The differences in school refusal networks among Chinese adolescents under varying cumulative ecological risks

The phenomenon of adolescent school refusal is closely associated with their ecological environment. While numerous studies have examined the impact of a single risk factor on adolescent school refusal, few have delved into the cumulative effects of multiple ecological risk factors across various backgrounds. This study surveyed 808 Chinese middle school students using a self-compiled cumulative ecological risk scale and a school refusal scale based on the cumulative ecological risk model. Networks of school refusal were constructed for students experiencing high and lower cumulative ecological risk, exploring network structural features and core symptoms of school refusal. Findings revealed commonalities and discrepancies in core symptoms between adolescents experiencing high and lower cumulative ecological risk. Among those with lower cumulative ecological risk, core symptoms included "boredom", "burden", and "avoidance of studying". Conversely, among those with highecumulative ecological risk, core symptoms were "boredom", "lack of planning", and "study pressure". Additionally, structural differences were observed in the school refusal networks between high and lower cumulative ecological risk groups. This study systematically delineated structural differences in adolescent school refusal networks and core symptoms across varying degrees of cumulative ecological risk, offering a foundation for scientifically preventing and effectively managing adolescent school refusal.