Assessing the co-occurrence of psychopathology and resilience: Evidence for the dual-factor model of mental health using a data-driven approach from a multi-ethnic youth epidemiology study in south-east Asia.

BACKGROUND

While studies have consistently shown that resilience is a protective factor for youth psychopathology, less is known about the co-occurrence between resilience and youth psychopathology symptoms particularly in the south-east Asian context, based on the dual-factor model (DFM) of mental health.

METHODS

Data was taken from the nationally-representative Youth Epidemiology and Resilience (YEAR) study conducted in Singapore. The analysis, which included 3336 Singapore youth aged 10 to 18, used a person-centered approach (i.e. Latent Profile Analysis) to identify subgroups of youths based on co-occurring resilience and psychopathology (across both internalising and externalising symptoms) as measured by the Youth Self-Report. Examined correlates include sociodemographic variables, perceived stress and academic expectations and stress.

FINDINGS: Six profiles were found - "Flourishing" (21.3 %), "Moderately Resilient & Moderately Symptomatic" (33.3 %), "Moderately Resilient & Moderately Symptomatic (Externalising)" (11.5 %), "Struggling (Internalising only)" (17.1 %), "Struggling (Co-morbid)" (5.9 %) and "Vulnerable" (10.9 %). The profiles differed in terms of various socio-demographic factors, perceived stress and academic expectations and stress.

INTERPRETATION: Findings demonstrate empirical support for the DFM in the south-east Asian context. By using a data-driven approach, this study found unique profiles that are not typically found in other DFM studies. Of significance, the "vulnerable" profile, who have low psychopathology but also low resilience, had significantly higher perceived stress compared to the "Moderately Resilient & Moderately Symptomatic" profile after adjusting for socio-demographic covariates, highlighting the important role of resilience. Clinical implications include the urgent need to include positive mental health indicators in a holistic assessment of youths' overall psychological functioning.