Abstract
Objective
School Phobia (SP), although is not a formal psychiatric diagnosis, is widely prevalent debilitating phenomenon with a gamut of underlying psychiatric conditions in an overwhelming majority of cases. This study documents the prevalence, symptom presentation and the relationship between the various subtypes of Anxiety Disorders (AD) and School Phobia.
Methods
In a prospective community survey of 500 adolescents, independent raters administered the Screen for Child Anxiety Related Emotional Disorders and Schedule for Affective Disorders and Schizophrenia for School-Age Children/Present and Lifetime to identify SP and subtype of AD respectively. Descriptive statistics for the prevalence and symptom presentation, Spearman’s Correlation test, Independent t tests, on-way ANOVA and Chi-square tests were done to compare the prevalence and severity of School Phobia among various age groups and gender. Univariate and multivariate analyses were done for documenting the relationship between the School Phobia and Anxiety Disorders.
Results
School Phobia was noted in 4.8 % of adolescents. Although age was related to SP, gender, school grade the adolescent was attending and family structure were not related to SP. Somatic symptoms were more often noted than cognitive-emotional symptoms among adolescents with SP. Panic Disorder (OR = 8.62), Social Anxiety Disorder (OR = 8.63), and Separation Anxiety Disorder (OR = 6.26), were significantly related to SP.
Conclusions
School Phobia is noted in a significant proportion of adolescents in the community. Anxiety Disorder is a major underlying factor resulting in SP. Community and clinical intervention and service models should include anxiety alleviation methods in adolescents with School Phobia.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Kearney CA. School absenteeism and school refusal behavior in youth: A contemporary review. Clin Psychol Rev. 2008;28:451–71.
Policy Watch: Right of Children to Free and Compulsory education Bill, 2008. http://www.indlaw.com/display.aspx?4438. Accessed on 6th November 2011.
Burke AE, Silverman WK. The prescriptive treatment of school refusal. Clin Psychol Rev. 1987;7:353–62.
Elliott JG. School refusal: Issues of conceptualisation, assessment and treatment. J Child Psychol Psychiatry. 1999;40:1001–12.
King NJ, Bernstein GA. School refusal in children and adolescents: A review of the past 10 years. J Am Acad Child Adolesc Psychiatry. 2001;40:197–205.
Heyne D, King NJ, Tonge BJ, Cooper H. School refusal: Epidemiology and management. Paediatr Drugs. 2001;3:719–32.
Bernstein GA, Massie ED, Thuras PD, Perwien AR, Borchardt CM, Crosby RD. Somatic symptoms in anxious-depressed school refusers. J Am Acad Child Adolesc Psychiatry. 1997;36:661–8.
Last CG, Strauss CC. School refusal in anxiety-disordered children and adolescents. J Am Acad Child Adolesc Psychiatry. 1990;29:31–5.
McShane G, Walter G, Rey JM. Characteristics of adolescents with school refusal. Aust N Z J Psychiatry. 2001;35:822–6.
Prabhuswamy M, Srinath S, Girimaji S, Seshadri S. Outcome of children with school refusal. Indian J Pediatr. 2007;74:375–9.
Russell PS, Nair MKC. ADad 1: Rationale and study design for anxiety disorders among adolescents in a rural community population in India. Indian J Pediatr. 2013; doi:10.1007/s12098-013-1206-5.
Birmaher B, Brent DA, Chiappetta L, Bridge J, Monga S, Baugher M. Psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED): A replication study. J Am Acad Child Adolesc Psychiatry. 1999;38:1230–6.
Canino IA, Gould MS, Prupis S, Shaffer D. A comparison of symptoms and diagnoses in Hispanic and black children in an outpatient mental health clinic. J Am Acad Child Psychiatry. 1986;25:254–9.
Kearney CA. School refusal behavior in youth: A functional approach to assessment and treatment. Washington, DC: American Psychological Association; 2001.
Kearney CA, Albano AM. The functional profiles of school refusal behavior. Diagnostic aspects Behav Modif. 2004;28:147–61.
Ollendick TH, Mayer JA. School phobia. In: Turner SM, ed. Behavioral Theories and Treatment of Anxiety. New York: Plenum Press; 1984. pp. 367–406.
Kearney CA, Silverman WK. Family environment of youngsters with school refusal behavior: A synopsis with implications for assessment and treatment. Am J Fam Ther. 1995;23:59–72.
Rao D, Young M, Raguram R. Culture, somatization, and psychological distress: Symptom presentation in South Indian patients from a public psychiatric hospital. Psychopathology. 2007;40:349–55.
Hersov L. School refusal. In: Rutter M, Hersov L, eds. Child Psychiatry: Modern Approaches. Oxford: Blackwell; 1977.
Fremont WP. School refusal in children and adolescents. Am Fam Physician. 2003;68:1555–60.
Kearney CA. Dealing with school refusal behavior: A primer for family physicians. J Fam Pract. 2006;55:685–92.
Conflict of Interest
None.
Role of Funding Source
Supported by an intramural grant from Child Development Centre, Thiruvanathapuram.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Nair, M.K.C., Russell, P.S.S., Subramaniam, V.S. et al. ADad 8: School Phobia and Anxiety Disorders Among Adolescents in a Rural Community Population in India. Indian J Pediatr 80 (Suppl 2), 171–174 (2013). https://doi.org/10.1007/s12098-013-1208-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12098-013-1208-3