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- Determinants of psychological adjustment of institutionalized adolescents: a systematic reviewPublication . Simão, Ana; dos Santos, Rita Alexandra Mendes; Brás, Marta; Nunes, CristinaBackground Adolescents in residential care present a greater risk of developing various problems in several domains compared to adolescents residing with their biological families. Psychological adjustment is an emerging area of investigation with this particularly vulnerable population to understand the factors that underlie the difficulties youths present within this context. Objective The present study aimed to contribute to recognizing these factors through a systematic literature review following the PRISMA guidelines. Methods A search was conducted in seven databases (Academic Search Complete, MEDLINE, Psychology and Behavioral Sciences Collection, PsycINFO, Web of Science, PsycArticles, Scopus), and quantitative studies from the last thirty years were included. RESULTS: Of the initial 8,174 articles identified, 64 were included, and all the studies were qualitatively assessed with the Mixed Methods Appraisal Tool. Four categories of factors influencing psychological adjustment were identified: personal characteristics, social characteristics, caregiving, and adjustment problems. Most of the studies were cross-sectional and published in European countries. Conclusions The present review contributes to the research on the psychological adjustment of adolescents in residential care by providing an update and supplementing the previous systematic reviews. The proposed organization of the different factors and domains found in publications allowed us to analyze in detail what most impacted these youths' psychological adjustment. Practical and institutional implications for professionals working with this population are discussed, as well as the limitations to overcome in future studies.
- Positive residential care integration scale: Portuguese adaptation and validationPublication . Simão, Ana; Martins, Cátia; Ratinho, Elias; Kothari, Brianne H.; Nunes, CristinaYoung people in residential care settings hold distinct preferences regarding their relationships with key adults, including caseworkers and caregivers. However, their perspectives are not consistently assessed or effectively integrated into case planning. Evaluating this integration is essential for fostering positive adjustment and placement stability. Given that residential care represents the predominant child welfare intervention in Portugal, this study adapts and validates an existing instrument for use with youth in residential care institutions, providing evidence of its validity and reliability. Self-report questionnaires—the Positive Residential Care Integration (PRCI) scale (an adapted Positive Home Integration scale) and Strengths and Difficulties Questionnaire—were administered to 511 youth (279 girls and 232 boys), aged 12 to 24 years, across 46 Portuguese residential care institutions. The study examined the face validity, discriminant validity, and reliability of the PRCI scale. Confirmatory factor analysis indicated good model fit, supporting a unidimensional six-item structure. Correlation analyses demonstrated associations with psychological adjustment and sociodemographic variables. The PRCI scale showed satisfactory psychometric properties, confirming its reliability for assessing youth integration in residential care. Cross-gender measurement invariance was also confirmed. These findings underscore the instrument’s relevance and validity for evaluating integration within residential settings and provide valuable guidance for caregivers, professionals, and caseworkers in child welfare services.
- Psychological adjustment and dark triad traits in adolescents living in residential care: a comparative study between boys and girlsPublication . Simão, Ana; Nunes, CristinaYoung people in residential care settings tend to present a heightened risk of emotional and behavioral problems. This study intended to explore connections between Dark Triad personality traits and psychological adjustment and to investigate potential sex and age differences in psychological adjustment and the expression of Dark Triad traits. Primary data were collected from a sample of 511 youth (279 girls and 232 boys) aged between 12 and 24 years, living in 46 Portuguese residential care institutions. Self-report questionnaires (Strengths and Difficulties Questionnaire, Short Dark Triad) were used to collect the primary data. Statistical methods were used such as analysis of variance, multivariate analysis of variance, and hierarchical regression analysis. Results showed that boys scored higher in all Dark Triad traits and in behavioral problems. Younger participants scored higher in Machiavellianism and Psychopathy, in emotional and behavioral problems, and in hyperactivity/inattention difficulties. These results could help institutional professionals and social policies assess and delineate individual programs.
- Psychological profile of adolescents living in residential care: implications for evidence-based interventionsPublication . Simão, Ana; Martins, Cátia; Nunes, CristinaPsychological adjustment in adolescents living in residential care settings is a multidetermined process. This study explores the psychological adjustment of adolescents living in residential care, aiming to identify distinct psychosocial profiles. The sample comprised 433 adolescents (196 boys and 237 girls), aged 12 to 18 years, from 46 Portuguese institutions. Participants self-reported on key variables, including social support, coping strategies, emotion regulation, Dark Triad traits, attachment, and institutional integration. Hierarchical cluster analysis revealed three theoretically coherent profiles, differentiated by number of close friends, duration of institutionalization, substance use, and psychiatric medication. These profiles reflect varying levels of psychological, emotional, behavioral, and social adjustment and align with international literature. This study offers a novel contribution by identifying specific adjustment patterns among adolescents in care, providing valuable insights to inform more tailored intervention and prevention strategies aimed at fostering healthier development and well-being in this vulnerable group.
- Positive residential care integration scale: Portuguese adaptation and validationPublication . Simão, Ana; Martins, Cátia; Ratinho, Elias; Kothari, Brianne H.; Nunes, CristinaYoung people in residential care settings hold distinct preferences regarding their relationships with key adults, including caseworkers and caregivers. However, their perspectives are not consistently assessed or effectively integrated into case planning. Evaluating this integration is essential for fostering positive adjustment and placement stability. Given that residential care represents the predominant child welfare intervention in Portugal, this study adapts and validates an existing instrument for use with youth in residential care institutions, providing evidence of its validity and reliability. Self-report questionnaires-the Positive Residential Care Integration (PRCI) scale (an adapted Positive Home Integration scale) and Strengths and Difficulties Questionnaire-were administered to 511 youth (279 girls and 232 boys), aged 12 to 24 years, across 46 Portuguese residential care institutions. The study examined the face validity, discriminant validity, and reliability of the PRCI scale. Confirmatory factor analysis indicated good model fit, supporting a unidimensional six-item structure. Correlation analyses demonstrated associations with psychological adjustment and sociodemographic variables. The PRCI scale showed satisfactory psychometric properties, confirming its reliability for assessing youth integration in residential care. Cross-gender measurement invariance was also confirmed. These findings underscore the instrument's relevance and validity for evaluating integration within residential settings and provide valuable guidance for caregivers, professionals, and caseworkers in child welfare services.
- The role of coping strategies, social support and dark triad traits in the psychological adjustment of adolescents in residential carePublication . Simão, Ana; Ratinho, Elias; Nunes, CristinaDark Triad traits have been increasingly studied due to their relevance for understanding emotional and behavioral adjustment. However, little is known about how these traits operate in vulnerable youth populations, particularly adolescents living in residential care. This study examined the direct and indirect effects of Dark Triad traits on psychological adjustment among institutionalized adolescents, considering the roles of coping strategies and social support. Participants were 433 adolescents aged 12 to 18 years (M = 15.33; 45% boys and 55% girls) from 46 Portuguese residential care institutions. Adolescents completed self-report measures assessing Dark Triad traits, coping strategies, perceived social support, and psychological adjustment. Correlational analyses and path analysis were conducted to test relationships between variables, and sex differences were also explored. Results showed that psychopathy had the strongest association with psychological adjustment, mainly through avoidant coping strategies. Machiavellianism and narcissism presented weaker effects. Problem-focused coping and higher levels of social support were associated with better psychological adjustment, whereas avoidant coping was consistently related to greater difficulties. Some patterns varied by sex. These findings highlight the importance of promoting adaptive coping strategies and strengthening social support in residential care settings to improve psychological outcomes among atrisk youth.
- Vulnerable attachment style questionnaire: preliminary evidence for a revised factor structure among adolescents in residential carePublication . Simão, Ana; Martins, Cátia; Bifulco, Antonia; Nunes, CristinaBackground/Objectives: The attachment framework has been used to understand individuals’ development and the emergence of difficulties in specific contexts and developmental stages. The Vulnerable Attachment Style Questionnaire (VASQ) is a brief self-report measure initially designed to assess adult attachment as a vulnerability factor for the development of depression. The present study aimed to examine the factor structure and psychometric properties of the VASQ in a sample of adolescents living in residential care and to provide preliminary evidence for a revised version of the instrument in this population. Methods: A total of 438 youths, aged 12 to 18 years (M = 15.34), completed the questionnaire. Data were randomly split to conduct independent exploratory and confirmatory factor analyses. Results: A three-factor model, consisting of two types of insecurity (ambivalent and avoidant) and a proximity-seeking dimension, emerged as the best-fitting solution. This revised structure involved removing several items while maintaining acceptable psychometric properties and meaningful associations with psychological adjustment. Concurrent validity was assessed by examining youth psychological adjustment, and positive correlations emerged as expected. Conclusions: The findings provide preliminary support for a shortened, restructured version of the VASQ for adolescents in residential care. Rather than confirming the original factorial structure, the results highlight the need to consider population-specific adaptations of the instrument. This version may have potential utility in clinical or intervention contexts and underscores the need to train institutional workers to develop competencies tailored to this population.
- Psychological adjustment of adolescents in residential care: a multi-informant analysis of youth and caregiver reportsPublication . Simão, Ana; Nunes, CristinaScientific evidence shows that perception of adolescents’ psychological adjustment in residential care varies depending on the informant. This study examined discrepancies between adolescents’ self-reports and caregiver reports of psychological adjustment in 46 residential care institutions across Portugal. Data were collected from a sample of 511 adolescents (aged 12–24) and their institutional caregivers using the Strengths and Difficulties Questionnaire and the Socially Desirable Response Set-5. Descriptive statistics and paired-samples t-tests were conducted to compare mean scores between informants. Intraclass correlation coefficients and Cohen’s Kappa were calculated to assess agreement. Results revealed significant differences across all subscales and the total difficulties score, with adolescents consistently reporting more emotional, behavioral, and peer-related problems than caregivers, regardless of sex or age. Agreement ranged from poor to moderate, with the lowest concordance for internalizing symptoms. These discrepancies underscore the role of developmental factors in shaping self- and caregiver perceptions and highlight the importance of multi-informant, developmentally sensitive assessments in residential care. Practical implications include incorporating adolescents’ perspectives into evaluation and intervention, enhancing caregiver training to recognize internalizing issues, and implementing age- and gender-tailored mental health programs.