The current study examined the relationship between functions of school refusal behavior and internalizing and externalizing symptom sets in a community sample of 200 youth and parents recruited from two truancy settings. The first hypothesis was that youth who endorsed refusing school primarily to avoid stimuli that provoke negative affectivity (function 1) would report more symptoms of generalized anxiety and depression. The second hypothesis was that youth who endorsed refusing school primarily to escape from aversive social or evaluative situations (function 2) would report more symptoms of social anxiety. The third hypothesis was that youth who endorsed refusing school primarily due to attention-getting behavior (function 3) would report more symptoms of separation anxiety. The fourth hypothesis was that parents who reported that their child refused school primarily due to pursuit of tangible reinforcement outside of school (function 4) would report more symptoms of oppositional behavior. High scores on function 1 were associated with higher generalized anxiety and depression symptom scores. Similarly, high scores on function 2 predicted high scores on social anxiety symptoms, and high scores on function 3 predicted high scores on separation iv anxiety symptoms. Finally, parent report demonstrated that high scores on function 4 predicted high scores on oppositional behavior. These results provide important clinical implications regarding assessment and treatment of youth with school refusal behavior in community settings
