School Refusal Assessment Scale-Revised: Factorial Invariance and Latent Means Differences across Gender and Age in Spanish Children

School refusal profiles maintained by negative reinforcement and their relationship with self-perceived health

Health alterations and school refusal behavior may significantly affect student evolution in all areas of student lives. The objective of this study was to use latent profile analysis to identify school refusal profiles sustained by negative reinforcement and to determine their relationship with distinct self-perceived health variables (Satisfaction, Well-being, Resilience, Performance, and Risk-Taking). The School Refusal Assessment Scale-Revised (SRAS-R) and the Child Health and Illness Profile (CHIP-CE/CRF) were administered to 737 students (60.9% male) aged between 8 and 10 (M = 8.76, SD = 0.74). Three profiles of school refusal maintained by negative reinforcement were obtained: no risk, moderate risk, and high risk. It was confirmed that school refusal through negative reinforcement correlates negatively with health dimensions, also finding that a higher risk profile for school refusal is associated with lower levels of self-perceived health. Similarly, it was determined that the high-risk profile is the most maladaptive, with significantly lower data in four of the five self-perceived health dimensions that were evaluated. In conclusion, remaining in situations with no or moderate risk of school refusal due to negative reinforcement encourages higher levels of self-perceived health, while being at high risk of school refusal due to negative reinforcement is associated with worse self-perceived health.

School refusal: mapping the literature by bibliometric analysis

School refusal is considered a risk factor for academic, social, and personal situations, such as school dropouts. Studies have been carried out on school refusal for almost 50 years. However, general research trends have not been mapped yet. This study summarizes the bibliometric analysis of scientific collaborations and prevalence across locations by country and institution, leading researchers, journals, and trends (keywords) in school refusal research. The United States, Japan, Spain, and England are the countries that stand out in terms of school refusal. It can be said that the Journal of American Academy of Child and Adolescent Psychiatry, Cognitive and Behavioral Practice, and Frontiers in Psychology are important journals that publish on school refusal. Researchers named Christopher A. Kearney, Carolina Gonzálvez, Jose Manuel Garcia-Fernandez, David A. Heyne, and Brigit M. Van Widenfelt have been found to have more intensive studies and collaborations on school refusal. The authors keywords common use for school refusal; are truancy, school absenteeism, adolescence, school attendance, school phobia, autism spectrum disorder, and bullying. The findings show that school refusal is a current research area, and scientific collaborations continue to be established. The findings reveal all the details of the school refusal research.

Confirming the Validity of the School-Refusal Assessment Scale-Revised in a Sample of Children With Attention-Deficit/Hyperactivity Disorder

Children with developmental disorders, such as attention-deficit/hyperactivity disorder (ADHD), are at high risk of school-refusal behavior (SRB) compared with their peers. One of the most used scales to assess SRB is the school refusal behavior scale – revised (SRAS-R). The SRAS-R has demonstrated good psychometric properties when used with the general population of children, but, recently, its validity has been questioned when used with children with developmental disorders. We tested the psychometric properties of the SRAS-R parental reports in 96 children with ADHD (M_age = 12.4; SD = 1.7, 61.5% boys). Results showed good model fit and internal consistency for the original four-factor structure. Three of the factors were strongly correlated, suggesting that SRB among children with ADHD is caused by several factors.

Exploring different types of school refusers through latent profile analysis and school-related stress associations

Children experience significant number of stressful situations at school during their academic years. The aims of this study were to identify school refusers groups of children through latent profile analysis and to test their associations with school-related sources and manifestation of stress. Data were obtained from 755 schoolchildren (8-11 years) from public and private schools of Alicante and Murcia (Spain), using the School Refusal Assessment Scale-Revised (SRAS-R) and the School Situation Survey (SSS). In general, positive and statistically significant correlations were identified between school refusal behavior and school-related sources and manifestations of stress. School refusers groups were derived from the combination of high and low scores in the four functional conditions assessed by the SRAS-R. "Low School Refusal Behavior Profile,""School Refusal Behavior by Positive Reinforcement Profile" and "Mixed School Refusal Behavior Profile" were identified. The percentages of children within these profiles were 47.7%, 46.6%, and 5.7%, respectively. The Mixed School Refusal Behavior Profile was the group with the highest average scores in the school-related stress factors. In contrast, the group with the lowest mean scores was the Low School Refusal Behavior Profile. By comparing the Low School Refusal Behavior Profile with the Mixed School Refusal Behavior Profile, the largest effect sizes were found. Findings are discussed from a socio-ecological perspective considering the school context conditions as key elements in the development of school refusal behaviors.

School Refusal Behavior and Aggression in Spanish Adolescents

In order to reduce school attendance problems and aggressive behavior, it is essential to determine the relationship between both variables. The aim of this study was twofold: (1) to examine the mean differences in scores on aggression, based on school refusal behavior, and (2) to analyze the predictive capacity of high scores on aggression, based on school refusal behavior factors. The sample consisted of 1455 Spanish secondary school students, aged 13–17 (M = 14.85; SD = 1.56). The School Refusal Assessment Scale-Revised (I. Avoidance of negative affectivity, II. Escape from aversive social and/or evaluative situations, III. Pursuit of attention from significant others, and IV. Pursuit of tangible reinforcement outside of school) and the Aggression Questionnaire (I. Physical Aggression, II. Verbal Aggression, III. Anger, and IV. Hostility) were used. Results indicated that students having high levels of Physical Aggression, Verbal Aggression, Anger, and Hostility received significantly higher scores on school refusal behavior. In most cases, school refusal behavior was found to be a positive and statistically significant predictor of aggression. Students that base their school refusal on the pursuit of tangible reinforcements outside of school earned higher scores, and other functional conditions underlying school refusal behavior were found to be associated with aggression issues. The role of aggression as a risk factor for school refusal behavior is discussed.

Affective Profiles and Anxiety or Non-Anxiety-Related Reasons for School Refusal Behavior: Latent Profile Analysis in Spanish Adolescents

Little has been studied on the relationship between affect and school problems related with attendance. This study aims to identify different affective profiles and to determine whether these profiles differ from each other based on the four functional conditions of school refusal behavior. Participants comprised 1,816 Spanish adolescents aged 15-18 years (M = 16.39; SD = 1.05). The Positive and Negative Affect Schedule for Children-Short Form and the School Refusal Assessment Scale-Revised for Children (SRAS-R-C) were administered. Latent profile analysis revealed five affective profiles: low affective profile, self-fulfilling profile, low positive affect profile, self-destructive profile, and high affective profile. The self-destructive profile revealed the highest average scores in the first three factors of the SRAS-R-C, whereas the high affective profile reached the highest average score in the fourth factor. On the contrary, the self-fulfilling profile obtained the lowest average scores in the first two factors of the SRAS-R-C, whereas the low affective profile revealed the lowest average scores in the last two factors. Findings suggest the relevance of developing more adaptative affective profiles, such as the self-fulfilling profile, which would contribute to diminishing school attendance problems.

Testing the Functional Profiles of School Refusal Behavior and Clarifying Their Relationship With School Anxiety

Students with school attendance problems are a diverse and heterogeneous group whose patterns of symptomatology can change over time. This study aims to identify different school refusal behavior profiles and to determine whether these profiles differ from each other based on four situational factors and three response systems of school anxiety across gender. The participants were 1,685 Spanish students (49% female) aged 15–18 years (M = 16.28; SD =0.97). The School Refusal Assessment Scale-Revised (SRAS-R) and the School Anxiety Inventory (SAI) were administered. Latent profile analysis revealed five school refusal behavior profiles: Non-School Refusal Behavior, Mixed School Refusal Behavior, School Refusal Behavior by Positive Reinforcement, Low School Refusal Behavior, and High School Refusal Behavior. The results indicated that High School Refusal Behavior and Mixed School Refusal Behavior groups were the most maladaptive profiles since it obtained the highest mean scores on school anxiety. In contrast, Non-School Refusal and School Refusal Behavior by Positive Reinforcement groups revealed the lowest scores in school anxiety. Non-significant gender-based differences were found, only girls were more represented in the mixed school refusal behavior profile in comparison with boys but with a small effect size. Findings are discussed in relation to the importance of promoting good mental health to prevent school attendance problems in adolescents and younger ages.

The School Climate and Academic Mindset Inventory (SCAMI): Confirmatory Factor Analysis and Invariance Across Demographic Groups

School climate is a multidimensional construct of the quality of a student’s academic environment, often subsuming dimensions such as safety, instructional practices, social relationships, school facilities, and school connectedness. Positive school climate has beneficial effects on a wide range of adjustment variables in youth, including academic achievement, mental health, school attendance and graduation, and school-based behavior. Studies regarding school climate assessment have burgeoned in recent years but remain marked by limited sample sizes, narrow developmental levels, restricted items, unclear psychometric strength across multiple demographic groups, and lack of integration with key student education contextual factors such as academic mindset and social emotional learning. The present study evaluated a comprehensive measure of aspects of school climate, academic mindset, and social emotional learning in a sample of 105,379 diverse students (M_age = 13.47 years; SD = 2.47). The 9-factor structure of the School Climate and Academic Mindset Inventory was supported via confirmatory factor analysis. A trimmed model displayed adequate goodness-of-fit for males and females, younger age groups, and European American, biracial/multiracial, Hispanic, Native American, and Native Hawaiian/Pacific Islander students. The trimmed model was slightly less strong for older age groups as well as for African American and Asian American students. The scale may be useful for assessing school climate interventions, longitudinal climate patterns, and school-based algorithms of future performance, though additional validation of the scale remains necessary.

Factorial Invariance, Latent Mean Differences of the Panas and Affective Profiles and Its Relation to Social Anxiety in Ecuadorian Sample

Positive (PA) and negative affect (NA) are related with aspects that are part of people’s psychological well-being, and the possibility of combining both dimensions to create four affective profiles, self-fulfilling (high PA and low NA), low affective (low PA and low NA), high affective (high PA and high NA) and self-destructive (low PA and high NA), has recently appeared. The current work aims to validate the short version of the Positive and Negative Affect Schedule (PANAS) in Ecuador, test the existence of the four affective profiles and analyze its relation with social anxiety. The Positive and Negative Affect Schedule for Children and the Social Anxiety Scale for Adolescents was employed in a sample of 1786 Ecuadorian students aged from 15 to 18 years (M = 16.31, SD = 1.01). The factorial invariance of the scale across sex and age groups was proved and latent mean analyses showed that girls and 18-year-old students obtained the highest scores in negative affect. With regard to the affective profiles, the cluster analyses confirmed the existence of the four mentioned profiles, and the self-fulfilling profile obtained the lowest scores in all the dimensions of social anxiety, whereas the self-destructive profile obtained the highest scores.

Internalizing Symptoms as Predictors of School Absenteeism Severity at Multiple Levels: Ensemble and Classification and Regression Tree Analysis

School attendance problems are highly prevalent worldwide, leading researchers to investigate many different risk factors for this population. Of considerable controversy is how internalizing behavior problems might help to distinguish different types of youth with school attendance problems. In addition, efforts are ongoing to identify the point at which children and adolescents move from appropriate school attendance to problematic school absenteeism. The present study utilized ensemble and classification and regression tree analysis to identify potential internalizing behavior risk factors among youth at different levels of school absenteeism severity (i.e., 1+%, 3+%, 5+%, 10+%). Higher levels of absenteeism were also examined on an exploratory basis. Participants included 160 youth aged 6-19 years (M = 13.7; SD = 2.9) and their families from an outpatient therapy clinic (39.4%) and community (60.6%) setting, the latter from a family court and truancy diversion program cohort. One particular item relating to lack of enjoyment was most predictive of absenteeism severity at different levels, though not among the highest levels. Other internalizing items were also predictive of various levels of absenteeism severity, but only in a negatively endorsed fashion. Internalizing symptoms of worry and fatigue tended to be endorsed higher across less severe and more severe absenteeism severity levels. A general expectation that predictors would tend to be more homogeneous at higher than lower levels of absenteeism severity was not generally supported. The results help confirm the difficulty of conceptualizing this population based on forms of behavior but may support the need for early warning sign screening for youth at risk for school attendance problems.

Subtyping of Adolescents with School Refusal Behavior: Exploring Differences Across Profiles in Self-Concept

Not all adolescents with school attendance problems attribute their behavior to the same causes. Knowing the subtypes of students who reject school and their relationship with new variables, such as self-concept, is an unresolved task. This study aimed to identify different school refusal behavior profiles and to determine whether these profiles differed from each other based on the scores of the eleven dimensions of self-concept (Physical appearance, Physical abilities, Parent relations, Same-sex relations, Opposite-sex relations, Honesty, Emotional stability, Self-esteem, Verbal, Math, and General school). The participants were 1315 Spanish students (57.6% male) aged 12-18 years (M = 15.21; SD = 1.74). The School Refusal Assessment Scale-Revised and the Self-Description Questionnaire II-Short Form were administered. A latent class analysis revealed four school refusal behavior profiles: Moderately High School Refusal Behavior, Moderately Low School Refusal Behavior, Mixed School Refusal Behavior and Non-School Refusal Behavior. The results indicated that the Mixed School Refusal Behavior group was the most maladaptive profile and revealed the lowest mean scores on self-concept. In contrast, Non-School Refusal and Moderately Low School Refusal Behavior groups revealed the highest scores in all dimensions of self-concept. Implications for working toward the prevention of school refusal in students with low self-concept are discussed.

Identifying Risk Profiles of School Refusal Behavior: Differences in Social Anxiety and Family Functioning Among Spanish Adolescents

School attendance problems negatively affect students' development. This study attempted to identify different school refusal behavior profiles and to examine their relationship with three dimensions of social anxiety (fear of negative evaluation, social avoidance and distress in new situations, and social avoidance and distress that is experienced more generally in the company of peers) and the perception of family functioning. Participants included 1842 Spanish adolescents (53% girls) aged 15-18 years (M = 16.43; SD = 1.05). The School Refusal Assessment Scale-Revised (SRAS-R), the Social Anxiety Scale for Adolescents (SAS-A), and the Family APGAR Scale (APGAR: Adaptation, Partnership, Growth, Affection, and Resolve) were administered. Latent class analysis revealed four school refusal behavior profiles: non-school refusal behavior, high school refusal behavior, moderately low school refusal behavior, and moderately high school refusal behavior. Analyses of variance (ANOVA) indicated that adolescents' with the profile of high school refusal behavior showed higher scores in all the subscales of social anxiety. In contrast, the non-school refusal behavior group revealed higher scores in the perception of good family functioning, whereas the high school refusal behavior profile obtained the lowest scores in this scale. These findings suggest that students who reject school are at a higher risk of developing social anxiety problems and manifesting family conflicts. These students should be prioritized in order to attend to their needs, promoting self-help to overcome social anxiety and family problems with the purpose of preventing school refusal behaviors.

Child and Adolescent Social Adaptive Functioning Scale: Factorial Invariance, Latent Mean Differences, and Its Impact on School Refusal Behavior in Spanish Children

This study aims to examine the factorial invariance and latent mean differences across gender of the Spanish version of the Child and Adolescent Social Adaptive Functioning Scale (Study 1) and to value the function of social functioning as a protective ability of school refusal behavior (Study 2). Participants were Spanish students aged 8–12 years carefully chosen by simple random cluster, 345 for the first study (M = 9.17; SD = 1.03) and 1,032 students for the second study (M = 10.02; SD = 1.77). The measures used were the Child and Adolescent Social Adaptive Functioning Scale (CASAFS) and the School Refusal Assessment Scale-Revised (SRAS-R). Results about the validation of the scale supported the model proposed in this study for the CASAFS, with 15 items and a four-factor structure (school performance, peer relationships, family relationships, and home duties/self-care). Findings revealed invariance across gender for this model and good internal consistency levels were exhibited in each of the four dimensions of the CASAFS (0.76, 0.72, 0.74, and 0.71). Latent mean differences did not report differences between boys and girls. Regarding the second study, the social functioning acted as a protective factor of school refusal behavior by negatively and significantly predicting high scores in school refusal behavior due to anxiety symptoms or feelings of negative affect linked to the obligation to attend school. Opposite results were found for those students who justify their refusal to attend school in pursuing tangible reinforcements outside the school setting. These findings strengthen the reliability and validity of the CASAFS and the idea of social functioning as a person’s ability which could prevent school refusal behavior is discussed.

Latent Class Analysis of School Refusal Behavior and Its Relationship With Cyberbullying During Adolescence

Cyberbullying is a common relational problem having negative repercussions on the academic performance of adolescents. Numerous questions remain to be answered with regard to the relationship between cyberbullying and school refusal behavior. This study examines school refusal profiles (measured by School Refusal Assessment Scale-Revised) and assesses whether these profiles vary with respect to the level of victimization, aggression, aggression-victimization, and observation of cyberbullying (measured with the Screening of Harassment among Peers). The sample consisted of 1,102 Spanish high school students, aged 12–18 (M = 14.30, SD = 1.71). Latent class analysis revealed three school refusal behavior profiles: non-school refusal behavior, school refusal behavior by negative reinforcements (oriented to the avoidance of social evaluation and negative affectivity in school situations), and school refusal behavior by positive reinforcements (oriented to obtaining the attention of others with significant or tangible reinforcements). The ANOVA found statistically significant differences for all cyberbullying behaviors. Students with school refusal by negative reinforcements had significantly higher mean scores as compared to the other profiles in victimization, aggression, aggression-victimization, and observation behaviors, while the levels of cyberbullying were similar between students without school refusal and students with school refusal behavior by positive reinforcements. These findings underscore the need to consider priority interventions to prevent cyberbullying in children who refuse school for the purpose of avoiding situations of anxiety and negative emotions.

School Refusal and Absenteeism: Perception of Teacher Behaviors, Psychological Basic Needs, and Academic Achievement

School refusal (SR) is a complex problem that may be caused by different risk factors such as individual and contextual factors (Kearney, 2007; Maynard et al., 2018; Heyne et al., 2019). These mechanisms can be described in the context of self-determination theory (SDT). For these reasons, the purpose of the present study is investigate the relationship between teacher perceived psychological control and support, psychological basic needs, SR behavior, and academic achievement, on adolescent sample. It is hypothesized that teacher perceived psychological control and autonomy support play a role on need frustration and need satisfaction; in turn, need satisfaction could reduce while need frustration could promote SR behavior and number of absences. Finally, SR behavior and number of absences could reduce academic achievement. 263 students (196 females, 67 males) with an average age of 16.14 (SD = 1.35; range 13-20 years). SEM analyses with observed variables have shown that the final model fit well the data, χ2(8) = 16.34, p = 0.04, CFI = 0.96, SRMR = 0.04, RMSEA (90% CI) = 0.06 (0.01; 0.10), showing the following significant path: need satisfaction was positively predicted by perceived teacher support and negatively predicted by teacher perceived psychological control; need frustration was positively predicted by teacher perceived psychological control; number of absences was negatively predicted by need satisfaction; SR was positively predicted by need frustration; school achievement was negatively predicted by SR and number of absences. These results have several implications for the school context and the deepening of the construct of SR and absenteeism.

Practitioner Review: School refusal: developments in conceptualisation and treatment since 2000

BACKGROUND

A generation has passed since the literature on the conceptualisation, assessment and treatment of school refusal was reviewed in this journal (Elliott, ). In the light of considerable gaps in the literature, identified at that time, and growing international interest, the current paper sought to identify progress subsequently made this century.

METHODS

We open with discussion of continuing conceptual uncertainty as to whether school refusal should incorporate both truancy and absenteeism marked by anxiety and distress. We then consider progress in treatment, and conclude by examining prognosis and subsequent adult functioning. In selecting intervention studies for review, our primary focus has been upon RCTS, systematic reviews and meta-analyses.

RESULTS

The literature review indicates that, since the turn of the century, there has been little substantial advance in knowledge that can guide practitioners. Many of the issues raised in the 1999 paper, in particular, conceptual confusion over this heterogeneous condition, a dearth of rigorous RCT designs, limited knowledge of underlying mechanisms and uncertainty as to the long-term effects of specific forms of intervention, are little clearer than before.

CONCLUSIONS

While several sound publications are available to guide intervention for school refusal, there is a continuing need for rigorous studies that can provide evidence to support individualised and tailored responses to an incapacitating problem with many causes and manifestations. While a multisystemic response to intervention approach is considered attractive, the practicalities of operating this across disparate professional borders are likely to present a long-term challenge.

Functional profiles of school refusal behavior and their relationship with depression, anxiety, and stress

Negative emotional states are common among youth with problematic school absenteeism, but little is known about their presence across different school refusal behavior profiles. The aim of this study was twofold: to identify different cluster solutions across functional profiles of school refusal behavior (I. Avoidance of Negative Affectivity, II. Escape from Social and/or Evaluative Situations, III. Pursuit of Attention, and IV. Pursuit of Tangible Reinforcement) and to determine whether these profiles differ from each other based on dimensions of depression, anxiety, and stress. The sample consisted of 1582 Ecuadorian adolescents aged 12-18 years (M = 14.83; SD = 1.86) who completed the School Refusal Assessment Scale-Revised (SRAS-R) and the Depression, Anxiety and Stress Scale-21 (DASS-21). Latent class analysis revealed three school refusal profiles: non-school refusal behavior, school refusal behavior by tangible reinforcements, and school refusal behavior by multiple reinforcements. The last group displayed the most maladaptive profile and revealed highest mean scores on the three dimensions of the DASS-21 compared to other groups. To promote mental health in this group it is a necessary goal due to their link with these negative emotional states. Prevention measures to strengthen emotional self-regulation should be considered in these cases.

Validation of the Visual Analogue Scale for Anxiety-Revised and school refusal across anxiety profiles

BACKGROUND/OBJECTIVES

This paper aimed to validate the Spanish version of scores of the Visual Analogue Scale for Anxiety-Revised (VAA-R) in child population, and to verify the existence of anxiety profiles and to relate them to school refusal.

METHOD

The sample was made up of 911 Spanish students between 8 and 12 years old (M = 9.61, SD = 1.23). The measures used were the VAA-R and the School Refusal Assessment Scale-Revised for Children (SRAS-R-C).

RESULTS

Confirmatory factorial analysis supported the three-dimensional VAA-R structure: Anticipatory Anxiety (AA), School-based performance Anxiety (SA) and Generalized Anxiety (GA). The VAA-R has an adequate reliability and structural invariance across sex and age. No latent mean differences were found across sex, but did occur through age in AA and GA factors. Cluster analysis identified four child anxiety profiles: High Anxiety, High Anxiety School-type, Low Anxiety, and Moderate Anxiety, which differed significantly in all dimensions of school refusal.

CONCLUSIONS

These findings may be useful for the assessment and treatment of anxious symptoms originated at school.

Positive and negative affect as predictors of social functioning in Spanish children

The aim of this study was to analyze the relationship between affect in its two commonly used theoretical categories, positive affect (PA) and negative affect (NA), and social functioning dimensions (school performance, family relationships, peer relationships and home duties/self-care). The sample comprised 390 students of primary education aged 8–11 years (M = 9.39; SD = 1.15). The short-form of the Positive and Negative Affect Schedule for children (PANAS-C-SF) and the Child and Adolescent Social Adaptive Functioning Scale (CASAFS) were used. Student’s t tests indicated that those reporting high levels on all the social functioning dimensions also reported significantly higher levels of PA than peers who reported low levels; by contrast, students reporting high levels of social functioning reported significantly lower levels of NA than peers who reported low levels. Similarly, logistic regression analyses showed that an increase in PA increased probability of high levels of social functioning, and that an increase in NA decreased the probability of presenting high levels of social functioning dimensions, with the exception of school performance. These results expand the PA and NA relationship with social functioning reported in adults to Spanish children, which is potentially of interest in the fields of Education and Psychology.

Positive and Negative Affect Schedule-Short Form: Factorial Invariance and Optimistic and Pessimistic Affective Profiles in Spanish Children

The distinction in recent years between positive affect (PA) and negative affect (NA) is becoming increasingly important due to their relationship with depression and anxiety. This work is composed of two studies. The first study aimed to validate the brief version of the Positive and Negative Affect Schedule for Children-Short Form (PANAS-C-SF) in a Spanish child sample. The second study sought to check the existence of four affective profiles: self-fulfilling (high PA and low NA), low affective (low PA and NA), high affective (high PA and NA), and self-destructive (low PA and high NA) and to relate them to optimism and pessimism. Samples for both studies were composed of 647 and 1,296 Spanish students (between 8 and 11 years), respectively. Through various multigroup confirmatory factor analyses (MCA), the invariance of the PANAS-SF and the lack of significant gender differences in the latent means were verified. In addition, cluster analysis confirmed the existence of the appropriate profiles. In this case, the self-fulfilling profile correlated with high scores in optimism and low scores pessimism, whereas the self-destructive profile correlated in the opposite direction. These contributions represent an advance in the study of child affect.

Aggression Profiles in the Spanish Child Population: Differences in Perfectionism, School Refusal and Affect

The aim of this study was to identify the existence of combinations of aggression components (Anger, Hostility, Physical Aggression and Verbal Aggression) that result in different profiles of aggressive behavior in children, as well as to test the differences between these profiles in scores of perfectionism, school refusal and affect. It is interesting to analyze these variables given: (a) their clinical relevance due to their close relationship with the overall psychopathology; and (b) the need for further evidence regarding how they are associated with aggressive behavior. The sample consisted of 1202 Spanish primary education students between the ages of 8 and 12. Three aggressive behavior profiles for children were identified using Latent Class Analysis (LCA): High Aggression (Z scores between 0.69 and 0.7), Moderate Aggression (Z scores between -0.39 and -0.47) and Low Aggression (Z scores between -1.36 and -1.58). These profiles were found for 49.08%, 38.46% and 12.48% of the sample, respectively. High Aggression scored significantly higher than Moderate Aggression and Low Aggression on Socially Prescribed Perfectionism (SPP), Self-Oriented Perfectionism (SOP), the first three factors of school refusal (i.e., FI. Negative Affective, FII. Social Aversion and/or Evaluation, FIII. To Pursue Attention), and Negative Affect (NA). In addition, Moderate Aggression also reported significantly higher scores than Low Aggression for the three first factors of school refusal and NA. Conversely, Low Aggression had significantly higher mean scores than High Aggression and Moderate Aggression on Positive Affect (PA). Results demonstrate that High Aggression was the most maladaptive profile having a high risk of psychological vulnerability. Aggression prevention programs should be sure to include strategies to overcome psychological problems that characterize children manifesting high levels of aggressive behavior.