What the study found
Among clinically referred adolescents, school aversion appeared as a central factor in the study's causal framework and was associated with downstream bullying, digital addiction, and suicide risk. Family structure was also identified as having a significant negative effect on school aversion.
Why the authors say this matters
The authors conclude that this integrated causal framework may help refine risk screening and intervention prioritization in clinical populations. They also say further validation is needed in non-clinical and longitudinal samples.
What the researchers tested
The researchers studied 423 adolescents referred to mental health services who completed standardized psychosocial assessments. They used directed acyclic graph (DAG) learning, DoWhy causal effect estimation with backdoor propensity-score weighting and logistic-model-based counterfactual simulation, using data from validated instruments and clinical intake records.
What worked and what didn't
DAG modeling retained family structure, bullying, and digital addiction as primary school-aversion-centered pathways, while trauma remained a nearby contextual factor. DoWhy analysis found significant associations for SchoolAversion → Bullying (ATE = 0.046, p = 0.001), SchoolAversion → DigitalAdd (ATE = 0.036, p = 0.008), and a negative effect of family structure on school aversion (ATE = -0.162, p = 0.031). Counterfactual simulation suggested that removing bullying or digital addiction had relatively small effects on school aversion, and an exploratory simulation for SchoolAversion → Suicide gave a risk difference of 0.266 with bootstrap 95% CI 0.182 to 0.346.
What to keep in mind
The abstract does not describe detailed study limitations beyond noting that further validation is needed in non-clinical and longitudinal samples. The findings come from clinically referred adolescents, so the reported results are limited to that setting.
Key points
- In 423 clinically referred adolescents, 57.7% showed school aversion or refusal.
- 39.7% of participants reported suicidal thoughts or attempts.
- DAG modeling kept family structure, bullying, and digital addiction as main school-aversion-related pathways.
- SchoolAversion → Bullying and SchoolAversion → DigitalAdd were significant in DoWhy analysis.
- Counterfactual simulations suggested removing bullying or digital addiction had relatively small effects on school aversion.
- The authors say more validation is needed in non-clinical and longitudinal samples.
Disclosure
- Research title:
- School aversion was linked to bullying, digital addiction, and suicide risk
- Authors:
- Mengmeng Zhang, Xin Ma, Hui Li, Botao Huang, Yuhan Luo, Jie Qian, Meijuan Wang
- Institutions:
- Tongji University, Heidelberg University, Peking University, Peking University Sixth Hospital, Shanghai Jiao Tong University, Shanghai Mental Health Center, Shanghai University, Yangpu Hospital of Tongji University, Shanghai Tenth People's Hospital
- Publication date:
- 2026-04-09
- OpenAlex record:
- View
Get the weekly research newsletter
Stay current with peer-reviewed research without reading academic papers — one filtered digest, every Friday.