Preliminary Study On The Mentalization Ability And Attachment Model Of School Refusal Adolescents

Objective:People live with greatly stress in modern life,the psychological problems of adolescents have been widely concerned.Schools are important places for young people to live,and school refusal has become one of the most serious psychological problems of adolescents.Our study initially explores the characteristics of mentalization and attachment of adolescents who refuse to go to school;the relationship between mentalization and attachment as well as the main influencing factors,so as to provide a scientific basis for prevention and treatment of school refusal behavior.Methods:The study was conducted between October 2018 and October 2019 at the Psychiatry department of the ShengJing Hospital of China Medical University.There are 79 patients were enrolled.General information registration?Reflective Functioning Questionnaire(RFQ)?Toronto Alexithymia Scale(TAS)?Interpersonal Reactivity Index(IRI)?Child's self-concept Scale(PHCSCS)and Experiences in Close Relationships(ECR)were using to evacuate.The data was analysed with the software package SPSS22.0.Results:1.Of the 90 patients enrolled,79 patients met the entry criteria(39 males and40 females),with a gender ratio of 0.975:1.There was no significant gender difference.2.Comparing the case study groups with the control groups,the score of RFQ?TAS(including its factors:difficult to identify emotions,difficult to describe emotions,extroverted thinking)?Perspective Taking factor and Personal Distress factor of IRI?PHCSCS(including its six factors:behavior,intelligence and school condition,body and appearance,anxiety,gregariousness,happiness and satisfaction)?ECR(including its two dimensions:avoidance and anxiety)have a significant difference.3.Most of the scales and factors of mentalization in the case group were significantly correlated with attachment avoidance dimension,and some of them were significantly correlated with attachment anxiety dimension(P < 0.05 or P < 0.01).The attachment of parents and children were significantly correlated(P < 0.01).4.The protective factors to school refusal contain reflective function and self-consciousness of adolescents(OR=0.107-0.958);The risk factors to school refusal containalexithymia and insecure attachment of adolescents(OR=0.757-43.198).Conclusion:1.Adolescents with school refusal behavior usually have poor mentalization,and their attachment mode is usually insecure.2.There is a close relationship between the mentalization and their attachment in school refusal adolescents.3.Adolescents' mentalization and attachment mode are influencing factors to school refusal.Reflective function and self-consciousness of adolescents are protective factors;alexithymia and insecure attachment of adolescents are risk factors.