Hostname: page-component-76fb5796d-zzh7m Total loading time: 0 Render date: 2024-04-25T22:55:42.578Z Has data issue: false hasContentIssue false

The Role of Cognition in School Refusal: An Investigation of Automatic Thoughts and Cognitive Errors

Published online by Cambridge University Press:  29 June 2011

Marija Maric*
Affiliation:
Leiden University Institute for Psychological Research, the Netherlands
David A. Heyne
Affiliation:
Leiden University Institute for Psychological Research, the Netherlands
Peter de Heus
Affiliation:
Leiden University Institute for Psychological Research, the Netherlands
Brigit M. van Widenfelt
Affiliation:
Leiden University Medical Center, the Netherlands
P. Michiel Westenberg
Affiliation:
Leiden University Institute for Psychological Research, the Netherlands
*
Reprint requests to Marija Maric, Department of Developmental Psychology, University of Amsterdam, Amsterdam, the Netherlands. E-mail: m.maric@uva.nl

Abstract

Aims: The purpose of this study was to investigate the cognitions of anxious school refusers. The cognitive constructs under investigation included negative cognition commonly linked to youth anxiety (i.e. negative automatic thoughts and cognitive errors) and positive automatic thoughts. Method: The cognition of school refusers (n = 50) and youth from a community sample (n = 181) was assessed with the Children's Automatic Thoughts Scale-Negative/Positive and the Children's Negative Cognitive Error Questionnaire-Revised. Results: When controlling for anxiety, school refusers were found to report more negative automatic thoughts concerning personal failure, fewer negative automatic thoughts concerning hostility, and fewer positive automatic thoughts. Negative automatic thoughts concerning personal failure and hostility, and the negative cognitive error of overgeneralizing were found to independently predict school refusal. Conclusions: The findings underscore the importance of further researching the role of cognition in the development, maintenance, and treatment of anxiety-based school refusal.

Type
Research Article
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alfano, C. A., Beidel, D. C. and Turner, S. M. (2006). Cognitive correlates of social phobia among children and adolescents. Journal of Abnormal Child Psychology, 34, 189201.CrossRefGoogle ScholarPubMed
American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington, DC: Author.Google Scholar
Anderson, J., King, N., Tonge, B., Rollings, S., Young, D. and Heyne, D. (1998). Cognitive-behavioral intervention for an adolescent school refuser: a comprehensive approach. Behavior Change, 15, 6773.CrossRefGoogle Scholar
Atkinson, L., Quarrington, B., Cyr, J. J. and Atkinson, F. V. (1989). Differential classification in school refusal. British Journal of Psychiatry, 155, 191195.CrossRefGoogle ScholarPubMed
Berg, I. (2002). School avoidance, school phobia, and truancy. In Lewis, M. (Ed.), Child and Adolescent Psychiatry: a comprehensive textbook (3rd ed.) (pp. 12601266). Sydney: Lippincott Williams and Wilkins.Google Scholar
Berg, I., Butler, A., Franklin, J., Hayes, H., Lucas, C. and Sims, R. (1993). DSM-III-R disorders, social factors and management of school attendance problems in the normal population. Journal of Child Psychology and Psychiatry, 34, 11871203.CrossRefGoogle ScholarPubMed
Berg, I. and Jackson, A. (1985). Teenage school refusers grow up: a follow-up study of 168 subjects, ten years on average after inpatient treatment. British Journal of Psychiatry, 147, 366370.CrossRefGoogle Scholar
Bernstein, G. A. (1991). Comorbidity and severity of anxiety and depressive disorders in a clinic sample. Journal of the American Academy of Child and Adolescent Psychiatry, 30, 4350.Google Scholar
Bernstein, G. A., Borchardt, C. M., Perwien, A. R., Crosby, R. D., Kushner, M. G., Thuras, P. D. and Last, C. G. (2000). Imipramine plus cognitive-behavioral therapy in the treatment of school refusal. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 276283.CrossRefGoogle ScholarPubMed
Bernstein, G. A., Massie, E. D., Thuras, P. D., Perwien, A. R., Borchardt, C. M. and Crosby, R. D. (1997). Somatic symptoms in anxious-depressed school refusers. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 661668.CrossRefGoogle ScholarPubMed
Bögels, S. M. and Zigterman, D. (2000). Dysfunctional cognitions in children with social phobia, separation anxiety disorder, and generalized anxiety disorder. Journal of Abnormal Child Psychology, 28, 205211.Google Scholar
Bools, C., Foster, J., Brown, I. and Berg, I. (1990). The identification of psychiatric disorders in children who fail to attend school: a cluster analysis of a non-clinical population. Psychological Medicine, 20, 171181.CrossRefGoogle Scholar
Buitelaar, J. K., van Andel, H., Duyx, J. H. M. and van Strien, D. C. (1994). Depressive and anxiety disorders in adolescence: a follow-up study of adolescents with school refusal. Acta Paedopsychiatrica, 56, 249253.Google Scholar
Creswell, C., Schniering, C. A. and Rapee, R. M. (2005). Threat interpretation in anxious children and their mothers: comparison with nonclinical children and the effects of treatment. Behaviour Research and Therapy, 43, 13751381.Google Scholar
Egger, H. L., Costello, E. J. and Angold, A. (2003). School refusal and psychiatric disorders: a community study. Journal of the American Academy of Child and Adolescent Psychiatry, 42, 797807.Google Scholar
Epkins, C. C. (1996). Cognitive specificity and affective confounding in social anxiety and dysphoria in children. Journal of Psychopathology and Behavioral Assessment, 18, 83101.CrossRefGoogle Scholar
Flakierska-Praquin, N., Lindström, M. and Gillberg, C. (1997). School phobia with separation anxiety disorder: a comparative 20- to 29-year follow-up study of 35 school refusers. Comprehensive Psychiatry, 38, 1722.Google Scholar
Hansen, C., Sanders, S. L., Massaro, S. and Last, C. G. (1998). Predictors of severity of absenteeism in children with anxiety-based school refusal. Journal of Clinical Child Psychology, 27, 246–254.Google ScholarPubMed
Heyne, D. (2006). School refusal. In Fisher, J. E. and O'Donohue, W. T. (Eds.), Practitioner's Guide to Evidence-Based Psychotherapy (pp. 599618). New York: Springer.Google Scholar
Heyne, D. and King, N. J. (2004). Treatment of school refusal. In Barrett, P. M. and Ollendick, T. H. (Eds.), Handbook of Interventions that Work with Children and Adolescents: prevention and treatment (pp. 243272). West Sussex: John Wiley and Sons.Google Scholar
Heyne, D., King, N., Tonge, B., Rollings, S., Pritchard, M., Young, D. and Myerson, N. (1998). The Self-Efficacy Questionnaire for School Situations: development and psychometric evaluation. Behaviour Change, 15, 3140.Google Scholar
Heyne, D., King, N. J., Tonge, B., Rollings, S., Young, D., Pritchard, M. and Ollendick, T. (2002). Evaluation of child therapy and caregiver training in the treatment of school refusal. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 687695.CrossRefGoogle ScholarPubMed
Heyne, D. and Rollings, S. (2002). School Refusal. Oxford: Blackwell Scientific Publications.Google ScholarPubMed
Heyne, D., Sauter, F. M., van Widenfelt, B. M., Vermeiren, R. and Westenberg, P. M. (in press). School refusal and anxiety in adolescence: non-randomized trial of a developmentally-sensitive cognitive behavioral therapy. Journal of Anxiety Disorders.Google Scholar
Hogendoorn, S. M., Wolters, L. H., Vervoort, L., Prins, P. J. M., Boer, F., Kooij, E. and de Haan, E. (2010). Measuring negative and positive thoughts in children: an adaptation of the Children's Automatic Thoughts Scale (CATS). Cognitive Therapy and Research, 34, 467478.Google Scholar
Honjo, S., Nishide, T., Niwa, S., Sasaki, Y., Kaneko, H., Inoko, K. and Nishide, Y. (2001). School refusal and depression with school inattendance in children and adolescents: comparative assessment between the children's depression inventory and somatic complaints. Psychiatry and Clinical Neurosciences, 55, 629634.Google Scholar
Hoshino, Y., Nikkuni, S., Kaneko, M., Endo, M., Yashima, Y. and Kumashiro, H. (1987). The application of DSM-III diagnostic criteria to school refusal. The Japanese Journal of Psychiatry and Neurology, 41, 17.Google Scholar
Jackson, L. (1964). Anxiety in adolescents in relation to school refusal. Journal of Child Psychology and Psychiatry, 5, 5973.CrossRefGoogle ScholarPubMed
Kearney, C. A. (2007). Forms and functions of school refusal behavior in youth: an empirical analysis of absenteeism severity. Journal of Child Psychology and Psychiatry, 48, 5361.CrossRefGoogle ScholarPubMed
Kearney, C. A. and Albano, A. M. (2007). When Children Refuse School: a cognitive-behavioral therapy approach/therapist's guide (2nd ed.). New York: Oxford University Press.Google Scholar
Kendall, P. C. and Chansky, T. E. (1991). Considering cognition in anxiety-disordered children. Journal of Anxiety Disorders, 5, 167185.Google Scholar
Kendall, P. C. and Korgeski, G. P. (1979). Assessment and cognitive-behavioral interventions. Cognitive Therapy and Research, 3, 121.Google Scholar
Kendall, P. C. and Treadwell, K. R. H. (2007). The role of self-statements as a mediator in treatment for youth with anxiety disorders. Journal of Consulting and Clinical Psychology, 75, 380389.CrossRefGoogle ScholarPubMed
Kennard, B. D., Ginsburg, G. S., Feeny, N. C., Sweeney, M. and Zagurski, R. (2005). Implementation challenges to TADS cognitive-behavioral therapy. Cognitive and Behavioral Practice, 12, 230239.Google Scholar
King, N. J., Tonge, B. J., Heyne, D. and Ollendick, T. H. (2000). Research on the cognitive-behavioral treatment of school refusal: a review and recommendations. Clinical Psychology Review, 20, 495507.CrossRefGoogle Scholar
Kort, W., Schittekatte, M., Dekker, P. H., Verhaeghe, P., Compaan, E. L., Bosmans, M. and Vermeir, G. (2005). WISC-III-NL Wechsler Intelligence Scale for Children. David Wechsler. Derde Editie NL. Handleiding en Verantwoording. Amsterdam: Harcourt Test Publishers. Amsterdam: NIP Dienstencentrum.Google Scholar
Last, C. G. and Strauss, C. C. (1990). School refusal in anxiety-disordered children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 3135.CrossRefGoogle ScholarPubMed
Leitenberg, H., Yost, L. W. and Carroll-Wilson, M. (1986). Negative cognitive errors in children: questionnaire development, normative data, and comparisons between children with and without self-reported symptoms of depression, low self-esteem, and evaluation anxiety. Journal of Consulting and Clinical Psychology, 54, 528536.Google Scholar
MacShane, G., Walter, G. and Rey, J. M. (2001). Characteristics of adolescents with school refusal. Australian and New Zealand Journal of Psychiatry, 35, 822826.Google Scholar
Mansdorf, I. J. and Lukens, E. (1987). Cognitive-behavioral psychotherapy for separation anxious children exhibiting school phobia. Journal of the American Academy of Child and Adolescent Psychiatry, 26, 222225.Google Scholar
March, J. S., Parker, J. D. A., Sullivan, K., Stallings, P. and Conners, K. (1997). The Multidimensional Anxiety Scale for Children (MASC): factor structure, reliability, and validity. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 554565.Google Scholar
Maric, M., Heyne, D. A., van Widenfelt, B. M. and Westenberg, P. M. (2011). Distorted cognitive processing in youth: the structure of negative cognitive errors and their associations with anxiety. Cognitive Therapy and Research, 35, 1120.CrossRefGoogle ScholarPubMed
McCune, N. and Hynes, J. (2005). Ten year follow-up of children with school refusal. Irish Journal of Psychological Medicine, 22, 5658.Google Scholar
Menard, S. W. (2009). Logistic Regression: from Introductory to Advanced Concepts and Applications. Los Angeles: SAGE.Google Scholar
Micco, J. A. and Ehrenreich, J. T. (2009). Validity and specificity of the children's automatic thoughts scale in clinically anxious and non-clinical children. Cognitive Therapy and Research, 33, 532536.Google Scholar
Miers, A. C., Blöte, A. W., Bögels, S. M. and Westenberg, P. M. (2008). Interpretation bias and social anxiety in adolescents. Journal of Anxiety Disorders, 22, 14621471.Google Scholar
Muris, P., Gadet, B., Moulaert, V. and Merckelbach, H. (1998). Correlations between two multidimensional anxiety scales for children. Perceptual and Motor Skills, 87, 269270.CrossRefGoogle ScholarPubMed
Muris, P., Merckelbach, H. and Luitjen, M. (2002). The connection between cognitive development and specific fears and worries in normal children and children with below-average intellectual abilities: a preliminary study. Behaviour Research and Therapy, 40, 3756.Google Scholar
Ollendick, T. H. and King, N. J. (1990). School phobia and separation anxiety. In Leitenberg, H. (Ed.), Handbook of Social and Evaluation Anxiety (pp. 179214). New York: Plenum Press.Google Scholar
Place, M., Hulsmeier, J., Davis, S. and Taylor, E. (2000). School refusal: a changing problem which requires a change of approach? Clinical Child Psychology and Psychiatry, 5, 345355.Google Scholar
Place, M., Hulsmeier, J., Davis, S. and Taylor, E. (2002). The coping mechanisms of children with school refusal. Journal of Research in Special Educational Needs, 2, doi:10.1111/j.1471-3802.2002.00167.xGoogle Scholar
Rynn, M. A., Barber, J. P., Khalid-Khan, S., Siqueland, L., Dembiski, M., McCarthy, K. S. and Gallop, R. (2006). The psychometric properties of the MASC in a pediatric psychiatric sample. Journal of Anxiety Disorders, 20, 139157.Google Scholar
Schniering, C. A. and Rapee, R. M. (2002). Development and validation of a measure of children's automatic thoughts: the Children's Automatic Thoughts Scale. Behaviour Research and Therapy, 40, 10911109.CrossRefGoogle ScholarPubMed
Schniering, C. A. and Rapee, R. M. (2004). The relationship between automatic thoughts and negative emotions in children and adolescents: a test of the cognitive content-specificity hypothesis. Journal of Abnormal Psychology, 113, 464470.CrossRefGoogle ScholarPubMed
Seligman, M. E. P. (1991). Learned Optimism: how to change your mind and your life. New York: Knopf.Google Scholar
Silverman, W. K. and Albano, A. M. (1996). Anxiety Disorders Interview Schedule for DSM-IV, Child and Parent Versions. San Antonia, TX: Psychological Corporation.Google Scholar
Silverman, W. K., Kurtines, W. M., Ginsburg, G. S., Weems, C. F., Rabian, B. and Serafini, L. T. (1999). Contingency management, self-control, and education support in the treatment of childhood phobic disorders: a randomized clinical trial. Journal of Consulting and Clinical Psychology, 67, 675687.Google Scholar
Treadwell, K. R. H. and Kendall, P. C. (1996). Self-talk in youth with anxiety disorders: states of mind, content specificity, and treatment outcome. Journal of Consulting and Clinical Psychology, 64, 941950.Google Scholar
Weems, C. F., Berman, S. L., Silverman, W. K. and Saavedra, L. M. (2001). Cognitive errors in youth with anxiety disorders: the linkages between negative cognitive errors and anxious symptoms. Cognitive Therapy and Research, 25, 559575.Google Scholar
Weems, C. F., Costa, N. M., Watts, S. E., Taylor, L. K. and Cannon, M. F. (2007). Cognitive errors, anxiety sensitivity, and anxiety control beliefs: their unique and specific associations with childhood anxiety symptoms. Behavior Modification, 31, 174201.Google Scholar
Submit a response

Comments

No Comments have been published for this article.