An Application of the Dual-Factor Model of Mental Health in Elementary School Children: Examining Academic Engagement and Social Outcomes

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Nicholas David Smith
Shannon Suldo
Brittany Hearon
John Ferron


Subjective well-being, dual-factor model of mental health, internalizing behaviors, externalizing behaviors, classroom relationships, student engagement


Conceptualizations of mental health have increasingly emphasized the presence of subjective well-being (SWB), rather than assessing internalizing and externalizing behaviors (IEB) and disorders in isolation. This cross-sectional study examined the mental health of 178 American elementary school students through this dual-factor lens. Approximately 54% of child participants (Grades 4 and 5) met sample-specific criteria for Complete Mental Health (high SWB and low IEB), 18.5% met criteria for Symptomatic But Content (high SWB, elevated IEB), 18.5% met criteria for Vulnerable (low SWB, low IEB), and 9% met criteria for Troubled (low SWB, elevated IEB). Students in the Symptomatic But Content group had fewer internalizing behaviors than the Troubled group. Associations between mental health group status and social and academic outcomes varied by teacher and student ratings. On student-reported outcomes, mental health groups with high SWB had greater perceptions of social support and academic engagement in the classroom, consistent with findings from other studies documenting advantages of SWB above and beyond low IEB (Complete Mental Health vs. Vulnerable) or when elevated IEB is present (Symptomatic But Content vs. Troubled).  In contrast, teacher perceptions of students’ engagement in the classroom and social relationships were more closely negatively associated with IEB. When SWB was examined as a continuous variable, regression analyses indicated positive, additive effect of SWB on all indicators of engagement- including teacher report measures.


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