UNLV Theses, Dissertations, Professional Papers, and Capstones 5-2011 School refusal behavior: The relationship between functions and symptom sets Marisa Charlene Hendron University of Nevada, Las Vegas Follow this and additional works at: https://digitalscholarship.unlv.edu/thesesdissertations Part of the Behavior and Behavior Mechanisms Commons, Child Psychology Commons, and the Clinical Psychology Commons Repository Citation Hendron, Marisa Charlene, "School refusal behavior: The relationship between functions and symptom sets" (2011). UNLV Theses, Dissertations, Professional Papers, and Capstones. 985. http://dx.doi.org/10.34917/2327179 This Thesis is protected by copyright and/or related rights. It has been brought to you by Digital Scholarship@UNLV with permission from the rights-holder(s). You are free to use this Thesis in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s) directly, unless additional rights are indicated by a Creative Commons license in the record and/ or on the work itself. This Thesis has been accepted for inclusion in UNLV Theses, Dissertations, Professional Papers, and Capstones by an authorized administrator of Digital Scholarship@UNLV. For more information, please contact [email protected]. SCHOOL REFUSAL BEHAVIOR: THE RELATIONSHIP BETWEEN FUNCTIONS AND SYMPTOM SETS by Marisa Charlene Hendron Bachelor of Arts Temple University 2006 A thesis submitted in partial fulfillment of the requirements for the Master of Arts in Psychology Department of Psychology College of Liberal Arts Graduate College University of Nevada, Las Vegas May 2011 Copyright by Marisa C. Hendron 2011 All Rights Reserved THE GRADUATE COLLEGE We recommend the thesis prepared under our supervision by Marisa Charlene Hendron entitled School Refusal Behavior: The Relationship Between Functions and Symptom Sets be accepted in partial fulfillment of the requirements for the degree of Master of Arts in Psychology Christopher Kearney, Committee Chair Brad Donohue, Committee Member Jennifer Rennels, Committee Member Lori Olafson, Graduate Faculty Representative Ronald Smith, Ph. D., Vice President for Research and Graduate Studies and Dean of the Graduate College May 2011 ABSTRACT School Refusal Behavior: The Relationship Between Functions and Symptom Sets by Marisa C. Hendron Dr. Christopher Kearney, Examination Committee Chair Professor of Psychology University of Nevada, Las Vegas The current study examined the relationship between functions of school refusal behavior and internalizing and externalizing symptom sets in a community sample of 200 youth and parents recruited from two truancy settings. The first hypothesis was that youth who endorsed refusing school primarily to avoid stimuli that provoke negative affectivity (function 1) would report more symptoms of generalized anxiety and depression. The second hypothesis was that youth who endorsed refusing school primarily to escape from aversive social or evaluative situations (function 2) would report more symptoms of social anxiety. The third hypothesis was that youth who endorsed refusing school primarily due to attention-getting behavior (function 3) would report more symptoms of separation anxiety. The fourth hypothesis was that parents who reported that their child refused school primarily due to pursuit of tangible reinforcement outside of school (function 4) would report more symptoms of oppositional behavior. High scores on function 1 were associated with higher generalized anxiety and depression symptom scores. Similarly, high scores on function 2 predicted high scores on social anxiety symptoms, and high scores on function 3 predicted high scores on separation iii anxiety symptoms. Finally, parent report demonstrated that high scores on function 4 predicted high scores on oppositional behavior. These results provide important clinical implications regarding assessment and treatment of youth with school refusal behavior in community settings. iv ACKNOWLEDGEMENTS I would like to thank my committee chair, Dr. Chris Kearney, for his continued guidance, support, and patience throughout this process. I would also like to thank Drs. Donohue, Rennels, and Olafson, my committee members, for their valuable contributions to this project. I greatly appreciate the hard work and dedication of my fellow lab members, Gillian, Courtney, and Rachel. I am especially grateful to my parents, Daniel and Charlene, who have always pushed me to achieve my goals and never let me give up. Finally, thank you to my husband, Lance, for his unconditional love and support. I would like to dedicate this thesis to our daughter, Raelene, who has forever changed my life in just a few short months. v TABLE OF CONTENTS ABSTRACT ....................................................................................................................... iii ACKNOWLEDGMENTS ...................................................................................................v LIST OF TABLES ........................................................................................................... viii CHAPTER 1 INTRODUCTION .......................................................................................1 CHAPTER 2 LITERATURE REVIEW ............................................................................4 School Absenteeism .....................................................................................................4 Prevalence of Absenteeism.........................................................................................11 Characteristics of Absenteeism ..................................................................................13 Classification Systems: Historical, Diagnostic, Empirical, and Functional ...............17 Etiological Factors ......................................................................................................22 Assessment .................................................................................................................30 Treatment ....................................................................................................................35 Psychopathology.........................................................................................................48 Current Study..............................................................................................................63 CHAPTER 3 METHODOLOGY ....................................................................................67 Participants .................................................................................................................67 Youth Measures ..........................................................................................................67 Parent Measures..........................................................................................................70 Procedure ....................................................................................................................71 CHAPTER 4 DATA ANALYSIS ...................................................................................75 Overview ....................................................................................................................75 Multivariate Analysis of Variance..............................................................................77 Hypothesis One ..........................................................................................................77 Hypothesis Two ..........................................................................................................78 Hypothesis Three ........................................................................................................79 Hypothesis Four..........................................................................................................80 Post Hoc Analysis.......................................................................................................81 CHAPTER 5 DISCUSSION ............................................................................................82 Relationship to Previous Research .............................................................................84 Clinical Implications ..................................................................................................87 Limitations and Suggestions for Future Study ...........................................................89 TABLES ............................................................................................................................92 MEASURES ......................................................................................................................97 REFERENCES ................................................................................................................110 vi VITA ................................................................................................................................136 vii LIST OF TABLES Table 1 Key Definitions Related to Problematic School Absenteeism ............................92 Table 2 Function of School Refusal Behavior and Personalized Treatment ....................93 Table 3 Means and Standard Deviations for RCADS Subscales across Functions ..........94 Table 4 Means and Standard Deviations for RCADS Subscales with Functions 1 and 2 Combined .............................................................................................................95