**4. Discussion**

In this application of the Dual Factor Model [16–18], to a population study, it was found that the model helped to explain the distribution of pupils by each of the situations defined by the four conditions.

As observed in previous research, we discovered that, globally, girls present a more disadvantageous situation in terms of their psychological distress [1, 2, 19, 20, 22, 23, 25, 26]. Additionally, we discovered that, globally, older pupils present a more disadvantageous situation concerning their psychological distress [22]. In a study by Yoon et al. [27], it is reaffirmed that adolescents exhibit clear signs of psychological distress as they age, with this trend becoming more prevalent among girls.

The results indicate that, globally, girls are more likely to report symptoms, even when report high life satisfaction. Boys are more likely to report the absence of symptoms, even when they report low life satisfaction. Also, the youngest are the most likely to express life satisfaction, regardless of the presence or absence of pronounced psychological symptoms. The oldest report the lowest levels of life satisfaction, regardless of the presence or absence of pronounced psychological symptoms. This fact demonstrates the need, already mentioned by the original authors [16–18], to take into account not only the extreme situations of "complete health" and "complete

*A New Look at Psychological Health and Life Satisfaction: A Quadripartite Model DOI: http://dx.doi.org/10.5772/intechopen.111506*


#### **Table 4.**

*The quadripartite model—the dual factor model [16, 17] adapted [28]—gender and age/grade differences.*

distress" but also the situations in which only one of the situations occurs (reduced psychological symptoms and high life satisfaction or pronounced psychological symptoms with low life satisfaction) (**Table 4**).

Finally, when considering other indicators of psychological well-being (perceived quality of life) and certain health behaviours (adequacy of sleep time, physical activity time, and screen time), we found that this pattern is repeated, favouring pupils in a state of *Complete Psychological Health* and making pupils in a state of *Complete Psychological Distress* more vulnerable.

As suggested by other authors, this study confirms that for a state of complete psychological well-being, both the dimensions of life satisfaction and absence of psychological distress symptoms are essential [16–18]. These same authors suggest that there is a need to consider situations in which only one of the situations occurs (low psychological symptoms and high life satisfaction or pronounced psychological symptoms with low life satisfaction) is present, as results suggest they may be alert to the differential position of gender across educational levels. The data suggest that, throughout schooling, psychological symptoms are most pronounced in girls even when they refer to high life satisfaction, while in boys, there is a decrease in life satisfaction, even without pronounced psychological symptoms. That is, among girls, it is suggested that girls' negative trend with age is from a status of Incomplete Psychological Distress to a Status of Complete Psychological Distress. In contrast, among boys, it is suggested that boys' negative trend with age is from a status of Complete Psychological Health to a Status of Incomplete Psychological Health.

The significance of being physically active, sleeping an adequate number of hours, and using screens in a balanced and moderated manner are three promising ways to increase the odds for boys and girls to grow older in a state of *Complete Psychological Health*. Consistently, longitudinal studies have demonstrated that screen time and sleep duration are associated with less psychological health [29, 30].

In the HBSC study from 2018 to 2022, not only did psychological symptoms increase significantly and life satisfaction decrease, but the gap between girls and boys and between the oldest and the younger seems to have worsened, increasing the health and well-being gap between gender and age groups/grades [22, 23].

Both DGEEC and HBSC studies have some limitations that should be considered. These are self-report studies with a cross-sectional design, which does not allow making inferences of causality. Despite these limitations, the selection of participants was randomised and stratified by administrative region and level of education, with a high number of participants.
