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Is it possible to experience high levels of well-being despite facing significant psychological challenges?

A recent systematic review conducted by Eunice Magalhães from the Center for Psychological Research and Social Intervention (CIS-Iscte) explored mental health anchored on the intricate relationship between well-being and psychopathology. The findings highlight the importance of considering both positive and negative dimensions of mental health in research and clinical practice.

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Eunice Magalhães, author of the study, explains that, for the past two decades mental health has been conceptualized as including two interrelated yet distinct dimensions – psychopathology and well-being. This dual-factor approach contradicts the one-dimensional traditional view of mental health as the absence of psychopathology.

“Research has showed that people can have positive mental health outcomes while scoring lower on psychopathology measures, but it is not incompatible to score high on well-being when dealing with psychopathology”, clarifies the researcher.

With the goal of systematizing the evidence anchored in this dual-factor approach, Eunice Magalhães reviewed a total of 85 empirical studies, with children, adolescents, and adults as participants.


Because the dual-factor model offers a more comprehensive understanding of mental health, it is possible to identify four mental health profiles based on the intersection of well-being and psychopathology. These were evident in the covered literature: “Complete/Positive Mental Health” (high well-being and low psychopathology), “Symptomatic but Content” (high well-being and psychopathology), “Vulnerable” (low well-being and psychopathology), and “Troubled” (low well-being and high psychopathology). Most of the analyzed 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%) tend to remain in the same group across time. Notably, evidence suggests that individuals can experience high levels of well-being despite facing significant psychological challenges, and also that people who do not show significant psychopathology do not necessarily present positive mental health. This finding highlights that psychological interventions must go beyond a traditional perspective of reducing symptoms.


Regarding the factors associated with mental health status groups, studies reviewed in this paper focus mainly on school-related outcomes, followed by supportive relationships, sociodemographic characteristics, psychological assets, individual attributes, physical health, and stressful events. Eunice Magalhães calls for further research that considers individual variables and encompasses diverse populations, particularly those at risk due to trauma or violence.


The implications of this review are significant for mental health practitioners and policymakers. By shifting the focus from exclusively addressing psychopathology to promoting well-being, interventions can be more effective in improving overall mental health. The author advocates for the development of tailored psychosocial programs that address the specific needs of different mental health groups, ultimately fostering resilience and positive adaptation. "By recognizing the interplay between well-being and psychopathology, we can create more effective interventions that support individuals in achieving better mental health outcomes.", Eunice Magalhães concludes.

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