Truancy in the United States: Examining Temporal Trends and Correlates by Race, Age, and Gender.

BACKGROUND: Truancy has long been regarded a common problem in urgent need of effective intervention. Knowledge about factors associated with truancy can guide the development and implementation of interventions. METHOD: This paper examined trends in truancy rates between 2002-2014 and correlates of truancy across racial/ethnic groups. Variables of interest included sociodemographic factors (e.g., age, gender, socio-economic background), behavioral factors (e.g., substance use, violence), and psychosocial factors (e.g., academic engagement, grades, parental control). Using data from a large sample of adolescents (n=209,393; 12-17 years) we estimated truancy prevalence rates and examined trends and correlates via regression analyses. RESULTS: Truancy rates remained constant between 2002 (10.8%) and 2014 (11.1%). Rates were highest among older youth, females, and Hispanic youth. For all racial/ethnic groups, truancy was significantly correlated with alcohol and marijuana use, fighting, the propensity to take risks, and lower academic engagement and school grades. Other factors were differentially associated with racial/ethnic groups. This divergence in risk patterns for different racial/ethnic groups points to some heterogeneity amongst truant youth. DISCUSSION: Despite truancy reduction efforts, truancy rates have remained stable. Efforts to prevent truancy and to intervene with truant youth may need to target risk factors more prevalent in specific racial/ethnic groups.

The relation between social anxiety and audience perception: examining Clark and Wells' (1995) model among adolescents.

BACKGROUND: Clark and Wells' cognitive model of social anxiety proposes that socially anxious individuals have negative expectations of performance prior to a social event, focus their attention predominantly on themselves and on their negative self-evaluations during an event, and use this negative self-processing to infer that other people are judging them harshly. AIMS: The present study tested these propositions. METHOD: The study used a community sample of 161 adolescents aged 14-18 years. The participants gave a speech in front of a pre-recorded audience acting neutrally, and participants were aware that the projected audience was pre-recorded. RESULTS: As expected, participants with higher levels of social anxiety had more negative performance expectations, higher self-focused attention, and more negative perceptions of the audience. Negative performance expectations and self-focused attention were found to mediate the relationship between social anxiety and audience perception. CONCLUSIONS: The findings support Clark and Wells' cognitive model of social anxiety, which poses that socially anxious individuals have distorted perceptions of the responses of other people because their perceptions are coloured by their negative thoughts and feelings.

Cognitive mediation of cognitive-behavioural therapy outcomes for anxiety-based school refusal.

BACKGROUND: Cognitive-behavioural therapy (CBT) has proven to be effective for anxiety-based school refusal, but it is still unknown how CBT for school refusal works, or through which mechanisms. AIMS: Innovative statistical approaches for analyzing small uncontrolled samples were used to investigate the role of self-efficacy in mediating CBT outcomes for anxiety-based school refusal. METHOD: Participants were 19 adolescents (12 to 17 years) who completed a manual-based cognitive-behavioural treatment. Primary outcomes (school attendance; school-related fear; anxiety) and secondary outcomes (depression; internalizing problems) were assessed at post-treatment and 2-month follow-up. RESULTS: Post-treatment increases in school attendance and decreases in fear about attending school the next day were found to be mediated by self-efficacy. Mediating effects were not observed at 2-month follow-up. CONCLUSIONS: These findings provide partial support for the role of self-efficacy in mediating the outcome of CBT for school refusal. They contribute to a small body of literature suggesting that cognitive change enhances CBT outcomes for young people with internalizing problems. Regarding methodology, the product of coefficient test appears to be a valuable way to study mediation in outcome studies involving small samples.

The role of cognition in school refusal: an investigation of automatic thoughts and cognitive errors.

AIMS: The purpose of this study was to investigate the cognitions of anxious school refusers. The cognitive constructs under investigation included negative cognition commonly linked to youth anxiety (i.e. negative automatic thoughts and cognitive errors) and positive automatic thoughts. METHOD: The cognition of school refusers (n = 50) and youth from a community sample (n = 181) was assessed with the Children's Automatic Thoughts Scale-Negative/Positive and the Children's Negative Cognitive Error Questionnaire-Revised. RESULTS: When controlling for anxiety, school refusers were found to report more negative automatic thoughts concerning personal failure, fewer negative automatic thoughts concerning hostility, and fewer positive automatic thoughts. Negative automatic thoughts concerning personal failure and hostility, and the negative cognitive error of overgeneralizing were found to independently predict school refusal. CONCLUSIONS: The findings underscore the importance of further researching the role of cognition in the development, maintenance, and treatment of anxiety-based school refusal.

The inverse association between psychological resilience and emerging school refusal among bullied autistic youth.

BACKGROUND: Autistic youth are often bullied at school, which may lead to school refusal (SR). Currently, there is little research on factors that may help prevent SR among autistic youth. To advance theory-driven preventative interventions, this study examined associations between psychological resilience and emerging SR (ESR) among autistic youth bullied at school. METHODS: Fifty-eight autistic boys in elementary school (grades 1-6; n = 36) or secondary school (grades 8-11; n = 22) who were bullied at school responded to an online survey, as did their mothers. Boys reported on the experience of being bullied, psychological resilience (via the Social Emotional Assets and Resilience Scale), and ESR. Their mothers provided information regarding the boys' Autism Spectrum Disorder (ASD) diagnosis. RESULTS: Fifty-six percent of this sample of bullied autistic youth displayed ESR. For the secondary school boys there was a significant inverse relationship between psychological resilience and ESR, principally via two characteristics of psychological resilience: 'controlling negative thoughts' and 'remaining calm when angry'. No significant relationship was found between psychological resilience and ESR among elementary school boys. CONCLUSION: Longitudinal research is needed to determine whether psychological resilience serves as a factor protecting against the emergence of SR among autistic youth who have been bullied.

Is Bullying Associated with Emerging School Refusal in Autistic Boys?

The experience of being bullied is widespread among autistic youth. Relatively little empirical work has been done on the relationship between the bullying of these youth and school refusal (SR). This study of 67 school-age autistic boys (M = 11.7 years, SD = 2.3 years) examined several factors that may contribute to SR. Data regarding boys' age, generalised anxiety disorder (GAD), major depressive disorder (MDD), key ASD diagnostic criteria, and frequency of being bullied were collected. Results indicated that, while boys displaying emerging SR also had significantly higher GAD and MDD than boys without emerging SR, only the frequency of being bullied made a significant contribution to emerging SR. Implications for prevention and treatment of SR among autistic youth are discussed.

The Back2School modular cognitive behavioral intervention for youths with problematic school absenteeism: study protocol for a randomized controlled trial.

BACKGROUND: School absenteeism (SA) is associated with anxiety, depression, and disruptive behavior. It is a risk factor for academic difficulties and school dropout, which predict problems in adulthood such as social, work-related, and health problems. The main goal of this study is to examine the initial effectiveness of a modular transdiagnostic cognitive behavioral therapy (CBT) intervention (Back2School) for increasing school attendance and decreasing psychological problems, relative to a comparator control arm (treatment as usual [TAU]). METHODS/DESIGN: One hundred sixty children, aged 7 to 16 years, will be randomly assigned to either Back2School or TAU. The design is a two (Back2School and TAU) by four (preassessment [T1], postassessment [T2], and 3-month [T3] and 1-year [T4] assessments) mixed between-within design. The primary outcome is school attendance based on daily registration. Secondary outcomes pertain to youth psychosocial functioning, quality of life, bullying, self-efficacy, and teacher-parent collaboration. These secondary outcomes are measured via youth, parent, and teacher reports. DISCUSSION: This study will provide critically needed empirical evidence on the initial effectiveness of a manualized treatment program for youth with SA. If the intervention is found to be effective, the program can be further implemented and tested in a larger school health effectiveness trial. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03459677 . Retrospectively registered on 9 March 2018.

Changes in social fears across childhood and adolescence: age-related differences in the factor structure of the Fear Survey Schedule for Children-Revised.

The (in)variance of the structure of fear across child and adolescent development was investigated using the response of 3,803 young people (aged 6-18 years) to the Fear Survey Schedule for Children-Revised (FSSC-R). It was hypothesized that the structure of fear, particularly social fear, would become more differentiated during adolescence. Confirmatory factor analysis was utilized to test the goodness-of-fit of a 5-factor solution (with one social factor, that is Failure and Criticism) and a 7-factor solution (with social items divided into three distinct subfactors) among three age groups. Results indicated that a 5-factor solution (including just one social factor) adequately characterizes the structure of fear in childhood (6-9 years), whereas a 7-factor solution (including three social factors) more appropriately characterizes the structure of fear in adolescence (10-13 and 14-18 years). It appears that a global social fear exists until around the age of 9, and that social fears becomes more differentiated thereafter.

Developmental pathways of social avoidance across adolescence: the role of social anxiety and negative cognition.

It is argued that the adolescent onset of social anxiety disorder (SAD) may be partly attributable to an increase in avoidance of social situations across this period. The current cohort-sequential study investigated developmental pathways of social avoidance in adolescence and examined the explanatory role of social anxiety and negative cognitive processes. A community sample of youth (9-21 years, N=331) participated in a four-wave study. Trajectory analyses revealed two pathways: an increased avoidance pathway and a low avoidance pathway. The pathways were hardly distinguishable at age 9 and they steadily diverged across adolescence. Logistic regression analyses showed that social anxiety and post-event rumination were significantly related to the increased avoidance pathway; anticipatory processing and self-focused attention were not. The findings suggest that adolescence is a key developmental period for the progression of social avoidance among youth who show relatively high levels of social anxiety and post-event rumination.

Distorted Cognitive Processing in Youth: The Structure of Negative Cognitive Errors and Their Associations with Anxiety.

The Children's Negative Cognitive Error Questionnaire (CNCEQ) is commonly used to measure four errors in young people's thinking, but research has failed to support the factorial validity of the measure. The primary objective of the present study was to examine the factor structure of a refined and extended version of the CNCEQ. Revision of the CNCEQ involved the exclusion of items rated as contaminated, and the addition of items measuring cognitive errors closely associated with anxiety ('threat conclusion' and 'underestimation of the ability to cope'). A secondary objective was to determine the relation between the negative cognitive errors and anxiety. Principal component analysis of data from 481 children and adolescents indicated five distinct negative cognitive error subscales labeled 'underestimation of the ability to cope', 'personalizing without mind reading', 'selective abstraction', 'overgeneralizing', and 'mind reading' which contained the new 'threat conclusion' items. Confirmatory factor analysis in an independent sample of 295 children and adolescents yielded further support for the five-factor solution. All cognitive errors except 'selective abstraction' were correlated with anxiety. Multiple regression analysis indicated that the strongest predictors of anxiety were the two subscales containing new items, namely 'underestimation of the ability to cope' and 'mind reading'. The results are discussed with respect to further development of the instrument so as to advance the assessment of distorted cognitive processing in young people with internalizing symptoms.