Psychometric properties of the Chinese version of the school refusal assessment scale-revised in a clinical sample of adolescents and their caregivers with depressive disorders.

内容摘要

School refusal behavior (SRB) is a prevalent and functionally heterogeneous problem among children and adolescents that can lead to serious academic, social, and psychological consequences. The School Refusal Assessment Scale-Revised (SRAS-R) is the most widely used instrument for identifying the functional motivations underlying school refusal, yet its psychometric properties have not been examined in Chinese clinical populations. The present study aimed to translate and culturally adapt the SRAS-R into Chinese and to evaluate its psychometric properties in a clinical sample of adolescents with depressive disorders. A total of 171 adolescent outpatients (age range 12-19 years; M&#xa0;=&#xa0;15.5, SD =&#xa0;1.90; 67.3% female) diagnosed with DSM-5 depressive disorders and meeting criteria for school refusal behavior completed both child and parent versions of the Chinese SRAS-R. Confirmatory factor analysis (CFA) using diagonally weighted least squares estimation was conducted. After removing Items 20 and 24, the four-factor model yielded strong CFI and RMSEA values for both parent (CFI&#xa0;=&#xa0;0.99, RMSEA&#xa0;=&#xa0;0.021, SRMR&#xa0;=&#xa0;0.094) and child reports (CFI&#xa0;=&#xa0;0.98, RMSEA&#xa0;=&#xa0;0.028, SRMR&#xa0;=&#xa0;0.097), although SRMR values were marginally above the prespecified threshold. Internal consistency reliability ranged from marginal to good across subscales (Cronbach's &#x3b1;: parent = 0.664-0.815; child = 0.700-0.864), with parent-reported Factor 4 showing the weakest reliability. Factor 1 (avoidance of aversive school situations) obtained the highest mean scores for both informants, consistent with the depression-related negative affectivity characteristic of this clinical sample. Cross-informant discrepancy analyses revealed&#xa0;that children reported significantly higher scores than parents on Factor 2 (escape from social/evaluative situations; p = .017, d =&#xa0;0.18) and Factor 4 (pursuit of tangible reinforcement; p <.001, d =&#xa0;0.27), suggesting that parents may underestimate internally driven motivations. Intraclass correlation coefficients indicated fair to good parent-child agreement (ICC&#xa0;=&#xa0;0.45-0.62), with the highest agreement for Factor 1 and the lowest for Factor 4. The findings provide initial internal-structure and reliability evidence for the Chinese SRAS-R in this single-site clinical sample and underscore the need for multi-informant assessment, while future studies should examine convergent, discriminant, criterion-related, and predictive validity in more diverse samples.