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theses

Youth school refusal (SR) is a pattern of difficulty attending school due to elevated levels of anxiety and is associated with a range of negative psychosocial correlates (e.g., negative cognitions and emotions; Berg, 1997). However, findings about which correlates are reliable predictors of SR remain heterogeneous and extant research has focused on samples of youth with clinical impairment, which poses a challenge in identifying dimensional aspects (e.g., sub clinical) or early signs of SR (e.g., Egger, Costello, & Angold, 2003; Lyon & Cotler, 2007). The present study examined the associations between SR and several psychosocial correlates (child, parent, family resources) across three groups of SR (i.e., clinical SR, subthreshold SR, and no SR (NSR)) in a clinical sample of 225 youth (ages 6-17 years) diagnosed with anxiety and/or depression. ANCOVAs, using Bonferroni-corrected pairwise comparisons, and chi-square tests of independence were used to examine the associations between three study groups and correlates, including youth reports of negative cognitions and affect and physiological arousal, youth, mother, and father reports of symptom severity and parent-intrusive behaviors, and mother and father reports of youth externalizing behavior difficulties, competencies, and socio-demographic factors. There were significant differences between SR conditions on various psychosocial correlates. Youth reports showed that SR youth had more severe panic symptoms than NSR youth and SR youth had less hostile thoughts compared to subthreshold youth. Across parent reports, results showed that SR youth had higher severity of internalizing symptoms (e.g., depression, separation anxiety) and lower social functioning compared to NSR youth. Parent reports also indicated that SR youth had more externalizing behavior difficulties than subthreshold youth groups, and that SR youth have greater panic symptom severity than both groups. These results suggest trends in the differences between groups distinguished by internalizing (e.g., anxiety and mood symptoms) and externalizing behaviors and overt symptomology (e.g., rule-breaking behavior, panic disorder symptoms). There were also significant differences between groups on current youth educational supports, with more SR youth using services compared to other groups. The study's findings provide preliminary support for examining SR as a dimensional construct and help to elucidate some key psychosocial correlates of SR.

ETD_9545

Psy.D.

Includes bibliographical references

doi:10.7282/t3-betq-bx36

ETD doctoral

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