The research, published in the journal Large-scale Assessments in Education, was led by Samuel Falcon of the University of Las Palmas de Gran Canaria together with Yuney Santos of Mid Atlantic University. Rather than looking only at test scores, the team turned its attention to what the authors call psychoeducational resources: the relational, motivational, and emotional assets that determine whether a student can actually use a second chance when one is offered. The study draws on the Spanish sample of PISA 2022, the Programme for International Student Assessment, which in Spain covered 29,775 students aged 15 to 16. Of these, 5,642 students, or 18.95 percent, had repeated a grade at least once, a striking figure when set against the OECD average of around 9 percent.

Spain is an unusually important laboratory for this question. Retention there has long been more frequent than in most other wealthy countries, persisting even through reforms intended to curb it. In PISA 2022, 22 percent of Spanish 15-year-olds reported having repeated a grade after entering primary school. That means retention is not a marginal intervention affecting a small and exceptional group; it is a routine feature of the educational trajectory of a large share of Spanish adolescents. Understanding what that experience does to students, beyond their mathematics and reading scores, therefore matters for an entire generation.

The methodological challenge is that students are not randomly assigned to repeat a grade. Retained students tend to differ from their promoted peers before the decision is ever made: in the Spanish sample they came from families with lower economic, social and cultural status, had fewer years of early childhood education, were more likely to be first-generation immigrants, more likely to be male, and more likely to have been born late in the year, a well-known relative-age effect. A naive comparison of retained and non-retained students would therefore confound the effect of retention with these pre-existing differences. To address this, the researchers used propensity score matching, a statistical technique that estimates each student’s probability of being retained from observed background characteristics and then pairs each retained student with a non-retained student of similar probability.

The matching procedure was unusually careful. The team tested several specifications, including generalised full matching and nearest-neighbour matching at 1:1 and 1:2 ratios with various calipers, and settled on 1:1 nearest-neighbour matching without replacement, which kept every retained student in the analysis while achieving excellent balance. After matching, the mean of the maximum absolute standardised mean differences was 0.026 for the original covariates, well below the conventional 0.10 threshold, and 0.074 even for higher-order and interaction terms. Missing values in the background covariates were handled through multiple imputation across five datasets, with estimates pooled using Rubin’s rules. The analyses also incorporated PISA’s complex survey design, combining matching weights with the final student weights and 80 replicate weights using balanced repeated replication with Fay’s adjustment.

The seven outcomes spanned three domains. School integration was captured by sense of belonging and perceived quality of student-teacher relationships. Learning-related resources included self-directed learning self-efficacy, perseverance, and curiosity. Emotional functioning was measured through emotional control and stress resistance, indices drawn from the OECD framework on social and emotional skills. The results were strikingly consistent in direction. After matching and adjustment, retained students scored significantly lower on six of the seven resources, with associations surviving a Benjamini-Hochberg false discovery rate correction across outcomes.

The largest differences appeared in the learning-related domain. Self-directed learning self-efficacy, students’ confidence in managing their own learning tasks independently, showed the biggest gap, with an effect size of d = -0.27, followed by perseverance at d = -0.25. Curiosity was lower as well (d = -0.12), while the relational and emotional differences were smaller: sense of belonging (d = -0.07), student-teacher relationships (d = -0.09), and emotional control (d = -0.09). Only stress resistance showed essentially no difference, with an effect size of -0.01 and a regression coefficient of exactly zero that was nowhere near statistical significance. Sensitivity analyses using alternative matching specifications reproduced the same pattern, suggesting the findings are not an artefact of one particular matching choice.

There is a deep irony in the two largest effects. The entire rationale for retention is that an extra year gives students time to master content they could not grasp the first time. But that rationale presupposes students who feel capable of organising their own learning, who persist when tasks become difficult, and who remain open to new ideas. The study suggests retained students are precisely the ones who report being weakest in these resources. The authors interpret this as consistent with retention being embedded in a longer history of academic struggle, in which the relationship with effort and academic agency may already be fragile. Repeating a grade, in this light, may not rebuild that relationship; it may simply extend a trajectory in which students feel less and less competent at steering their own learning.

The relational findings matter for a similar reason. Retained students are typically separated from their original peer group, placed with younger classmates, and carry a visible marker of prior failure in front of teachers and peers. Cross-national PISA evidence has repeatedly shown that repeaters report lower belonging, and the Spanish data confirm this pattern even after matching on background characteristics. Interestingly, the picture on emotions was mixed: retained students reported more difficulty regulating irritation, anger, and frustration, yet showed no difference in general stress resistance. The authors suggest these two constructs capture distinct aspects of emotional functioning, and that retention may be more closely tied to emotional regulation in challenging situations than to a general tolerance for pressure, though they caution that this interpretation requires longitudinal testing.

The researchers are careful about what their design can and cannot show. Because the data are cross-sectional and observational, the results are adjusted associations, not causal effects. The propensity score model could not account for prior achievement, attendance, learning difficulties, behaviour, teacher judgements, or the school-level practices that shape retention decisions, so residual confounding is likely. There is also no way to know whether retained students already had lower belonging or perseverance before repeating, or whether the differences emerged afterwards. Missing data posed a further complication, particularly for self-directed learning self-efficacy, where questionnaire routing tied to COVID-19 school closures left 34 percent of observations unavailable, and missingness was consistently higher among retained students. Even so, the consistency of the pattern across six outcomes, three domains, and multiple matching specifications is difficult to dismiss.

The policy implications are sobering. If repeating a grade is meant to be a second opportunity, the study suggests that time alone does not create the conditions for recovery. The authors argue that retention should not be treated as an intervention in itself, and they point to candidate domains for future support research: transition planning after retention, monitoring of school belonging, teacher guidance aimed at rebuilding academic confidence, and structured help for self-regulated learning, with particular attention to self-directed learning self-efficacy and perseverance, the two resources showing the largest gaps. More broadly, the findings reinforce a growing argument that evaluations of grade retention should not be restricted to test scores. Whether students remain connected to school, confident in managing their learning, and emotionally equipped to continue may ultimately determine whether the extra year helps or harms, and those dimensions are invisible in achievement data alone. For a country where nearly one in five adolescents repeats a grade, that is a message worth taking seriously.

Subject of Research: Associations between grade retention and psychoeducational resources among Spanish students in PISA 2022

Article Title: Grade retention and psychoeducational resources: evidence from PISA 2022 using propensity score matching

Article References: Falcon, S., & Santos, Y. (2026). Grade retention and psychoeducational resources: evidence from PISA 2022 using propensity score matching. Large-scale Assessments in Education, 14(1), Article 48. https://doi.org/10.1186/s40536-026-00323-9

Image Credits: AI Generated

DOI: 10.1186/s40536-026-00323-9

Keywords: grade retention, PISA 2022, propensity score matching, psychoeducational resources, school belonging, student-teacher relationships, self-directed learning self-efficacy, perseverance, curiosity, emotional control, Spain, educational psychology

The research team, led by Jiaxin You and colleagues at Tongji Hospital and Tongji Medical College of Huazhong University of Science and Technology, began with a deceptively simple question: do depression, anxiety, and resilience always appear in the same configurations across adolescents, or do some young people carry profiles that look qualitatively different from others? After rigorous data cleaning, 33,230 participants remained in the final analysis. Rather than treating the sample as a homogeneous whole, the researchers applied latent profile analysis, a statistical technique that sorts individuals into unobserved subgroups based on their response patterns across depressive symptoms measured with the nine-item Patient Health Questionnaire, anxiety symptoms measured with the seven-item Generalized Anxiety Disorder scale, and multiple dimensions of resilience assessed with the Resilience Scale for Chinese Adolescents.

The results revealed a three-profile structure that captures a striking gradient of mental health. The first and presumably largest group, labeled High Resilience-Low Distress, combines strong psychological resources with minimal depressive and anxious symptoms. The second, Moderate Resilience-Moderate Distress, sits in the middle of the distribution, with intermediate levels on both sides of the ledger. The third, Low Resilience-High Distress, represents the group of greatest clinical concern: adolescents whose resilience reserves are depleted while their symptom burden is elevated. Each participant was then assigned to their most likely profile using posterior probabilities, a procedure that preserves the probabilistic nature of the classification while allowing the researchers to estimate separate symptom networks within each subgroup.

Network analysis represents a conceptual shift from the traditional latent-variable view of psychopathology. Instead of assuming that depression and anxiety are underlying diseases that cause visible symptoms, network models treat symptoms themselves as causally interconnected elements: insomnia may fuel fatigue, fatigue may deepen depressed mood, and depressed mood may amplify thoughts of worthlessness. Within each of the three adolescent profiles, the researchers estimated such a network, then examined which nodes—individual symptoms or resilience dimensions—held the most influence. Two metrics anchored this investigation: expected influence, which quantifies how strongly a node connects to the rest of its network, and bridge expected influence, which identifies the nodes that tie the symptom community to the resilience community. Bridge nodes are of special interest because they represent potential leverage points where interventions aimed at one domain could cascade into the other.

The centrality findings varied by profile in ways that carry real clinical implications. In the High Resilience-Low Distress and Moderate Resilience-Moderate Distress groups, anxiety-related nodes emerged as the most prominent within-network features, suggesting that even among adolescents who are functioning relatively well, anxious symptoms form the most dynamically connected portion of the psychological landscape. In the Low Resilience-High Distress group, however, the picture changed decisively: depressed mood became the most central node. This shift suggests that as adolescents move from moderate to severe distress, the organizing hub of their symptom network migrates from anxiety toward depression, a transition that could inform which symptoms clinicians prioritize at different severity levels.

Perhaps the most striking finding concerns emotional control, a resilience dimension that functioned as the strongest negative bridge to the symptom community across all three profiles. In other words, regardless of whether an adolescent was flourishing, struggling, or falling somewhere in between, the capacity to regulate emotional responses was consistently the resilience factor most tightly—and inversely—linked to depressive and anxious symptoms. This consistency across heterogeneous subgroups elevates emotional control from one resilience skill among many to a candidate transdiagnostic mechanism, one whose strengthening could plausibly buffer symptom networks in adolescents across the full spectrum of mental health.

On the symptom side, the identity of the strongest negative bridge node also shifted across profiles. Among the High Resilience-Low Distress adolescents, anhedonia—the loss of interest or pleasure in activities—formed the strongest negative bridge, whereas in both the moderate and high-distress groups, thoughts of death or self-harm took on that role. The emergence of suicidal ideation as the most influential bridge node in the two more distressed profiles is a sobering signal: it indicates that in vulnerable adolescents, this severe symptom is not merely one marker among many but the point of strongest contact between the resilience and symptom systems. Screening and safety planning that target thoughts of death or self-harm in moderate- and high-distress adolescents may therefore interrupt some of the most consequential connections in their psychological networks.

The researchers also subjected their networks to formal statistical comparison. Exploratory network comparison tests revealed significant differences in both network structure and global strength between the High Resilience-Low Distress profile and each of the other two profiles, indicating that the overall architecture of symptom-resilience interconnections is not the same across subgroups. Yet the finer-grained analysis told a more nuanced story: no individual edge comparison remained statistically significant after Holm-Bonferroni correction for multiple testing, and several strong edges proved similar across profiles. This pattern suggests that while the networks of resilient and distressed adolescents differ in their global configuration, the core relational pathways—such as the negative link between emotional control and distress—appear to be preserved features of adolescent psychology rather than artifacts of any single subgroup.

Methodological care underpins these conclusions. The team estimated profiles using robust maximum likelihood with multiple fit indices, including the sample-size-adjusted Bayesian information criterion, the bootstrap likelihood ratio test, and the Lo–Mendell–Rubin adjusted likelihood ratio test, to justify the three-profile solution. Network stability was assessed with the correlation stability coefficient, and missing data were handled under explicit assumptions about whether values were missing completely at random, at random, or not at random. The study received ethical approval from the Medical Ethics Committee of Tongji Hospital and was conducted in accordance with the Declaration of Helsinki, with electronic informed consent obtained from both participants and their legal guardians before survey administration.

The authors are careful to frame their findings as a descriptive, cross-sectional characterization rather than a causal account. Network analysis of a single time point cannot establish that emotional control causes lower distress, nor that depressed mood drags other symptoms along with it; longitudinal designs will be needed to test whether the central and bridge nodes identified here serve as genuine drivers of change over time. Nevertheless, the scale of the sample and the combination of person-centered and network-centered methods give the findings unusual weight. If future research confirms that emotional control is a stable negative bridge and that the centrality of depressed mood in highly distressed adolescents is reproducible, school-based mental health programs could be redesigned to teach emotion regulation as a frontline preventive strategy, while screening protocols could weight anhedonia and thoughts of death or self-harm according to a student’s broader profile of risk. In a field where interventions often arrive too late, identifying the exact nodes where resilience meets distress may prove to be the map that practitioners have been waiting for.

Subject of Research: Network analysis of depression, anxiety, and resilience across adolescent latent mental health profiles

Article Title: Central and bridge nodes in depression, anxiety, and resilience networks across adolescent latent profiles: a latent profile and network analysis

Article References: You, J., Xia, T., Lu, X., Xie, X., Xu, R., & Huang, H. (2026). Central and bridge nodes in depression, anxiety, and resilience networks across adolescent latent profiles: a latent profile and network analysis. BMC Psychology. https://doi.org/10.1186/s40359-026-05633-9

Image Credits: AI Generated

DOI: 10.1186/s40359-026-05633-9

Keywords: adolescents, depression, anxiety, resilience, latent profile analysis, network analysis, mental health, bridge nodes, expected influence, psychopathology, emotional control, cross-sectional study

The therapy under evaluation, known as Neuro-Physiological Psychotherapy (NPP), was developed for maltreated children placed in adoptive and foster families. It is deliberately multi-modal: rather than relying on a single technique, it integrates somatosensory work that addresses the body’s sensory and motor systems, creative and play-based interventions, dyadic therapies that treat the child and caregiver as a unit, and structured support for therapeutic parenting. The theoretical scaffolding draws heavily on Stephen Porges’ Polyvagal Theory, which proposes that the autonomic nervous system continuously evaluates safety and threat through a process called neuroception, and that states of calm social engagement can only emerge once the body’s defensive arousal systems have been downregulated. In practical terms, NPP attempts to help a hypervigilant child’s nervous system learn, through repeated safe relational experiences, that the world is no longer dangerous.

Earlier work by the same team had shown significant differences between children receiving NPP and a non-equivalent control group, but questions remained about whether those gains would persist in a larger cohort and, crucially, whether they would extend to children with prenatal alcohol exposure (PAE)—a group often assumed to be harder to treat because alcohol acts directly on the foetal brain. The new evaluation addressed both questions. Adopted children and young people who received NPP were compared with a control group using two widely validated instruments: the Behaviour Rating of Executive Functioning (BRIEF), completed by parents and teachers, and the Child Behaviour Checklist (CBCL), completed by parents to capture a broad range of emotional and behavioural difficulties.

The results were striking in their consistency. On the BRIEF, the treatment group showed significantly better global executive functioning than controls, with the analysis reporting F(1,74) = 7.53, p = .008, and a partial eta squared of .09, indicating a moderate effect size. Behavioural regulation showed an even stronger separation, F(1,74) = 10.62, p = .0002, with a partial eta squared of .22—a large effect by conventional standards. Emotional control, the capacity to modulate emotional responses rather than being overwhelmed by them, also differed significantly between groups, F(1,74) = 10.38, p = .002. Importantly, these were not merely the optimistic reports of parents invested in their child’s therapy: teacher-reported indices, gathered by professionals who had no stake in the treatment programme, showed similar patterns of advantage for the intervention group.

The CBCL data told a complementary story. Parents of children who had received NPP reported significantly fewer total behavioural difficulties than control-group parents, F(1,74) = 5.63, p = .003, and significantly fewer externalising problems—the aggressive, defiant, and rule-breaking behaviours that most often drive family breakdown and placement disruption, F(1,74) = 8.36, p = .005. For adoptive families, externalising behaviour is frequently the symptom that precipitates crisis; a therapy that measurably reduces it addresses one of the most clinically urgent outcomes in the field.

The most novel contribution of the study, however, lies in its treatment of prenatal alcohol exposure. Using Linear Mixed-effects Modelling on the Behavioural Regulation Index score, the researchers tested whether the presence of PAE changed how children responded to NPP. It did not. The model indicated that NPP was as effective for children with PAE as for those without, with a coefficient of -12.82 (SE = 5.12, t = -2.51, p = .015) reflecting the significant improvement associated with the therapy. This finding challenges a quiet therapeutic nihilism that sometimes surrounds foetal alcohol spectrum disorder, the condition that may arise when alcohol exposure in the womb disrupts brain formation. A recent systematic review of interventions for executive function difficulties in FASD had found the evidence base thin; this study contributes controlled, quantified support for a treatment approach that works at the level of the nervous system rather than trying to teach skills to a brain not yet ready to learn them.

The neuroscience rationale is worth unpacking. Prenatal alcohol exposure alters brain structure in measurable ways, including differences in cortical and subcortical regions that support attention, memory, and self-regulation, and neuroimaging studies have documented maturational differences in the amygdala and prefrontal cortex of exposed children. Early maltreatment compounds these changes through stress biology: chronic activation of the hypothalamic-pituitary-adrenal axis during critical developmental windows recalibrates threat responses, and research on childhood adversity consistently links such dysregulation to later psychiatric illness. Polyvagal Theory adds a third layer, describing how the vagus—the tenth cranial nerve—mediates the shift between defensive states and social engagement. NPP’s designers reasoned that if trauma and alcohol exposure disrupt the body’s regulatory circuitry, then therapy must engage that circuitry directly, through sensory input, rhythmic dyadic interaction, and caregiver relationships that repeatedly signal safety. The significant improvements in behavioural regulation and emotional control observed in the study are precisely the outcomes this framework would predict.

The study’s authors, led by Elaine McCullough and colleagues at Family Futures and collaborating clinicians including Raja Mukherjee of Surrey and Borders Partnership NHS Foundation Trust, are careful about what the data can and cannot show. The control group was non-equivalent, meaning participants were not randomly assigned, so causality cannot be established with the certainty of a randomised trial. The measures are parent and teacher reports rather than direct neuropsychological testing, and the cohort, though larger than in previous evaluations, remains modest in size. Nevertheless, the convergence of findings across informants, instruments, and analytic methods—and the demonstration that treatment effects hold for children with prenatal alcohol exposure—represents a substantial advance over the team’s earlier work. The authors frame the results as support for interventions that recognise the complex, multi-system effects of neurodevelopmental trauma and that are explicitly informed by neuroscience, rather than for any single technique in isolation.

The wider implications reach beyond the clinic. Children with FASD frequently carry co-occurring diagnoses—ADHD, attachment difficulties, mood disorders—and their families often navigate services that are fragmented and poorly informed about the condition. Public health data suggest that alcohol consumption during pregnancy remains common, and UK prevalence studies have estimated that fetal alcohol spectrum disorders affect a meaningful share of the birth population, most of whom are never diagnosed. For adopted children, in whom PAE and post-natal maltreatment frequently co-occur, the clinical picture is among the most complex in child mental health. A therapy that integrates somatosensory, creative, and dyadic work with parenting support—and that demonstrably improves executive functioning and reduces externalising behaviour in this population—offers a template for what neurodevelopmentally informed care could look like if embedded in mainstream services. The authors’ conclusion is measured but pointed: when treatment speaks the language of the nervous system, some of society’s most vulnerable children can be helped not simply to cope, but to regulate, relate, and recover.

Subject of Research: Effectiveness of Neuro-Physiological Psychotherapy for adopted children with neurodevelopmental trauma and prenatal alcohol exposure

Article Title: An Evaluation of Neuro-Physiological Psychotherapy for Adopted Children and Young People with Neurodevelopmental Trauma and Prenatal Alcohol Exposure Who May Meet Criteria for Foetal Alcohol Syndrome Disorder

Article References: An Evaluation of Neuro-Physiological Psychotherapy for Adopted Children and Young People with Neurodevelopmental Trauma and Prenatal Alcohol Exposure Who May Meet Criteria for Foetal Alcohol Syndrome Disorder. (n.d.). https://doi.org/10.1007/s40653-026-00956-6

Image Credits: AI Generated

DOI: 10.1007/s40653-026-00956-6

Keywords: Neuro-Physiological Psychotherapy, neurodevelopmental trauma, prenatal alcohol exposure, foetal alcohol spectrum disorder, adopted children, executive functioning, Polyvagal Theory, behavioural regulation, emotional control, therapeutic parenting, BRIEF, Child Behaviour Checklist