Characteristics of adolescents with school refusal
Abstract
OBJECTIVE: To describe the characteristics of young people presenting with school refusal to a child and adolescent psychiatric unit and examine differences between those admitted for inpatient treatment and the rest. METHOD: One hundred and ninety-two adolescents who had been assessed or treated for school refusal between 1994 and 1998 at the Rivendell Unit, Sydney, Australia were identified. An instrument was developed and used to gather data from files. Diagnoses were made by the consensus of two of the investigators using DSM IV criteria from all sources of information. RESULTS: The commencement of school refusal generally occurred in the first 2 years of high school. School refusers had a high prevalence not only of anxiety, but also of mood and disruptive behaviour disorders. A family history of psychiatric illness was present in over half the sample. There were no differences between those subsequently admitted as inpatients and the rest in terms of symptom scores, family composition, family conflict, family separation or history of abuse. Those admitted for inpatient treatment were more likely to have a diagnosis of mood disorders and comorbid diagnoses and to have a maternal history of psychiatric illness. CONCLUSIONS: School refusal in adolescence can be a symptom of a variety of disorders, particularly anxiety and mood disorder. Treatment programs need to be geared to the range of diagnoses which occur in this patient group and to the various circumstances associated with the onset of the problem.
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Diagnostic groupings often involve anxiety, mood, and disruptive behavior disorders, including some combination of these.
“Such groupings often involve anxiety, mood, and disruptive behavior disorders, including some combination of these (Bernstein and Garfinkel, 1986; Last and Strauss, 1990; McShane et al., 2001; Kearney and Albano, 2004).”
From Reconciling Contemporary Approaches to School Attendance and School Absenteeism: Toward Promotion and Nimble Response, Global Policy Review and Implementation, and Future Adaptability (Part 1) (2019) · cites this paper as McShane et al., 2001
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Kearney, C. A., & Diliberto, R. (2013) · doi:10.1002/9781118528563.wbcbt37 · Cited by 14 · see citing works
Fukuya, Y., Fujiwara, T., Isumi, A., Doi, S. K., & Ochi, M. (2021) · Frontiers in Pediatrics · doi:10.3389/fped.2021.640780 · Cited by 13 · see citing works
Differential Effects of Mental Health Problems Among Truant Youths
Dembo, R., Wareham, J., Schmeidler, J., Briones-Robinson, R., & Winters, K. C. (2014) · The Journal of Behavioral Health Services & Research · doi:10.1007/s11414-014-9435-6 · Cited by 12 · see citing works
Matsuura, H., Iwasaka, H., Nezu, S., Ota, T., Okazaki, K., Yamamuro, K., Nakanishi, Y., Kishimoto, N., Iida, J., & Kishimoto, T. (2020) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s246651 · Cited by 13 · see citing works
Monteagudo, M. C. M., García-Fernández, J. M., & Inglés, C. J. (2013) · Dialnet (Universidad de la Rioja) · Cited by 12 · see citing works
Toothbrushing and School Refusal in Elementary School: A Longitudinal Study
Fukuya, Y., Matsuyama, Y., Isumi, A., Doi, S. K., Ochi, M., & Fujiwara, T. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17207505 · Cited by 12 · see citing works
The impact of parental and individual factors on school refusal: a multiple-mediation model
Hughes, P. M., Ostrout, T. L., & Lewis, S. F. (2020) · Journal of Family Studies · doi:10.1080/13229400.2020.1842232 · Cited by 12 · see citing works
Boussand, E., Phan, O., & Benoit, L. (2021) · Neuropsychiatrie de l Enfance et de l Adolescence · doi:10.1016/j.neurenf.2021.04.013 · Cited by 11 · see citing works
A study on psychiatric conditions in children with school refusal- A clinic based study
Biswas, H., & Sahoo, M. K. (2023) · Journal of Family Medicine and Primary Care · doi:10.4103/jfmpc.jfmpc_1200_22 · Cited by 10 · see citing works
School Refusal in Adolescence: Personality Traits and Their Influence on Treatment Outcome
de Groot, C., Heyne, D., & Boon, A. (2023) · Journal of Emotional & Behavioral Disorders · doi:10.1177/10634266231151903 · Cited by 7 · see citing works
Melvin, G. A., & Gordon, M. S. (2018) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2018.07.005 · Cited by 10 · see citing works
Working with school-refusing young people in Tower Hamlets, London
Kljakovic, M., & Kelly, A. (2019) · Clinical Child Psychology and Psychiatry · doi:10.1177/1359104519855426 · Cited by 10 · see citing works
Refus scolaire anxieux : profils psychopathologiques d’adolescents suivis en hôpital de jour
Romaní, J. A. M., Campredon, S., & Fonséca, D. D. (2017) · Archives de Pédiatrie · doi:10.1016/j.arcped.2017.08.003 · Cited by 10 · see citing works
- Authors
- Mcshane, G., Walter, G., & Rey, J. M.
- Affiliations
- Rivendell Unit, Hospital Road, Concord West, NSW, 2138
- Child and Adolescent Mental Health Services, Central Sydney Area Health Service, Sydney, Australia
- The University of Sydney (AU)
- Corresponding author
- Mcshane, Gerard
- Venue
- Australian & New Zealand Journal of Psychiatry
- Publisher
- SAGE Publications
- Published
- 2001-12
- Volume
- 35
- Issue
- 6
- Pages
- 822-826
- ISSN
- 0004-8674 (ISSN-L)
- 1440-1614
- OpenAlex
- W2105421664
- Cited by
- 199
- References
- 23
- Citations by year
- 2026: 6 · 2025: 9 · 2024: 10 · 2023: 13 · 2022: 10 · 2021: 10 · 2020: 16 · 2019: 15 · 2018: 18 · 2017: 7 · 2016: 5 · 2015: 12 · 2014: 12 · 2013: 14 · 2012: 4
- FWCI
- 16.71
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Australian & New Zealand Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Education › Youth Substance Use and School Attendance
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Health Sciences › Health Professions › Speech and Hearing › School Health and Nursing Education
- Keywords
- school refusal, adolescents, anxiety disorders, mood disorders, disruptive behavior disorders, comorbidities, family history of mental illness, hospitalization, maternal psychiatric history, family conflict, family separation, child and adolescent psychiatry
- MeSH terms
- Adolescent, Australia, Mental Disorders, Child, Female, Humans, Male, Phobic Disorders, Psychiatric Status Rating Scales
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