Clinical Mental Health Department, The First Hospital of Hebei Medical University, Hebei, China.
The Key Laboratory of Brain Sciences and Psychology, Hebei, China.
Front Public Health. 2024 Aug 6;12:1450935. doi: 10.3389/fpubh.2024.1450935. eCollection 2024.
Recent years have seen an increase in school refusal behavior among adolescents, potentially due to factors like excessive short-form video viewing, bullying, and school anxiety. Limited research has investigated how these factors contribute to school refusal behavior. This study used random forest regression, path analysis, and network analysis to identify key variables and pathways leading to school refusal behavior.
In this cross-sectional questionnaire-based study, 2,056 (996 male, 1,060 female, mean age: 14.79 ± 1.24 years) middle and senior high school students were asked to complete the School Refusal Behavior Assessment questionnaire to assess school refusal behavior features, the Excessive Short-Form Video Viewing Scale as well as self-reported viewing times during leisure days to assess excessive short-form video viewing, the SNAP-IV Rating Scale to assess the severity of inattention symptoms, and the self-administered questionnaires to assess experiences of being bullied and school anxiety.
The prevalence of school refusal behavior in the surveyed adolescents was found to be 31.9% [95% confidence interval (CI): 29.8-33.9%]. In terms of significance, the severity of inattention symptoms exhibited the greatest predictive power, while excessive short-form video viewing accounted for the most variance. Path analysis revealed that excessive short-form video viewing not only directly affects school refusal behavior features but also does so indirectly through severity of inattention symptoms and school anxiety. Key bridge factors in this pathway include intense fear and anxiety associated with school attendance, manifesting as somatic symptoms and avoidance behaviors.
The findings indicate that not only does excessive short-form video viewing directly influence school refusal behavior features in adolescents, but it also indirectly impacts these features through mechanisms involving severity of inattention symptoms and school anxiety. The bridge factors highlight potential targets for interventions among the SRB features and predictors.
近年来，青少年的学校拒绝行为有所增加，这可能是由于过度观看短视频、遭受欺凌和学校焦虑等因素所致。目前，很少有研究探讨这些因素如何导致学校拒绝行为。本研究采用随机森林回归、路径分析和网络分析来确定导致学校拒绝行为的关键变量和途径。
这是一项基于横断面问卷调查的研究，共纳入 2056 名（996 名男性，1060 名女性；平均年龄 14.79 ± 1.24 岁）中学生和高中生，要求他们完成学校拒绝行为评估问卷，以评估学校拒绝行为特征；过度观看短视频量表和自我报告的休闲日观看时间，以评估过度观看短视频；SNAP-IV 评定量表，以评估注意力不集中症状的严重程度；以及自我管理的问卷，以评估被欺凌和学校焦虑的经历。
调查青少年的学校拒绝行为发生率为 31.9%（95%置信区间：29.8%-33.9%）。就显著性而言，注意力不集中症状的严重程度表现出最大的预测能力，而过度观看短视频则占最大的方差。路径分析显示，过度观看短视频不仅直接影响学校拒绝行为特征，而且通过注意力不集中症状和学校焦虑的严重程度间接影响这些特征。该途径中的关键桥梁因素包括与上学相关的强烈恐惧和焦虑，表现为躯体症状和回避行为。
研究结果表明，过度观看短视频不仅直接影响青少年的学校拒绝行为特征，而且通过涉及注意力不集中症状和学校焦虑严重程度的机制间接影响这些特征。桥梁因素突出了学校拒绝行为特征和预测因素的潜在干预目标。
