Sensory Processing Sensitivity and Psychosocial Characteristics in Elementary School Children with School Refusal

Sensory Processing Sensitivity and Psychosocial Characteristics in Elementary School Children with School Refusal | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Sensory Processing Sensitivity and Psychosocial Characteristics in Elementary School Children with School Refusal Satoshi Nobusako, Harumi Mouri, Emiko Takata This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8925413/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 7 You are reading this latest preprint version Abstract Background School refusal (SR) in late childhood is often accompanied by emotional distress, yet temperamental factors conferring vulnerability remain insufficiently understood. Sensory processing sensitivity (SPS), within the environmental sensitivity framework, may amplify stress reactivity and maladjustment; however, evidence in elementary school–aged children is limited. This study examined SPS and related psychosocial characteristics in children with and without SR experiences. Methods Japanese children in Grades 3–6 with current or past SR (SR group; n = 27) and peers with regular attendance (RA group; n = 35) completed self-report measures of SPS (Japanese version of the Highly Sensitive Child Scale for Childhood; J-HSCS-C), stress responses (Children’s Stress Response scale; CSR), and interpersonal sensitivity (Short Forms of the Children’s Interpersonal Sensitivity Measure; CISM). Parents completed the J-HSCS-C. Group comparisons and within-group correlations were conducted. Results The SR group reported higher overall SPS than the RA group (J-HSCS-C mean 5.12 vs. 4.53; t(60) = 2.19, p = .033, d = 0.56). Differences were concentrated in the combined Low Sensory Threshold/Ease of Excitation (LST/EOE) facet (SR > RA; z = − 2.54, p = .011), whereas Aesthetic Sensitivity did not differ. The SR group showed markedly elevated stress responses (CSR total: z = − 4.39, p < .001), while no significant group differences were observed for CISM scores. In the SR group, SPS was positively associated with stress responses (SPS mean with CSR total: r = 0.44, p < .05) and negative interpersonal sensitivity (SPS mean with CISM-NIS: r = 0.42, p < .05). In the RA group, SPS was associated primarily with negative interpersonal sensitivity (SPS mean with CISM-NIS: r = 0.54, p < .01) and showed no significant association with CSR total (r = 0.30). Exploratory parent–child analyses suggested clearer correspondence in the SR group (total SPS: r = 0.45, p < .05) than in the RA group (total SPS: r = 0.22). Conclusions Children with SR experiences may be characterized by elevated SPS—particularly LST/EOE—alongside heightened stress reactivity. Considering SPS may be useful for assessment and support planning for elementary school children experiencing SR. Childhood Interpersonal Sensitivity School Refusal (SR) Sensory Processing Sensitivity (SPS) Stress Responses Figures Figure 1 Figure 2 Figure 3 Research Highlights Elementary school children with school refusal showed higher SPS, mainly in LST/EOE Stress responses were markedly elevated in children with school refusal Interpersonal sensitivity showed no group differences, but correlated with SPS and stress Parent–child SPS correspondence was greater in the school refusal group Introduction School refusal (SR) refers to a child’s difficulty attending or remaining at school due to emotional distress, rather than willful truancy or external constraints. Accumulating evidence links SR to a broad range of adverse outcomes, including academic underachievement, emotional difficulties, and impaired social development, with potential long-term consequences extending into adolescence and adulthood [ 1 , 2 ]. Notably, SR is not limited to adolescence; school attendance problems emerging in elementary school predict later educational, psychosocial, and socioeconomic disadvantages [ 3 ]. Together, these findings highlight childhood as a critical window for understanding SR, when early identification and intervention may be especially impactful. Previous research has conceptualized school refusal (SR) as a multifactorial phenomenon arising from the interaction of child-related, family-related, and school-related factors [ 1 ]. Among child-related factors, internalizing problems—particularly anxiety—have been consistently identified as central correlates of SR. Systematic and scoping reviews have demonstrated robust associations between SR and various forms of anxiety, including separation anxiety, social anxiety, and school-related anxiety, across childhood and adolescence [ 4 , 5 , 6 ]. In addition, stress-related emotional and somatic responses, such as irritability, fatigue, and physical complaints, as well as interpersonal difficulties within the school context, have been implicated in the development and maintenance of SR [ 1 , 2 ]. However, despite extensive research on anxiety, stress, and interpersonal factors, it remains unclear whether sensory processing sensitivity (SPS)—a temperamental tendency toward heightened responsiveness to environmental stimuli—constitutes an underlying individual characteristic associated with SR in elementary school–aged children. Environmental sensitivity refers to individual differences in how strongly children register and process environmental stimuli and, consequently, how much they are affected by both adverse and supportive contexts [ 7 ]. Within this broader framework, SPS has been conceptualized as a temperament-like trait characterized by deeper processing of sensory and social information, heightened emotional reactivity and empathy, increased awareness of subtle stimuli, and a tendency toward overstimulation under high demands [ 7 , 8 ]. In developmental research, SPS is commonly assessed using the Highly Sensitive Child Scale (HSCS), a brief 12-item self-report measure that captures three dimensions: ease of excitation (EOE), low sensory threshold (LST), and aesthetic sensitivity (AES) [ 9 , 10 ]. For Japanese elementary school children, Kibe and Hirano [ 11 ] developed the Japanese version of the Highly Sensitive Child Scale for Childhood (J-HSCS-C) by adapting the HSCS and refining the wording of the adolescent Japanese version [ 12 ] to ensure comprehensibility for Grades 3–6. Psychometric evaluations have suggested a developmental pattern in which EOE and LST are less clearly differentiated during childhood and instead form a combined EOE/LST factor, whereas AES emerges as a distinct dimension; the total scale has demonstrated acceptable internal consistency [ 11 ]. In the present study, children’s SPS was operationalized using the J-HSCS-C. However, despite the growing literature on SPS and environmental sensitivity in child development, the extent to which SPS is associated with SR during late childhood remains insufficiently understood. SR is commonly accompanied by pronounced emotional distress and somatic complaints and is frequently associated with internalizing difficulties such as anxiety and depression [ 2 , 6 ]. Beyond emotional symptoms, SR has also been linked to poorer social functioning, including difficulties in peer relationships and discomfort in social interactions within school settings, which may further contribute to avoidance of school attendance [ 2 , 13 , 14 ]. Taken together, these findings suggest that SR is closely related to heightened stress reactivity and interpersonal sensitivity in children. Accordingly, the present study assessed children’s stress responses using the Children’s Stress Response scale (CSR) [ 15 ] and interpersonal sensitivity using the Short Forms of the Children’s Interpersonal Sensitivity Measure (CISM) [ 16 , 17 ]. In the present study, we examined SPS in typically developing elementary school children with and without experiences of SR. Children’s SPS was assessed using the J-HSCS-C [ 9 , 11 , 12 ], together with self-report measures of stress responses (CSR) and interpersonal sensitivity (CISM). First, we compared levels of SPS, stress responses, and interpersonal sensitivity between children who were currently experiencing SR or had a history of SR and peers with regular school attendance. We then examined associations between SPS and both stress responses and interpersonal sensitivity within each group and across the full sample. Finally, adopting a multi-informant perspective, parents completed the J-HSCS-C based on their perceptions of their child, and we explored the degree of parent–child correspondence in SPS scores as a preliminary indicator of parental understanding of children’s sensitivity traits. We hypothesized that children with SR experiences would exhibit higher SPS, stronger stress responses, and greater interpersonal sensitivity than regularly attending children, and that SPS would be positively associated with stress responses and interpersonal sensitivity. Because evidence regarding parent–child agreement in SPS in the context of SR remains limited, analyses involving parent reports were treated as exploratory. Methods Participants Typically developing elementary school children and their parents participated in this study. Participants were recruited through parent support organizations related to school refusal (SR), local educational support centers, and public elementary schools. The study comprised two groups. The first group consisted of 27 children who were either currently experiencing SR or had a history of SR during elementary school (mean grade ± standard deviation = 4.70 ± 1.01; grade range: 3rd–6th grade; 15 boys and 12 girls), along with their parents. In the present study, SR was defined as a condition in which a child does not attend or is unable to attend school for psychological, emotional, physical, or social reasons, excluding cases attributable to illness or economic factors. The second group included 35 children with no experience of SR (mean grade ± standard deviation = 4.31 ± 1.09; grade range: 3rd–6th grade; 22 boys and 13 girls) and their parents. Grade level was recorded according to the Japanese elementary school system, in which children typically progress from the 3rd to the 6th grade during late childhood. Children with current or past SR experiences were classified as the SR group, whereas those without such experiences were classified as the regular attendance (RA) group. The primary aim of this study was to examine the association between school refusal (SR) and environmental sensitivity traits. However, previous studies have reported that both SR behavior and environmental sensitivity are associated with neurodevelopmental conditions, including Autism Spectrum Disorder (ASD) [ 18 – 20 ]. To control for potential confounding effects, children with neurodevelopmental disorders were excluded from the study. The exclusion criteria were as follows: (1) SR attributable to general medical conditions, such as illness or infectious diseases (e.g., influenza), injuries resulting from falls or traffic accidents, or physical disabilities including cerebral palsy, hemiplegia, or muscular dystrophy; (2) a clinical diagnosis of a neurodevelopmental disorder, including ASD, Attention Deficit/Hyperactivity Disorder (ADHD), developmental coordination disorder, or specific learning disorder; (3) a diagnosis of intellectual disability. Eligibility was confirmed based on the results of routine health examinations conducted by school physicians or the participant’s primary care physician, as well as interviews with parents. All experimental procedures in this study were approved by the institutional ethics committee of the authors’ affiliated institution (approval number: R5-46). The study involved no foreseeable risks to the participants, and no personally identifiable information was collected. Written informed consent was obtained from all participating elementary school children and their parents, along with the provision of relevant background information. All procedures were conducted in accordance with the ethical standards of the 1964 Declaration of Helsinki concerning research involving human participants. Procedures Children in both groups completed the Japanese version of the Highly Sensitive Child Scale for Childhood (J-HSCS-C), the Children’s Stress Response scale (CSR), and the short form of the Children’s Interpersonal Sensitivity Measure (CISM). In addition, parents of these children were asked to complete the J-HSCS-C to report their perceptions of their child’s environmental sensitivity. Japanese version of Highly Sensitive Child Scale for Childhood (J-HSCS-C) The Japanese version of the Highly Sensitive Child Scale for Childhood (J-HSCS-C) is a self-report questionnaire developed to assess individual differences in children’s SPS. The scale was created by adapting the original HSCS developed by Pluess et al. [ 9 ] and by simplifying and adjusting the item wording of the Japanese version for adolescence (J-HSCS-A) to ensure comprehensibility for elementary school children (Grades 3–6) [ 11 , 12 ]. The J-HSCS-C consists of 12 items and was used in the present study to evaluate children’s self-reported SPS. Exploratory factor analysis (maximum likelihood with promax rotation) has supported a two-factor structure, in which Ease of Excitation (EOE) and Low Sensory Threshold (LST) load on a combined factor (EOE/LST), and Aesthetic Sensitivity (AES) forms the second factor [ 11 ]. This pattern suggests that, in childhood, heightened excitability and low sensory threshold may be less clearly differentiated and may be captured as a single component [ 11 ]. Subscale scores are computed as the mean of the corresponding items, and an overall SPS score is calculated as the mean across all items; higher scores indicate greater sensory processing sensitivity. The internal consistency of the total scale has been reported as acceptable (Cronbach’s α = .84), with subscale coefficients of α = .81 for EOE/LST and α = .62 for AES [ 11 ]. To capture children’s SPS from a multi-informant perspective, we also collected parent-reported ratings of children’s SPS. Given that SPS reflects a temperament-like trait characterized by heightened internal reactivity, discrepancies between self- and other-reports may occur; nevertheless, the use of parent-report measures has been considered informative in assessing SPS in younger populations [ 21 – 23 ]. Accordingly, parents completed the same J-HSCS-C items based on their perceptions of their child, enabling us to examine whether parents’ understanding of their child’s SPS is associated with SR. Children’s Stress Response (CSR) The Children’s Stress Response scale (CSR) is a self-report questionnaire developed to provide a brief and efficient assessment of children’s stress reactions. It is intended for use with children and adolescents from approximately 9 years of age (upper elementary school) through high school [ 15 ]. The CSR comprises 12 items representing physical, motivational, and emotional responses to stress. Each item is rated on a 4-point Likert scale ranging from 0 (“not at all applicable”) to 3 (“very applicable”), with higher total scores indicating greater stress responsiveness. The CSR includes three subscales. The Anger subscale (Items 3, 7, and 11) captures reactions such as feeling irritated, becoming quick-tempered, or feeling annoyed without a clear reason. The Apathy subscale (Items 1, 4, 8, and 12) reflects reduced motivation and energy, including sluggishness, lack of motivation, difficulty making an effort, and difficulty concentrating. The Depression/Physical Reaction subscale (Items 2, 5, 6, 9, and 10) assesses emotional and somatic complaints, such as palpitations, stomachaches, feeling like crying, headaches, and feeling down. The total score ranges from 0 to 36, and subscale scores can also be calculated. The CSR has demonstrated good internal consistency, with Cronbach’s alpha coefficients of .87 for Anger, .82 for Apathy, and .73 for Depression/Physical Reaction [ 15 ]. In addition, CSR scores have been reported to correlate positively with the Public Health Research Foundation Type Stress Inventory (PSI), supporting concurrent validity [ 15 ]. Short Forms of the Children's Interpersonal Sensitivity Measure (CISM) The Short Forms of the Children’s Interpersonal Sensitivity Measure (CISM) is a revised and abbreviated version of the Interpersonal Sensitivity Scale originally developed by Kouda and Hidaka [ 16 ], adapted to facilitate use with children [ 17 ]. The scale is designed to assess individual differences in the tendency to respond sensitively to others’ behaviors and attitudes. Exploratory factor analysis has supported a two-factor structure consisting of Negative Interpersonal Sensitivity and Positive Interpersonal Sensitivity, with a total of 11 items. Negative Interpersonal Sensitivity (Items 1–7) reflects a tendency to experience anxiety or fear in response to others’ evaluations or attitudes. In contrast, Positive Interpersonal Sensitivity (Items 8–11) captures a tendency to feel reassurance when exposed to others’ positive verbal and nonverbal cues. Higher scores indicate greater levels of interpersonal sensitivity. The short-form CISM has demonstrated high internal consistency, with Cronbach’s alpha coefficients of .90 for Negative Interpersonal Sensitivity and .91 for Positive Interpersonal Sensitivity. In addition, moderate correlations with related constructs, such as interpersonal vulnerability and empathic sensitivity, have been reported, supporting the concurrent validity of the scale [ 17 ]. In the present study, the short-form CISM was used to assess children’s interpersonal sensitivity traits. Statistical analysis We conducted statistical comparisons of each variable measured between the SR and RA groups. For sex, we used the chi-square test. For grade level, J-HSCS-C variables, CSR variables, and CISM variables, we first assessed the normality of distributions using the Shapiro–Wilk test. Variables that were normally distributed were compared between groups using independent samples t-tests, whereas those that were not normally distributed were compared using the Mann–Whitney U test. Across each group and the total sample, to examine the relationships among environmental sensitivity, stress responses, and interpersonal sensitivity, we conducted correlation analyses between J-HSCS-C variables, CSR variables, and CISM variables. Based on the results of the Shapiro–Wilk test, Pearson correlation coefficients were used for variables with normal distributions, whereas Spearman’s rank correlation coefficients were used for variables with non-normal distributions. Furthermore, to investigate whether the extent to which parents understand their child’s environmental sensitivity is associated with SR, we conducted correlation analyses, across each group and the total sample, between the child’s self-reported J-HSCS-C scores and parent-reported J-HSCS-C scores. Again, based on the results of the Shapiro–Wilk test, Pearson correlation coefficients were used for variables with normal distributions, whereas Spearman’s rank correlation coefficients were used for variables with non-normal distributions. We set the significance level at α = 0.05 for all analyses and calculated effect sizes where applicable. All statistical analyses were conducted using SPSS version 29 (IBM Corporation, Armonk, NY, USA). Results Table 1 summarizes all measured data from the participants. There were no significant differences between the SR and RA groups in terms of grade level ( z = -1.432, p = 0.152, r = -0.182) or sex ( χ² (1) = 0.338, p = 0.561, φ = 0.074). Table 1 Summary of measurement data for both groups. Group Grade Sex J-HSCS-C Self report J-HSCS-C Parent report CSR CISM LST/EOE AES Total LST/EOE AES Total Anger Apathy D&Pr Total NIS PIS School Refusal (SR) n = 27 Mean 4.70 M, n=15 F, n = 12 4.95 5.44 5.12 5.47 5.20 5.38 4.96 7.00 5.07 17.04 2.21 3.58 SD 1.01 1.28 1.02 0.97 1.05 0.86 0.86 2.85 2.85 3.50 7.27 1.00 0.44 Min 3 1.75 3 2.75 3.25 3.25 3.58 0 1 0 2 1 2.75 Max 6 7 7 6.75 7.00 6.75 6.75 9 12 12 32 4 4 Skewness -0.456 -0.879 -0.293 -0.313 -0.750 -0.011 -0.695 -0.453 0.076 0.204 0.106 0.350 -0.562 Kurtosis -0.799 0.283 -0.548 -0.347 -0.166 -0.554 -0.211 -0.973 -0.859 -0.938 -0.066 -1.226 -0.920 Regular Attendance (RA) n = 35 Mean 4.31 M, n=22 F, n = 13 4.11 5.36 4.53 4.68 4.34 4.56 2.91 2.60 2.14 7.66 1.98 3.60 SD 1.09 1.34 0.99 1.08 0.76 1.02 0.76 2.90 2.51 2.50 6.65 0.79 0.58 Min 3 1.63 3 2.33 3.38 2 3.17 0 0 0 0 1 1.50 Max 6 7 7 7 6.38 6.50 6.33 9 9 10 24 3.71 4 Skewness 0.282 0.104 -0.301 0.118 0.453 0.273 0.470 0.646 0.706 1.290 0.818 0.551 -1.999 Kurtosis -1.215 -0.950 0.046 -0.491 -0.350 0.147 -0.050 -0.710 -0.275 1.687 0.000 -0.712 4.866 AES, Aesthetic Sensitivity; CISM, Short Forms of the Children's Interpersonal Sensitivity Measure; CSR, Children’s Stress Response scale; D&Pr, Depression and Physical reaction; EOE, Ease of Excitation; F, Female; J-HSCS-C, Japanese version of the Highly Sensitive Child Scale for Childhood; LST, Low Sensory Threshold; M, Male; Max, Maximum; Min, Minimum; N, Number; NIS, Negative Interpersonal Sensitivity; PIS, Positive Interpersonal Sensitivity; SD, Standard Deviation Figure 1 presents the comparison of J-HSCS-C scores between the SR and RA groups. The overall mean J-HSCS-C score in the SR group was 5.12, whereas that in the RA group was 4.53 (see Table 1 ). The SR group showed significantly higher scores than the RA group on three individual items (Item 6, 9, 11) within the LST/EOE subscale, the overall mean LST/EOE score, and the overall mean J-HSCS-C score (Item 6, z = -2.008, p = 0.045, r = -0.255; Item 9, z = -3.077, p = 0.002, r = -0.391; Item 11, z = -1.981, p = 0.048, r = -0.252; LST/EOE, z = -2.536, p = 0.011, r = -0.322; J-HSCS-C, t (60) = 2.187, p = 0.033, r = 0.27, d = 0.56, Δ = -0.60). However, no significant differences were found in the individual items of the AES subscale or in the overall mean AES score. Figure 2 shows the comparison of CSR scores between the SR and RA groups. The SR group showed significantly higher scores than the RA group on many items of the CSR as well as on the total score (Item 3, z = -2.438, p = 0.015, r = -0.31; Item 11, z = -2.516, p = 0.012, r = -0.32; Anger total, z = -2.647, p = 0.008, r = -0.34; Item 1, z = -2.952, p = 0.003, r = -0.38; Item 4, z = -4.798, p < 0.001, r = -0.61; Item 8, z = -4.611, p < 0.001, r = -0.59; Item 12, z = -3.118, p = 0.002, r = -0.40; Apathy total, z = -4.996, p < 0.001, r = -0.63; Item 2, z = -2.034, p = 0.042, r = -0.26; Item 6, z = -2.949, p = 0.003, r = -0.38; Item10, z = -2.166, p = 0.030, r = -0.28; Depression and Physical reaction total, z = -3.341, p = 0.001, r = -0.42; CSR total, z = -4.387, p < 0.001, r = -0.56). Among all CSR items, only Item 5, Item 7, and Item 9 showed no significant differences between the SR and RA groups. Figure 3 presents the comparison of CISM scores between the SR and RA groups. No significant differences were found between the SR and RA groups for any individual items or the overall mean scores of all CISM subscales. Table 2 (upper panel) presents the results of the correlation analyses among the measured variables in the SR group. The main findings of the correlation analysis in the SR group indicated that the overall mean J-HSCS-C score was significantly positively correlated with Anger in the CSR ( r = 0.387, p = 0.046), Apathy in the CSR ( r = 0.405, p = 0.036), the CSR total score ( r = 0.444, p = 0.020), and the mean score of Negative Interpersonal Sensitivity in the CISM ( r = 0.415, p = 0.035). Furthermore, the CSR total score was significantly positively correlated with the mean score of Negative Interpersonal Sensitivity in the CISM ( r = 0.681, p < 0.001). Table 2 Correlation matrix among the measured variables. J-HSCS-C CSR CISM LST/EOE AES Mean Anger Apathy D&Pr Total NIS PIS School Refusal (SR) n = 27 J-HSCS-C LST/EOE ― AES 0.159 ― Mean .938** .492** ― CSR Anger .484* -0.003 .387* ― Apathy .429* 0.073 .405* 0.333 ― D&Pr 0.222 0.164 0.254 0.364 .494** ― Total .465* 0.094 .444* .717** .792** .829** ― CISM NIS .411* -0.007 .415* .461* .430* .672** .681** ― PIS 0.143 0.179 0.157 0.113 0.270 -0.035 0.189 0.249 ― Regular Attendance (RA) n = 35 J-HSCS-C LST/EOE ― AES .458** ― Mean .962** .682** ― CSR Anger 0.298 -0.168 0.231 ― Apathy 0.334 0.008 0.327 .570** ― D&Pr 0.174 0.012 0.189 .470** .537** ― Total 0.321 -0.057 0.295 .836** .849** .770** ― CISM NIS .477** .423* .539** 0.308 .352* 0.332 .391* ― PIS 0.157 0.085 0.177 -0.174 -0.329 -0.051 -0.239 0.269 ― Total n = 62 J-HSCS-C LST/EOE ― AES .346** ― Mean .961** .555** ― CSR Anger .435** -0.087 .364** ― Apathy .475** 0.065 .427** .582** ― D&Pr .287* 0.073 .296* .511** .635** ― Total .467** 0.010 .419** .814** .886** .829** ― CISM NIS .455** 0.188 .464** .414** .354** .482** .474** ― PIS 0.072 0.146 0.112 -0.102 -0.127 -0.082 -0.124 0.250 ― **p < 0.01, *p < 0.05 AES, Aesthetic Sensitivity; CISM, Short Forms of the Children's Interpersonal Sensitivity Measure; CSR, Children’s Stress Response scale; D&Pr, Depression and Physical reaction; EOE, Ease of Excitation; J-HSCS-C, Japanese version of the Highly Sensitive Child Scale for Childhood; LST, Low Sensory Threshold; NIS, Negative Interpersonal Sensitivity; PIS, Positive Interpersonal Sensitivity Table 2 (middle panel) presents the results of the correlation analyses among the measured variables in the RA group. The main findings of the correlation analysis in the RA group indicated that the overall mean J-HSCS-C score was significantly positively correlated with the mean score of Negative Interpersonal Sensitivity in the CISM ( r = 0.539, p = 0.001). In addition, the CSR total score was significantly positively correlated with the mean score of Negative Interpersonal Sensitivity in the CISM ( r = 0.391, p = 0.020). No significant correlations were found between the subscale scores or the overall mean score of the J-HSCS-C and the subscale scores or total score of the CSR. Table 2 (lower panel) presents the results of the correlation analyses among the measured variables across the total sample. The main findings of the correlation analysis across the total sample indicated that the overall mean J-HSCS-C score was significantly positively correlated with Anger in the CSR ( r = 0.364, p = 0.004), Apathy in the CSR ( r = 0.427, p = 0.001), Depression and Physical Reaction in the CSR ( r = 0.296, p = 0.020), the CSR total score ( r = 0.419, p = 0.001), and the mean score of Negative Interpersonal Sensitivity in the CISM ( r = 0.464, p < 0.001). Furthermore, the CSR total score was significantly positively correlated with the mean score of Negative Interpersonal Sensitivity in the CISM ( r = 0.474, p < 0.001). Table 3 presents the results of correlation analyses between children’s self-reported J-HSCS-C scores and parent-reported J-HSCS-C scores. In the SR group, significant positive correlations between children's self-reports and parent-reports were found for Item 2 ( rs = 0.553, p = 0.003), Item 6 ( rs = 0.401, p = 0.038), Item 7 ( rs = 0.686, p < 0.001), Item 9 ( rs = 0.417, p = 0.031), Item 11 ( rs = 0.398, p = 0.040), LST/EOE ( rs = 0.402, p = 0.037), Item 1 ( rs = 0.394, p = 0.042), Item 3 ( rs = 0.553, p = 0.003), Item 5 ( rs = 0.520, p = 0.005), Item 10 ( rs = 0.389, p = 0.045), AES ( r = 0.571, p = 0.002), and the J-HSCS-C overall mean score ( r = 0.445, p = 0.020). In contrast, in the RA group, a significant positive correlation was observed only for Item 11 ( r = 0.410, p = 0.014). Across the entire sample, significant positive correlations were found between children’s and parents’ J-HSCS-C scores for Item 2 ( rs = 0.356, p = 0.005), Item 7 ( rs = 0.415, p = 0.001), Item 9 ( r = 0.333, p = 0.008), Item 11 ( rs = 0.491, p < 0.001), LST/EOE ( r = 0.437, p < 0.001), Item 5 ( rs = 0.257, p = 0.044), and the J-HSCS-C overall mean score ( r = 0.396, p = 0.001). Table 3 Correlation Matrix Between Self-Report and Parent-Report Scores on the Highly Sensitive Child Scale. Item 2 Item 4 Item 6 Item 7 Item 8 Item 9 Item 11 Item 12 LST/EOE Item 1 Item 3 Item 5 Item 10 AES J-HSCS-C SR group Parent-Child Correlation 0.553** 0.254 0.401* 0.686** 0.176 0.417* 0.398* 0.381 0.402* 0.394* 0.553** 0.520** 0.389* 0.571** 0.445* RA group Parent-Child Correlation 0.098 0.105 -0.124 0.206 -0.171 0.175 0.410* -0.176 0.270 -0.003 -0.008 0.125 0.042 -0.004 0.223 Total Parent-Child Correlation 0.356** 0.202 0.195 0.415** 0.033 0.333** 0.491** 0.140 0.437** 0.168 0.233 0.257* 0.170 0.222 0.396** The numbers represent correlation coefficients. ** p < 0.01, * p < 0.05 AES, Aesthetic Sensitivity; EOE, Ease of Excitation; J-HSCS-C, Japanese version of the Highly Sensitive Child Scale for Childhood; LST, Low Sensory Threshold; RA, Regular attendance; SR, School refusal Discussion In this study of typically developing elementary school children, those with current or past SR showed higher SPS and markedly elevated stress responses compared with peers with RA, while no group differences were observed in interpersonal sensitivity. Specifically, SR-related differences in SPS were concentrated in the combined LST/EOE component (rather than aesthetic sensitivity), and SR children reported higher CSR scores across most items and subscales. Correlational analyses further indicated that, in the SR group, SPS was positively associated with stress responses and negative interpersonal sensitivity, whereas in the RA group SPS was related primarily to negative interpersonal sensitivity and showed no significant associations with stress responses. Finally, parent–child correspondence in SPS scores was more evident in the SR group than in the RA group, and parent-report analyses were therefore interpreted as exploratory. Facet-Specific SPS Differences in SR: Elevated EOE/LST and Comparable AES First, elementary school children with current or past SR showed significantly higher SPS than peers with RA, and this SR-related difference was concentrated in the combined EOE/LST component rather than AES. Specifically, the SR group scored higher on the J‑HSCS‑C total (SR: M = 5.12; RA: M = 4.53) and on EOE/LST (SR: M = 4.95; RA: M = 4.11), whereas AES did not differ between groups (SR: M = 5.44; RA: M = 5.36). Although we did not classify individuals into sensitivity groups, the SR group mean exceeded the exploratory HSCS cut-off proposed for the “highly sensitive” group in children (> 4.75), while the RA group mean fell below it; importantly, such cut-offs should be interpreted cautiously and may vary across samples and cultures [ 9 ]. Conceptually, EOE/LST captures a propensity to become easily overwhelmed by demands and to experience unpleasant sensory arousal, whereas AES reflects heightened awareness of subtleties and responsiveness to aesthetic or potentially positive cues [ 7 , 10 ]. Prior work has similarly suggested that the EOE/LST-related facet of sensitivity is more strongly tied to negative affectivity and internalizing difficulties than AES [ 9 , 10 ]. From an SR perspective, school refusal is typically characterized by emotional distress and avoidance of school-related situations that elicit anxiety and somatic complaints [ 1 , 6 ]. Taken together, our findings raise the possibility that heightened EOE/LST-related SPS may function as an underlying dispositional factor that amplifies children’s stress and anxiety in response to the sensory, academic, and interpersonal demands of school, thereby increasing vulnerability to SR. Nevertheless, because the present study was cross-sectional, longitudinal work is needed to determine whether elevated SPS precedes SR onset or emerges as a consequence of SR-related experiences. Markedly Elevated Stress Responses in SR: CSR Findings and Clinical Implications Second, children with SR experiences reported markedly elevated stress responses on the CSR compared with peers with RA, with higher scores observed across the Anger, Apathy, and Depression/Physical Reaction domains as well as on the CSR total score. This pattern is broadly consistent with prior work indicating that SR is frequently accompanied by internalizing difficulties (e.g., anxiety and depressive symptoms), emotional distress, and somatic complaints, which may contribute to the onset and maintenance of school avoidance [ 1 , 2 , 4 – 6 ]. Clinically, the present findings suggest that assessment of SR in late childhood should include careful evaluation of children’s stress-related emotional, motivational, and physical reactions, as these responses may represent proximal targets for intervention [ 1 ]. For example, interventions that reduce stress arousal and strengthen coping and emotion-regulation skills (e.g., cognitive-behavioral approaches) may be particularly relevant for children showing prominent CSR elevations [ 1 , 24 ]. Notably, within the SR group, SPS was positively associated with CSR indices, raising the possibility that heightened SPS may amplify stress reactivity in school-related contexts; this potential linkage between SPS and stress responding is discussed further in the following section. Interpersonal Sensitivity in SR: No Group Differences but NIS Links to SPS and CSR Third, we observed no group differences between SR and RA in CISM scores, suggesting that interpersonal sensitivity, as assessed by this trait-oriented measure, may not function as a categorical marker of SR experiences in late childhood. However, correlational analyses highlighted a more nuanced pattern: NIS (but not PIS) was systematically related to both SPS and CSR. In the SR group, SPS was positively associated with NIS (r = .415) and CSR total scores (r = .444), and CSR total scores showed a particularly strong association with NIS (r = .681). In the RA group, SPS was also positively related to NIS (r = .539), and CSR total scores correlated with NIS (r = .391), whereas SPS showed no significant associations with CSR indices. Given that SPS involves heightened responsivity to both sensory and socio-emotional cues [ 7 , 9 ], these findings suggest that children higher in SPS may be more prone to interpret and react to interpersonal situations in a threat-focused manner captured by NIS, particularly when they also experience elevated stress reactions. At the same time, the absence of SR–RA mean differences in CISM may reflect heterogeneity in SR pathways, in which interpersonal difficulties are prominent for some children but not for others [ 1 ], and/or the distinction between dispositional interpersonal sensitivity and context-specific social impairment. This interpretation is consistent with broader SR literature indicating that SR is often accompanied by emotional distress and may involve peer-relationship difficulties and discomfort in school-based social interactions, which can contribute to avoidance of school settings [ 2 , 13 , 14 ]. Taken together, our results position NIS not as a group-differentiating characteristic but as a clinically relevant correlate that clusters with SPS and stress reactions, warranting longitudinal investigation to clarify directionality and mechanisms. Exploratory Parent–Child Correspondence in SPS: Greater Concordance in SR and Interpretive Caveats In an exploratory analysis, we examined parent–child correspondence in SPS using parallel child- and parent-reported J‑HSCS‑C ratings. Parent–child correlations were more evident in the SR group, spanning multiple items as well as composite scores (LST/EOE, AES, and the total score), whereas in the RA group a significant association emerged for only a single item (Table 3 ). One interpretation is that SR-related difficulties increase the salience and observability of children’s sensory–emotional reactivity in daily life, potentially prompting parents to monitor triggers and reactions more closely and thereby improving concordance. Alternatively, stronger correspondence in the SR group may reflect methodological or statistical influences (e.g., greater between-child variability, shared situational stressors, or parent response tendencies shaped by concern), rather than uniquely accurate parental insight. Recent studies have supported the psychometric utility of parent-report versions of the HSCS and emphasized the value of multi-informant assessment when studying SPS, while also noting that sensitivity involves internal processing that may not be fully accessible to external observers and may be influenced by parental perceptions and stress [ 21 – 23 ]. Given the modest sample size and the number of item-level tests conducted, these findings should be interpreted as preliminary; importantly, they do not allow causal conclusions regarding whether parental understanding contributes to SR onset or, conversely, whether SR experiences heighten parental awareness of children’s SPS. Future research should validate parent-report measurement of SPS in Japanese samples and incorporate additional informants (e.g., teachers) and/or observational indices to clarify the reliability and clinical meaning of cross-informant agreement [ 23 , 25 ]. Limitations and Future Directions Several limitations should be acknowledged. First, the sample size—particularly in the SR group—was modest, which may limit generalizability and statistical precision. Replication in larger, multi-site samples is needed to confirm the robustness of the observed SPS and stress-response patterns and to evaluate whether they hold across different school contexts. Second, because the study was cross-sectional, we cannot infer temporal ordering or causality among SPS, stress responses, interpersonal sensitivity, and SR. Longitudinal studies following children across the elementary school years are warranted to determine whether higher SPS prospectively predicts the onset or persistence of SR and to clarify developmental pathways linking SPS to stress reactivity and school-attendance outcomes. Third, SR is embedded within broader ecological contexts, yet we did not systematically assess or model potentially relevant environmental and psychosocial factors (e.g., peer difficulties/bullying, family stress, school climate, teacher support, and access to school-based resources). Future work should incorporate multi-level assessments and test process-oriented models to examine how SPS interacts with specific stressors and supports, thereby identifying modifiable targets for prevention and intervention. Fourth, the current sample comprised typically developing Japanese children in Grades 3–6, and neurodevelopmental diagnoses were excluded to reduce potential confounding; thus, generalizability to younger children, other cultural contexts, and clinically more complex populations may be limited. Future studies should evaluate whether the observed SPS–SR patterns generalize across developmental stages and sociocultural settings and should extend to more diverse samples, including children with neurodevelopmental conditions, while appropriately accounting for relevant confounds. Finally, although the J-HSCS-C was administered as both a child self-report and a parent-report measure, the psychometric validity of the Japanese parent-report application has not yet been sufficiently established. Future research should more directly evaluate the reliability and validity of the parent-report approach in Japanese samples (e.g., factor structure, measurement properties across informants, and stability over time). Conclusion In typically developing elementary school children, those with current or past SR exhibited higher SPS—particularly in the combined EOE/LST component—and substantially elevated stress responses compared with peers with RA. Although no group differences were observed in interpersonal sensitivity, SPS was positively associated with stress responses and negative interpersonal sensitivity, and this pattern was most evident in the SR group. Exploratory parent–child analyses further suggested clearer correspondence in SPS ratings in the SR group than in the RA group. Collectively, these findings indicate that SPS may represent a relevant temperamental characteristic linked to SR in late childhood and underscore the importance of sensitivity-informed assessment and support that addresses children’s heightened reactivity and stress burden. Future studies with larger samples and longitudinal designs are needed to clarify developmental pathways and to evaluate how tailored supports may mitigate SR-related difficulties. Declarations Ethics approval and consent to participate The study protocol was reviewed and approved by the Research Ethics Committee of Kio University (approval number: R5-46)༎All procedures were conducted in accordance with the ethical standards of the 1964 Declaration of Helsinki and its later amendments༎Written informed consent was obtained from the parents/guardians prior to participation, and assent/consent procedures appropriate for elementary school children were followed༎No personally identifiable information was collected, and no foreseeable risks to participants were identified༎ Consent for publication Not applicable༎ Competing interests The authors declare that they have no competing interests༎ Funding This work was supported by JSPS KAKENHI Grant-in-Aid for Scientific Research (C): Grant Number 22K02671 (to Emiko Takata), and Grant Number 24K14339 (to Satoshi Nobusako)༎ Author Contribution Satoshi Nobusako: Data curation; Formal analysis; Funding acquisition; Methodology; Project administration; Resources; Software; Validation; Visualization; Writing—original draft; Writing—review & editing．Harumi Mouri: Data curation; Methodology; Validation; Writing—review & editing．Emiko Takata: Conceptualization; Data curation; Funding acquisition; Investigation; Methodology; Project administration; Resources; Supervision; Validation; Writing—review & editing．All authors read and approved the final manuscript． Acknowledgement The authors would like to express their sincere gratitude to all the elementary school children and their parents who participated in this study. Data Availability The datasets generated and/or analyzed during the current study are available from the corresponding author upon reasonable request. References Kearney CA, Gonzálvez C, Graczyk PA, Fornander MJ. Reconciling contemporary approaches to school attendance and school absenteeism: toward promotion and nimble response, global policy review and implementation, and future adaptability (Part 1). Front Psychol. 2019;10:2222. https://doi.org/10.3389/fpsyg.2019.02222 . Di Vincenzo C, Pontillo M, Bellantoni D, Di Luzio M, Lala MR, Villa M, Demaria F, Vicari S. School refusal behavior in children and adolescents: a five-year narrative review of clinical significance and psychopathological profiles. Ital J Pediatr. 2024;50(1):107. https://doi.org/10.1186/s13052-024-01667-0 . Ansari A, Hofkens TL, Pianta RC. Absenteeism in the first decade of education forecasts civic engagement and educational and socioeconomic prospects in young adulthood. J Youth Adolesc. 2020;49(9):1835–48. https://doi.org/10.1007/s10964-020-01272-4 . Finning K, Moore D, Ukoumunne OC, Danielsson-Waters E, Ford T. The association between child and adolescent emotional disorder and poor attendance at school: a systematic review protocol. Syst Reviews. 2017;6(1):121. https://doi.org/10.1186/s13643-017-0523-6 . Finning K, Ukoumunne OC, Ford T, Danielsson-Waters E, Shaw L, Romero de Jager I, Stentiford L, Moore DA. The association between anxiety and poor attendance at school: a systematic review. Child Adolesc Mental Health. 2019;24(3):205–16. https://doi.org/10.1111/camh.12322 . Tekin I, Aydın S. School refusal and anxiety among children and adolescents: a systematic scoping review. New Dir Child Adolesc Dev. 2022;2022(185–186):43–65. https://doi.org/10.1002/cad.20484 . Greven CU, Lionetti F, Booth C, Aron EN, Fox E, Schendan HE, Pluess M, Bruining H, Acevedo B, Bijttebier P, Homberg J. Sensory processing sensitivity in the context of environmental sensitivity: a critical review and development of research agenda. Neurosci Biobehav Rev. 2019;98:287–305. https://doi.org/10.1016/j.neubiorev.2019.01.009 . Aron EN, Aron A. Sensory-processing sensitivity and its relation to introversion and emotionality. J Personal Soc Psychol. 1997;73(2):345–68. https://doi.org/10.1037/0022-3514.73.2.345 . Pluess M, Assary E, Lionetti F, Lester KJ, Krapohl E, Aron EN, Aron A. Environmental sensitivity in children: development of the Highly Sensitive Child Scale and identification of sensitivity groups. Dev Psychol. 2018;54(1):51–70. https://doi.org/10.1037/dev0000406 . Weyn S, Van Leeuwen K, Pluess M, Lionetti F, Goossens L, Bosmans G, Van Den Noortgate W, Debeer D, Bröhl AS, Bijttebier P. Improving the measurement of environmental sensitivity in children and adolescents: the Highly Sensitive Child Scale–21 item version. Assessment. 2022;29(4):607–29. https://doi.org/10.1177/1073191120983894 . Kibe C, Hirano M. Development of the Japanese version of the Highly Sensitive Child Scale for Childhood (J-HSCS-C) [in Japanese]. Japanese J Personality. 2020;29(1):8–10. https://doi.org/10.2132/personality.29.1.3 . Kibe C, Hirano M. Development of the Japanese version of the Highly Sensitive Child Scale for Adolescence (J-HSCS-A) [in Japanese]. Japanese J Personality. 2019;28(2):108–18. https://doi.org/10.2132/personality.28.2.1 . Gonzálvez C, Díaz-Herrero Á, Sanmartín R, Vicent M, Pérez-Sánchez AM, García-Fernández JM. Identifying risk profiles of school refusal behavior: differences in social anxiety and family functioning among Spanish adolescents. Int J Environ Res Public Health. 2019;16(19):3731. https://doi.org/10.3390/ijerph16193731 . Sorrenti L, Meduri CF, Caparello C, Fumia A, Filippello P. The role of student’s awareness of current experiences on peer and emotional problems and school refusal. Front Psychol. 2025;16:1578961. https://doi.org/10.3389/fpsyg.2025.1578961 . Matsuo R, Ota M, Ida M, Takeda S. Development of the Children’s Stress Response Test for assessment and effect measurement. Yonago Igaku Zasshi. 2015;66:75–80. Kouda S, Hidaka M. Development of the Interpersonal Sensitivity Measure: examination of factor structure and reliability/validity [in Japanese]. Kurume Univ Psychol Res. 2007;6:43–50. Nara F, Kishi R. (2022) Development of the short form of the Children’s Interpersonal Sensitivity Measure. Bulletin of the Center for Research and Development and Culture, Fukushima University 6:9–15. Acevedo BP, Aron EN, Pospos S, Jessen D. The functional highly sensitive brain: a review of the brain circuits underlying sensory processing sensitivity and seemingly related disorders. Philosophical Trans Royal Soc B: Biol Sci. 2018;373(1744):20170161. https://doi.org/10.1098/rstb.2017.0161 . Attary T, Ghazizadeh A. Localizing sensory processing sensitivity and its subdomains within its relevant trait space: a data-driven approach. Sci Rep. 2021;11(1):20343. https://doi.org/10.1038/s41598-021-99686-y . Liss M, Mailloux J, Erchull MJ. The relationships between sensory processing sensitivity, alexithymia, autism, depression, and anxiety. Pers Indiv Differ. 2008;45(3):255–9. https://doi.org/10.1016/j.paid.2008.04.009 . Slagt M, Dubas JS, van Aken MAG, Ellis BJ, Deković M. Sensory processing sensitivity as a marker of differential susceptibility to parenting. Dev Psychol. 2018;54(3):543–58. https://doi.org/10.1037/dev0000431 . Costa-López B, Ruiz-Robledillo N, Albaladejo-Blázquez N, Baryła-Matejczuk M, Ferrer-Cascales R. Psychometric properties of the Spanish version of the Highly Sensitive Child Scale: the parent version. Int J Environ Res Public Health. 2022;19(5):3101. https://doi.org/10.3390/ijerph19053101 . Sperati A, Spinelli M, Fasolo M, Pastore M, Pluess M, Lionetti F. Investigating sensitivity through the lens of parents: validation of the parent-report version of the Highly Sensitive Child Scale. Dev Psychopathol. 2024;36(1):415–28. https://doi.org/10.1017/S0954579422001298 . Heyne D. Developmental issues associated with adolescent school refusal and cognitive-behavioral therapy manuals. Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie. 2022;50(6):471–94. https://doi.org/10.1024/1422-4917/a000881 . Lionetti F, Aron EN, Aron A, Klein DN, Pluess M. Observer-rated environmental sensitivity moderates children’s response to parenting quality in early childhood. Dev Psychol. 2019;55(11):2389–402. https://doi.org/10.1037/dev0000795 . Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 08 Apr, 2026 Reviewers agreed at journal 30 Mar, 2026 Reviewers invited by journal 20 Mar, 2026 Editor invited by journal 24 Feb, 2026 Editor assigned by journal 22 Feb, 2026 Submission checks completed at journal 22 Feb, 2026 First submitted to journal 20 Feb, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8925413","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":610701181,"identity":"cce9bc05-79af-48a2-ad19-e172644e9812","order_by":0,"name":"Satoshi 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Scale\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"Figure1.png","url":"https://assets-eu.researchsquare.com/files/rs-8925413/v1/e53004c0c00dc9a56f9d96d3.png"},{"id":105432976,"identity":"03d75925-9f88-4bd3-a485-0c9e3eeecc1a","added_by":"auto","created_at":"2026-03-26 02:57:28","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":2610797,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eGroup comparisons on the Children’s Stress Response (CSR) scale\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"Figure2.png","url":"https://assets-eu.researchsquare.com/files/rs-8925413/v1/d5a6340f134a9a076ef93e59.png"},{"id":105566202,"identity":"57fa4a32-f766-47b0-a055-34cb0f4f90e5","added_by":"auto","created_at":"2026-03-27 12:55:40","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":3714351,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eGroup comparisons on the Children’s Interpersonal Sensitivity Measure (CISM)\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"Figure3.png","url":"https://assets-eu.researchsquare.com/files/rs-8925413/v1/0f6f652079db0a43fd2f739f.png"},{"id":105570220,"identity":"0f673b42-44da-4fc7-a4c1-68c6fa5df2fa","added_by":"auto","created_at":"2026-03-27 13:15:26","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":6063495,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8925413/v1/6baabea9-57b1-4dc4-9437-ad34b37ceb13.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Sensory Processing Sensitivity and Psychosocial Characteristics in Elementary School Children with School Refusal","fulltext":[{"header":"Research Highlights","content":"\u003cul start=\"50\"\u003e\n \u003cli\u003eElementary school children with school refusal showed higher SPS, mainly in LST/EOE\u003c/li\u003e\n \u003cli\u003eStress responses were markedly elevated in children with school refusal\u003c/li\u003e\n \u003cli\u003eInterpersonal sensitivity showed no group differences, but correlated with SPS and stress\u003c/li\u003e\n \u003cli\u003eParent\u0026ndash;child SPS correspondence was greater in the school refusal group\u003c/li\u003e\n\u003c/ul\u003e"},{"header":"Introduction","content":"\u003cp\u003eSchool refusal (SR) refers to a child\u0026rsquo;s difficulty attending or remaining at school due to emotional distress, rather than willful truancy or external constraints. Accumulating evidence links SR to a broad range of adverse outcomes, including academic underachievement, emotional difficulties, and impaired social development, with potential long-term consequences extending into adolescence and adulthood [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Notably, SR is not limited to adolescence; school attendance problems emerging in elementary school predict later educational, psychosocial, and socioeconomic disadvantages [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Together, these findings highlight childhood as a critical window for understanding SR, when early identification and intervention may be especially impactful.\u003c/p\u003e \u003cp\u003ePrevious research has conceptualized school refusal (SR) as a multifactorial phenomenon arising from the interaction of child-related, family-related, and school-related factors [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Among child-related factors, internalizing problems\u0026mdash;particularly anxiety\u0026mdash;have been consistently identified as central correlates of SR. Systematic and scoping reviews have demonstrated robust associations between SR and various forms of anxiety, including separation anxiety, social anxiety, and school-related anxiety, across childhood and adolescence [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. In addition, stress-related emotional and somatic responses, such as irritability, fatigue, and physical complaints, as well as interpersonal difficulties within the school context, have been implicated in the development and maintenance of SR [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. However, despite extensive research on anxiety, stress, and interpersonal factors, it remains unclear whether sensory processing sensitivity (SPS)\u0026mdash;a temperamental tendency toward heightened responsiveness to environmental stimuli\u0026mdash;constitutes an underlying individual characteristic associated with SR in elementary school\u0026ndash;aged children.\u003c/p\u003e \u003cp\u003eEnvironmental sensitivity refers to individual differences in how strongly children register and process environmental stimuli and, consequently, how much they are affected by both adverse and supportive contexts [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Within this broader framework, SPS has been conceptualized as a temperament-like trait characterized by deeper processing of sensory and social information, heightened emotional reactivity and empathy, increased awareness of subtle stimuli, and a tendency toward overstimulation under high demands [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. In developmental research, SPS is commonly assessed using the Highly Sensitive Child Scale (HSCS), a brief 12-item self-report measure that captures three dimensions: ease of excitation (EOE), low sensory threshold (LST), and aesthetic sensitivity (AES) [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. For Japanese elementary school children, Kibe and Hirano [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e] developed the Japanese version of the Highly Sensitive Child Scale for Childhood (J-HSCS-C) by adapting the HSCS and refining the wording of the adolescent Japanese version [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e] to ensure comprehensibility for Grades 3\u0026ndash;6. Psychometric evaluations have suggested a developmental pattern in which EOE and LST are less clearly differentiated during childhood and instead form a combined EOE/LST factor, whereas AES emerges as a distinct dimension; the total scale has demonstrated acceptable internal consistency [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. In the present study, children\u0026rsquo;s SPS was operationalized using the J-HSCS-C. However, despite the growing literature on SPS and environmental sensitivity in child development, the extent to which SPS is associated with SR during late childhood remains insufficiently understood.\u003c/p\u003e \u003cp\u003eSR is commonly accompanied by pronounced emotional distress and somatic complaints and is frequently associated with internalizing difficulties such as anxiety and depression [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Beyond emotional symptoms, SR has also been linked to poorer social functioning, including difficulties in peer relationships and discomfort in social interactions within school settings, which may further contribute to avoidance of school attendance [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Taken together, these findings suggest that SR is closely related to heightened stress reactivity and interpersonal sensitivity in children. Accordingly, the present study assessed children\u0026rsquo;s stress responses using the Children\u0026rsquo;s Stress Response scale (CSR) [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e] and interpersonal sensitivity using the Short Forms of the Children\u0026rsquo;s Interpersonal Sensitivity Measure (CISM) [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn the present study, we examined SPS in typically developing elementary school children with and without experiences of SR. Children\u0026rsquo;s SPS was assessed using the J-HSCS-C [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e], together with self-report measures of stress responses (CSR) and interpersonal sensitivity (CISM). First, we compared levels of SPS, stress responses, and interpersonal sensitivity between children who were currently experiencing SR or had a history of SR and peers with regular school attendance. We then examined associations between SPS and both stress responses and interpersonal sensitivity within each group and across the full sample. Finally, adopting a multi-informant perspective, parents completed the J-HSCS-C based on their perceptions of their child, and we explored the degree of parent\u0026ndash;child correspondence in SPS scores as a preliminary indicator of parental understanding of children\u0026rsquo;s sensitivity traits. We hypothesized that children with SR experiences would exhibit higher SPS, stronger stress responses, and greater interpersonal sensitivity than regularly attending children, and that SPS would be positively associated with stress responses and interpersonal sensitivity. Because evidence regarding parent\u0026ndash;child agreement in SPS in the context of SR remains limited, analyses involving parent reports were treated as exploratory.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eParticipants\u003c/h2\u003e \u003cp\u003eTypically developing elementary school children and their parents participated in this study. Participants were recruited through parent support organizations related to school refusal (SR), local educational support centers, and public elementary schools.\u003c/p\u003e \u003cp\u003eThe study comprised two groups. The first group consisted of 27 children who were either currently experiencing SR or had a history of SR during elementary school (mean grade\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation\u0026thinsp;=\u0026thinsp;4.70\u0026thinsp;\u0026plusmn;\u0026thinsp;1.01; grade range: 3rd\u0026ndash;6th grade; 15 boys and 12 girls), along with their parents. In the present study, SR was defined as a condition in which a child does not attend or is unable to attend school for psychological, emotional, physical, or social reasons, excluding cases attributable to illness or economic factors. The second group included 35 children with no experience of SR (mean grade\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation\u0026thinsp;=\u0026thinsp;4.31\u0026thinsp;\u0026plusmn;\u0026thinsp;1.09; grade range: 3rd\u0026ndash;6th grade; 22 boys and 13 girls) and their parents. Grade level was recorded according to the Japanese elementary school system, in which children typically progress from the 3rd to the 6th grade during late childhood. Children with current or past SR experiences were classified as the SR group, whereas those without such experiences were classified as the regular attendance (RA) group.\u003c/p\u003e \u003cp\u003eThe primary aim of this study was to examine the association between school refusal (SR) and environmental sensitivity traits. However, previous studies have reported that both SR behavior and environmental sensitivity are associated with neurodevelopmental conditions, including Autism Spectrum Disorder (ASD) [\u003cspan additionalcitationids=\"CR19\" citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. To control for potential confounding effects, children with neurodevelopmental disorders were excluded from the study. The exclusion criteria were as follows: (1) SR attributable to general medical conditions, such as illness or infectious diseases (e.g., influenza), injuries resulting from falls or traffic accidents, or physical disabilities including cerebral palsy, hemiplegia, or muscular dystrophy; (2) a clinical diagnosis of a neurodevelopmental disorder, including ASD, Attention Deficit/Hyperactivity Disorder (ADHD), developmental coordination disorder, or specific learning disorder; (3) a diagnosis of intellectual disability.\u003c/p\u003e \u003cp\u003eEligibility was confirmed based on the results of routine health examinations conducted by school physicians or the participant\u0026rsquo;s primary care physician, as well as interviews with parents.\u003c/p\u003e \u003cp\u003eAll experimental procedures in this study were approved by the institutional ethics committee of the authors\u0026rsquo; affiliated institution (approval number: R5-46). The study involved no foreseeable risks to the participants, and no personally identifiable information was collected. Written informed consent was obtained from all participating elementary school children and their parents, along with the provision of relevant background information. All procedures were conducted in accordance with the ethical standards of the 1964 Declaration of Helsinki concerning research involving human participants.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eProcedures\u003c/h3\u003e\n\u003cp\u003eChildren in both groups completed the Japanese version of the Highly Sensitive Child Scale for Childhood (J-HSCS-C), the Children\u0026rsquo;s Stress Response scale (CSR), and the short form of the Children\u0026rsquo;s Interpersonal Sensitivity Measure (CISM). In addition, parents of these children were asked to complete the J-HSCS-C to report their perceptions of their child\u0026rsquo;s environmental sensitivity.\u003c/p\u003e\n\u003ch3\u003eJapanese version of Highly Sensitive Child Scale for Childhood (J-HSCS-C)\u003c/h3\u003e\n\u003cp\u003eThe Japanese version of the Highly Sensitive Child Scale for Childhood (J-HSCS-C) is a self-report questionnaire developed to assess individual differences in children\u0026rsquo;s SPS. The scale was created by adapting the original HSCS developed by Pluess et al. [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e] and by simplifying and adjusting the item wording of the Japanese version for adolescence (J-HSCS-A) to ensure comprehensibility for elementary school children (Grades 3\u0026ndash;6) [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. The J-HSCS-C consists of 12 items and was used in the present study to evaluate children\u0026rsquo;s self-reported SPS.\u003c/p\u003e \u003cp\u003eExploratory factor analysis (maximum likelihood with promax rotation) has supported a two-factor structure, in which Ease of Excitation (EOE) and Low Sensory Threshold (LST) load on a combined factor (EOE/LST), and Aesthetic Sensitivity (AES) forms the second factor [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. This pattern suggests that, in childhood, heightened excitability and low sensory threshold may be less clearly differentiated and may be captured as a single component [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Subscale scores are computed as the mean of the corresponding items, and an overall SPS score is calculated as the mean across all items; higher scores indicate greater sensory processing sensitivity. The internal consistency of the total scale has been reported as acceptable (Cronbach\u0026rsquo;s α\u0026thinsp;=\u0026thinsp;.84), with subscale coefficients of α\u0026thinsp;=\u0026thinsp;.81 for EOE/LST and α\u0026thinsp;=\u0026thinsp;.62 for AES [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eTo capture children\u0026rsquo;s SPS from a multi-informant perspective, we also collected parent-reported ratings of children\u0026rsquo;s SPS. Given that SPS reflects a temperament-like trait characterized by heightened internal reactivity, discrepancies between self- and other-reports may occur; nevertheless, the use of parent-report measures has been considered informative in assessing SPS in younger populations [\u003cspan additionalcitationids=\"CR22\" citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. Accordingly, parents completed the same J-HSCS-C items based on their perceptions of their child, enabling us to examine whether parents\u0026rsquo; understanding of their child\u0026rsquo;s SPS is associated with SR.\u003c/p\u003e\n\u003ch3\u003eChildren’s Stress Response (CSR)\u003c/h3\u003e\n\u003cp\u003eThe Children\u0026rsquo;s Stress Response scale (CSR) is a self-report questionnaire developed to provide a brief and efficient assessment of children\u0026rsquo;s stress reactions. It is intended for use with children and adolescents from approximately 9 years of age (upper elementary school) through high school [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. The CSR comprises 12 items representing physical, motivational, and emotional responses to stress. Each item is rated on a 4-point Likert scale ranging from 0 (\u0026ldquo;not at all applicable\u0026rdquo;) to 3 (\u0026ldquo;very applicable\u0026rdquo;), with higher total scores indicating greater stress responsiveness.\u003c/p\u003e \u003cp\u003eThe CSR includes three subscales. The Anger subscale (Items 3, 7, and 11) captures reactions such as feeling irritated, becoming quick-tempered, or feeling annoyed without a clear reason. The Apathy subscale (Items 1, 4, 8, and 12) reflects reduced motivation and energy, including sluggishness, lack of motivation, difficulty making an effort, and difficulty concentrating. The Depression/Physical Reaction subscale (Items 2, 5, 6, 9, and 10) assesses emotional and somatic complaints, such as palpitations, stomachaches, feeling like crying, headaches, and feeling down.\u003c/p\u003e \u003cp\u003eThe total score ranges from 0 to 36, and subscale scores can also be calculated. The CSR has demonstrated good internal consistency, with Cronbach\u0026rsquo;s alpha coefficients of .87 for Anger, .82 for Apathy, and .73 for Depression/Physical Reaction [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. In addition, CSR scores have been reported to correlate positively with the Public Health Research Foundation Type Stress Inventory (PSI), supporting concurrent validity [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e].\u003c/p\u003e\n\u003ch3\u003eShort Forms of the Children's Interpersonal Sensitivity Measure (CISM)\u003c/h3\u003e\n\u003cp\u003eThe Short Forms of the Children\u0026rsquo;s Interpersonal Sensitivity Measure (CISM) is a revised and abbreviated version of the Interpersonal Sensitivity Scale originally developed by Kouda and Hidaka [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e], adapted to facilitate use with children [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. The scale is designed to assess individual differences in the tendency to respond sensitively to others\u0026rsquo; behaviors and attitudes. Exploratory factor analysis has supported a two-factor structure consisting of Negative Interpersonal Sensitivity and Positive Interpersonal Sensitivity, with a total of 11 items.\u003c/p\u003e \u003cp\u003eNegative Interpersonal Sensitivity (Items 1\u0026ndash;7) reflects a tendency to experience anxiety or fear in response to others\u0026rsquo; evaluations or attitudes. In contrast, Positive Interpersonal Sensitivity (Items 8\u0026ndash;11) captures a tendency to feel reassurance when exposed to others\u0026rsquo; positive verbal and nonverbal cues. Higher scores indicate greater levels of interpersonal sensitivity.\u003c/p\u003e \u003cp\u003eThe short-form CISM has demonstrated high internal consistency, with Cronbach\u0026rsquo;s alpha coefficients of .90 for Negative Interpersonal Sensitivity and .91 for Positive Interpersonal Sensitivity. In addition, moderate correlations with related constructs, such as interpersonal vulnerability and empathic sensitivity, have been reported, supporting the concurrent validity of the scale [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. In the present study, the short-form CISM was used to assess children\u0026rsquo;s interpersonal sensitivity traits.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eWe conducted statistical comparisons of each variable measured between the SR and RA groups. For sex, we used the chi-square test. For grade level, J-HSCS-C variables, CSR variables, and CISM variables, we first assessed the normality of distributions using the Shapiro\u0026ndash;Wilk test. Variables that were normally distributed were compared between groups using independent samples t-tests, whereas those that were not normally distributed were compared using the Mann\u0026ndash;Whitney U test.\u003c/p\u003e \u003cp\u003eAcross each group and the total sample, to examine the relationships among environmental sensitivity, stress responses, and interpersonal sensitivity, we conducted correlation analyses between J-HSCS-C variables, CSR variables, and CISM variables. Based on the results of the Shapiro\u0026ndash;Wilk test, Pearson correlation coefficients were used for variables with normal distributions, whereas Spearman\u0026rsquo;s rank correlation coefficients were used for variables with non-normal distributions.\u003c/p\u003e \u003cp\u003eFurthermore, to investigate whether the extent to which parents understand their child\u0026rsquo;s environmental sensitivity is associated with SR, we conducted correlation analyses, across each group and the total sample, between the child\u0026rsquo;s self-reported J-HSCS-C scores and parent-reported J-HSCS-C scores. Again, based on the results of the Shapiro\u0026ndash;Wilk test, Pearson correlation coefficients were used for variables with normal distributions, whereas Spearman\u0026rsquo;s rank correlation coefficients were used for variables with non-normal distributions.\u003c/p\u003e \u003cp\u003eWe set the significance level at α\u0026thinsp;=\u0026thinsp;0.05 for all analyses and calculated effect sizes where applicable. All statistical analyses were conducted using SPSS version 29 (IBM Corporation, Armonk, NY, USA).\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e summarizes all measured data from the participants. There were no significant differences between the SR and RA groups in terms of grade level (\u003cem\u003ez\u003c/em\u003e = -1.432, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.152, \u003cem\u003er\u003c/em\u003e = -0.182) or sex (\u003cem\u003eχ\u0026sup2;\u003c/em\u003e(1)\u0026thinsp;=\u0026thinsp;0.338, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.561, \u003cem\u003eφ\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.074).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSummary of measurement data for both groups.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"19\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c13\" colnum=\"13\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c14\" colnum=\"14\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c15\" colnum=\"15\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c16\" colnum=\"16\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c17\" colnum=\"17\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c18\" colnum=\"18\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c19\" colnum=\"19\"\u003e\u003c/div\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eGroup\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eGrade\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eJ-HSCS-C\u003c/p\u003e \u003cp\u003eSelf report\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c11\" namest=\"c9\"\u003e \u003cp\u003eJ-HSCS-C\u003c/p\u003e \u003cp\u003eParent report\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c16\" namest=\"c13\"\u003e \u003cp\u003eCSR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c19\" namest=\"c18\"\u003e \u003cp\u003eCISM\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLST/EOE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eAES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eLST/EOE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eAES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003eAnger\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003eApathy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003eD\u0026amp;Pr\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c18\"\u003e \u003cp\u003eNIS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c19\"\u003e \u003cp\u003ePIS\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003eSchool Refusal\u003c/p\u003e \u003cp\u003e(SR)\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003eM, n=15\u003c/p\u003e \u003cp\u003eF, n\u0026thinsp;=\u0026thinsp;12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e5.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e5.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e5.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e5.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e4.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e7.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e5.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e \u003cp\u003e17.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c18\"\u003e \u003cp\u003e2.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c19\"\u003e \u003cp\u003e3.58\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e2.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e2.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e3.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e \u003cp\u003e7.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c18\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c19\"\u003e \u003cp\u003e0.44\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e3.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e3.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c18\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c19\"\u003e \u003cp\u003e2.75\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMax\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e6.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e7.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e6.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e6.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c18\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c19\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSkewness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.456\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.879\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-0.293\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.313\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-0.750\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e-0.011\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e-0.695\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e-0.453\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e0.076\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e0.204\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e \u003cp\u003e0.106\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c18\"\u003e \u003cp\u003e0.350\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c19\"\u003e \u003cp\u003e-0.562\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eKurtosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.799\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.283\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-0.548\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.347\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-0.166\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e-0.554\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e-0.211\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e-0.973\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e-0.859\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e-0.938\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e \u003cp\u003e-0.066\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c18\"\u003e \u003cp\u003e-1.226\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c19\"\u003e \u003cp\u003e-0.920\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003eRegular Attendance\u003c/p\u003e \u003cp\u003e(RA)\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003eM, n=22\u003c/p\u003e \u003cp\u003eF, n\u0026thinsp;=\u0026thinsp;13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e4.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e4.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e4.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e4.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e2.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e2.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e2.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e \u003cp\u003e7.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c18\"\u003e \u003cp\u003e1.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c19\"\u003e \u003cp\u003e3.60\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e2.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e2.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e2.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e \u003cp\u003e6.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c18\"\u003e \u003cp\u003e0.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c19\"\u003e \u003cp\u003e0.58\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e3.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c18\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c19\"\u003e \u003cp\u003e1.50\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMax\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e6.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e6.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e6.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c18\"\u003e \u003cp\u003e3.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c19\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSkewness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.282\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.104\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-0.301\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.118\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.453\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.273\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.470\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e0.646\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e0.706\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e1.290\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e \u003cp\u003e0.818\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c18\"\u003e \u003cp\u003e0.551\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c19\"\u003e \u003cp\u003e-1.999\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eKurtosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-1.215\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.950\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.046\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.491\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-0.350\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.147\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e-0.050\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e-0.710\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e-0.275\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e1.687\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c18\"\u003e \u003cp\u003e-0.712\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c19\"\u003e \u003cp\u003e4.866\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"19\"\u003eAES, Aesthetic Sensitivity; CISM, Short Forms of the Children's Interpersonal Sensitivity Measure; CSR, Children\u0026rsquo;s Stress Response scale; D\u0026amp;Pr, Depression and Physical reaction; EOE, Ease of Excitation; F, Female; J-HSCS-C, Japanese version of the Highly Sensitive Child Scale for Childhood; LST, Low Sensory Threshold; M, Male; Max, Maximum; Min, Minimum; N, Number; NIS, Negative Interpersonal Sensitivity; PIS, Positive Interpersonal Sensitivity; SD, Standard Deviation\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e presents the comparison of J-HSCS-C scores between the SR and RA groups. The overall mean J-HSCS-C score in the SR group was 5.12, whereas that in the RA group was 4.53 (see Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). The SR group showed significantly higher scores than the RA group on three individual items (Item 6, 9, 11) within the LST/EOE subscale, the overall mean LST/EOE score, and the overall mean J-HSCS-C score (Item 6, \u003cem\u003ez\u003c/em\u003e = -2.008, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.045, \u003cem\u003er\u003c/em\u003e = -0.255; Item 9, \u003cem\u003ez\u003c/em\u003e = -3.077, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.002, \u003cem\u003er\u003c/em\u003e = -0.391; Item 11, \u003cem\u003ez\u003c/em\u003e = -1.981, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.048, \u003cem\u003er\u003c/em\u003e = -0.252; LST/EOE, \u003cem\u003ez\u003c/em\u003e = -2.536, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.011, \u003cem\u003er\u003c/em\u003e = -0.322; J-HSCS-C, \u003cem\u003et\u003c/em\u003e(60)\u0026thinsp;=\u0026thinsp;2.187, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.033, \u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.27, \u003cem\u003ed\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.56, \u003cem\u003eΔ\u003c/em\u003e = -0.60). However, no significant differences were found in the individual items of the AES subscale or in the overall mean AES score.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e shows the comparison of CSR scores between the SR and RA groups. The SR group showed significantly higher scores than the RA group on many items of the CSR as well as on the total score (Item 3, \u003cem\u003ez\u003c/em\u003e = -2.438, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.015, \u003cem\u003er\u003c/em\u003e = -0.31; Item 11, \u003cem\u003ez\u003c/em\u003e = -2.516, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.012, \u003cem\u003er\u003c/em\u003e = -0.32; Anger total, \u003cem\u003ez\u003c/em\u003e = -2.647, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.008, \u003cem\u003er\u003c/em\u003e = -0.34; Item 1, \u003cem\u003ez\u003c/em\u003e = -2.952, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.003, \u003cem\u003er\u003c/em\u003e = -0.38; Item 4, \u003cem\u003ez\u003c/em\u003e = -4.798, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001, \u003cem\u003er\u003c/em\u003e = -0.61; Item 8, \u003cem\u003ez\u003c/em\u003e = -4.611, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001, \u003cem\u003er\u003c/em\u003e = -0.59; Item 12, \u003cem\u003ez\u003c/em\u003e = -3.118, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.002, \u003cem\u003er\u003c/em\u003e = -0.40; Apathy total, \u003cem\u003ez\u003c/em\u003e = -4.996, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001, \u003cem\u003er\u003c/em\u003e = -0.63; Item 2, \u003cem\u003ez\u003c/em\u003e = -2.034, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.042, \u003cem\u003er\u003c/em\u003e = -0.26; Item 6, \u003cem\u003ez\u003c/em\u003e = -2.949, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.003, \u003cem\u003er\u003c/em\u003e = -0.38; Item10, \u003cem\u003ez\u003c/em\u003e = -2.166, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.030, \u003cem\u003er\u003c/em\u003e = -0.28; Depression and Physical reaction total, \u003cem\u003ez\u003c/em\u003e = -3.341, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.001, \u003cem\u003er\u003c/em\u003e = -0.42; CSR total, \u003cem\u003ez\u003c/em\u003e = -4.387, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001, \u003cem\u003er\u003c/em\u003e = -0.56). Among all CSR items, only Item 5, Item 7, and Item 9 showed no significant differences between the SR and RA groups.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e presents the comparison of CISM scores between the SR and RA groups. No significant differences were found between the SR and RA groups for any individual items or the overall mean scores of all CISM subscales.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e (upper panel) presents the results of the correlation analyses among the measured variables in the SR group. The main findings of the correlation analysis in the SR group indicated that the overall mean J-HSCS-C score was significantly positively correlated with Anger in the CSR (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.387, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.046), Apathy in the CSR (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.405, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.036), the CSR total score (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.444, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.020), and the mean score of Negative Interpersonal Sensitivity in the CISM (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.415, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.035). Furthermore, the CSR total score was significantly positively correlated with the mean score of Negative Interpersonal Sensitivity in the CISM (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.681, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCorrelation matrix among the measured variables.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"14\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c13\" colnum=\"13\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c14\" colnum=\"14\"\u003e\u003c/div\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e \u003cp\u003eJ-HSCS-C\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c11\" namest=\"c8\"\u003e \u003cp\u003eCSR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c14\" namest=\"c13\"\u003e \u003cp\u003eCISM\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eLST/EOE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eAnger\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eApathy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eD\u0026amp;Pr\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003eNIS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003ePIS\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"8\" rowspan=\"9\"\u003e \u003cp\u003eSchool Refusal\u003c/p\u003e \u003cp\u003e(SR)\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eJ-HSCS-C\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eLST/EOE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e―\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.159\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e―\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.938**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.492**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e―\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eCSR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAnger\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.484*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.387*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e―\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eApathy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.429*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.073\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.405*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.333\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e―\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eD\u0026amp;Pr\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.222\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.164\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.254\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.364\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.494**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e―\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.465*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.094\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.444*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.717**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.792**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.829**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e―\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCISM\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNIS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.411*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.007\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.415*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.461*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.430*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.672**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e.681**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e―\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePIS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.143\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.179\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.157\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.113\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.270\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e-0.035\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.189\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e0.249\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e―\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"8\" rowspan=\"9\"\u003e \u003cp\u003eRegular Attendance\u003c/p\u003e \u003cp\u003e(RA)\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eJ-HSCS-C\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eLST/EOE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e―\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.458**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e―\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e 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colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eCSR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAnger\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.298\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.168\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.231\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e―\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eApathy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.334\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.008\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.327\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.570**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e―\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eD\u0026amp;Pr\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.174\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.012\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.189\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.470**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.537**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e―\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.321\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.057\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.295\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.836**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.849**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.770**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e―\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCISM\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNIS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.477**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.423*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e 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\u003cp\u003e0.085\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.177\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-0.174\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-0.329\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e-0.051\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e-0.239\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e0.269\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e―\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"8\" rowspan=\"9\"\u003e \u003cp\u003eTotal\u003c/p\u003e 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colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.346**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e―\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e 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colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eApathy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.475**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.065\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.427**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.582**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e―\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eD\u0026amp;Pr\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.287*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.073\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.296*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.511**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.635**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e―\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.467**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.010\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.419**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.814**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.886**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.829**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e―\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCISM\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNIS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.455**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.188\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.464**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.414**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.354**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.482**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e.474**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e―\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePIS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.072\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.146\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.112\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-0.102\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-0.127\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e-0.082\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e-0.124\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e0.250\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e―\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"14\"\u003e**p\u0026thinsp;\u0026lt;\u0026thinsp;0.01, *p\u0026thinsp;\u0026lt;\u0026thinsp;0.05\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"14\"\u003eAES, Aesthetic Sensitivity; CISM, Short Forms of the Children's Interpersonal Sensitivity Measure; CSR, Children\u0026rsquo;s Stress Response scale; D\u0026amp;Pr, Depression and Physical reaction; EOE, Ease of Excitation; J-HSCS-C, Japanese version of the Highly Sensitive Child Scale for Childhood; LST, Low Sensory Threshold; NIS, Negative Interpersonal Sensitivity; PIS, Positive Interpersonal Sensitivity\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e (middle panel) presents the results of the correlation analyses among the measured variables in the RA group. The main findings of the correlation analysis in the RA group indicated that the overall mean J-HSCS-C score was significantly positively correlated with the mean score of Negative Interpersonal Sensitivity in the CISM (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.539, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.001). In addition, the CSR total score was significantly positively correlated with the mean score of Negative Interpersonal Sensitivity in the CISM (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.391, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.020). No significant correlations were found between the subscale scores or the overall mean score of the J-HSCS-C and the subscale scores or total score of the CSR.\u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e (lower panel) presents the results of the correlation analyses among the measured variables across the total sample. The main findings of the correlation analysis across the total sample indicated that the overall mean J-HSCS-C score was significantly positively correlated with Anger in the CSR (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.364, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.004), Apathy in the CSR (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.427, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.001), Depression and Physical Reaction in the CSR (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.296, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.020), the CSR total score (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.419, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.001), and the mean score of Negative Interpersonal Sensitivity in the CISM (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.464, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Furthermore, the CSR total score was significantly positively correlated with the mean score of Negative Interpersonal Sensitivity in the CISM (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.474, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e presents the results of correlation analyses between children\u0026rsquo;s self-reported J-HSCS-C scores and parent-reported J-HSCS-C scores. In the SR group, significant positive correlations between children's self-reports and parent-reports were found for Item 2 (\u003cem\u003ers\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.553, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.003), Item 6 (\u003cem\u003ers\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.401, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.038), Item 7 (\u003cem\u003ers\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.686, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), Item 9 (\u003cem\u003ers\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.417, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.031), Item 11 (\u003cem\u003ers\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.398, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.040), LST/EOE (\u003cem\u003ers\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.402, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.037), Item 1 (\u003cem\u003ers\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.394, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.042), Item 3 (\u003cem\u003ers\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.553, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.003), Item 5 (\u003cem\u003ers\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.520, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.005), Item 10 (\u003cem\u003ers\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.389, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.045), AES (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.571, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.002), and the J-HSCS-C overall mean score (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.445, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.020). In contrast, in the RA group, a significant positive correlation was observed only for Item 11 (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.410, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.014). Across the entire sample, significant positive correlations were found between children\u0026rsquo;s and parents\u0026rsquo; J-HSCS-C scores for Item 2 (\u003cem\u003ers\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.356, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.005), Item 7 (\u003cem\u003ers\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.415, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.001), Item 9 (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.333, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.008), Item 11 (\u003cem\u003ers\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.491, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), LST/EOE (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.437, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), Item 5 (\u003cem\u003ers\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.257, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.044), and the J-HSCS-C overall mean score (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.396, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.001).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCorrelation Matrix Between Self-Report and Parent-Report Scores on the Highly Sensitive Child Scale.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"16\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c13\" colnum=\"13\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c14\" colnum=\"14\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c15\" colnum=\"15\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c16\" colnum=\"16\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eItem 2\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eItem 4\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eItem 6\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eItem 7\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eItem 8\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eItem 9\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eItem 11\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eItem 12\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eLST/EOE\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e \u003cp\u003eItem 1\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c12\"\u003e \u003cp\u003eItem 3\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c13\"\u003e \u003cp\u003eItem 5\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c14\"\u003e \u003cp\u003eItem 10\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c15\"\u003e \u003cp\u003eAES\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c16\"\u003e \u003cp\u003eJ-HSCS-C\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSR group\u003c/p\u003e \u003cp\u003eParent-Child\u003c/p\u003e \u003cp\u003eCorrelation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.553**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.254\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.401*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.686**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.176\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.417*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.398*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e0.381\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.402*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.394*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e0.553**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e0.520**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e0.389*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c15\"\u003e \u003cp\u003e0.571**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e \u003cp\u003e0.445*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRA group\u003c/p\u003e \u003cp\u003eParent-Child\u003c/p\u003e \u003cp\u003eCorrelation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.098\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.105\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-0.124\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.206\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-0.171\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.175\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.410*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e-0.176\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.270\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e-0.003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e-0.008\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e0.125\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e0.042\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c15\"\u003e \u003cp\u003e-0.004\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e \u003cp\u003e0.223\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003cp\u003eParent-Child\u003c/p\u003e \u003cp\u003eCorrelation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.356**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.202\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.195\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.415**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.033\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.333**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.491**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e0.140\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.437**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.168\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e0.233\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e0.257*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e0.170\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c15\"\u003e \u003cp\u003e0.222\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e \u003cp\u003e0.396**\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"16\"\u003eThe numbers represent correlation coefficients. **\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01, *\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"16\"\u003eAES, Aesthetic Sensitivity; EOE, Ease of Excitation; J-HSCS-C, Japanese version of the Highly Sensitive Child Scale for Childhood; LST, Low Sensory Threshold; RA, Regular attendance; SR, School refusal\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn this study of typically developing elementary school children, those with current or past SR showed higher SPS and markedly elevated stress responses compared with peers with RA, while no group differences were observed in interpersonal sensitivity. Specifically, SR-related differences in SPS were concentrated in the combined LST/EOE component (rather than aesthetic sensitivity), and SR children reported higher CSR scores across most items and subscales. Correlational analyses further indicated that, in the SR group, SPS was positively associated with stress responses and negative interpersonal sensitivity, whereas in the RA group SPS was related primarily to negative interpersonal sensitivity and showed no significant associations with stress responses. Finally, parent\u0026ndash;child correspondence in SPS scores was more evident in the SR group than in the RA group, and parent-report analyses were therefore interpreted as exploratory.\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eFacet-Specific SPS Differences in SR: Elevated EOE/LST and Comparable AES\u003c/h2\u003e \u003cp\u003eFirst, elementary school children with current or past SR showed significantly higher SPS than peers with RA, and this SR-related difference was concentrated in the combined EOE/LST component rather than AES. Specifically, the SR group scored higher on the J‑HSCS‑C total (SR: M\u0026thinsp;=\u0026thinsp;5.12; RA: M\u0026thinsp;=\u0026thinsp;4.53) and on EOE/LST (SR: M\u0026thinsp;=\u0026thinsp;4.95; RA: M\u0026thinsp;=\u0026thinsp;4.11), whereas AES did not differ between groups (SR: M\u0026thinsp;=\u0026thinsp;5.44; RA: M\u0026thinsp;=\u0026thinsp;5.36). Although we did not classify individuals into sensitivity groups, the SR group mean exceeded the exploratory HSCS cut-off proposed for the \u0026ldquo;highly sensitive\u0026rdquo; group in children (\u0026gt;\u0026thinsp;4.75), while the RA group mean fell below it; importantly, such cut-offs should be interpreted cautiously and may vary across samples and cultures [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eConceptually, EOE/LST captures a propensity to become easily overwhelmed by demands and to experience unpleasant sensory arousal, whereas AES reflects heightened awareness of subtleties and responsiveness to aesthetic or potentially positive cues [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Prior work has similarly suggested that the EOE/LST-related facet of sensitivity is more strongly tied to negative affectivity and internalizing difficulties than AES [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. From an SR perspective, school refusal is typically characterized by emotional distress and avoidance of school-related situations that elicit anxiety and somatic complaints [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Taken together, our findings raise the possibility that heightened EOE/LST-related SPS may function as an underlying dispositional factor that amplifies children\u0026rsquo;s stress and anxiety in response to the sensory, academic, and interpersonal demands of school, thereby increasing vulnerability to SR. Nevertheless, because the present study was cross-sectional, longitudinal work is needed to determine whether elevated SPS precedes SR onset or emerges as a consequence of SR-related experiences.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eMarkedly Elevated Stress Responses in SR: CSR Findings and Clinical Implications\u003c/h2\u003e \u003cp\u003eSecond, children with SR experiences reported markedly elevated stress responses on the CSR compared with peers with RA, with higher scores observed across the Anger, Apathy, and Depression/Physical Reaction domains as well as on the CSR total score. This pattern is broadly consistent with prior work indicating that SR is frequently accompanied by internalizing difficulties (e.g., anxiety and depressive symptoms), emotional distress, and somatic complaints, which may contribute to the onset and maintenance of school avoidance [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan additionalcitationids=\"CR5\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Clinically, the present findings suggest that assessment of SR in late childhood should include careful evaluation of children\u0026rsquo;s stress-related emotional, motivational, and physical reactions, as these responses may represent proximal targets for intervention [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. For example, interventions that reduce stress arousal and strengthen coping and emotion-regulation skills (e.g., cognitive-behavioral approaches) may be particularly relevant for children showing prominent CSR elevations [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Notably, within the SR group, SPS was positively associated with CSR indices, raising the possibility that heightened SPS may amplify stress reactivity in school-related contexts; this potential linkage between SPS and stress responding is discussed further in the following section.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eInterpersonal Sensitivity in SR: No Group Differences but NIS Links to SPS and CSR\u003c/h2\u003e \u003cp\u003eThird, we observed no group differences between SR and RA in CISM scores, suggesting that interpersonal sensitivity, as assessed by this trait-oriented measure, may not function as a categorical marker of SR experiences in late childhood. However, correlational analyses highlighted a more nuanced pattern: NIS (but not PIS) was systematically related to both SPS and CSR. In the SR group, SPS was positively associated with NIS (r = .415) and CSR total scores (r = .444), and CSR total scores showed a particularly strong association with NIS (r = .681). In the RA group, SPS was also positively related to NIS (r = .539), and CSR total scores correlated with NIS (r = .391), whereas SPS showed no significant associations with CSR indices. Given that SPS involves heightened responsivity to both sensory and socio-emotional cues [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e], these findings suggest that children higher in SPS may be more prone to interpret and react to interpersonal situations in a threat-focused manner captured by NIS, particularly when they also experience elevated stress reactions. At the same time, the absence of SR\u0026ndash;RA mean differences in CISM may reflect heterogeneity in SR pathways, in which interpersonal difficulties are prominent for some children but not for others [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e], and/or the distinction between dispositional interpersonal sensitivity and context-specific social impairment. This interpretation is consistent with broader SR literature indicating that SR is often accompanied by emotional distress and may involve peer-relationship difficulties and discomfort in school-based social interactions, which can contribute to avoidance of school settings [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Taken together, our results position NIS not as a group-differentiating characteristic but as a clinically relevant correlate that clusters with SPS and stress reactions, warranting longitudinal investigation to clarify directionality and mechanisms.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eExploratory Parent\u0026ndash;Child Correspondence in SPS: Greater Concordance in SR and Interpretive Caveats\u003c/h2\u003e \u003cp\u003eIn an exploratory analysis, we examined parent\u0026ndash;child correspondence in SPS using parallel child- and parent-reported J‑HSCS‑C ratings. Parent\u0026ndash;child correlations were more evident in the SR group, spanning multiple items as well as composite scores (LST/EOE, AES, and the total score), whereas in the RA group a significant association emerged for only a single item (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). One interpretation is that SR-related difficulties increase the salience and observability of children\u0026rsquo;s sensory\u0026ndash;emotional reactivity in daily life, potentially prompting parents to monitor triggers and reactions more closely and thereby improving concordance. Alternatively, stronger correspondence in the SR group may reflect methodological or statistical influences (e.g., greater between-child variability, shared situational stressors, or parent response tendencies shaped by concern), rather than uniquely accurate parental insight. Recent studies have supported the psychometric utility of parent-report versions of the HSCS and emphasized the value of multi-informant assessment when studying SPS, while also noting that sensitivity involves internal processing that may not be fully accessible to external observers and may be influenced by parental perceptions and stress [\u003cspan additionalcitationids=\"CR22\" citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. Given the modest sample size and the number of item-level tests conducted, these findings should be interpreted as preliminary; importantly, they do not allow causal conclusions regarding whether parental understanding contributes to SR onset or, conversely, whether SR experiences heighten parental awareness of children\u0026rsquo;s SPS. Future research should validate parent-report measurement of SPS in Japanese samples and incorporate additional informants (e.g., teachers) and/or observational indices to clarify the reliability and clinical meaning of cross-informant agreement [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eLimitations and Future Directions\u003c/h2\u003e \u003cp\u003eSeveral limitations should be acknowledged. First, the sample size\u0026mdash;particularly in the SR group\u0026mdash;was modest, which may limit generalizability and statistical precision. Replication in larger, multi-site samples is needed to confirm the robustness of the observed SPS and stress-response patterns and to evaluate whether they hold across different school contexts.\u003c/p\u003e \u003cp\u003eSecond, because the study was cross-sectional, we cannot infer temporal ordering or causality among SPS, stress responses, interpersonal sensitivity, and SR. Longitudinal studies following children across the elementary school years are warranted to determine whether higher SPS prospectively predicts the onset or persistence of SR and to clarify developmental pathways linking SPS to stress reactivity and school-attendance outcomes.\u003c/p\u003e \u003cp\u003eThird, SR is embedded within broader ecological contexts, yet we did not systematically assess or model potentially relevant environmental and psychosocial factors (e.g., peer difficulties/bullying, family stress, school climate, teacher support, and access to school-based resources). Future work should incorporate multi-level assessments and test process-oriented models to examine how SPS interacts with specific stressors and supports, thereby identifying modifiable targets for prevention and intervention.\u003c/p\u003e \u003cp\u003eFourth, the current sample comprised typically developing Japanese children in Grades 3\u0026ndash;6, and neurodevelopmental diagnoses were excluded to reduce potential confounding; thus, generalizability to younger children, other cultural contexts, and clinically more complex populations may be limited. Future studies should evaluate whether the observed SPS\u0026ndash;SR patterns generalize across developmental stages and sociocultural settings and should extend to more diverse samples, including children with neurodevelopmental conditions, while appropriately accounting for relevant confounds.\u003c/p\u003e \u003cp\u003eFinally, although the J-HSCS-C was administered as both a child self-report and a parent-report measure, the psychometric validity of the Japanese parent-report application has not yet been sufficiently established. Future research should more directly evaluate the reliability and validity of the parent-report approach in Japanese samples (e.g., factor structure, measurement properties across informants, and stability over time).\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIn typically developing elementary school children, those with current or past SR exhibited higher SPS\u0026mdash;particularly in the combined EOE/LST component\u0026mdash;and substantially elevated stress responses compared with peers with RA. Although no group differences were observed in interpersonal sensitivity, SPS was positively associated with stress responses and negative interpersonal sensitivity, and this pattern was most evident in the SR group. Exploratory parent\u0026ndash;child analyses further suggested clearer correspondence in SPS ratings in the SR group than in the RA group. Collectively, these findings indicate that SPS may represent a relevant temperamental characteristic linked to SR in late childhood and underscore the importance of sensitivity-informed assessment and support that addresses children\u0026rsquo;s heightened reactivity and stress burden. Future studies with larger samples and longitudinal designs are needed to clarify developmental pathways and to evaluate how tailored supports may mitigate SR-related difficulties.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e \u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e \u003cp\u003e The study protocol was reviewed and approved by the Research Ethics Committee of Kio University (approval number: R5-46)༎All procedures were conducted in accordance with the ethical standards of the 1964 Declaration of Helsinki and its later amendments༎Written informed consent was obtained from the parents/guardians prior to participation, and assent/consent procedures appropriate for elementary school children were followed༎No personally identifiable information was collected, and no foreseeable risks to participants were identified༎\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eConsent for publication\u003c/strong\u003e \u003cp\u003eNot applicable༎\u003c/p\u003e \u003c/p\u003e\u003cp\u003e \u003ch2\u003eCompeting interests\u003c/h2\u003e \u003cp\u003eThe authors declare that they have no competing interests༎\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e \u003cp\u003eThis work was supported by JSPS KAKENHI Grant-in-Aid for Scientific Research (C): Grant Number 22K02671 (to Emiko Takata), and Grant Number 24K14339 (to Satoshi Nobusako)༎\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eSatoshi Nobusako: Data curation; Formal analysis; Funding acquisition; Methodology; Project administration; Resources; Software; Validation; Visualization; Writing\u0026mdash;original draft; Writing\u0026mdash;review \u0026amp; editing．Harumi Mouri: Data curation; Methodology; Validation; Writing\u0026mdash;review \u0026amp; editing．Emiko Takata: Conceptualization; Data curation; Funding acquisition; Investigation; Methodology; Project administration; Resources; Supervision; Validation; Writing\u0026mdash;review \u0026amp; editing．All authors read and approved the final manuscript．\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003eThe authors would like to express their sincere gratitude to all the elementary school children and their parents who participated in this study.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThe datasets generated and/or analyzed during the current study are available from the corresponding author upon reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eKearney CA, Gonz\u0026aacute;lvez C, Graczyk PA, Fornander MJ. 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Dev Psychol. 2019;55(11):2389\u0026ndash;402. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1037/dev0000795\u003c/span\u003e\u003cspan address=\"10.1037/dev0000795\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-psychology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"psyo","sideBox":"Learn more about [BMC Psychology](http://bmcpsychology.biomedcentral.com/)","snPcode":"","submissionUrl":"","title":"BMC Psychology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Childhood, Interpersonal Sensitivity, School Refusal (SR), Sensory Processing Sensitivity (SPS), Stress Responses","lastPublishedDoi":"10.21203/rs.3.rs-8925413/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8925413/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eSchool refusal (SR) in late childhood is often accompanied by emotional distress, yet temperamental factors conferring vulnerability remain insufficiently understood. Sensory processing sensitivity (SPS), within the environmental sensitivity framework, may amplify stress reactivity and maladjustment; however, evidence in elementary school\u0026ndash;aged children is limited. This study examined SPS and related psychosocial characteristics in children with and without SR experiences.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eJapanese children in Grades 3\u0026ndash;6 with current or past SR (SR group; n\u0026thinsp;=\u0026thinsp;27) and peers with regular attendance (RA group; n\u0026thinsp;=\u0026thinsp;35) completed self-report measures of SPS (Japanese version of the Highly Sensitive Child Scale for Childhood; J-HSCS-C), stress responses (Children\u0026rsquo;s Stress Response scale; CSR), and interpersonal sensitivity (Short Forms of the Children\u0026rsquo;s Interpersonal Sensitivity Measure; CISM). Parents completed the J-HSCS-C. Group comparisons and within-group correlations were conducted.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe SR group reported higher overall SPS than the RA group (J-HSCS-C mean 5.12 vs. 4.53; t(60)\u0026thinsp;=\u0026thinsp;2.19, p = .033, d\u0026thinsp;=\u0026thinsp;0.56). Differences were concentrated in the combined Low Sensory Threshold/Ease of Excitation (LST/EOE) facet (SR\u0026thinsp;\u0026gt;\u0026thinsp;RA; z\u0026thinsp;=\u0026thinsp;\u0026minus;\u0026thinsp;2.54, p = .011), whereas Aesthetic Sensitivity did not differ. The SR group showed markedly elevated stress responses (CSR total: z\u0026thinsp;=\u0026thinsp;\u0026minus;\u0026thinsp;4.39, p \u0026lt; .001), while no significant group differences were observed for CISM scores. In the SR group, SPS was positively associated with stress responses (SPS mean with CSR total: r\u0026thinsp;=\u0026thinsp;0.44, p \u0026lt; .05) and negative interpersonal sensitivity (SPS mean with CISM-NIS: r\u0026thinsp;=\u0026thinsp;0.42, p \u0026lt; .05). In the RA group, SPS was associated primarily with negative interpersonal sensitivity (SPS mean with CISM-NIS: r\u0026thinsp;=\u0026thinsp;0.54, p \u0026lt; .01) and showed no significant association with CSR total (r\u0026thinsp;=\u0026thinsp;0.30). Exploratory parent\u0026ndash;child analyses suggested clearer correspondence in the SR group (total SPS: r\u0026thinsp;=\u0026thinsp;0.45, p \u0026lt; .05) than in the RA group (total SPS: r\u0026thinsp;=\u0026thinsp;0.22).\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eChildren with SR experiences may be characterized by elevated SPS\u0026mdash;particularly LST/EOE\u0026mdash;alongside heightened stress reactivity. Considering SPS may be useful for assessment and support planning for elementary school children experiencing SR.\u003c/p\u003e","manuscriptTitle":"Sensory Processing Sensitivity and Psychosocial Characteristics in Elementary School Children with School Refusal","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-26 02:57:19","doi":"10.21203/rs.3.rs-8925413/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-04-08T19:24:52+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"108060840611731971077951130234038617975","date":"2026-03-30T18:52:01+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-03-20T09:40:39+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-02-24T15:43:10+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-02-22T22:27:48+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-02-22T22:27:44+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Psychology","date":"2026-02-20T11:16:13+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-psychology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"psyo","sideBox":"Learn more about [BMC Psychology](http://bmcpsychology.biomedcentral.com/)","snPcode":"","submissionUrl":"","title":"BMC Psychology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"cfbd3767-670b-48ed-ba97-1bfa85de528b","owner":[],"postedDate":"March 26th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-03-26T02:57:20+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-26 02:57:19","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8925413","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8925413","identity":"rs-8925413","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}