Skip to main content
Journal cover image

School refusal and psychiatric disorders: a community study.

Publication ,  Journal Article
Egger, HL; Costello, EJ; Angold, A
Published in: J Am Acad Child Adolesc Psychiatry
July 2003

OBJECTIVE: To examine the association between anxious school refusal and truancy and psychiatric disorders in a community sample of children and adolescents using a descriptive rather than etiological definition of school refusal. METHOD: Data from eight annual waves of structured psychiatric interviews with 9- to 16-year-olds and their parents from the Great Smoky Mountains Study were analyzed. RESULTS: Pure anxious school refusal was associated with depression (odds ratio [OR] = 13, 95% confidence interval [CI] 3.4, 42) and separation anxiety disorder (OR = 8.7, 95% CI 4.1, 19). Pure truancy was associated with oppositional defiant disorder (OR = 2.2, 95% CI 1.2, 4.2), conduct disorder (OR = 7.4, 95% CI 3.9, 14), and depression (OR = 2.6, 95% CI 1.2, 56). Of mixed school refusers (children with both anxious school refusal and truancy), 88.2% had a psychiatric disorder. They had increased rates of both emotional and behavior disorders. Specific fears, sleep difficulties, somatic complaints, difficulties in peer relationships, and adverse psychosocial variables had different associations with the three types of school refusal. CONCLUSIONS: Anxious school refusal and truancy are distinct but not mutually exclusive and are significantly associated with psychopathology, as well as adverse experiences at home and school. Implications of these findings for assessment, identification, and intervention for school refusal are discussed.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

J Am Acad Child Adolesc Psychiatry

DOI

ISSN

0890-8567

Publication Date

July 2003

Volume

42

Issue

7

Start / End Page

797 / 807

Location

United States

Related Subject Headings

  • Student Dropouts
  • Residence Characteristics
  • Psychophysiologic Disorders
  • Prevalence
  • Humans
  • Diagnostic and Statistical Manual of Mental Disorders
  • Developmental & Child Psychology
  • Depression
  • Attention Deficit and Disruptive Behavior Disorders
  • 5201 Applied and developmental psychology
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Egger, H. L., Costello, E. J., & Angold, A. (2003). School refusal and psychiatric disorders: a community study. J Am Acad Child Adolesc Psychiatry, 42(7), 797–807. https://doi.org/10.1097/01.CHI.0000046865.56865.79
Egger, Helen Link, E Jane Costello, and Adrian Angold. “School refusal and psychiatric disorders: a community study.J Am Acad Child Adolesc Psychiatry 42, no. 7 (July 2003): 797–807. https://doi.org/10.1097/01.CHI.0000046865.56865.79.
Egger HL, Costello EJ, Angold A. School refusal and psychiatric disorders: a community study. J Am Acad Child Adolesc Psychiatry. 2003 Jul;42(7):797–807.
Egger, Helen Link, et al. “School refusal and psychiatric disorders: a community study.J Am Acad Child Adolesc Psychiatry, vol. 42, no. 7, July 2003, pp. 797–807. Pubmed, doi:10.1097/01.CHI.0000046865.56865.79.
Egger HL, Costello EJ, Angold A. School refusal and psychiatric disorders: a community study. J Am Acad Child Adolesc Psychiatry. 2003 Jul;42(7):797–807.
Journal cover image

Published In

J Am Acad Child Adolesc Psychiatry

DOI

ISSN

0890-8567

Publication Date

July 2003

Volume

42

Issue

7

Start / End Page

797 / 807

Location

United States

Related Subject Headings

  • Student Dropouts
  • Residence Characteristics
  • Psychophysiologic Disorders
  • Prevalence
  • Humans
  • Diagnostic and Statistical Manual of Mental Disorders
  • Developmental & Child Psychology
  • Depression
  • Attention Deficit and Disruptive Behavior Disorders
  • 5201 Applied and developmental psychology