Who Is Flourishing? Identifying Dual-Factor Mental Health Profiles and Ecological Predictors Among Adolescents In Rural China

Background and Purpose

Mental health is increasingly recognized as extending beyond the presence or absence of symptoms. Scholars in positive psychology have long advocated a shift from traditional disease-based frameworks to a focus on subjective well-being. The dual-factor model further highlights that subjective well-being and symptoms of distress represent distinct yet complementary dimensions of mental health. Despite this, few studies integrate both positive psychology and resource-based perspectives to simultaneously assess positive and negative mental health indicators and identify who is flourishing versus distressed. Additionally, adolescents in rural China remain an understudied population in this area. To address the gap, this study aims to identify mental health profile groups using a person-centered lens and to examine predictors of these profiles.

Methods

Data were collected in September 2025 from a middle school in rural China. The analytic sample included 243 youth ages 12-17 years (M = 13.97 years, SD = 1.01; 54.7% female; 70.8% left-behind status). Depression was measured using the Patient Health Questionnaire (PHQ-8), anxiety using the Generalized Anxiety Disorder scale (GAD-7), and positive well-being using the Warwick-Edinburgh Mental Well-being Scale (WEMWBS). This analytical approach is grounded in the dual-factor model of mental health, which conceptualizes mental health as encompassing both negative indicators (e.g., depression and anxiety) and positive indicators (e.g., well-being), rather than as a binary of disorder presence or absence. Latent Profile Analysis was applied to identify subgroups of adolescents with distinct psychological functioning patterns, distinguishing those at greater risk of psychological distress from those who are flourishing. Following profile identification, binary logistic regression was conducted to examine factors associated with class membership.

Results

The results indicated two profiles of psychological functioning. The flourishing profile (67.6%) showed below-average depression (z = −0.49) and anxiety (z = −0.53), alongside above-average positive well-being (z = 0.29), suggesting generally healthy psychological functioning. The distressed profile (32.4%) displayed the opposite pattern, with above-average depression (z = 0.99) and anxiety (z = 1.04) and below-average positive well-being (z = −0.57), indicating poorer psychological functioning. Compared to the flourishing group, participants in the distressed group were more likely to report higher level of peer bullying (OR = 1.32, p < .001), fewer positive childhood experiences (OR = 0.78, p < .05), and greater use of an emotion-oriented coping (OR = 1.37, p < .001), lower use of task-oriented coping strategies (OR=0.79, p<.001).

Conclusions and Implications

Findings suggest that it is important to employ multi-level approaches to adolescent mental health promotion. Beyond symptom reduction, interventions should simultaneously target protective factors across ecological levels: fostering adaptive, task-oriented coping skills at the individual level; nurturing positive childhood experiences at the family and community levels; and preventing peer bullying at the school level. Our results call for ecologically informed, multi-level interventions that equip at-risk adolescents with the resources needed to flourish.