Familial features of children and adolescents with school refusal

Aim: The aim is to assess the familial features of children with complaints of school refusal and investigate the familial features in the development of school refusal.Material and Method: 55 children with complaints of school refusal and their parents were included in the study and were compared with the control group. A sociodemographic data form, Separation Anxiety Disorder Symptom Check List, Beck Depression Inventory, Toronto Alexithymia Inventory, State-Trait Anxiety Inventory and Symptom Check List-90-R, was applied to the parents. The data obtained were assessed with chi-square and Mann Whitney U test.Results: 34 % of the school refusal group (61,8 %) is made up of males. 74,5 % of children with school refusal were diagnosed with separation anxiety disorder. Children whose parents were housewives and poorly educated had a meaningfully more frequent incidence of school refusal than those whose parents worked and had a high level of education (p<0,0001). Parents in the school refusal group had higher levels of anxiety, depression and alexithymia in comparison with the control group (p<0,005). In addition, parents in the school refusal group were found to have more psychological symptoms (p<0,0001). Physical violence by parents (odds ratio, 9,2 [95 % CI, 3,2-26,4]; p<0,0001); the history of physical disease in the mother (odds ratio, 9,4 [95 % CI, 1,1-77,6]; p=0,014), father (odds ratio, 9,2 [95 % CI, 2,0-42,8]; p<0,001) or the child (odds ratio, 5,8 [95 % CI, 2,3-14,5]; p<0,0001); the presence of mental illnesses in the mother (odds ratio, 2,4 [95 % CI, 1,9-3,1]; p<0,0001), father (odds ratio, 8,0 [95 % CI, 1,0-67,6]; p=0,026) or the extended family (odds ratio, 13,1 [95 % CI, 2,9-60,0]; p<0,0001) were found to be risk factors in the development of school refusal.Conclusion: Genetical and environmental factors contribute to the development of school refusal in both children and adolescents. Therefore, the determination of the factors contributing to the development of school refusal and the provision of necessary precautions will be of great assistance to clinicians in the therapeutic process.