School refusal profiles maintained by negative reinforcement and their relationship with self-perceived health

Health alterations and school refusal behavior may significantly affect student evolution in all areas of student lives. The objective of this study was to use latent profile analysis to identify school refusal profiles sustained by negative reinforcement and to determine their relationship with distinct self-perceived health variables (Satisfaction, Well-being, Resilience, Performance, and Risk-Taking). The School Refusal Assessment Scale-Revised (SRAS-R) and the Child Health and Illness Profile (CHIP-CE/CRF) were administered to 737 students (60.9% male) aged between 8 and 10 (M = 8.76, SD = 0.74). Three profiles of school refusal maintained by negative reinforcement were obtained: no risk, moderate risk, and high risk. It was confirmed that school refusal through negative reinforcement correlates negatively with health dimensions, also finding that a higher risk profile for school refusal is associated with lower levels of self-perceived health. Similarly, it was determined that the high-risk profile is the most maladaptive, with significantly lower data in four of the five self-perceived health dimensions that were evaluated. In conclusion, remaining in situations with no or moderate risk of school refusal due to negative reinforcement encourages higher levels of self-perceived health, while being at high risk of school refusal due to negative reinforcement is associated with worse self-perceived health.