Exploring the roles of anxiety, sleep and sense of belonging in school attendance and school refusal behaviour

Abstract

Reductions in school refusal behaviour (SRB), defined as a general difficulty with attending or remaining in school, have been a longstanding strategic priority for schools, local authorities and central government. Research into risk factors associated with SRB is vital for the development of effective assessment and intervention practices to address the problem. A systematic literature review, embedded within a theoretical framework of risk and resilience, was conducted to appraise the research evidence into anxiety as a risk factor for SRB. Twenty-one studies were reviewed, spanning the past three decades. Support was gained for anxiety as a significant risk factor for SRB in some cases, but not as an overall or central explanation for the problem. The need was highlighted in future research for collective commitment towards addressing a range of terminological, methodological and reporting issues in order to improve comparability between studies, and increase the generalisability of findings. The incorporation of physiological measures of anxiety in conjunction with self-report measures was proposed as a potentially fruitful extension for future investigations.

The empirical paper presented a pilot study which extended previous research comparing anxious high-attenders with anxious low-attenders. The sample comprised 13 girls in Year 8 (n=9) and Year 9 (n=4) attending an average-sized mainstream secondary school, who reported elevated anxiety. The girls were grouped by attendance: high (n=7, M=99.7%, SD=0.63) and low (n=6, M=92.2%, SD=1.58). Physiological measures of psychological stress (i.e. heart rate variability: HRV) and sleep, assessed using electrocardiogram and wrist actigraphy respectively, were incorporated within an exploration of anxiety, sleep and sense of belonging as factors that may differentiate between the two groups. The groups did not differ on sense of belonging or any indices of psychopathology by self-report, nor on any physiological measures of sleep or psychological stress at the beginning of the week. However, the high attendance group showed non-significant trends towards poorer sleep quality and lower HRV, at the end of the week. The findings tentatively challenge the assumption that anxious students who sustain high attendance in school are demonstrating psychological resilience. Implications for Educational Psychology practice and future research are discussed.

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