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. 2024 May 30;50:107. doi: 10.1186/s13052-024-01667-0

Table 2.

Methodologies and results of the investigated studies

Study Sample Method(s) Measures Results
Gonzalves et al. [23] Sample: 1315 Spanish students (range age: 12–18) Experimental study

SRAS-R

SDQ-II-Short Form

Four different School Refusal Behaviour profiles: Moderately High School Refusal Behaviour(n 489, (37.2%)), Moderately Low High School Refusal Behaviour (n 433 (32.9%)) Mixed School Refusal Behaviour (n 177, (13.5%), Non-School Refusal Behaviour (n 216 - (16.4%). Mixed School Refusal Behaviour group was the most maladaptive profile and revealed the lowest mean scores on self-concept.
Delgado et al. [26] Sample: 1,102 Spanish high school students aged 12–18 years (mean age 14.30; SD 1.71). Experimental study SRAS-R

Results showed 3 behaviour profiles: (1) SRB by negative reinforcements (419–38.02%) (2) SRB by positive reinforcements (389 -35.29%) (3) non-SRB students (267- 24.22%).

The first group showed higher rates than the others in victimization, aggression, both, and observation of cyberbullying.

Gonzalvez et al. [24] Sample: 1,816 Spanish adolescents (range age: 15–18 years) Experimental study

PANAS-C-SF

SRAS-R-C

5 affective profiles: a) low affective profile (n = 40; 2.2%), b)self-fulfilling profile (n = 899; 49.5%),c) low positive affect profile (n = 698; 38.4%), d) self-destructive profile (n = 86; 4.7%), and e) high affective profile (n = 93; 5.1%). Statistically significant differences were found among profiles in the four conditions of SRAS-R-C (p < 0.001).
Fujita et al. [25] Sample: 227 students, aged 10–18 years, with any psychiatric disorder (except moderate-to-severe or profound intellectual disability), showing SRB, defined as at least 30 days of absence from classes, and Problematic Internet Use (PIU) Observational cross-sectional analytical study

IAT

QCD

GAD-7

PHQ9

46/112 (41.1%) students with SRB exhibited PIU, with an IAT score > 50. They showed lower CQD scores in each part of day except at night (p range 0,5 − 0,05) and significant higher scores in PHQ9 and GAD-7 tests and more frequently diagnosed with mood disorders.
Ellen Kathrine Munkhaugen et al. [27] Sample: 62 individuals (age range 9–16 y- mean age 12.3) whit ASD, without intellectual disability, divided into 2 groups: ASD plus SRB (n 33- 53.2%) and ASD without SRB (n 29) Experimental study

BRIEF

SRS

CBCL

Significant difference between the two groups in: social functioning (p = 0.002) measured by SRB, in executive functions (p = 0.002) measured by BRIEF, in emotional and behavioural problems (p = 0.001) measured by CBCL.
Vicki Bitsika et al. [28] Sample: 67 mothers and their sons (age range 7–18 ), with ASD, bullying experience and school refusal (SR) Experimental study CASI-4 Boys with SR had significantly higher GAD and MDD than boys without SR (p = 0.13) and the frequency of being bullied made a significant contribution to emerging SR (p = 0.004)
Abbey j. McClemont et al. [29] Sample: 97 parents with 154 children (age range 4–16 y) aged at least 18 with diagnosis of ASD (n = 36), ADHD (n = 16), ASD + ADHD (n = 31), other diagnosis (i.e., anxiety disorders, mood disorders, disruptive behaviour disorders, learning disorders, language/communication disorders, sensory/auditory processing disorders; n = 15), and no diagnosis (n = 56). Brief Report LIKERT scale 35% of parents state that their child has never refused school because of bullying. A significant difference between groups in lifetime school refusal due to bullying (p < 0.001). Children with ASD + ADHD were more likely to have ever refused school because of bullying (68%) than children with ASD (28%) or no diagnosis (18%).
Carpentieri et al. [30] Sample: 103 adolescent with a mean age of 16.2 (SD ± 1.14), divided into two group: with school refusal (SRa) n = 28 and not school refusal (non-SRa) n = 75 Experimental study

HAM-A

HAM-D

YMRS

GAF

GFSS

GFRS

SWAP-200-A

SRa showed higher anxious and depressive symptoms (HAM-A p = 0.036; HAM-D p = 0.031), lower level of global functioning (GAF < p < 0.001, GAF_past year p = 0.025), lower levels of social and role functioning (GFSS p = 0.003, GFRS p = 0.002), higher rates of Schizoid (p = 0.046) and Schizotypal (p = 0.034) personality disorders, lower Health Functioning (p = 0.001) and the Q Health Index (p = 0.002).
Al Keilani and Delvenne [8] Sample: 71 patients (age range: 8–16 years) from the Child and Adolescent Psychiatric Department of Queen Fabiola Children’s University Hospital, with an anxious school refusal behaviour (ASR) Retrospective study A checklist including: patient’s gender, status, age of onset of school refusal, age of assessment, duration of school refusal, associated events, life events, use of psychotropic medication, family psychiatric history and family composition, individual psychiatric history Significant sex difference: 70.42% of male (p < 0.0003) with ASR. Risk factors: family separation (56.3%), conflict at home (27%), contact rupture with father (25.3%), maternal psychiatric illness (45.07%), paternal psychiatric illness (28.2%), academic difficulties (36.6%) and change school or moving home (19.7%). Concerning psychopathological diagnosis, anxiety (39.4%) and mood disorder (32.4%).
Xavier Benarous et al. [31] Sample: 191 adolescents aged 12–18 years (M = 15.0, 44% boys) Retrospective chart review study

C-GAF

CGI-S

DEP-ADO

7% with SW/SR (n = 83) met HKM criteria (n = 14, M = 14.3, 64% boys), accounting for one in six adolescents with SW/SR. No significantly differ from the other forms or SW/SR in terms of demographic factors, academic performance or psychosocial factors. SW/SR and HKM + patients had higher rates of anxiety disorders (Odd Ratio, OR = 35.2) and lower rates of disruptive behavioural disorders (OR = 0.03). None of the HKM + reported use of illicit drugs, alcohol, compared to 25% of youths with other SW/SR.

Behaviour Inventory of Executive Function (BRIEF), Child and Adolescent Symptom Inventory-revision 4 (CASI-4), Children-Global Assessment of Functioning scale (C-GAF), Clinical Global Impressions-Severity scale (CGI-S), Child Behaviour Checklist (CBCL), General Anxiety Disorder-7(GAD-7), Global Assessment of Functioning (GAF), Global Functioning Social Scale (GFSS), Global Functioning Role Scale (GFRS), Hamilton Rating Scale for Anxiety (HAM-A), Hamilton Rating Scale for Depression (HAM-D), Internet Use with Internet Addiction Test (IAT), Patient Health Questionnaire − 9 (PHQ9), Positive and Negative Affect Schedule Short Form (PANAS-C-SF), Questionnaire-Children with Difficulties (QCD), School Refusal Assessment Scale-Revised for Children (SRAS-R-C), Self-Description Questionnaire (SDQ-II-Short Form), Shelder-Westen Assessment Procedure for Adolescents (SWAP-200-A), Social Responsiveness Scale (SRS), Young Mania Rating Scale (YMRS)