Beyond Medical Absence: Grade-Related and Year-To-Year Persistent Patterns of Parent-Reported Psychological/Functional Absence in Routine School Attendance Records.
Psychological/functional absences may be obscured within broad medical leave categories in routine attendance records. This study examined whether parent-reported psychological/functional absence is patterned and persistent in a Chinese secondary school context.
We analyzed retrospective attendance records from 2183 students and 26,092 absence events across the 2022-2025 academic years. Parent-reported reasons were coded into 8 categories. Event-level logistic regression with student-clustered robust standard errors examined associations with grade, sex, cohort, academic year, and month; student-year lagged models examined recurrence.
Psychological/functional absence accounted for 5179 events (19.8%). In the fully adjusted event-level model, Grade 11 students had higher odds of psychological/functional absence than Grade 8 students (OR = 2.62, 95% CI [1.45, 4.72], p = 0.001). Prior-year psychological/functional absence predicted current-year occurrence (OR = 3.50, 95% CI [2.67, 4.59], p < 0.001), and prior-year count predicted current-year count (IRR = 1.06, 95% CI [1.04, 1.07], p < 0.001) IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY: Repeated psychological/functional absences may help schools identify students needing timely, non-punitive follow-up.
Psychological/functional absence appears to be a recurring administrative signal, but should not be interpreted as a clinical diagnosis.
We analyzed retrospective attendance records from 2183 students and 26,092 absence events across the 2022-2025 academic years. Parent-reported reasons were coded into 8 categories. Event-level logistic regression with student-clustered robust standard errors examined associations with grade, sex, cohort, academic year, and month; student-year lagged models examined recurrence.
Psychological/functional absence accounted for 5179 events (19.8%). In the fully adjusted event-level model, Grade 11 students had higher odds of psychological/functional absence than Grade 8 students (OR = 2.62, 95% CI [1.45, 4.72], p = 0.001). Prior-year psychological/functional absence predicted current-year occurrence (OR = 3.50, 95% CI [2.67, 4.59], p < 0.001), and prior-year count predicted current-year count (IRR = 1.06, 95% CI [1.04, 1.07], p < 0.001) IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY: Repeated psychological/functional absences may help schools identify students needing timely, non-punitive follow-up.
Psychological/functional absence appears to be a recurring administrative signal, but should not be interpreted as a clinical diagnosis.