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Social Isolation, Related Constructs and Problematic School Attendance Problems in Adolescence: A Systematic Review

Jul 2026 · Children · Vol 13 · 0 citations · 91 references
Medicine

Abstract

Highlights What are the main findings? • Loneliness, bullying, and school alienation track with school refusal and absenteeism; peer acceptance, reciprocal friendships, and teacher support track with graduation and successful school transition.• Longitudinally, loneliness and weak teacher support precede intentions to quit school, while supportive relationships buffer against later disengagement. What are the implications of the main findings? • Attendance problems may benefit from relational, not only symptomatic, assessment; the evidence reviewed suggests that school connectedness could represent a promising, potentially modifiable target for future prevention and intervention efforts.• The field needs longitudinal, multi-informant studies that separate subjective, interpersonal, and institutional disconnection, and distinguish school refusal, truancy, withdrawal, and dropout. Abstract Background: Problematic school attendance in adolescence is a heterogeneous phenomenon with academic, emotional, and developmental consequences. Although relational factors are increasingly recognised, the literature remains conceptually fragmented, with overlapping constructs such as social isolation, loneliness, social withdrawal, and peer difficulties examined under partially distinct frameworks. Objective: This systematic review aimed to synthesize empirical evidence on the association between social isolation, related constructs, and problematic school attendance during adolescence. Methods: Following PRISMA 2020 guidelines, searches were conducted in PubMed, Scopus, and Embase (final search: 20 January 2026). Eligible studies were observational or qualitative empirical investigations involving adolescents aged 11–18 years and examining at least one relational construct (objective/subjective social isolation, loneliness, social withdrawal, peer rejection) together with at least one school attendance outcome (school refusal, withdrawal, truancy, avoidance, dropout). Risk of bias was assessed with design-specific JBI tools and findings were synthesized narratively. Results: Eleven studies met the inclusion criteria: six cross-sectional, four longitudinal/cohort, and one qualitative. Loneliness, bullying, school alienation, and social isolation at school were most consistently associated with school refusal and absenteeism, whereas peer acceptance, reciprocal friendships, teacher emotional support, and school belonging were associated with reduced dropout intentions, higher graduation rates, and better school transition. Longitudinally, loneliness and low teacher support preceded increases in intention to quit, while supportive relationships appeared to protect against later disengagement. Conclusions: Social isolation and related constructs are meaningfully associated with problematic school attendance in adolescence. Social isolation and related constructs appear to be meaningfully associated with problematic school attendance in adolescence, although the evidence base remains limited and heterogeneous. These findings suggest that a relational perspective may usefully complement existing approaches to attendance difficulties, and point to the need for longitudinal, multi-informant studies disentangling subjective, interpersonal, and institutional disconnection across distinct attendance profiles.

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