The Relationship Between Emotion Regulation Difficulties and Comorbid Mental Disorders in Children and Adolescents with School Refusal Behavior

ObjectiveWe aimed to examine the comorbid mental disorders observed in children and adolescents with school refusal behavior (SRB), as well as the role of these disorders in their emotion regulation difficulties.Method95 healthy controls (HC) and 96 individuals with SRB were included. Revised Child Anxiety and Depression Scale (RCADS), School Refusal Assessment Scale-Revised (SRAS-R), Swanson, Nolan, and Pelham Teacher and Parent Rating Scale (SNAP-4), Difficulties in Emotion Regulation Scale (DERS), Strengths and Difficulties Questionnaire (SDQ), and Clinical Global Impression-severity subscale (CGI) were implemented to assess the comorbid psychopathologies and symptom severities.ResultsHC and individuals with SRB were matched on demographic variables. Total and subscores of all scales and symptom severities were significantly different between the groups. There were significant correlations between impulsivity subscore of DERS and hyperactivity/inattention,-emotional problems,-prosocial behaviour subscores of SDQ. Impulsivity subscore of the DERS was also correlated with SRAS total score.ConclusionOur findings indicated that individuals with SRB had more emotion regulation difficulties, anxiety symptoms and behavioural problems, also, impulsivity plays an important role on attention/hyperactivity, emotional problems, prosocial behaviour, and severity of SR in individuals with SR. Further longitudinal studies investigating the role of impulsivity in SR are needed.