Functional profiles of school refusal behavior and their relationship with depression, anxiety, and stress

Negative emotional states are common among youth with problematic school absenteeism, but little is known about their presence across different school refusal behavior profiles. The aim of this study was twofold: to identify different cluster solutions across functional profiles of school refusal behavior (I. Avoidance of Negative Affectivity, II. Escape from Social and/or Evaluative Situations, III. Pursuit of Attention, and IV. Pursuit of Tangible Reinforcement) and to determine whether these profiles differ from each other based on dimensions of depression, anxiety, and stress. The sample consisted of 1582 Ecuadorian adolescents aged 12-18 years (M = 14.83; SD = 1.86) who completed the School Refusal Assessment Scale-Revised (SRAS-R) and the Depression, Anxiety and Stress Scale-21 (DASS-21). Latent class analysis revealed three school refusal profiles: non-school refusal behavior, school refusal behavior by tangible reinforcements, and school refusal behavior by multiple reinforcements. The last group displayed the most maladaptive profile and revealed highest mean scores on the three dimensions of the DASS-21 compared to other groups. To promote mental health in this group it is a necessary goal due to their link with these negative emotional states. Prevention measures to strengthen emotional self-regulation should be considered in these cases.