{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T09:04:02Z","timestamp":1785488642665,"version":"3.56.0"},"reference-count":89,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"European Union\u2014Next Generation EU\u2014PNRR M6C2\u2014Investment 2.1 \u201cEnhancement and strengthening of biomedical research in the NHS\u201d","award":["PNRR-MAD-2022-12376834"],"award-info":[{"award-number":["PNRR-MAD-2022-12376834"]}]},{"award":["PNRR-MAD-2022-12376834"],"award-info":[{"award-number":["PNRR-MAD-2022-12376834"]}],"id":[{"id":"https:\/\/ror.org\/019w4f821","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Problematic school attendance in adolescence is a heterogeneous phenomenon with academic, emotional, and developmental consequences. Although relational factors are increasingly recognised, the literature remains conceptually fragmented, with overlapping constructs such as social isolation, loneliness, social withdrawal, and peer difficulties examined under partially distinct frameworks. Objective: This systematic review aimed to synthesize empirical evidence on the association between social isolation, related constructs, and problematic school attendance during adolescence. Methods: Following PRISMA 2020 guidelines, searches were conducted in PubMed, Scopus, and Embase (final search: 20 January 2026). Eligible studies were observational or qualitative empirical investigations involving adolescents aged 11\u201318 years and examining at least one relational construct (objective\/subjective social isolation, loneliness, social withdrawal, peer rejection) together with at least one school attendance outcome (school refusal, withdrawal, truancy, avoidance, dropout). Risk of bias was assessed with design-specific JBI tools and findings were synthesized narratively. Results: Eleven studies met the inclusion criteria: six cross-sectional, four longitudinal\/cohort, and one qualitative. Loneliness, bullying, school alienation, and social isolation at school were most consistently associated with school refusal and absenteeism, whereas peer acceptance, reciprocal friendships, teacher emotional support, and school belonging were associated with reduced dropout intentions, higher graduation rates, and better school transition. Longitudinally, loneliness and low teacher support preceded increases in intention to quit, while supportive relationships appeared to protect against later disengagement. Conclusions: Social isolation and related constructs are meaningfully associated with problematic school attendance in adolescence. Social isolation and related constructs appear to be meaningfully associated with problematic school attendance in adolescence, although the evidence base remains limited and heterogeneous. These findings suggest that a relational perspective may usefully complement existing approaches to attendance difficulties, and point to the need for longitudinal, multi-informant studies disentangling subjective, interpersonal, and institutional disconnection across distinct attendance profiles.<\/jats:p>","DOI":"10.3390\/children13081020","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T08:20:18Z","timestamp":1785486018000},"page":"1020","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Social Isolation, Related Constructs and Problematic School Attendance Problems in Adolescence: A Systematic Review"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4351-7395","authenticated-orcid":false,"given":"Giuseppe","family":"Accogli","sequence":"first","affiliation":[{"name":"Scientific Institute IRCCS \u201cE. Medea\u201d, Scientific Direction, 23842 Bosisio Parini, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgia","family":"Carlucci","sequence":"additional","affiliation":[{"name":"Unit for Severe Disabilities in Developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Scientific Hospital for Neurorehabilitation, Associazione \u201cLa Nostra Famiglia\u201d, Scientific Institute IRCCS \u201cE. Medea\u201d, 72100 Brindisi, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3165-0105","authenticated-orcid":false,"given":"Antonio","family":"Trabacca","sequence":"additional","affiliation":[{"name":"Scientific Institute IRCCS \u201cE. Medea\u201d, Scientific Direction, 23842 Bosisio Parini, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7843-8721","authenticated-orcid":false,"given":"Maria Gloria","family":"Rossetti","sequence":"additional","affiliation":[{"name":"Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy"},{"name":"Unit of Psychiatry, Azienda Ospedaliera Universitaria Integrata (AOUI) Verona, 37126 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Scoditti","sequence":"additional","affiliation":[{"name":"Unit for Severe Disabilities in Developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Scientific Hospital for Neurorehabilitation, Associazione \u201cLa Nostra Famiglia\u201d, Scientific Institute IRCCS \u201cE. Medea\u201d, 72100 Brindisi, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4021-8456","authenticated-orcid":false,"given":"Paolo","family":"Brambilla","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy"},{"name":"Department of Neurosciences and Mental Health, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9729-2641","authenticated-orcid":false,"given":"Roberto","family":"Sassi","sequence":"additional","affiliation":[{"name":"Department of Computer Science, University of Milan, 20133 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1381-6538","authenticated-orcid":false,"given":"Antonella","family":"Delle Fave","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cinzia","family":"Bressi","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy"},{"name":"Department of Neurosciences and Mental Health, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9589-4662","authenticated-orcid":false,"given":"Fabrizia Claudia","family":"Guarnieri","sequence":"additional","affiliation":[{"name":"CNR Institute of Neuroscience, 20854 Vedano al Lambro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabella","family":"Fanizza","sequence":"additional","affiliation":[{"name":"Unit for Severe Disabilities in Developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Scientific Hospital for Neurorehabilitation, Associazione \u201cLa Nostra Famiglia\u201d, Scientific Institute IRCCS \u201cE. Medea\u201d, 72100 Brindisi, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1727-5396","authenticated-orcid":false,"given":"Marcella","family":"Bellani","sequence":"additional","affiliation":[{"name":"Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy"},{"name":"Unit of Psychiatry, Azienda Ospedaliera Universitaria Integrata (AOUI) Verona, 37126 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Hansen, T., Nes, R.B., Hynek, K., Nilsen, T.S., Reneflot, A., Stene-Larsen, K., Tornes, R.A., and Bidonde, J. (2024). Tackling Social Disconnection: An Umbrella Review of RCT-Based Interventions Targeting Social Isolation and Loneliness. BMC Public Health, 24.","DOI":"10.1186\/s12889-024-19396-8"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1071\/AH080468","article-title":"Social Isolation and Loneliness among Older People: Issues and Future Challenges in Community and Residential Settings","volume":"32","author":"Grenade","year":"2008","journal-title":"Aust. Health Rev."},{"key":"ref_3","unstructured":"Berg, R.L., and Cassells, J.S. (1992). The Second Fifty Years: Promoting Health and Preventing Disability, National Academies Press (US)."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"i38","DOI":"10.1093\/geronb\/gbp037","article-title":"Measuring Social Isolation Among Older Adults Using Multiple Indicators From the NSHAP Study","volume":"64B","author":"Cornwell","year":"2009","journal-title":"J. Gerontol. B Psychol. Sci. Soc. Sci."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1177\/002214650905000103","article-title":"Social Disconnectedness, Perceived Isolation, and Health among Older Adults","volume":"50","author":"Cornwell","year":"2009","journal-title":"J. Health Soc. Behav."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1346","DOI":"10.1177\/0898264312460275","article-title":"Social Isolation, Loneliness and Health among Older Adults","volume":"24","author":"Coyle","year":"2012","journal-title":"J. Aging Health"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e010799","DOI":"10.1136\/bmjopen-2015-010799","article-title":"Loneliness, Social Isolation and Social Relationships: What Are We Measuring? A Novel Framework for Classifying and Comparing Tools","volume":"6","author":"Valtorta","year":"2016","journal-title":"BMJ Open"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1177\/0898264316673511","article-title":"Social Isolation, Depression, and Psychological Distress Among Older Adults","volume":"30","author":"Taylor","year":"2018","journal-title":"J. Aging Health"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"S39","DOI":"10.1353\/pbm.2003.0049","article-title":"Social Isolation and Health, with an Emphasis on Underlying Mechanisms","volume":"46","author":"Cacioppo","year":"2003","journal-title":"Perspect. Biol. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1307","DOI":"10.1093\/sf\/soy088","article-title":"Loneliness in Europe: Personal and Societal Individualism-Collectivism and Their Connection to Social Isolation","volume":"97","author":"Swader","year":"2019","journal-title":"Soc. Forces"},{"key":"ref_11","unstructured":"Arnet, J.J. (2014). Adolescence and Emerging Adulthood, Pearson Education. [5th ed.]. Pearson New International Edition."},{"key":"ref_12","unstructured":"Laser, J.A., and Nicotera, N. (2011). Working with Adolescents: A Guide for Practitioners, Guilford Press."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1146\/annurev.psych.52.1.83","article-title":"Adolescent Development","volume":"52","author":"Steinberg","year":"2001","journal-title":"Annu. Rev. Psychol."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Okajima, I., Honda, Y., Semba, O., Kiyota, Y., and Tani, Y. (2022). Effects of COVID-19-Related Anxiety and Sleep Problems on Loneliness and Feelings of School Refusal in Adolescents. Front. Psychiatry, 13.","DOI":"10.3389\/fpsyt.2022.918417"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1111\/josh.13306","article-title":"Loneliness During the School Years: How It Affects Learning and How Schools Can Help","volume":"93","author":"Jefferson","year":"2023","journal-title":"J. Sch. Health"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"995","DOI":"10.1136\/jech-2011-200047","article-title":"School Dropout: A Major Public Health Challenge: A 10-Year Prospective Study on Medical and Non-Medical Social Insurance Benefits in Young Adulthood, the Young-HUNT 1 Study (Norway)","volume":"66","author":"Pape","year":"2012","journal-title":"J. Epidemiol. Community Health"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1186\/s43045-023-00314-4","article-title":"Social Isolation among Adolescents and Its Association with Depression Symptoms","volume":"30","author":"Alsadoun","year":"2023","journal-title":"Middle East. Curr. Psychiatry"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1111\/1467-8721.01233","article-title":"Loneliness and Peer Relations in Childhood","volume":"12","author":"Asher","year":"2003","journal-title":"Curr. Dir. Psychol. Sci."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1111\/soin.12018","article-title":"Adolescent Loneliness and Health in Early Adulthood","volume":"83","author":"Goosby","year":"2013","journal-title":"Sociol. Inq."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1007\/s00787-009-0059-y","article-title":"Childhood Loneliness as a Predictor of Adolescent Depressive Symptoms: An 8-Year Longitudinal Study","volume":"19","author":"Qualter","year":"2010","journal-title":"Eur. Child. Adolesc. Psychiatry"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"125","DOI":"10.4236\/ojd.2014.34016","article-title":"Rethinking Loneliness\u2014A Qualitative Study about Adolescents\u2019 Experiences of Being an Outsider in Peer Group","volume":"3","year":"2014","journal-title":"Open J. Depress."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1146\/annurev.psych.60.110707.163642","article-title":"Social Withdrawal in Childhood","volume":"60","author":"Rubin","year":"2009","journal-title":"Annu. Rev. Psychol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1037\/0012-1649.36.3.366","article-title":"What Parents Know, How They Know It, and Several Forms of Adolescent Adjustment: Further Support for a Reinterpretation of Monitoring","volume":"36","author":"Kerr","year":"2000","journal-title":"Dev. Psychol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1007\/s10826-006-9123-0","article-title":"Adolescent Perceptions of Parental Behaviors, Adolescent Self-Esteem, and Adolescent Depressed Mood","volume":"16","author":"Plunkett","year":"2007","journal-title":"J. Child. Fam. Stud."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Prior, M., Sanson, A., Smart, D., and Oberklaid, F. (2000). Pathways from Infancy to Adolescence: Australian Temperament Project 1983\u20132000, Australian Institute of Family Studies.","DOI":"10.1037\/e567532013-001"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1017\/S0954579400006829","article-title":"The Waterloo Longitudinal Project: Predicting Internalizing and Externalizing Problems in Adolescence","volume":"7","author":"Rubin","year":"1995","journal-title":"Dev. Psychopathol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1016\/j.adolescence.2007.10.011","article-title":"Retrospective Report of Social Withdrawal during Adolescence and Current Maladjustment in Young Adulthood: Cross-Cultural Comparisons between Australian and South Korean Students","volume":"31","author":"Kim","year":"2008","journal-title":"J. Adolesc."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1111\/pcn.12895","article-title":"Hikikomori: Multidimensional Understanding, Assessment, and Future International Perspectives","volume":"73","author":"Kato","year":"2019","journal-title":"Psychiatry Clin. Neurosci."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1002\/wps.20705","article-title":"Defining Pathological Social Withdrawal: Proposed Diagnostic Criteria for Hikikomori","volume":"19","author":"Kato","year":"2020","journal-title":"World Psychiatry"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1111\/j.1440-1819.2011.02292.x","article-title":"Association of Childhood Family Environments with the Risk of Social Withdrawal (\u2018Hikikomori\u2019) in the Community Population in Japan","volume":"66","author":"Umeda","year":"2012","journal-title":"Psychiatry Clin. Neurosci."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1933","DOI":"10.1111\/cdev.12096","article-title":"Developmental Changes in Executive Functioning","volume":"84","author":"Lee","year":"2013","journal-title":"Child. Dev."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1007\/s10578-020-01064-8","article-title":"Identifying Social Withdrawal (Hikikomori) Factors in Adolescents: Understanding the Hikikomori Spectrum","volume":"52","author":"Hamasaki","year":"2021","journal-title":"Child. Psychiatry Hum. Dev."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Amendola, S., Presaghi, F., Teo, A.R., and Cerutti, R. (2022). Psychometric Properties of the Italian Version of the 25-Item Hikikomori Questionnaire for Adolescents. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph191610408"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1007\/s11218-024-09966-4","article-title":"Sensitive Minds, Supportive Environments: A Gateway to Marginality and Dropout Intentions, Moderated by Teacher-Student Relationships","volume":"28","author":"Marini","year":"2025","journal-title":"Soc. Psychol. Educ."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1007\/s41105-025-00586-9","article-title":"How Is Loneliness Orientation Implicated in the Relationship between Sleep Problems, Loneliness Intensity, and School Refusal in Adolescents?","volume":"23","author":"Okajima","year":"2025","journal-title":"Sleep Biol. Rhythm."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Sezer, F., and G\u00fcrtepe, A. (2025). Investigation of Attachment Social Exclusion and Risky Behaviors in Adolescents. BMC Psychol., 13.","DOI":"10.1186\/s40359-025-02822-w"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Esqueda Villegas, F., and Pozas, M. (2025). To Learn or to Leave, That Is the Question for Mexican Middle-School Students: Exploring Predictors of Intentions to Leave School Early. Education 3-13, 1\u201313.","DOI":"10.1080\/03004279.2025.2566984"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1080\/00313831.2014.904424","article-title":"Assessing Reasons for School Non-Attendance","volume":"59","author":"Havik","year":"2015","journal-title":"Scand. J. Educ. Res."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.cedpsych.2015.12.003","article-title":"Dropping out of High School: The Role of Parent and Teacher Self-Determination Support, Reciprocal Friendships and Academic Motivation","volume":"44\u201345","author":"Ricard","year":"2016","journal-title":"Contemp. Educ. Psychol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"967","DOI":"10.1080\/01443410.2021.1948505","article-title":"Intentions to Quit, Emotional Support from Teachers, and Loneliness among Peers: Developmental Trajectories and Longitudinal Associations in Upper Secondary School","volume":"41","author":"Tvedt","year":"2021","journal-title":"Educ. Psychol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.cedpsych.2018.09.001","article-title":"The Role of a Supportive Interpersonal Environment and Education-Related Goal Motivation during the Transition beyond Upper Secondary Education","volume":"55","author":"Vasalampi","year":"2018","journal-title":"Contemp. Educ. Psychol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"102667","DOI":"10.1016\/j.ssresearch.2021.102667","article-title":"Social Isolation and Achievement of Students with Learning Disabilities","volume":"104","author":"Bruefach","year":"2022","journal-title":"Soc. Sci. Res."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.1177\/13591045211025782","article-title":"School Refusal and Isolation: The Perspectives of Five Adolescent School Refusers in London, UK","volume":"26","author":"Kljakovic","year":"2021","journal-title":"Clin. Child. Psychol. Psychiatry"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1016\/j.appdev.2010.09.001","article-title":"Joint Contributions of Peer Acceptance and Peer Academic Reputation to Achievement in Academically At-Risk Children: Mediating Processes","volume":"31","author":"Chen","year":"2010","journal-title":"J. Appl. Dev. Psychol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1186","DOI":"10.1111\/j.1467-8624.2007.01060.x","article-title":"Effects of Naturally Existing Peer Groups on Changes in Academic Engagement in a Cohort of Sixth Graders","volume":"78","author":"Kindermann","year":"2007","journal-title":"Child. Dev."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"995","DOI":"10.1007\/s10964-006-9118-6","article-title":"The Role of Peer Groups in Adolescents\u2019 Educational Expectations and Adjustment","volume":"36","author":"Kiuru","year":"2007","journal-title":"J. Youth Adolesc."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1037\/0033-2909.117.3.497","article-title":"The Need to Belong: Desire for Interpersonal Attachments as a Fundamental Human Motivation","volume":"117","author":"Baumeister","year":"1995","journal-title":"Psychol. Bull."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1093\/scan\/nsp007","article-title":"Neural Correlates of Social Exclusion during Adolescence: Understanding the Distress of Peer Rejection","volume":"4","author":"Masten","year":"2009","journal-title":"Soc. Cogn. Affect. Neurosci."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.childyouth.2018.04.017","article-title":"Social Exclusion, Sense of School Belonging and Mental Health of Migrant Children in China: A Structural Equation Modeling Analysis","volume":"89","author":"Li","year":"2018","journal-title":"Child. Youth Serv. Rev."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1097\/00004583-200104000-00009","article-title":"Prevalence of Psychiatric Disorders in Youths Across Five Sectors of Care","volume":"40","author":"Garland","year":"2001","journal-title":"J. Am. Acad. Child Adolesc. Psychiatry"},{"key":"ref_51","unstructured":"Chiland, C., and Young, J.G. (1990). School Refusal: An Overview. Why Children Reject School: Views from Seven Countries, Yale University Press."},{"key":"ref_52","unstructured":"Malcolm, H., Wilson, V., Davidson, J.J., and Kirk, S. (2003). Absence from Schools: A Study of Its Causes and Effects in Seven LEAs, The SCRE Centre University of Glasgow."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Heyne, D.A., and Sauter, F.M. (2012). School Refusal. The Wiley-Blackwell Handbook of the Treatment of Childhood and Adolescent Anxiety, John Wiley & Sons.","DOI":"10.1002\/9781118315088.ch21"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1177\/0143034310361674","article-title":"The Effect of Pupil Absenteeism on Literacy and Numeracy in the Primary School","volume":"31","author":"Carroll","year":"2010","journal-title":"Sch. Psychol. Int."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1080\/10824669.2014.962696","article-title":"Chronic Absenteeism and Its Effects on Students\u2019 Academic and Socioemotional Outcomes","volume":"19","author":"Gottfried","year":"2014","journal-title":"J. Educ. Stud. Placed Risk (JESPAR)"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"358.e9","DOI":"10.1016\/j.jadohealth.2006.11.138","article-title":"Truancy\u2019s Effect on the Onset of Drug Use among Urban Adolescents Placed at Risk","volume":"40","author":"Henry","year":"2007","journal-title":"J. Adolesc. Health"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1177\/07419325070280060201","article-title":"School Characteristics Related to High School Dropout Rates","volume":"28","author":"Christle","year":"2007","journal-title":"Remedial Spec. Educ."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1080\/02671520600942446","article-title":"Truancy in Secondary School Pupils: Prevalence, Trajectories and Pupil Perspectives","volume":"21","author":"Attwood","year":"2006","journal-title":"Res. Pap. Educ."},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Garry, E.M., and Others, A. (1996). Truancy: First Step to a Lifetime of Problems, US Department of Justice, Office of Justice Programs, Office of Juvenile Justice and Delinquency Prevention.","DOI":"10.1037\/e306412003-001"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"921","DOI":"10.1177\/1359104519855426","article-title":"Working with School-Refusing Young People in Tower Hamlets, London","volume":"24","author":"Kljakovic","year":"2019","journal-title":"Clin. Child. Psychol. Psychiatry"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.cbpra.2018.03.006","article-title":"Differentiation Between School Attendance Problems: Why and How?","volume":"26","author":"Heyne","year":"2019","journal-title":"Cogn. Behav. Pract."},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Rumberger, R.W. (2011). Dropping Out: Why Students Drop Out of High School and What Can Be Done About It, Harvard University Press.","DOI":"10.4159\/harvard.9780674063167"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.addbeh.2005.04.011","article-title":"Truancy and Illicit Drug Use among Adolescents Surveyed via Street Outreach","volume":"31","author":"Chou","year":"2006","journal-title":"Addict. Behav."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"235","DOI":"10.2105\/AJPH.92.2.235","article-title":"Classroom-Based Surveys of Adolescent Risk-Taking Behaviors: Reducing the Bias of Absenteeism","volume":"92","author":"Guttmacher","year":"2002","journal-title":"Am. J. Public Health"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1097\/01.CHI.0000046865.56865.79","article-title":"School Refusal and Psychiatric Disorders: A Community Study","volume":"42","author":"Egger","year":"2003","journal-title":"J. Am. Acad. Child Adolesc. Psychiatry"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1016\/j.cpr.2007.07.012","article-title":"School Absenteeism and School Refusal Behavior in Youth: A Contemporary Review","volume":"28","author":"Kearney","year":"2008","journal-title":"Clin. Psychol. Rev."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1136\/adc.76.2.90","article-title":"School refusal and truancy","volume":"76","author":"Berg","year":"1997","journal-title":"Arch. Dis. Child."},{"key":"ref_68","first-page":"685","article-title":"Dealing with School Refusal Behavior: A Primer for Family Physicians","volume":"55","author":"Kearney","year":"2006","journal-title":"J. Fam. Pract."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1111\/j.1469-7610.2006.01634.x","article-title":"Forms and Functions of School Refusal Behavior in Youth: An Empirical Analysis of Absenteeism Severity","volume":"48","author":"Kearney","year":"2007","journal-title":"J. Child Psychol. Psychiatry"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1007\/s10648-008-9078-3","article-title":"An Interdisciplinary Model of School Absenteeism in Youth to Inform Professional Practice and Public Policy","volume":"20","author":"Kearney","year":"2008","journal-title":"Educ. Psychol. Rev."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1017\/S0033291700021024","article-title":"Classification of Severe School Attendance Problems","volume":"15","author":"Berg","year":"1985","journal-title":"Psychol. Med."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1111\/j.1468-2850.1996.tb00087.x","article-title":"The Evolution and Reconciliation of Taxonomic Strategies for School Refusal Behavior","volume":"3","author":"Kearney","year":"1996","journal-title":"Clin. Psychol. Sci. Pract."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1037\/0735-7028.34.1.57","article-title":"Bridging the Gap among Professionals Who Address Youths with School Absenteeism: Overview and Suggestions for Consensus","volume":"34","author":"Kearney","year":"2003","journal-title":"Prof. Psychol. Res. Pract."},{"key":"ref_74","doi-asserted-by":"crossref","unstructured":"Watson, T.S., and Skinner, C.H. (2004). Absenteeism. Encyclopedia of School Psychology, Kluwer Academic\/Plenum.","DOI":"10.1007\/978-0-387-22556-2"},{"key":"ref_75","unstructured":"(2026, May 22). CDC Health Effects of Social Isolation and Loneliness, Available online: https:\/\/www.cdc.gov\/social-connectedness\/risk-factors\/index.html."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 Statement: An Updated Guideline for Reporting Systematic Reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"Sorrenti, L., Fumia, A., Caparello, C., Meduri, C.F., and Filippello, P. (2025). The Mediation Role of School Alienation Between Perceptions of the School Atmosphere and School Refusal in Italian Students. Educ. Sci., 15.","DOI":"10.3390\/educsci15070786"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1007\/s11218-015-9293-y","article-title":"School Factors Associated with School Refusal- and Truancy-Related Reasons for School Non-Attendance","volume":"18","author":"Havik","year":"2015","journal-title":"Soc. Psychol. Educ."},{"key":"ref_79","doi-asserted-by":"crossref","unstructured":"Aromataris, E., and Munn, Z. (2020). Chapter 7: Systematic Reviews of Etiology and Risk. JBI Manual for Evidence Synthesis, JBI.","DOI":"10.46658\/JBIRM-17-01"},{"key":"ref_80","first-page":"179","article-title":"Qualitative Research Synthesis: Methodological Guidance for Systematic Reviewers Utilizing Meta-Aggregation","volume":"13","author":"Lockwood","year":"2015","journal-title":"JBI Evid. Implement."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/j.neubiorev.2017.05.010","article-title":"Social Connectedness, Mental Health and the Adolescent Brain","volume":"80","author":"Lamblin","year":"2017","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_82","doi-asserted-by":"crossref","unstructured":"Raniti, M., Rakesh, D., Patton, G.C., and Sawyer, S.M. (2022). The Role of School Connectedness in the Prevention of Youth Depression and Anxiety: A Systematic Review with Youth Consultation. BMC Public Health, 22.","DOI":"10.1186\/s12889-022-14364-6"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1111\/camh.12322","article-title":"Review: The Association between Anxiety and Poor Attendance at School\u2014A Systematic Review","volume":"24","author":"Finning","year":"2019","journal-title":"Child. Adolesc. Ment. Health"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"357.e9","DOI":"10.1016\/j.jadohealth.2006.10.013","article-title":"Social and School Connectedness in Early Secondary School as Predictors of Late Teenage Substance Use, Mental Health, and Academic Outcomes","volume":"40","author":"Bond","year":"2007","journal-title":"J. Adolesc. Health"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1186\/s13052-024-01667-0","article-title":"School Refusal Behavior in Children and Adolescents: A Five-Year Narrative Review of Clinical Significance and Psychopathological Profiles","volume":"50","author":"Pontillo","year":"2024","journal-title":"Ital. J. Pediatr."},{"key":"ref_86","doi-asserted-by":"crossref","unstructured":"Cole, A., Bond, C., Qualter, P., and Maes, M. (2021). A Systematic Review of the Development and Psychometric Properties of Loneliness Measures for Children and Adolescents. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18063285"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"1490","DOI":"10.1080\/00313831.2024.2434822","article-title":"A Review and Qualitative Synthesis of the Voices of Children, Parents, and School Staff with Regards to School Attendance Problems in the Nordic Countries","volume":"69","author":"Hejl","year":"2025","journal-title":"Scand. J. Educ. Res."},{"key":"ref_88","doi-asserted-by":"crossref","unstructured":"Davies, C.A., Cordier, R., Graham, P., Littlefair, D., Speyer, R., and Melo, D. (2025). Interventions to Improve Connectedness, Belonging, and Engagement in Secondary Schools: A Systematic Review and Meta-Analysis. Educ. Sci., 15.","DOI":"10.3390\/educsci15050582"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"880","DOI":"10.1111\/josh.70036","article-title":"A Scoping Review of School Connectedness Interventions for Adolescents","volume":"95","author":"Attri","year":"2025","journal-title":"J. Sch. Health"}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/8\/1020\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T08:57:03Z","timestamp":1785488223000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/8\/1020"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,31]]},"references-count":89,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["children13081020"],"URL":"https:\/\/doi.org\/10.3390\/children13081020","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,31]]}}}