵制效能感对青少年新媒介依赖的预测作用。结果发现:(1)40%的青少年至少存在边缘网络成瘾行为,19.8%的青少年为手机依赖者。青少年网络成瘾和手机依赖这两种新媒介依赖行为间具有显著的关联性,46.4%的青少年存在至少一种新媒介依赖行为。(2)青少年新媒介依赖行为与其抵制效能感、父母行为/态度及父母行为监控显著相关。青少年抵制效能感在父母行为/态度与青少年新媒介依赖行为之间起到完全中介的作用,在父母行为监控与青少年新媒介依赖行为间起到部分中介的作用。研究结果对提高青少年新媒介依赖行为预防干预活动的有效性和针对性具有重要的指导意义。     

Antidepressant Medication: Is It a Viable and Valuable Adjunct to Cognitive-Behavioral Therapy for School Refusal?

Cognitive-behavioral therapy (CBT) is an evidence-based treatment for school refusal. However, some youth do not respond to CBT. The serious risks associated with school nonattendance call for novel approaches to help those who do not respond to CBT. Because school refusal is commonly associated with anxiety disorders, and the combination of CBT and antidepressant medication enhances outcomes in the treatment of anxiety disorders, combined treatment may be effective for school refusal. This narrative review evaluates the current evidence base for adding antidepressant treatment to CBT for school refusal. Six randomized controlled trials (RCTs), two open trials, six case studies/series, and one observational study were identified and reviewed. There is support for combined CBT and imipramine, but this medication is not typically used due to the risk of concerning side effects. Two recent RCTs failed to provide evidence for the superiority of combined CBT and fluoxetine. Further research in this area is required because the extant studies have a number of methodological limitations. Recommendations are provided for clinicians who consider prescribing antidepressant medication or referring for adjunctive antidepressant treatment for school refusal.     

Additive,Multi-Component Treatment of Emerging Refusal Topographies in a Pediatric Feeding Disorder

This case study describes inter-disciplinary treatment of chronic food refusal and tube dependency in a 2-year-old female with a pediatric feeding disorder. Evidence-based behavioral components—including escape extinction (EE), differential reinforcement of alterative mealtime behavior (DRA), and stimulus fading—were introduced sequentially as the focus of treatment shifted to address refusal topographies along the chain of behaviors associated with consumption. The assessment process, treatment planning and sequencing, and generalization of treatment gains to caregivers are presented in detail. In doing so, the study illustrates the core features involved in applying a flexible, evidenced-based approach to treat severe feeding difficulties.     

Construction of a Hypercompetitive Attitude Scale

Theory testing in the area of hypercompetitiveness has been impeded by the lack of an adequate psychometric instrument. Four studies were conducted as part of an initial research program designed to remedy this deficiency by constructing an individual difference measure of general hypercompetitive attitude with satisfactory psychometric properties. In Studies 1 and 2, a 26-item scale was derived primarily through item-total correlational analysis; it demonstrated adequate internal and test-retest reliabilities. The remaining two studies were concerned with determining the construct validity of the scale. In line with theoretical expectations based on Horney's theory of neurosis, subjects who perceived themselves as hypercompetitive were less psychologically healthy. The potential usefulness of the scale in therapeutic, athletic, school, and business settings is discussed.     

Psychometric Properties of the Bullying Participant Behaviors Questionnaire (BPBQ) among Chinese Middle School Students

The Bullying Participant Behaviors Questionnaire (BPBQ) is an efficient self-report measure for investigating bullying participant role behaviors. The present study evaluated the psychometric properties of the BPBQ in a Chinese middle school sample. A total of 516 middle school students (47.7% girls; age range?=?12–14 years) were recruited from an urban middle school in China. Results revealed that a five-factor model fit the data best. Correlations between the BPBQ subscale scores and the external criterion variables, including empathy and sympathy, moral disengagement, and trait anger, provided evidence of criterion validity. Furthermore, the BPBQ had good alpha reliability and moderate to good test-retest reliability. In conclusion, the BPBQ is a promising assessment tool to measure bullying participant behaviors among Chinese middle school students.