The Journal of School Nursing2023, Vol. 39(1) 72–86© The Author(s) 2021Article reuse guidelines:sagepub.com/journals-permissionsDOI: 10.1177/10598405211060415journals.sagepub.com/home/jsn
Psychological capital (PsyCap) is a term coined in organizational psychology and refers to a person’s development of states that motivate behavior. Also known in the literature as PsyCap, this construct typically refers to positive states of hope, self-efficacy, resilience, and optimism that are amenable to intervention and that are related to subjective well-being and life satisfaction. The aims of this systematic scoping review were to explore how PsyCap is described in youth mental health literature and how PsyCap and mental health are related. Results from four databases were reported following PRISMA guidelines. A total of 772 studies were identified and 16 studies were fully reviewed, including an overall sample of 6,772 youth from six countries. PsyCap has a positive relationship with mental health in youth. Future studies should involve school nurses to validate the constructs that characterize PsyCap and validate an instrument for measuring PsyCap in youth mental health in English.
Keywordsmental health, health disparities, health/wellness, academic achievement/attendance, alternative therapies, evidence-based practice, integrative reviews, alcohol/tobacco/drug use prevention
An awareness of the dire state of adolescent mental health has grown tremendously over the past decade with the current COVID-19 pandemic further exacerbating an existing mental health crisis among youth (Hill et al., 2021; Loades et al., 2020). Suicide is now the second leading cause of death for youth ages 10–24 years, 1 in 5 high school students reports contemplating suicide, and more than one-third of students report persistent feelings of hopelessness or sadness (Centers for Disease Control & Prevention [CDC], 2020). Despite these statistics, a global strategy to intervene on behalf of the growing number of adolescents and young adults experiencing significant psychological distress has not been well-established (Baroud et al., 2019; Crabtree et al., 2021).
Languishing, or living with low levels of emotional wellbeing and/or positive functioning, may be more than what is commonly referred to as being a “moody teenager” (Holthaus, n.d.; Venning et al., 2012). Fifty percent of all lifetime cases of mental illness develop by age 14 years, and 75% by age 24 years (Kessler et al., 2005; Merikangas et al., 2010), and yet, not quite half of children and adolescents with a mental health disorder receive treatment (National Alliance on Mental Illness [NAMI], 2021). A variety of factors may be contributing to the mental health crisis in young people, and a substantial amount of research has described the risk factors for, and negative consequences of, youth mental health difficulties (Duchesne et al., 2008; Fergusson & Woodward, 2002; Lewinsohn et al., 1998; Lewinsohn et al., 2000; Woodward & Fergusson, 2001). However, focusing on enhancing youth’s inner resources and positive attributes provides an alternative strategy that may provide important insights into positive youth development. Young people are making decisions during this transitional stage of development that may ultimately lead to lifetime coping skills and health behaviors, making it a critical moment in which to empower them towards positive choices.
Positive psychology offers an alternative to the psychology of individual deficits and pathologies; positive psychology is about the “study of strength and virtue” and concerns “nurturing what is best” in human beings (Seligman & Csikszentmihalyi, 2000, p. 7). Positive psychology literature has been associated with improved mental health outcomes and positive coping mechanisms.
A wide body of literature is devoted to a positive psychology approach, and for good reason. Much like developing the muscles in one’s back can relieve pain for someone with a bone and joint injury, enhancing the psychological strengths or inner resources of youth may alleviate some of the suffering they experience. Recent positive psychology literature suggests the co-occurrence of positive characteristics may work in combination to more fully predict mental health outcomes. For example, optimism, in combination with gratitude, zest, and persistence, has shown an enhanced sense of school membership among a cross-cultural sample of students (Chan et al., 2021). Additionally, Jones et al. (2013) studied how the combination of hope, optimism, selfefficacy, gratitude, and hedonia (i.e, pleasure) more fully predict an individual’s emotional symptoms than any construct alone. An explanation for the co-occurrence of positive characteristics is coined as “covitality” (Weiss et al., 2002, p. 1147), yet this broad term does not discriminate between those attributes that are trait-like (i.e., genetic) and state-like (i.e., malleable and open to development).
As healthcare providers, we want to study those areas amenable to intervention and development. Psychological capital (PsyCap) is one potential way to focus on and understand more fully the state-like positive attributes of an individual. PsyCap refers to a set of positive attributes (i.e., hope, self-efficacy, resilience, and optimism) that are open to development and focused on “who the individual is becoming” as opposed to “who the individual is” (Luthans et al., 2007, pp. 20-21). PsyCap is a concept that originated in organizational psychology literature from studying employees’ work performance, competitive edge, and burnout (Luthans, 2002). Higher levels of PsyCap are associated with improved subjective well-being and life satisfaction within the business literature across international borders (Youssef-Morgan & Luthans, 2015).
Hope. Hope is defined as the “belief that one can find pathways to desired goals and become motivated to use those pathways” and “serves to drive the emotions and wellbeing of people” (Snyder et al., 2002, p. 257). In terms of the PsyCap construct, hope is comprised of two components: (1) goal-directed thought-pathways (e.g., willpower), and (2) agency (e.g., waypower) (Luthans et al., 2007).
Self-Efficacy. Self-efficacy, as a dimension of PsyCap, is described by Luthans et al. (2007) as an individual’s confidence in their motivation, cognitive ability, and plan of action required to execute a task successfully. Building upon central themes of Bandura’s (1997) model of self-efficacy, PsyCap self-efficacy emphasizes the importance of an individual’s belief in their ability to be successful.
Resilience. Resilience is described as an individual’s ability to adapt and succeed despite adverse environments and risk factors (Masten & Reed, 2002). Masten and Reed (2002) found resiliency in a developmentally challenging environment contributed to the differences in health outcomes. It involves using everyday skills and personal resources to overcome obstacles (Luthans et al., 2007; Masten & Reed, 2002). Luthans et al. (2007) proposed two tenets of PsyCap resiliency: an individual’s determination to “go beyond the normal” (p. 116) and “an underlying value system” that guides their thoughts, actions, and emotions (p. 119).
Optimism. Optimism has been explained as an individual’s general disposition towards past and/or future events; this perspective is one that is traced with attributes such as hope and confidence, social status and success, role acceptance, and achievement of cultural expectations (Sanford et al., 1946). The relationship between optimism and pessimism is often viewed dichotomously, with a multitude of experiments showing optimistic individuals do better than more pessimistic individuals in most all aspects of life (Seligman, 1998). Seligman (1998) suggested learned optimism is a cognitive skill that can be taught. In PsyCap optimism, Luthans et al. (2007) further ascribe that an optimist credits positive events to their personal ability or personal contribution in making the positive outcomes come about.
PsyCap has begun to appear in health literature, yet the four dimensions first proposed by Luthans and his research team (i.e., hope, self-efficacy, resilience, and optimism), are not consistently included in the conceptual description of PsyCap across health studies. This may be impacted by the assertion of Luthans et al. (2007) that the four dimensions of PsyCap are not set in stone. It is possible that additional attributes (e.g., gratitude, perceived social support, and spirituality) may need to be added to the conceptual understanding of PsyCap to more fully explain and predict life satisfaction and subjective well-being among youth. Empirical support for the main dimensions of PsyCap among youth is needed, because there are significant, unique developmental differences between youth and working adults.
There is a need to explore if hope, self-efficacy, resilience, and optimism most frequently predict and describe the statelike characteristics that promote positive outcomes for a youth’s “possible self” in health research. If not, additional positive attributes might contribute to the knowledge base concerning PsyCap. This idea that the whole (i.e., combination of positive attributes) is more than the sum of its parts aligns with the theoretical paradigm of the nursing discipline (Nightingale, 1859). This literature review will contribute to our understanding of how PsyCap and mental health outcomes are related to each other in youth health research.
The primary aim of this study is to explore how PsyCap is described in youth mental health research and the secondary aim is to explore how PsyCap and youth mental health are related to each other in the literature to date. The research questions are (1) how is PsyCap described in youth mental health research? and (2) how is PsyCap related to youth mental health?
The research questions for this review were selected in response to the findings from a systematic review exploring protective factors for adolescent mental health. A greater understanding of inner resources that are relevant crossculturally are needed within adolescent mental health research (Preston & Rew, 2021). Finks (2020) step-by-step process for conducting literature reviews was followed with modifications made for the completion of a systematic scoping review as recommended by Joanna Briggs Institute (JBI) (Peters et al., 2015). A systematic scoping review process was selected in alignment with the study aims. The systematic scoping review is intended to help clarify conceptual boundaries of a topic. It is a credible method to map the literature available related to a specific discipline (Peters et al., 2015). The authors found this approach particularly relevant for the purposes of our study. One distinction between full systematic reviews and systematic scoping reviews is that the evidence will be summarized and existing literature mapped (p.141), as opposed to being synthesized (Peters et al., 2015). An additional distinction is that an overview of the existing evidence will be provided regardless of quality, so no formal quality assessment is performed (Arksey & O’ Malley, 2005). The scoping review protocol was established prior to commencing the study.
Inclusion and exclusion criteria were determined based on the research questions in order to provide a comprehensive base of understanding of PsyCap in youth mental health research. A practical screening tool was developed (see Supplemental Appendix A). The inclusion criteria were: (1) the sample population was children, youth/adolescents, or young adults, (2) the study included discussion of PsyCap and a mental health outcome, (3) available in English, and (4) peer-reviewed. Owing to time constraints, we did not include posters, abstracts, or editorials.
After meeting with the university health sciences and psychology librarians, a rigorous search strategy was undertaken. The databases PsycInfo (EBSCO), Web of Science, PubMed, and Cumulative Index of Nursing and Allied Health Literature (CINAHL) were selected to include the primary databases with literature on the psychology of health housed by the university. The online platform, Rayyan, was utilized throughout the screening process to allow the authors to collaboratively conduct the literature review (Rayyan, 2020). A citation search on Google Scholar was conducted using selected exemplar articles to capture any relevant articles not already included. The selected search terms were: (Psychological capital OR psycap OR “positive psychology”) AND ((gratitude OR connectedness OR future time perspective OR character strengths OR curiosity) OR (hope AND efficacy AND resilien* AND optimis*)) AND (youth OR adolescen* OR teen* OR young adult OR child* OR kid). While the literature on positive psychology is broad and expansive, it was included within our search strategy in combination with a positive state-like characteristic (i.e., gratitude) to capture studies that may have explored psychological capital in health literature in a non-traditional manner.
Two reviewers met to discuss the research questions and goal of the study prior to beginning the data extraction process. A data extraction template was discussed, and the reviewers agreed upon utilizing a pre-established form recommended for scoping review studies from JBI (Aromataris & Munn, 2020). The pre-determined data extraction template was utilized to extract data from all studies that met eligibility criteria. The two reviewers performed data extraction independently, and consulted each other on any discrepancies until consensus was reached. A flow diagram was completed following Principles of the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines to present our results. Figure 1 depicts the process of study identification, screening, removal, and inclusion.
Of the 16 papers fully reviewed and retained, six studies were conducted in China, five studies were from the United States of America, two studies were from India, one study was from Australia, one study was from the United Kingdom, and one study was from Spain. The total sample was comprised of 6,772 participants. The sample sizes ranged from 37 to 1,473 youth for a total of 16 independent studies. The age range of the retained sample was 7–25 years old, with the exception of the study by Selvaraj and Bhat (2018) that included participants who fell outside of this range (age = 18–54 years old, 67.8% were 18–22 years old). The research team decided to include the Selvaraj and Bhat (2018) study since the majority of participants fell within the desired age range and the authors referred to them as college students. The study settings ranged, with 10 of the studies occurring in a school setting, three studies in community centers, one study in psychiatric and general hospitals, one study among youth who graduated high school but were currently unemployed, and one study included youth and coaches involved in sport programs. Of the 16 studies retained, eight of them had roughly equal representation of males and females, three studies had greater than 60% male representation, two studies had greater than 60% female representation, and authors of four studies did not report on gender. Only two authors reported that respondents selfidentified as other than heterosexual (Rew et al., 2017; Selvaraj & Bhat, 2018). No studies explicitly reported including males who self-identify as part of the LGBTQ + community (see Table 1). Of the retained studies, eight did not provide information on racial and ethnic differences in the sample, eight reported 78%–100% representation from the country it was conducted within, and two studies reported an “ethnically diverse” sample with no single race comprising greater than 50% of the sample (Rew et al., 2017; Rew et al., 2019). All studies included in the review followed the principles of the Declaration of Helsinki for the protection of human subjects.
A total of four intervention studies were included in this systematic scoping review, including two randomized control trials and two quasi-experimental studies. Seven studies were correlational, four studies performed mediational analyses, and one study took a qualitative approach. Table 1 provides a synopsis of the articles retained.
During the review process, we noted that a variety of instruments were employed to measure the attributes of PsyCap in mental health research on youth. Table 2 provides a map of which scales were incorporated by the 16 independent studies retained in this review.
The primary aim of this literature review was to explore how PsyCap is described in youth mental health research. Two-thirds of the studies (10/16) conceptualized PsyCap according to Luthans et al. (2007)’s definition. One-third of the studies (6/16) considered potential additional attributes that might better explain this positive psychological strength, including gratitude, future time perspective, social connectedness, hedonia, and achievement motivation. See Table 3, which provides a map of PsyCap descriptions.
The secondary aim of this literature review was to investigate how psychological capital relates to youth mental health in the literature. The majority of studies (8/16) explored PsyCap in relation to a positive mental health outcome. An additional five studies looked at both positive and negative mental health outcomes (e.g., anxiety, depression, and life satisfaction). A small number of studies (3/16) focused on PsyCap in relation to only a negative mental health outcome. See Table 4 which provides a map of the role of PsyCap in each of the studies meeting inclusion criteria within this review.
To our knowledge, this is the first systematic scoping review of PsyCap and its relation to mental health in youth. Although the construct of PsyCap had its origins in organizational psychology, it is encouraging to find that all 16 of these independent studies occurred in school, sports, or clinical settings. It was interesting to note that most studies were conducted outside of the United States of America. Most of the studies provided similar descriptions of PsyCap, although some explored additional variables, which brings up additional research questions that warrant further investigation.
Our first research question was how is PsyCap described in youth mental health research? The four HERO constructs: hope, efficacy, resilience, and optimism, recurred in the studies throughout this review. Several studies responded to the original call to expand understanding of the PsyCap attributes (Luthans et al., 2007). Health professionals should not assume the predictors of mental health and subjective wellbeing are the same in youth as they are among working adults (Seligman & Csikszentmihalyi, 2000). We found several studies that added to youth health literature by including gratitude and connectedness as predictors in the PsyCap equation.
Gratitude. The results of this scoping review indicate that as we seek to promote youth mental health during a developmental transition when they are faced with a wide range of outside environmental influences and life-decisions, an attitude of gratitude may serve as an inner resource that promotes healthy coping and should be considered when studying the concept of PsyCap among youth. This may be particularly poignant for students as gratitude has been associated with a heightened level of meaningfulness and engagement in the classroom setting (Flinchbaugh et al., 2011). Including the concept of gratitude as an additional inner, state-like resource could be one piece of the puzzle to address social inequities related to academic performance (Arum et al., 2012). Moreover, a student’s utilization of internal resources in the classroom will likely influence their behavior outside of the classroom setting, leading to positive development in a variety of contexts.
Connectedness. A total of six studies in this review incorporated aspects of connectedness within their conceptualization/operationalization of PsyCap and found positive associations with mental and behavioral health outcomes (Khan & Husain, 2010; Lui et al., 2020; Morgan et al., 2019; Rew et al., 2017; Sanchez-Terual & Robles, 2020; Song & Song, 2021). These findings align with prior work. Resnick et al. (1993) conducted a US study using a statewide database of 3600 7th–12th graders and found protective factors, such caring and connectedness, were more influential on high-risk behavior than demographic risk factors. Kia-Keating et al. (2011) found connectedness (i.e., social support and sense of belonging) was associated with increased motivation, academic achievement, and life satisfaction. Additionally, in a study examining bullying interventions, You et al. (2008) found the combination of enhanced connectedness and hope improved life satisfaction among bullied youth. Understanding the relationship between connectedness and PsyCap in relation to youth mental health is meaningful to nurses seeking to uphold the ethical mandate of social justice.
Our second research question was what is the role or relationship of PsyCap to mental health in youth? Of the 16 studies that explored PsyCap in relation to a mental health outcome among youth, all 16 studies demonstrated a significant positive relationship with positive mental health outcomes and a significant negative relationship with negative mental health outcomes. While the majority of studies in the literature on PsyCap have been conducted among adults, based on the findings of this review, PsyCap demonstrates a relationship with positive mental health outcomes among youth.
While this finding is worth noting, it does not imply causation. For example, these findings cannot tell us whether higher levels of PsyCap led to lower levels of negative mental health, or if higher levels of negative mental health led to lower levels of PsyCap (see Table 4). The inability to imply causation justifies the need for longitudinal studies to better understand the temporal relationships between PsyCap and mental health outcomes.
In light of student health, strategies to enhance PsyCap in the school setting warrant further investigation in how this may be a resource an adolescent can utilize to enhance subjective well-being, and inversely decrease depression, anxiety, and suicidal ideation, despite adverse environments and trauma.
This systematic scoping review has several limitations. First, as the nature of a scoping review, no formal quality assessment was conducted, therefore, no conclusions regarding the level of evidence to support PsyCap as a positive influence on youth mental health can be made. This review is helpful for identifying areas for future research on the topic of PsyCap, and health care providers should use caution in deciding how to incorporate the findings of this review into their practice. A second limitation is that we restricted our search to four databases and limited our findings to studies published in English. It is possible that relevant articles were missed, however, additional hand searches of retrieved articles revealed no additional references. A third limitation is the generalizability of the findings of this review. Given the range of attributes characterizing PsyCap across studies, and the global boundaries, some of the attributes may not be cross-culturally relevant.
Future Research. A few of the studies in this review (5/16) include gratitude and connectedness in combination with traditional PsyCap constructs. To enhance our understanding of inner resources high-risk youth have the potential to develop, additional studies need to be conducted. Rew et al. (2017; 2019) began this work by accessing the homeless population and considering positive attributes that may play a role in mental health outcomes.
Another area of future research relates to the use of instruments. The most frequently used measure of PsyCap in youth mental health was the Positive Psychological Capital Questionnaire (PPQ). It is currently not available in English, making it unavailable for English-language research. Nevertheless, this finding is a valuable contribution to the literature on PsyCap and mental health in relation to youth.
Not all students have equal access to mental health care (Harris et al., 2020; Maughan & Bergren, 2021), yet most have access to a school nurse. As holistic care providers, school nurses are concerned with more than students meeting developmental and academic benchmarks, but also seek to enhance student wellbeing and reduce the impact of social inequities, such as access to health care (Canales et al., 2019). For example, those in rural areas are twice as likely to attempt suicide as compared to those living in urban areas (Barry et al., 2020). School nurses implementing interventions that enhance PsyCap may provide a means for addressing mental and behavioral health disparities. Morgan et al. (2019) discussed the use of a sporting program intervention developed specifically for youth who would usually be excluded from such activities. Another example is the intervention by Fang and Ding (2020), where students participated in a weekly curriculum with interactive topics focused on raising awareness and committed action to benefit their future possible self.
School nurses are central in the school and community network because of their well-established relationships with students, families, administrators, and social support agencies (Davis et al., 2019). The authors argue no other single health care professional is in a more prime position in the community to intervene on behalf of student health, holistically. Brief PsyCap interventions are well-suited for implementation in the school setting to enhance student success (Luthans et al., 2007) and mental health outcomes (Rew et al., 2017; Selvaraj & Bhat, 2018; Xiong et al., 2020). An increased incidence of students being prescribed psychotropic medications (Dai Cao et al., 2021; John et al., 2015) calls for school nurses to incorporate populationlevel strategies to facilitate students’ vision for their future self and enhance their inner resources (e.g., PsyCap attributes).
Furthermore, school nurses are uniquely suited to influence further development of the concept of PsyCap and other concepts of positive psychology in youth health literature. The emergent nature of PsyCap literature has not addressed the social determinants of health (SDOH) in relation to mental health among youth and young adults, and further research is needed. School nurses need to engage in research and collaborate with local universities to enhance the literature on the value of school nursing (Maughan & Bergren, 2021), and build the knowledge base regarding how primary prevention strategies, such as PsyCap interventions in the school setting, may reduce mental and behavioral health disparities among disenfranchised and marginalized populations.
The primary aim of this systematic scoping review was to describe how PsyCap is described in youth mental health research, and this was met. The secondary aim was to explore how PsyCap is related to youth mental health in the literature to date and this was met. To our knowledge, this is the first literature review to explore PsyCap in relation to mental health among youth. This systematic scoping review maps out and summarizes the current literature available on PsyCap in youth mental health research. As school healthcare providers seek to incorporate evidence-based interventions that are cross-culturally relevant for mental health promotion, this review provides a map supporting further investigation into holistic development of inner resources.
Thank you to Dr. Roxanne Bogucka, Health Science Librarian, & Dr. Carolyn Cunningham, Psychology Librarian, at the University of Texas at Austin, for assisting with database and search term selection and revision.
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
The authors received no financial support for the research, authorship, and/or publication of this article.
Angela Preston https://orcid.org/0000-0002-8575-4324
Cara Calloway Young https://orcid.org/0000-0001-6599-7145
Supplemental material for this article is available online.
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1 School of Nursing, University of Texas, Austin, USA
Corresponding Author:Angela Preston, School of Nursing, University of Texas, Austin, TX 78712, USA.Email: angelapreston@utexas.edu
