Abnormal Inhibitory Control Ability Of Adolescents With School Refusal Behavior: Behavioral Characteristics And Intervention Study Of Solution-focused Brief Therapy

School refusal behavior（SRB）is defined as student-motivated refusal to attend school and/or difficulties remaining in class for an entire day.No previous studies have involved impairments in core functioning in students with SRB.Inhibitory control,a core component of executive function,predicts adolescents’academic performance and future career achievement and may play an important role in the development of SRB.In addition,solution-focused brief therapy（SFBT）has been shown to have good effects in school practice and to be useful in addressing study-weariness.However,there were no studies directly examining the efficacy of SFBT interventions for SRB students in hospital settings.Therefore,the present study examined emotional difficulties and abnormal inhibitory control ability of SRB students through scales and experiments,respectively,and investigated the effects of hospital SFBT interventions on the above problems in SRB students.Research 1 examined the emotional difficulties of SRB students.Participants included 88 SRB students and 87 typically school attendance（TSA）students.Three scales were used,including Positive Affect and Negative Affect Schedule（PANAS）,Attention to Positive and Negative Inventory（APNI）,and State-Trait Anxiety Inventory（STAI）.The results showed that SRB students had significantly lower positive affect（PA）and attention to positive information（API）than TSA students,as well as significantly higher negative affect（NA）,attention to negative information（ANI）,trait and state anxiety than TSA students.Research 2 examined inhibitory control abnormalities in SRB students.Participants included 55 SRB and 55 TSA students.Cool and hot inhibitory control abilities were examined by Color-word Stroop task（hereafter referred to as cool Stroop task）and Stroop emotion recognition under word interference task（SERWIT,hereafter referred to as hot Stroop task）,respectively.The lexical materials were replaced with school-related and unrelated words in hot Stroop task.The results revealed that SRB students’cool and hot inhibitory control abilities were both impaired.Specifically,on the cool Stroop task,SRB students had significantly higher reaction times（RTs）to incongruous stimulus than TSA students,and significantly higher interference and inhibition effect on RTs effect values than TSA students.On the hot Stroop task,SRB students had significantly higher RTs to school-related incongruous stimulus than TSA students,as well as higher total and school-related interference effects for the RTs effect values.Index of school refusal（school-related interference effect minus school-unrelated interference effect）was also significantly higher for SRB students than for TSA students.Research 3 was a non-randomized controlled trial with 39 SRB participants,21of whom received solution-focused approach intervention（SFBT group）and 18 of whom received other psychotherapy interventions（hereafter referred to as active control group,AC group）.All participants were measured at baseline（T0）,after the3^rd（T3）,the 6^th（T6）,and the 10^th（T10）intervention.The results showed that SFBT in hospital setting increased PA and decreased ANI.Meanwhile,SFBT significantly reduced the total interference effect,the school-related interference effect and the index of school refusal between T3 to T6,and was effective in improving hot inhibitory control ability in students with SRB.Combining the three researches,SRB students had significant emotional difficulties and impaired inhibitory control,SFBT in hospital setting was effective in reducing their emotional problems and enhancing hot inhibitory control ability.The present study provided experimental evidence to understand the emotional characteristics and core functional impairment of SRB students,and provided empirical evidence for SFBT to effectively intervene adolescents with study-weariness,which has important theoretical as well as practical implications.