School Refusal and Determinants: Parental Psychopathology, Family Functioning, Attachment and Temperament

In the current study investigated the psychopathologies of parents, family functioning, child temperament characteristics, and attachment of kindergarten and primary school-age children who were brought to the child and adolescent psychiatry outpatient clinic due to school refusal behavior. Fifty-two children with school refusal and 64 children without school refusal and their parents participated in the current study. School Refusal Assessment Scale, Systemic Family Functionality Scale(SFFS), Family Harmony Scale(FHS), Kerns Secure Attachment Scale(KSAS), Temperament Scale for Children(TSC), and Depression Anxiety Stress Scales(DASS) for parents were used. It was determined that, compared to children without school refusal, the children with school refusal had lower KSAS score(mother)(p = 0.049), higher DASS-stress and anxiety(mother) scores(p = 0.014 and p = 0.020, respectively), lower TSC-Responsiveness/Reactivity subscale score (p = 0.005), lower SFFS-intrafamilial support and SFFS-intrafamilial connection scores (p = 0.002 and p < 0.001, respectively), and lower FHS-total score (p = 0.002). It was determined that school refusal was 11 times more common in children who had difficulty adjusting to school in previous years. Each point increase in the SFFS-intrafamilial connection score reduced school refusal by 30%. In the current study shows that among the interventions required for treatment, the family should also be targeted in addition to the child and adolescent. Therefore, it is essential to identify factors such as parents' psychopathology and their roles in the family, family functioning, and family harmony in school refusal. Because parents play a crucial role in both the development and maintenance of school refusal, using more parent-targeted strategies or techniques is necessary to improve interventions.