ArticleFrontiers in psychiatry2022
Effects of COVID-19-Related Anxiety and Sleep Problems on Loneliness and Feelings of School Refusal in Adolescents.
Article in Frontiers in psychiatry, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 15 citations in OpenAlex.
- Social Isolation, Related Constructs and Problematic School Attendance Problems in Adolescence: A Systematic Review.Children (Basel, Switzerland) · 2026Review
- Network analysis of school refusal behavior and internalizing and externalizing problems among Chinese adolescents.BMC psychology · 2026Article
- How is loneliness orientation implicated in the relationship between sleep problems, loneliness intensity, and school refusal in adolescents?Sleep and biological rhythms · 2025Article
- School Refusal Behavior in Japan: The Impact of COVID-19 on Children.Children (Basel, Switzerland) · 2025Review
- Adolescent Sense of Coherence over a Four-Year Period and the Pandemic: Junior and Senior High School Students Enrolled Before and After the Pandemic Broke out in Japan.Behavioral sciences (Basel, Switzerland) · 2025Article
- Association between COVID-19 pandemic and school refusal among elementary school children in Japan: difference-in-differences analysis.Frontiers in public health · 2025Article
- The Migrant-Local Difference in the Relationship Between Social Support, Sleep Disturbance, and Loneliness Among Older Adults in China: Cross-Sectional Study.JMIR public health and surveillance · 2024Article
- Hope Buffers the Effect of Fear of COVID-19 on Depression among College Students: Insomnia as a Mediator.International journal of environmental research and public health · 2023Article
- Association Between Loneliness, Premenstrual Symptoms, and Other Factors During the COVID-19 Pandemic: A Cross-Sectional Study with Japanese High School Students.International journal of women's health · 2023Article
- Role of emotion regulation capacities in affective state among Chinese high school students in the post-pandemic era of COVID-19.Frontiers in psychology · 2022Article
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
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Abstract
Background: COVID-19-related anxiety, sleep problems, and loneliness may be risk factors for school refusal in children and adolescents. However, few studies have examined the mechanisms by which these risk factors cause school refusal. This study examined the process by which COVID-19-related anxiety, sleep problems, and loneliness cause school refusal, using structural equation modeling. Methods: In this cross-sectional questionnaire-based study, 256 (109 male, 147 female, mean age: 15.37 ± 0.48 years) senior high school students were asked to complete the Stress and Anxiety associated with Viral Epidemics-6 questionnaire to assess COVID-19-related anxiety, the Athens Insomnia Scale (AIS), Sleep Debt Index (SDI), and chronotype (MSFsc) to assess sleep problems, the Three-Item Loneliness Scale (TILS) to assess loneliness, and Feelings of School-Avoidance Scale (FSAS) to assess school refusal. Results: Structural equation modeling showed that sleep problems affected loneliness (β = 0.52) and feelings of school refusal (β = 0.37), and that loneliness affected feelings of school refusal (β = 0.47). There was no significant pathway of COVID-19-related anxiety on sleep problems, loneliness, or feelings of school refusal. The indirect effect of sleep problems on feelings of school refusal through loneliness was significant. The results of hierarchical multiple regression analysis showed that AIS (β = 0.30) and SDI (β = 0.13) scores were associated with TILS, and AIS (β = 0.26) and MSFsc (β = -0.14) scores were associated with FSAS scores. Conclusion: The findings of this study showed that sleep problems affected feelings of school refusal
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