Knollmann Martin, Reissner Volker, Kiessling Susanne, Hebebrand Johannes
Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, LVR-Klinikum Essen, Kliniken und Institut der Universität Duisburg-Essen.
Z Kinder Jugendpsychiatr Psychother. 2013 Sep;41(5):335-45. doi: 10.1024/1422-4917//a000248.
We investigated subtypes of school-avoiding children and adolescents in a German sample using cluster analysis.
169 outpatients of a specialized outpatient unit for children and adolescents with school-avoiding behavior were subjected to cluster analysis using factor scores (principal factoring, varimax-rotation: measures of internalizing and externalizing symptoms, e.g., CBCL, YSR, and variables indicating the quality of school avoiding behavior, such as initial parental knowledge of school absence, activities during school absence). The resulting clusters were compared to other variables such as parental mental health problems, parental divorce, bullying in school, class repetition, and IQ.
Three groups were identified: "school refusers" with low externalizing symptoms who mainly stayed at home with their parents and were informed about their school absence from the beginning. Second, the "truants" with strong externalizing symptoms who spent school time alone or together with peers outside their home and were absent in school without initial parental knowledge. In a third cluster, children showed more externalizing problems than the school refusers and less externalizing problems than the truants. Most of their parents were informed about the school absence from the beginning, although the dominant activity was staying at home alone. Internalizing symptoms had no impact on cluster formation. Comparisons of the three groups, however, showed higher internalizing problems for school refusers and the third cluster, which was then labeled "school avoidance with mixed symptoms."
In most cases, significant differences regarding potential stressors at home (e.g., parental mental health problems) or in school (e.g., bullying, class repetition) were not obtained.
我们在一个德国样本中使用聚类分析研究了逃避上学的儿童和青少年的亚型。
对169名有逃避上学行为的儿童和青少年专科门诊的门诊患者进行聚类分析，使用因子得分（主因子分析，方差最大化旋转：内化和外化症状的测量，如儿童行为检查表、青少年自我报告表，以及表明逃避上学行为质量的变量，如家长对孩子缺课的初始知晓情况、缺课期间的活动）。将所得聚类与其他变量进行比较，如父母的心理健康问题、父母离婚、学校欺凌、留级和智商。
识别出三组：“学校拒绝者”，外化症状低，主要与父母待在家里，从一开始就被告知缺课情况。第二组是“逃学者”，外化症状强烈，在上学时间独自或与同龄人在户外，缺课时父母一开始并不知晓。在第三组中，儿童的外化问题比学校拒绝者多，比逃学者少。他们的大多数父母从一开始就被告知缺课情况，尽管主要活动是独自待在家里。内化症状对聚类形成没有影响。然而，三组之间的比较显示，学校拒绝者和第三组（随后被标记为“混合症状的逃避上学”）的内化问题更高。
在大多数情况下，未发现家庭（如父母心理健康问题）或学校（如欺凌、留级）潜在压力源方面的显著差异。
