The British Journal of Psychiatry 155: 191-195 (1989)
© 1989 The Royal College of Psychiatrists
Differential classification in school refusal
L Atkinson, B Quarrington, JJ Cyr and FV Atkinson
Early Intervention and Developmental Evaluation Services, Surrey Place Centre, Toronto, Ontario, Canada.
It has been argued that school refusal may not be a unitary syndrome, but a
common presenting symptom founded on differing underlying dynamics. The
paper explores this hypothesis empirically. The clinical files of 100
refusers were scored for several variables which could potentially
differentiate between school refusal subtypes, and for several commonly
accepted beliefs about school refusal. The data were subjected to a variety
of analyses, culminating in cluster analysis. Cluster (C) 1 consisted of
children who feared separation from dependent, overprotective mothers. C2
youngsters were perfectionistic and depressed. They dominated mothers who
had been deprived in childhood. C3 consisted of extensively disturbed
children from multiproblem families, who had suffered early separation or
loss, and who were fearful and depressed.