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Dual-factor models of mental health propose that mental health includes two interrelated yet distinct dimensions - psychopathology and well-being. However, there is no systematization of the evidence following these models. This review aims to address the following research question: what evidence exists using dual-factor models? The current systematic review was conducted using PRISMA guidelines on the following databases: Web-of-science, Scopus, Academic Search Complete, APA PsycArticles, APA PsycInfo, Psychology and Behavioral Sciences Collection, ERIC, and MEDLINE. The screening process resulted in 85 manuscripts that tested the assumptions of dual-factor models. Evidence revealed psychometric substantiation on the two-dimensionality of the dual-factor model, and 85% of the manuscripts provided evidence related to classifying participants into different mental health groups. Most studies showed that the Complete Mental Health or Positive Mental Health group is the most prevalent status group, and longitudinal evidence suggests that most participants (around 50%-64%) remain in the same group across time. Regarding the factors associated with mental health status groups, studies reviewed in this manuscript focus mainly on school-related outcomes, followed by supportive relationships, sociodemographic characteristics, psychological assets, individual attributes, physical health, and stressful events. This review highlights the importance of considering the two dimensions of mental health when conceptualizing, operationalizing, and measuring mental health. Fostering mental health must go beyond reducing symptoms, and practitioners would be able to include well-being-related interventions in their regular practice to improve individuals' mental health outcomes.

Background: Compared to residential care, family foster care is the preferable type of alternative care for neglected or abused children as it provides a familiar context that supports children’s developmental needs. New foster families are needed to care for these children. Objective: This systematic review aims to provide a critical analysis of the literature, identifying factors that explain the intention to become and to continue as a foster family. This review was performed following the PRISMA checklist and guidelines, through a search conducted in the following databases (no restrictions were made): PsycArticles, PsycInfo, Psychology and Behavioral Sciences Collection, Academic Search Complete, ERIC, Scopus, and Web of Science. Study eligibility: The review includes empirical quantitative and/or qualitative studies in English, Portuguese, and Spanish, with community and/or foster parents’ samples and explores the factors for becoming and/or retention of foster parents. Results: Forty-nine studies were included. The results revealed that the intention to become a foster parent is largely influenced by motivational factors, personal and family characteristics, individual values and beliefs, social context influences, and perceived familiarity with the child protection system. The retention of foster families is closely related to factors within the child protection system, personal or family characteristics, foster child characteristics, and placement challenges. The relationship with agencies and professional support stands out as the most important factors. Limitations and Implications: This review did not include studies focused on children with specific needs and characteristics, and future research should consider the particular challenges of fostering this group. Practice implications of these findings for the recruitment, selection, and retention of foster families will be discussed. Highlights Motivations, personal and family characteristics, and perceived familiarity or support from the child protection system were dimensions identified as associated with intention and retention. The child protection system must be prepared to support families that are highly motivated and meet the necessary conditions to foster. Formal support might reduce foster families’ willingness to discontinue fostering.

Regardless of the type of residential care context, entering in care is an impactful event that involves the separation of young people from their relatives, as well as the need to adapt to a new context. This adaptation might be facilitated by the quality of relationships with professionals in these settings, which in turn may positively impact young people’s psychological adjustment.Purpose: The current systematic review aims to identify the factors that might be associated with quality relationships in residential homes (i.e., generalist care, therapeutic care, juvenile justice settings) at different ecological levels.Method: A systematic electronic search was conducted in eight databases: Academic Search Complete, APA PsycArticles, APA PsycINFO, Psychology and Behavioral Sciences Collection, ERIC, MEDLINE, Web of Science and Scopus, using a combination of words related with quality relationship, residential care, children, and adolescent. Based on the PRISMA statement, 919 manuscripts were yielded, and thirteen studies met the inclusion criteria.Results: Child (e.g., gender or age), professionals (e.g., professionals’ characteristics, behaviors, and skills), organizational (e.g., Ratios of children to professionals on staff) and cross-cutting factors (e.g., time spent together, length of relationship) were found to be associated with quality relationships between professionals and young people in care.Discussion: The residential care settings should be able to provide appropriate resources and services which address young people’s complex needs. Practical implications are discussed.

ABSTRACT Background/Aim: Young people in care may show significant mental health difficulties because of previous adverse experiences, such as maltreatment or violence. However, no meta-analyses have been conducted on this topic. We aim to identify the role of previous maltreatment in current symptoms of children and adolescents in out-of-home care. Method: A search in Academic Search Complete, PsycArticles, PsycInfo, Psychology and Behavioral Sciences Collection, ERIC, Medline, Web of Science and Scopus databases was conducted. Studies were included if they were empirical and quantitative, involved school-aged children and adolescents, assessed maltreatment before placement in care and current internalizing and externalizing symptoms. Multiple effect sizes were extracted from each primary study, and a three-level meta-analysis for each type of maltreatment associated with internalizing and externalizing symptoms was conducted. Results: The search yielded 122 effects sizes from 28 studies. Results indicated significant overall effects of general maltreatment (r = .260), abuse (emotional/physical) (r = .135) and sexual abuse (r = .247) on internalizing symptoms. In relation to externalizing symptoms, overall effects of abuse (emotional/physical) (r = .097) and sexual abuse (r = .187) were identified. The overall effect sizes of neglect were neither significant for internalizing or externalizing symptoms. A set of moderators was tested, and significant effects were found for the type of maltreatment measure on internalizing symptoms and for gender on externalizing symptoms. Conclusions: This study provides new insights beyond previous systematic reviews, as we were able to disentangle the associations between maltreatment and internalizing and externalizing symptoms in out-of-home care.

Research with young people in Residential Care (RC) has primarily focused on mental health problems, overlooking resilience and adaptation. Considering that previous trauma experiences and adversity (e.g., previous abuse and neglect) cannot be changed, it is critical to identify the current protective factors of adaptation in RC. Purpose: this systematic review aims to identify the protective factors or the resilience portfolio that may be positively associated with adolescents’ healthy adaptation in RC. Method: based on the PRISMA statement and using a combination of keywords related with RC, adolescents, resilience, and adaptation a search in eight databases was conducted in November 2020: Academic Search Complete, APA PsycArticles, APA PsycINFO, Psychology and Behavioral Sciences Collection, ERIC, MEDLINE, Web of Science and Scopus. This search yielded 4442 articles and 11 studies met our inclusion criteria. Results: Overall, the studies reported protective factors at different levels, namely, individual assets, resources from different contexts (family, RC, and community), appraisals and coping behavior. Conclusion: this review highlighted the importance of exploring resilience as a dynamic process of assets and resources rather than as a stable individual attribute. This review aims to contribute to a deep discussion about resilience in RC, informing policy-making and professional practices and enhancing young people’s adaptation in RC.

The literature suggests the positive role of social support in mental health in residential care. However, most of the studies are focused on psychopathology and fewer on well-being. Also, theoretically-oriented and multidimensional studies on social support are needed. To address these problems, a qualitative study was developed with 29 young people in residential care (76% males), aged from 12 to 19 years old. Data was collected with a semi-structured interview. Results showed young people identify meaningful sources of social support (peers, residential care, and family), considering them available and effective support providers. Social support was also identified as an enhancer of positive psychological functioning and as a buffer of psychological functioning problems. Future research should involve more systematic, multidimensional approaches, both in assessing social support and in mental health. Important implications are recognized for professionals in the justice system.

Little evidence exists on the relationship between rights’ perceptions and well-being outcomes during the adolescence, and particularly in care, as well as on the mediating role of place attachment. Young people in residential care are psychologically and socially vulnerable, showing greater difficulties than their peers do in the family. Youth’s rights fulfilment in residential care may positively affect their psychological functioning together with positive attachments to this place. A sample of 365 adolescents in residential care settings ( M =  14.71, SD  = 1.81) completed a set of self-reported measures, specifically, the Rights perceptions scale, the Place attachment scale and Scales of psychological well-being. Results revealed significant mediating effects of place attachment (Global scale and subscales of Friends Bonding and Place Dependence) on the relationship between Participation and Protection rights in residential care and Psychological well-being (Positive Relations with others, Personal Growth and Self-Acceptance). The positive role of rights fulfilment in residential care, specifically participation opportunities, as well as the role of youth’s attachment to the care setting are discussed based on previous evidence and theoretical assumptions. A set of practical implications is described.

ObjectivesThis study aimed to analyze the relationship between family climate and identity development, and the moderating role of the development stage and (in)adaptive outcomes in that relationship.MethodsA cross-sectional quantitative study was developed with 387 participants (65.4% female; 162 adolescents aged between 15–19 years and 225 emerging adults aged between 20–25 years). Data was collected using self-reported measures: Sociodemographic questionnaire, Dimensions of Identity Development Scale, Brief Symptom Inventory and Family Climate Inventory.ResultsThe results of structural equation modeling showed moderating effects of developmental stage (Δχ2 (38) = 93.47, p = 0.009) and outcomes (Δχ2 (38) = 63.50, p = 0.006) in the relationship between family climate and identity development, suggesting that family cohesion predicted identity outcomes differently for adolescents and emerging adults, as well as for participants with adaptive and non-adaptive developmental trajectories. Also, family conflict predicted identity formation outcomes differently in function of developmental outcomes.ConclusionsAs high levels of family conflict and cohesion are associated to higher levels of exploration in depth, future studies should focus on enmeshed family interactional patterns and its outcomes on children across development. Our data highlights the role of family climate on the identity development in adolescence and emerging adulthood and the importance of analyzing family risk and protection factors as conditions for individual developmental outcomes.

Background The importance of fostering the development of empathy in undergraduate students is continuously emphasized in international recommendations for medical education. Paradoxically, some studies in the North-American context using self-reported measures have found that empathy declines during undergraduate medical training. Empathy is also known to be gender dependent- (highest for female medical students) and related to specialty preference - (higher in patient-oriented than technology-oriented specialties). This factor has not been studied in Portuguese medical schools. Methods This is a cross-sectional study of undergraduate medical students on self-rated measures of empathy collected at entrance and at the conclusion of the medical degree, and on the association of empathy measures with gender and specialty preferences in one medical school in Portugal. Empathy was assessed using the Portuguese adaptation of the Jefferson Scale of Physician Empathy-students version (JSPE-spv) among three cohorts of undergraduate medical students in the first (N = 356) and last (N = 120) year. The construct validity of JSPE-spv was cross-validated with Principal Component Analysis and Confirmatory Factor Analysis. Reliability was assessed using Cronbach' Alpha. Global JSPE-spv score differences were examined by year of medical school, gender and specialty preferences (people-oriented vs technology-oriented specialties). Results The empathy scores of students in the final year were higher as compared to first year students (F (1,387) = 19.33, p < .001, ɳ 2 p = 0.48; π = 0.99). Female students had higher empathy scores than male students (F (1,387) = 8.82, p < .01, ɳ 2 p = 0.23; π = 0.84). Significant differences in empathy were not found between the students who prefer people-oriented specialties compared to those who favor the technology-oriented specialties (F (1,387) = 2.44, p = .12, ɳ 2 p = 0.06; π = 0.06). Conclusions This cross-sectional study in one medical school in Portugal showed that the empathy measures of senior year students were higher than the scores of freshmen. A longitudinal cohort study is needed to test variations in students' empathy measures throughout medical school.

Evidence suggests that secondary victimization exacerbates the impact of sexual violence and undermines victim recovery. This study aims to a) provide evidence of the validity and reliability of the Secondary Victimization Scale (SVS) and b) test the mediating role of empathy in the relationship between personality and secondary victimization. A sample of 285 Portuguese adults (aged 18-75, 86% females) completed an online survey. The original three-dimensional structure of the SVS was retained, and appropriate reliability was found – Minimising of Suffering (? = .87), Victim Blaming (? = .89), and Victim Avoidance (? = .85). High SVS scores were associated with greater endorsement of sexual violence beliefs and higher social dominance. Indirect effects of empathy on the relationship between agreeableness, openness to experience, and secondary victimization were also found. The SVS is a valid and reliable measure that enables further cross-cultural studies on secondary victimization. Raising social awareness of sexual violence is critical to protect victims and prevent secondary victimization.