PDF(Pubmed)
Abstract：
The aim of the study was to explore the clinical significance of school refusal behavior, its negative impact on psychological well-being of children and adolescents and its relationship with the most common psychopathological conditions during childhood and adolescence (e.g. neurodevelopmental disorders, psychiatric disorders). School refusal behavior refers to a distressing condition experienced by children and adolescents that compromise regular school attendance and determine negative consequences on mental health and adaptive functioning. A narrative review of the literature published between January 2019 and March 2023 was conducted. Ten studies (n = 10) were included from a literature search of the electronic databases PubMed, CINAHL, PsycInfo, MedLine, and Cochrane Library. The results indicate that school refusal is highly present in neurodevelopmental disorders such as autism and attention-deficit/hyperactivity disorder due to the presence of behavioral problems and deficits in communication skills. As for psychiatric disorders, school refusal appears to be highly common in anxiety disorders, depressive disorders, and somatic symptoms. We also found that school refusal behavior may be associated with various emotional and behavioral conditions that act as risk factors. Especially, but are not limited to, it may be associated with a diminished self-concept, exposure to cyberbullying, specific affective profiles and excessive technology usage. Our results indicate that school refusal is a condition with many clinical facets. It can be attributed to both vulnerability factors, both temperamental and relational, and to various psychopathological conditions that differ significantly from each other, such as neurodevelopmental disorders and psychiatric disorders. Recognizing these aspects can improve the implementation of patient-tailored therapeutic interventions that are consequently more likely to produce effective outcomes. The therapeutic intervention should facilitate the recognition of cognitive biases regarding school as a threatening environment, while regulating negative emotions associated with school attendance. Additionally, therapeutic intervention programs linked to social skill training and problem-solving training, conducted directly within the school setting, can enhance children\'s abilities to cope with academic performance and social relationships, ultimately preventing school refusal.
摘要：
这项研究的目的是探讨学校拒绝行为的临床意义，它对儿童和青少年心理健康的负面影响及其与儿童和青少年时期最常见的精神病理学状况的关系(例如神经发育障碍，精神疾病)。学校拒绝行为是指儿童和青少年所经历的一种令人痛苦的状况，这种状况损害了正常的入学率，并确定了对心理健康和适应功能的负面影响。对2019年1月至2023年3月发表的文献进行了叙述性回顾。从电子数据库PubMed的文献检索中纳入了10项研究(n=10)，CINAHL,PsycInfo,MedLine,科克伦图书馆结果表明，由于存在行为问题和沟通技巧缺陷，自闭症和注意力缺陷/多动症等神经发育障碍中高度存在拒绝学校。至于精神疾病，拒绝上学似乎在焦虑症中非常常见，抑郁症,和躯体症状。我们还发现，学校拒绝行为可能与作为危险因素的各种情绪和行为状况有关。尤其是,但不限于,它可能与自我概念减弱有关，暴露于网络欺凌，具体的情感概况和过度的技术使用。我们的结果表明，拒绝上学是许多临床方面的条件。这可以归因于两个脆弱性因素，气质和关系，以及各种不同的精神病理学状况，如神经发育障碍和精神疾病。认识到这些方面可以改善患者量身定制的治疗干预措施的实施，从而更有可能产生有效的结果。治疗干预应促进对学校作为威胁环境的认知偏见的认识，同时调节与出勤率相关的负面情绪。此外,与社交技能培训和解决问题培训相关的治疗干预计划，直接在学校环境中进行，可以提高孩子应对学习成绩和社会关系的能力，最终阻止学校拒绝。
