Global research trends on psychological well‑being of children in foster care homes from 2003 to 2023: a bibliometric analysis using Scopus database

Purpose The study focuses on contemporary trends in the psychological well‑being of foster children residing in care homes over the past two decades. Moreover, it aims to predict future research directions by analyzing hotspots, offering valuable references for academics engaged in further studies in this field. Methods A quantitative analysis was conducted on nine hundred and twelve documents, including research papers and reviews, from 2003 to 2023. These publications focused on the psychological well‑being of foster children and were incorporated from the Scopus database. For visual analysis, we utilized the bibliometric analytical tool VOSviewer to generate a map of information on the authors, journals, organizations, nations, citations, and keywords. We also employed Microsoft Excel tables to record the essential details. Results The psychological well‑being of children and adolescents residing in foster homes is an emerging area of research. The findings show that there has been an ongoing rise in relevant research publications over time. The United States (416) and Harvard Medical School (56) were the most active countries and organizations in this study. AIDS Care: Psychological and Socio-Medical Aspects of AIDS/HIV (91 articles) and Vulnerable Children and Youth Studies (86 articles) are two prominent journals, while the Journal of Child Psychology and Psychiatry had the most co-citations (630). Nelson (52 publications) and Zeanah (50 publications) are the top two leading authors based on citation counts. Institutional care, orphans, HIV/AIDS orphans, psychological well‑being, and mental health, resilience are popular research keywords in this study. Conclusion This study indicates the prevailing interest in the specified domains over the past two decades. Our findings primarily indicate that addressing mental health concerns, along with understanding the needs of children in foster care homes, can enhance their psychological well‑being. Developing effective interventions to enhance the psychological well‑being of children in foster care is bound to have a profound effect on them and will serve as a key focus for future research in this field.

Frontiers in Psychology 03 frontiersin.orgAND (LIMIT-TO (LANGUAGE, "English"))].This initial search yielded 1,581 publications.Following the PRISMA guidelines for identifying and screening relevant sources, as depicted in Figure 1, the results were meticulously screened (Moher et al., 2010).This involved limiting the scope to research articles and reviews published in Englishlanguage academic journals within the field of psychology, specifically between January 1st, 2003, and December 31st, 2023.To ensure the quality of the literature data, documents deemed irrelevant to the study's topic were excluded.This included materials outside the field of psychology, non-English publications, book chapters, conference papers, books, notes, letters, and errata.This refined process resulted in the exclusion of 669 papers, leaving a final corpus of 912 documents for analysis.Comprehensive references and records from these documents were then exported in CSV format for further processing.

Data analysis
The study employed VOSviewer (1.6.17) and Microsoft Excel 2021 for analytics.Changes and patterns in the number of articles were examined using Microsoft Excel 2021, while document analysis was conducted using VOSviewer, 1 a software configuration developed by Van Eck and Waltman.Widely recognized for its ability to produce excellent visualization and analytical results, VOSviewer is frequently used for document analysis.It offers a range of analytical techniques, including co-authorship and co-citation analysis, network and keyword analysis, density visualizations, clustering, and mapping and visualization techniques.
To better understand the current state of research on the psychological well-being of children in foster care, the available literature was thoroughly reviewed using descriptive and bibliometric methods.This involved analyzing the number of publications and citations over time to track the growth of the field.We analyzed the field's productivity by creating ranking tables for describing the core journals, research areas, leading authors, and countries that significantly contribute to the field's advancement.
1 www.vosviewer.comBibliometric mapping, using the freely available software VOSviewer, visually represents the structure of a research field, encompassing social, intellectual, and conceptual aspects.In these maps, elements like journals, publications, or authors are depicted as circular nodes.Node size reflects volume (e.g., an author's publication count), while node position indicates similarity to other nodes, with closer nodes being more alike.Nodes are visually linked to represent their connections, with line thickness reflecting the strength of these relationships.Each node's color indicates its assigned cluster is determined by grouping nodes with similarities, providing a comprehensive visual representation of the field's structure (Van Eck and Waltman, 2010).
To delve deeper into the research landscape's structure, VOSviewer software utilized a distance-based approach involving a three-step process: normalizing differences between nodes, creating a two-dimensional map reflecting node similarity based on distance, and clustering closely related nodes (Van Eck and Waltman, 2011).Co-authorship analyses, focusing on authors and their affiliated countries/territories, were conducted to examine social structures within the research field.These analyses revealed collaborative networks and highlighted frequent co-publication patterns.Co-citation analysis of journals provided insights into the intellectual structure, with clusters representing disciplines underpinning the research field.Stronger co-citation relationships, indicated by frequent joint citations, suggested shared theoretical and semantic grounds.Lastly, co-occurrence analysis of author keywords unveiled the conceptual structure, with clusters representing prominent topical areas explored in the literature over the past two decades.

Annual publication output analysis
Analyzing annual publication output illuminates the research trends and growing importance of a particular field of study.Figure 2 presents the yearly publication numbers and their growth rate, drawn from the Scopus database, highlighting the development of research on the psychological well-being of children in foster care.While the concept of psychological well-being emerged earlier, dedicated research focusing on foster children remained limited in the early 21st century.Between 2003 (n = 7) and2007 (n = 22), the number of publications remained relatively low.However, post-2007, there was a noticeable increase in research activity, reaching an initial peak in 2010 (n = 48).Despite a slight dip in 2011 (n = 35), publication numbers surged to their highest point in 2017, with a remarkable 62 articles published.Although a gradual decline followed in 2019, productivity has since stabilized, as evidenced by the consistent output in 2022 (n = 44) and 2023 (n = 44).This suggests a potential for continued growth in this research area in the coming years.

Most prolific countries/regions analysis
Figure 3 illustrates the collaborative landscape of research on the psychological well-being of children in foster care, highlighting countries/regions with multiple publications between 2003 and 2023.A total of 101 countries/regions contributed to this body of research.Using a threshold of at least 20 publications and a minimum link strength of 1, the network visualization comprises 13 nodes and 36 links, representing collaborating countries and regions.The United States emerges as the most prolific contributor, with 416 publications, constituting 45.61% (416/912) of the total output.Following the United States, the most active countries are South Africa (99), the United Kingdom (89), Canada (56), China (45), Kenya (34), Italy (23), the Netherlands (23), India (22),and Spain (22).Table 1 further ranks the top 10 contributing countries/ regions based on overall link strength, Scopus citations, and the number of published articles.Notably, the United States holds the top position across all three metrics, underscoring its significant influence and expertise in this research domain.

Active organization analysis
Figure 4, generated using VOSviewer software, visually identifies key contributing organizations, while Table 2 provides a ranked list of the top 10 most prolific organizations based on publication count (Tao et al., 2021).Harvard Medical School emerges as the leading

Scholarly journals and co-cited journals analysis
A total of 912 documents were published across 307 journals.Figure 5 presents the leading 10 scholarly journals in this field.AIDS Care: Psychological and Socio-Medical Aspects of AIDS/HIV emerges as the leading publication outlet with 91 documents, followed closely by Vulnerable Children and Youth Studies with 86 documents.Children and Youth Services Review published 47 documents, while Child Abuse and Neglect contributed 32 documents.Frontiers in Psychology ranks fifth with 19 published articles.These journals, along with others in the top 10, represent a multidisciplinary range, encompassing psychology, sociology, public health, social work, and anthropology.In 2022, most journals in this field had impact factors between 3 and 4, with the Journal of Child Psychology and Psychiatry being a notable exception with an impact factor of 7.6.
Table 3 also highlights the 10 most frequently cited journals, indicating their scholarly impact and prominence within the field.These journals have impact factors ranging from 1.7 to 13.3 (average IF: 5.17).The Journal of the American Academy of Child and Adolescent Psychiatry holds the highest impact factor (13.3), followed by the Mapping the top 10 countries/regions with a minimum of 20 publications.Table 4 provides a consolidated view of the top 10 authors based on both publication count and citation impact, highlighting their prolific contributions and influence within the field.Furthermore, the analysis identifies the 10 most frequently co-cited authors, indicating a strong influence on the shared knowledge base of the field.Zeanah, C.H. (876 co-citations) emerges as the most frequently co-cited author, followed by Nelson,, Fox, N.A. (711 co-citations), and Rutter, M. (657 co-citations).These authors have made substantial contributions to understanding the psychological well-being of foster children in residential care settings.

Cited references analysis
Table 5 showcasing the top 10 most cited references in the field, offers valuable insights into the foundational research on the psychological well-being of children in foster care.This analysis helps illuminate connections between organizations, countries, and authors, highlighting key themes and influential works in the field.
Figure 7 presents a visualization of the citation network generated using VOSviewer software.The most cited reference, "Attachment in Institutionalized and Community Children in Romania" by Zeanah et al. (2005), underscores the significance of attachment research in understanding the experiences of children in foster care.This seminal work, published in the Journal of Child Development in 2005, highlights the journal's influence and the enduring relevance of attachment theory in this research area.Case et al. (2004) with their work, "Orphans in Africa: Parental Death, Poverty, and School Enrolment, " ranks second, emphasizing the intersection of socioeconomic factors and well-being for children in vulnerable circumstances.Cluver et al. (2007) further underscore the vulnerability of this population with their study "Psychological Distress amongst AIDS-Orphaned Children in Urban South Africa, " focusing on the psychological impact of AIDS on children.Similarly, Makame et al. (2002) contribute important findings from the Tanzanian context with their research "Psychological Well-being of Orphans in Dar El Salaam, Tanzania, " further highlighting the diverse experiences of orphans globally.Bruskas (2008), in their study "Children in Foster Care: A Vulnerable Population at Risk, " directly address the challenges faced by foster children, emphasizing their heightened vulnerability.The prominence of these works, alongside others in the top 10, underscores the critical focus on psychological well-being, quality of life, and the experiences of orphans and foster children across different geographical contexts.
The dominance of US-based authors like Zeanah, Case, Bruskas, Bhargava, and Williams-Butler in the top 10 most cited works suggests a significant influence of the United States in shaping research on the psychological well-being of children in foster care settings.

Co-occurrence of keywords analysis
Keywords are essential elements in academic literature as they offer a concise summary of a research topic and effectively convey the core content of an article.By analyzing keywords, we can gain insights into the central themes and emerging trends within a specific field.One effective method is keyword co-occurrence analysis, which involves calculating how frequently pairs of keywords appear together within the same research papers.this approach allows researchers to identify research hotspots by examining the composition, distribution, and clustering of keywords.For instance, a study by Zhu et al. (2022) demonstrated how analyzing keyword co-occurrence can effectively uncover the distribution of research hotspots within a specific field.
Figure 8 provides a visual representation of the cooperative network for keyword co-occurrences.In this particular study the search terms included "psychological well-being, " "children, " "adolescents, " "foster care homes, " "residential care, " "institutionalized children, " "orphan, " and "semi-orphan." notably the keyword "HIV/ AIDS orphans" emerged as a significant hub exhibiting strong connections with other keywords.

Hot research topics
Analyzing keywords is essential for summarizing study topics and exploring research hotspots within a specific field.Examining keyword frequency in the study field and specialized disciplines can provide a comprehensive overview of the research on the psychological well-being of children in foster care.The size of nodes denotes keyword frequency, while edge thickness represents the level of keyword co-occurrence (Hernández-Torrano et al., 2020).Five distinct clusters emerge from the analysis: Cluster 1 (Red): This cluster examines the concept of "institutional care" as a prominent model within child welfare services, encompassing various settings where children receive care outside of a traditional family setting.The term "institutional care" emerges as the largest node, reflecting its significance in this area.It connects to 29 keywords, including "residential care, " "foster care, " and "orphanages, " highlighting different forms and aspects of foster care homes.
Cluster 2 (Green): This cluster focuses on factors related to orphans, who often fall under the care of foster systems.The term "orphans" appears as the largest node, reflecting its significance in this area of research.It connects to 67 keywords, encompassing a broad range of topics relevant to the experiences of orphans, including "vulnerable children, " "HIV/AIDS, " "poverty, " "care, " "gender, " and "education." Cluster 3 (Blue): This cluster focuses on the mental health concerns of children, particularly those in foster care.The central node, "children, " underscores the cluster's emphasis on the well-being of this vulnerable group.This central node connects to 47 keywords that represent a spectrum of emotional and behavioral challenges relevant to foster children.These keywords include "adolescents, " "mental health, " "depression, " "behavioral problems, " "post-traumatic stress disorder, " "child sexual abuse, " "AIDS orphans, " "depressive symptoms, " and "anxiety." Cluster 4 (Orange): This cluster centers on the concept of "psychological well-being, " represented by the largest node, and explores factors that contribute to positive mental health in foster children.The 32 keywords associated with this cluster include "well-being, " "caregiver, " "life satisfaction, " "subjective well-being, " "perceived social support, " "self-esteem, " and "psychosocial well-being." Cluster 5 (Purple): This cluster delves into the crucial role of coping strategies in fostering psychological well-being, particularly for children facing challenging circumstances.Keywords within this cluster include "resilience, " "quality of life, " "social support, " "coping, " "self-efficacy, " "stress, " and "intervention, " highlighting both internal resources and external support systems that contribute to positive adaptation.

Recent trends
Beyond foundational knowledge of prominent research topics, a comprehensive analysis of research trends is essential to identify emerging fields and predict future research frontiers.Research on psychological well-being has made significant strides, revealing its multifaceted nature and impact on foster children's lives.A key area of focus within this field is the psychological well-being of children in foster care, particularly orphans.This research analysis delves into the trends shaping our understanding of the challenges and support mechanisms related to the psychological well-being of orphans.Studies consistently demonstrate the vulnerability of orphaned children in institutional settings, highlighting the detrimental effects on their psychological well-being.Children raised in institutions often exhibit a higher prevalence of internalizing and externalizing behaviors, and lower well-being than their non-institutionalized peers due to encountering adverse experiences throughout their childhood (Bruskas and Tessin, 2013;Padmaja et al., 2014).This disparity is attributed to various factors, including the stressful nature of institutional environments, limited opportunities for emotional support, and the potential for developmental disruptions (Yimer, 2022).Early experiences of loss, resource scarcity, and disrupted attachments contribute significantly to the emotional and behavioral challenges faced by orphans (Gudyanga et al., 2015).Furthermore, research suggests that the type of orphanhood experienced can influence specific dimensions of well-being.For instance, while both half-and double-orphans may face challenges, half-orphans tend to report higher levels of self-acceptance and positive relationships, indicating potential protective factors associated with having one surviving parent (Malla et al., 2019).
This heightened vulnerability to adverse experiences within institutional settings has significant implications for the mental health of orphaned children and adolescents.A prominent research trend centers on their increased susceptibility to mental health issues.Studies highlight a prevalence of behavioral and emotional problems, including conduct disorders, peer difficulties, emotional dysregulation, hyperactivity, and underdeveloped prosocial skills (Rahman et al., 2012;Kaur et al., 2018;Shiferaw et al., 2018).This vulnerability stems from the traumatic experiences associated with orphanhoods, such as the loss of parents, potential exposure to neglect or abuse, and the instability of institutional environments.Adding to these immediate challenges, research further explores the long-term impact of orphanhood on mental health.Findings indicate a higher susceptibility   to conditions such as anxiety, depression, stress, and social dysfunction (Dey and Daliya, 2019).Parental deprivation emerges as a significant factor influencing mental health outcomes (Kumari and Jahan, 2020), with studies consistently reporting elevated levels of depression, loneliness, post-traumatic stress disorder, and limited social support among individuals who have experienced the loss of parents (Zhao et al., 2010;Shiferaw et al., 2018;Bhatt et al., 2020).
Given the profound impact of orphanhood on mental health, researchers are increasingly exploring interventions and support systems to enhance the well-being of this vulnerable population.A Mapping of keyword co-occurrence network related to the psychological well-being of foster children.(Zeytinoglu et al., 2023).Despite their vulnerability, orphans often demonstrate a remarkable capacity for resilience.While they may exhibit lower selfesteem and quality of life, studies suggest that orphaned children may possess a greater resilience capacity than their non-orphaned counterparts (Salifu Yendork and Somhlaba, 2014;Erango and Ayka, 2015;Katyal, 2015).This resilience is particularly evident in children in foster care, who often demonstrate remarkable resilience, likely developed through coping mechanisms honed in the face of adversity.By understanding the factors that contribute to this resilience, we can develop interventions to further bolster their ability to thrive despite early life challenges.Further amplifying the importance of resilience, emerging research emphasizes the role of resilience and emotional regulation in fostering psychological well-being among adolescents, highlighting potential avenues for intervention and support (Hamidi et al., 2023).These emerging trends underscore the urgent need for targeted interventions and robust support systems designed to address the psychological and emotional needs of children in foster care.By fostering resilience, we can pave the way for improved well-being and positive long-term outcomes.

Future trends
Future trends highlight the urgent need to bolster intervention programs for orphans and foster children beyond addressing basic needs.There is a growing emphasis on incorporating emotional support, counseling services, and training for caregivers and educators.Furthermore, empowering children in foster care with essential life skills interventions, such as stress management, resilience-building, problem-solving, and decision-making, is gaining traction (Hailegiorgis et al., 2018;Shafiq et al., 2020;Duraisamy et al., 2023a,b).This shift towards a more holistic and therapeutic approach signifies a promising direction for future research and program development.To enhance the psychological well-being of these vulnerable populations, researchers (Cherewick et al., 2023) suggest prioritizing interventions that foster strong community ties, autonomy, and self-esteem.However, further research is needed to explore the factors that affect autonomy and self-acceptance within these populations.Looking ahead, it is crucial to evaluate the long-term effectiveness of psychosocial interventions and conduct longitudinal studies to gain a deeper understanding of the experiences of adolescent orphans.Additionally, there is a pressing need to raise awareness and provide rehabilitative programs specifically designed for orphans.These programs should focus on developing emotional intelligence, self-esteem, and other positive psychological qualities that are essential for their future success.Furthermore, developing targeted psychological intervention strategies that address the unique cognitive, emotional, and behavioral needs of specific orphan groups is paramount.By pursuing these future directions, researchers and practitioners can contribute to improved well-being and brighter futures for orphans and foster children.

Conclusion
This bibliometric analysis maps research trends on the psychological well-being of children in foster care, spanning from 2003 to 2023.Findings reveal that addressing emotional and behavioral issues, alongside understanding the unique needs of children in residential care, are crucial for improving their overall well-being.This study underscores the critical need for developing effective interventions to support these children.Furthermore, it highlights the importance of holistic approaches that not only address basic needs but also prioritize emotional support.By integrating these strategies, we can empower these vulnerable children to thrive despite the challenges they face.
The significance of this study lies in its use of bibliometric analysis to shed light on the evolving landscape of research concerning the psychological well-being of children in foster care.By visually mapping research trends, we gain a deeper understanding of the field's trajectory, enabling us to pinpoint promising avenues for future exploration more effectively.Our analysis underscores the critical importance of psychological well-being for these children, emphasizing its connection to the development of intervention programs aimed at fostering positive life outcomes.Our findings reveal prominent research clusters centered around the impact of well-being on children in institutional care, mental health concerns, and the significance of psychosocial interventions and resilience-building strategies.Notably, a thorough review of existing research revealed no prior bibliometric studies examining scholarly output on the psychological well-being of children specifically in foster care homes.This gap in the literature highlights the valuable opportunity presented by the present study to provide insights into the current state of global research on this important topic.Our findings illuminate existing gaps in knowledge and pave the way for further research on interventions and support systems tailored to enhance the well-being of foster children.By highlighting these crucial aspects, this bibliometric study offers valuable insights for researchers, policymakers, and child welfare professionals working to improve the lives of vulnerable children in foster care.

Strengths and limitations
This study offers a comprehensive and insightful exploration of research trends on the psychological well-being of children in foster care.By employing rigorous bibliometric methodologies and a substantial dataset from the Scopus database, the study effectively maps the evolution of research in this crucial area, providing an up-todate and granular examination of publication trends, hot research topics, influential authors, and leading institutions, all contributing to a deeper understanding of the field.Notably, a significant research gap identified by the study is the scarcity of bibliometric studies specifically focused on the psychological well-being of children in foster care homes, making this contribution a valuable foundation for future research.The analysis, enhanced by VOSviewer visualizations of research networks, offers a unique perspective on the intellectual structure of the field, enabling the identification of emerging research frontiers.Through systematic data analysis, the study not only contributes significantly to understanding the current state of knowledge but also illuminates promising avenues for future investigation in this domain.Despite its strengths, the study's reliance on the Scopus database may have resulted in the exclusion of relevant studies indexed elsewhere.Additionally, focusing on English-language publications could have limited the scope of the analysis, and the use of keyword analysis may have inadvertently omitted research employing different terminology.

Recommendation
To provide a more comprehensive understanding of the field, future research should address these limitations by expanding data sources, search parameters, and language inclusion.Incorporating alternative methodologies like meta-analysis can provide a more comprehensive understanding of the research field.Encouraging researchers to collaborate with a wider network of peers and organizations can foster a more interconnected research landscape, potentially leading to more impactful and generalizable findings.
FIGURE 1PRISMA flow chart of the selection process.

FIGURE 2
FIGURE 2Yearly publications related to the study on the psychological well-being of foster children from 2003 to 2023.

FIGURE 3
FIGURE 3 Journal of Child Psychology and Psychiatry (7.6) and Social Sciences and Medicine (5.4).In terms of co-citation counts, the Journal of Child Psychology and Psychiatry leads with 630 co-citations, followed by AIDS Care: Psychological and Socio-Medical Aspects of HIV/AIDS (629), Child Development (610), and Development and Psychopathology (548).This co-citation analysis identifies the Journal of Child Psychology and Psychiatry as a central publication in the study of psychological well-being among children in foster care homes.

Figure
Figure6Avisualizes the network of authors who have published more than 10 articles in the field, generated using VOSviewer.The resulting map comprises 60 nodes (authors) and 134 links (collaborations).Figure6Bfurther highlights the most extensive collaboration network, which includes prominent authors such as Nelson, C.A., Zeanah, C.H., Fox, N.A., Li, X., and Thurman, T.R.In FIGURE 4 (A) Mapping of organizations in the study of psychological well-being of foster children.(B) Mapping the top 10 prolific organizations with a minimum of 10 publications.
FIGURE 5 (A) Mapping the top 10 scholarly journals with a minimum of 10 publications.(B) Mapping of co-cited journals participating in the study of the psychological well-being of foster children.
This bibliometric analysis examined research published between 2003 and 2023 on the psychological well-being of children in foster care homes using VOSviewer software.The yearly publication trends, influential countries, key journals, active organizations, and productive authors were analyzed to provide insights for future research.Initially, research in this area was limited, with publications increasing gradually after 2003 and significantly after 2010.While there were fluctuations, the field stabilized in recent years, suggesting continued growth.The United States has emerged as a leading contributor to this field, evidenced by its high publication output and the dominance of US institutions among the top 10 organizations.China and South Africa also demonstrate considerable research engagement.The following journals are identified as crucial publication platforms: AIDS Care-Psychological and Socio-Medical Aspects of AIDS/HIV, Vulnerable Children and Youth Studies, Children and Youth Services Review, Child Abuse and Neglect, and Frontiers in Psychology.Researchers can also benefit from examining frequently cited journals like the Journal of Child Psychology and Psychiatry, AIDS Care: Psychological and Socio-Medical Aspects of AIDS/HIV, Child Development, Development and Psychopathology, and Children and Youth Services Review.The analysis identified a prominent network of collaborating authors, including Nelson, C.A., Zeanah, C.H., and Fox, N.A., who have made substantial contributions to the field through their prolific publication and citation records.Their work represents a valuable resource for understanding the psychological well-being of children in foster care.
FIGURE 6 (A) Mapping of main authors in the field of psychological well-being of foster children.(B) Mapping of the largest collaboration network of top 10 authors.(C) Mapping of co-cited authors engaging in the study of the psychological well-being of foster children.

TABLE 1
Summary of the top 10 most prolific countries/regions for the number of articles published.

TABLE 2
Summary of the top 10 prolific organizations contributed to the publications.

TABLE 3
An overview of the articles in the top 10 scholarly journals and co-cited journals.

TABLE 4
Summary of the topmost 10 productive authors and co-authors in the study of psychological well-being of foster children.

TABLE 5
An overview of the 10 most-cited references.

TABLE 6
Summary of the top 30 keywords for the psychological well-being of foster children based on frequency.