Profiles derived from the School Refusal Assessment Scale-Revised and its relationship to anxiety

Anxiety is a common mental health factor associated with school refusal behaviour. This study aims to identify different school refusal behaviour profiles and to determine whether or not these profiles differ from each other based on three anxiety dimensions (Anticipatory Anxiety, School-based performance anxiety and Generalized Anxiety). Participants were Spanish children (N = 1113; 52.3% male) aged 8-11 years (M = 9.53; SD = 1.10). The School Refusal Assessment Scale-Revised (SRAS-R) and the Visual Analogue Scale for Anxiety-Revised (VAA-R) were administered. Cluster analysis revealed four school refusal behaviour profiles: Non-School refusal, School Refusal by Positive Reinforcement, School Refusal by Negative Reinforcement, and School Refusal by Mixed Reinforcement. The Mixed Reinforcement group was the most maladaptive profile since it obtained the highest mean scores on the three dimensions and the total score of the VAA-R. In contrast, Non-School Refusal and Positive Reinforcement groups revealed the lowest scores in all of the anxiety dimensions. Our findings underscore the idea certain school refusal behaviour profiles have a higher risk of presenting anxious symptoms. In these cases, the control of anxiety may be an important goal of preventive interventions.