嚴重社交退縮對學生長期不到校之影響分析調查

The Impact of Severe Social Withdrawal on Prolonged School Non-attendance

蔣立德(Li-Te Chiang) ； 林亮吟(Liang-Yin Lin) ； 廖芳玫(Fang-Mei Liao)

《北市醫學雜誌》 12卷3期 (2015/09) Pp. 34-41

https://doi.org/10.6200/TCMJ.2015.12.3.05

摘要

目的：調查長期不到校（School Non-Attendance, SNA）合併嚴重社交退縮的孩子，在不同年齡層的差異，並統計分析各族群的盛行率與變化趨勢。方法：將設計的問卷寄到台北市高中職以下學校，回收後依社交退縮與否將個案分成兩組，並分別對兩組個案的就醫情況，年齡分布分析。結果：具有社交退縮的個案，比未明顯有社交退縮的個案，較早出現不規則上學的問題，接受精神醫療的時間也較早。拒學的盛行率在國中後明顯升高。大部分個案並未接受精神科的服務；其中以焦慮或憂鬱的診斷比例最高。結論：SNA的個案中有社交退縮問題的比例高，對這群個案的心理應該要積極介入。

關鍵字

拒學 ； 社交退縮 ； 社交畏懼 ； 焦慮症 ； 憂鬱症

並列摘要

Objective: The purpose of this research was to investigate the prevalence of prolonged school non-attendance (SNA) with severe social withdrawal behaviors (SW) among children in three educational stages after 3 months of school entry in Taipei City. Methods: Designed questionnaires were sent to all elementary, junior high, senior high and vocational schools of Taipei City. Those with prolonged SNA and stayed mainly at home with no following conditions were defined as cases with SW: (1) no activity outside school with friends; (2) not engaging internet interaction with friends but only internet games; (3) not having any part-time or full-time jobs, and (4) not attending any cram school. Results: Among 353450 students registered in Taipei City in 2011, 334 students were identified as SNA and 277 (82.93%) of them having problems of school refusal. The estimated prevalence of SNA was around 1/1,000 and school refusal was 0.095%. SW group showed significantly earlier onset of difficulty in attending school regularly and they received psychiatric service at a younger age. The prevalence of school refusal increased along with age with highest manifestation after grade 7. The problem did not fade with time and only 29.24% of the school refusal students had psychiatric referral. Anxiety and depressive disorder were the most frequent diagnoses. Conclusions: SW problems can be easily identified by applying screening questionnaire among SNA cases. The results indicated a substantial number of SW students hidden among the SNA students, and these students need more active mental health intervention.

並列關鍵字

school refusal ； social withdrawal ； social phobia ； anxiety disorder ； depressive disorder