Psychometric properties of the General Health Questionnaire-12 in a sample of Hong Kong employees

The General Health Questionnaire-12 (GHQ-12) is a widely used instrument for measuring psychological strain, but the factor structure of the GHQ-12 is inconclusive. The present study examined one-factor, two- and three-factor models of the GHQ-12 using structural equations modelling in a longitudinal data-set of Hong Kong employees. The findings supported a two-factor model consisting of a ‘Social Dysfunction’ factor measured by three items, and an ‘Anxiety/Depression’ factor measured by four items. Implications and limitations are discussed.     

A comparative assessment of the factor structures and psychometric properties of the GHQ-12 and the GHQ-20 based on data from a Finnish population-based sample

The General Health Questionnaire (GHQ) is a self-report questionnaire designed to identify psychological distress. Psychometric properties of two versions of GHQ-12 and GHQ-20 were assessed in a large population-based sample of Finnish twins, ages 22 to 27 (n= 4580). Participants were randomized into two subgroups, namely Twin1 (n= 2294) and Twin2 (n= 2286). The GHQ-12 data were assessed using Confirmatory Factor Analysis (CFA). The factor structure of the GHQ-20 was first assessed with Exploratory Factor Analysis (EFA) in the Twin1 dataset, and the results obtained were then subjected to CFA in Twin1 and Twin2 datasets. The CFA of the GHQ-12 indicated that the best fit and the simplest solution were provided by the three-factor solution in both subpopulations. Analyses of the GHQ-20 suggested that the four-factor structure was superior to the three-factor model. This result is also theoretically justifiable. Compared to the 12-item version, GHQ-20 provides additional fourth factor of anhedonia, suggesting some discriminative power.     

短式知觉压力量表(PSS-10)在中国大学生中的信效度

考察短式知觉压力量表(PSS-10)在中国大学生中的效度和信度。用PSS-10、一般健康问卷(GHQ-12)、生活取向测验修订版(LOT-R)、一般自我效能量表(GSES)以及Connor-Davidson心理韧性量表(CD-RISC)对1762名大学生进行调查。PSS-10的条目质量良好; 经探索与验证后,量表的潜在结构为稳定的两个因子,与实测数据拟良好; PSS-10的效标关联效度较好。总量表、无助感和自我效能信念的内部一致性系数达到了测量学要求; 两周后其重测信度大于0.6; 它们的问卷辨识系数均大于0.9。短式知觉压力量表在中国大学生中具有良好的信效度,能够作为有效测量大学生领悟或感受到压力的程度。     

Examining the Factor Structure and Discriminant Validity of the 12-Item General Health Questionnaire (GHQ-12) Among Spanish Postpartum Women

In this study, the authors tested alternative factor models of the 12-item General Health Questionnaire (GHQ-12) in a sample of Spanish postpartum women, using confirmatory factor analysis. The authors report the results of modeling three different methods for scoring the GHQ-12 using estimation methods recommended for categorical and binary data. A discriminant function analysis was also performed to test the utility of a multiple factor model. A two-phase cross-sectional study was designed: (a) 1,453 women visiting at 6 weeks postpartum completed the GHQ-12 and the Edinburgh Postnatal Depression Scale questionnaire and (b) based on the Edinburgh Postnatal Depression Scale outcomes, participants were stratified and randomly selected within each stratum for clinical evaluation. Using the Likert-type scoring approach, Hankins's one-factor model with "method effects" obtained the best fit. In addition, Graetz's three-factor model provided little discrimination between diagnostic groups, the factors being highly correlated. These results support the presence of only one latent factor in the GHQ-12.     

The 12-Item General Health Questionnaire (GHQ-12): reliability, external validity and factor structure in the Spanish population

The purpose of this study was to analyze the internal consistency and the external and structure validity of the 12-Item General Health Questionnaire (GHQ-12) in the Spanish general population. A stratified sample of 1001 subjects, ages between 25 and 65 years, taken from the general Spanish population was employed. The GHQ-12 and the Inventory of Situations and Responses of Anxiety-ISRA were administered. A Cronbach's alpha of .76 (Standardized Alpha: .78) and a 3-factor structure (with oblique rotation and maximum likelihood procedure) were obtained. External validity of Factor I (Successful Coping) with the ISRA is very robust (.82; Factor II, .70; Factor III, .75). The GHQ-12 shows adequate reliability and validity in the Spanish population. Therefore, the GHQ-12 can be used with efficacy to assess people's overall psychological well-being and to detect non-psychotic psychiatric problems. Additionally, our results confirm that the GHQ-12 can best be thought of as a multidimensional scale that assesses several distinct aspects of distress, rather than just a unitary screening measure.     

Alternative factor models and factorial invariance of the GHQ-12: a large sample analysis using confirmatory factor analysis

This study tested alternative factor models of the General Health Questionnaire-12 (GHQ-12), based on previous research findings, with a large sample using confirmatory factor analysis. An alternative models framework was used to test 6 factor analytic models. A 3-factor model was the best explanation of the sample data. The 3 factors were labeled Anxiety-Depression, Social Dysfunction, and Loss of Confidence. The model was found to be factorially invariant between men and women. The utility of the 3 subscales, as opposed to the total GHQ-12 score, is questioned as they appear to provide little information beyond that of a general factor.     

An investigation into the psychometric properties of the Hospital Anxiety and Depression Scale in individuals with chronic fatigue syndrome

The study sought to determine the psychometric properties of the Hospital Anxiety and Depression Scale (HADS) in individuals with chronic fatigue syndrome (CFS) assessed using a web-based data collection tool. Exploratory and confirmatory factor analyses were conducted on the HADS to determine its psychometric properties in 117 individuals with CFS. Seven models were tested to determine model fit to the data. Internal reliability estimations of the anxiety and depression sub-scales were found to be acceptable, however, a three-factor model was found to provide a significantly better fit to the data when compared to the bi-dimensional two-factor structure previously assumed to underpin the HADS' construct validity. The clinical utility of the HADS in the assessment of anxiety and depression in CFS appears to be fundamentally compromised by the presence of a three-dimensional underlying factor structure. Future revision of the HADS is recommended if the instrument is to be used reliably to screen CFS patients.     

Possible contribution of better maternal psychological well-being to the acquisition of sleeping through the night in infants during the early postpartum period

The objective of this study was to elucidate whether better maternal psychological well-being contributes to the acquisition of “sleeping through the night” (STN) in infants during the early postpartum period. Fifty-two primiparous mothers completed the General Health Questionnaire-28 (GHQ-28) in the third trimester (prenatal) and when the conceptional ages of their babies reached 8–9 weeks (hereafter, 2 months), 12–13 weeks (3 months), and 16–17 weeks (4 months). They also recorded babies’ nocturnal sleep patterns in a timetable for 5 consecutive days each month postpartum. “Regular STN” was defined when the mean of longest nocturnal sleep duration for 5 consecutive days was > 8 h or between 6 and 8 h with < 1.0 nocturnal awakenings. According to these criteria, a total of 14 infants (27 %) acquired regular STN at 4 months (referred to as “STN infants”), with STN infants showing a marked increase in longest nocturnal sleep duration and a decrease in nocturnal awakenings from 2 to 3 months of age. The mothers of STN infants demonstrated steady reductions in postnatal GHQ-28 scores and had significantly lower prenatal GHQ-28 scores compared with the mothers of non-STN infants (3.7 ± 3.0 vs. 6.4 ± 4.1, p = 0.027). In random forest models for binomial classification, both prenatal and postnatal (at 4 months) GHQ-28 scores were identified as significant covariates for distinguishing STN infants, and other important covariates, including weeks of delivery, stepfamily, birth weight of the infant, and maternal co-sleeping at bedtime, were selected. Among these covariates, maternal co-sleeping at bedtime had relatively stronger correlations with both STN infants (r = − 0.440) and prenatal maternal GHQ-28 scores (r = 0.377). In conclusion, because prenatal maternal psychological well-being was thought to predict the acquisition of STN in infants, infants born from mothers with better psychological well-being appear to have some advantages in acquiring STN. These cross-lagged correlations suggest that the pathway from mothers to infants may be mediated by certain parenting behaviors, such as maternal co-sleeping at bedtime.     

The factor structure and factorial invariance of the 12-item General Health Questionnaire (GHQ-12) across time: evidence from two community-based samples

This study provides new knowledge about the factor structure of the 12-item General Health Questionnaire (GHQ-12; D. Goldberg, 1972) through the application of confirmatory factor analysis to longitudinal data, thereby enabling investigation of the factor structure, its invariance across time, and the rank-order stability of the factors. Two community-based longitudinal adult samples with 1-year (n = 640) and 6-year (n = 330) follow-up times were studied. As a result, the correlated 3-factor model (i.e., Anxiety/Depression, Social Dysfunction, and Loss of Confidence) showed a better fit with both samples than the alternative models. The correlated 3-factor structure was also relatively invariant across time in both samples, indicating that the scale has good construct validity. The rank-order stabilities of the factors were low across time, which suggests that the GHQ-12 measures temporal mental state.     

Perinatal maternal mental health and infant socio-emotional development: A growth curve analysis using the MPEWS cohort

Pregnancy and the early post partum period are widely understood as a critical period for the infant’s emotional development and the earliest influence shaping social interaction. The present study aims to understand the potential influence of both antenatal and postnatal maternal anxiety and depressive symptoms on socio-emotional outcomes in offspring aged 12 months. The study used longitudinal data from a prospective cohort study on Australian pregnant women and their children. Data were available for 282 mothers and their children. Maternal depressive and anxiety symptoms were measured in early pregnancy, trimester three of pregnancy, six and 12 months postpartum. Social and emotional development in children was measured using the Brief Infant and Toddler Social Emotional Assessment (BITSEA) at 12 months. Using growth curve analysis of 4 waves of repeated measurement to examine intercept and slope, we found that both initial maternal depression and anxiety symptom levels, and the growth of these symptoms over time, predicted more problems with children’s social and emotional development. In the final model anxiety accounted for 19% of the variance in child socio-emotional problems and depression 23% of variance. The results emphasise the importance of perinatal maternal mental health as a potential risk factor for child development. This carries important implications for policy development, such as the need to build early identification and early intervention models in to the current clinical practice for perinatal care, specifically, to develop targeted screening, assessment and interventions to address maternal mental health issues for at-risk parents during pregnancy, and continuing monitoring of young children whose mothers have experienced perinatal mental health difficulties.     

Optimism and Mental Health in Adolescence: a Prospective Validation Study of the Dutch Life-Orientation Test-Revised (LOT-R-A) for Adolescents

The study aimed to examine the psychometric properties of the Dutch Life Orientation Test-Revised for Adolescents (LOT-R-A), a self-report questionnaire assessing dispositional optimism, and to evaluate the two-factor structure (optimism, pessimism). The LOT-R-A and the questionnaires measuring well-being (MHC-SF-A) and psychological problems (SDQ) were completed by 459 Dutch adolescents (178 boys and 281 girls) between the ages of 11 and 18 years at baseline and 281 adolescents at a four-week follow-up. The results confirmed the two-factor structure (optimism, pessimism) of the LOT-R-A. The findings provided evidence of internal consistency of scores ranging from low to good, and evidence of good test-retest reliability of scores. Further, scores of optimism were cross-sectionally positively associated with scores of positive emotions and well-being and negatively with scores of psychological problems and negative emotions, providing evidence of convergent and divergent validity of optimism scores with emotions, well-being, and psychological problems. Lastly, scores of optimism were prospectively positively associated with scores of well-being and negatively with scores of psychological problems, providing evidence of criterion validity of optimism scores with well-being and psychological problems. Based on these findings it can be concluded that the LOT-R-A is a valid instrument to examine optimism among adolescents. Future research can help to elucidate the role of optimism in mental health interventions and can gather knowledge on how these interventions can be refined to optimally cultivate optimism during the developmental period of adolescence.     

Validity of the SF-12 in a Canadian Old Order Mennonite Community

To assess the validity of the Physical and Mental Component Summary scores (PCS-12 and MCS-12) of the SF-12 Health Survey (SF-12) in an Old Order Mennonite (OOM) community in Ontario, Canada. Most SF-12 validation studies have focused on general populations or clinical groups. This paper adds to the SF-12 literature by validating the instrument in a minority population. Sixty percent of the adult OOM population (n?=?1,171) completed a survey which had the SF-12 embedded within it. The survey also included questions on health determinants and the prevalence of chronic conditions. Factor analysis was used to confirm the two-factor structure of the SF-12. Item-scale correlations were calculated to assess convergent and discriminant validity. PCS-12 and MCS-12 variability by known subgroups were also explored. Factor analysis confirmed the two-factor structure and hypothesized loadings on the latent physical and mental health factors. Item-scale correlations demonstrated satisfactory convergent and discriminant validity. SF-12 summary scores distinguished well, and in the expected manner, between groups of respondents for gender, age, income adequacy, marital status, self-reported health measures, and other health determinants such as coping, trust, social interaction, and spirituality. PCS-12 and MCS-12 scores were lower in those with various chronic conditions compared to those without.The SF-12 appears to be a valid instrument for measuring health status in this minority population. Future SF-12 studies in OOMs and other populations may benefit from using Version 2 of the SF-12, where the dichotomous questions have been replaced by questions offering respondents more choice.     

A psychometric evaluation of the Hospital Anxiety and Depression Scale during pregnancy

The utility of the Hospital Anxiety and Depression Scale (HADS) as a screening instrument for anxiety and depression during pregnancy was investigated. A maximum likelihood factor analysis was conducted on the HADS to determine its psychometric properties and utility in 100 women from two culturally diverse populations (UK and Uzbekistan) at 12-weeks and 34-weeks pregnancy. The findings suggest that the HADS lacks the internal reliability requirements of a clinical assessment tool in this population. There was little evidence found to suggest that the HADS measures two dimensions of anxiety and depression consistently and reliably. The findings from this study suggest that the HADS could not be recommended as a clinical screening tool for anxiety and depression in pregnant women. Further research in this area is both desirable and required.     

Revisiting the factor structure of the 12-item Disgust Propensity and Sensitivity Scale – Revised: Evidence for a third component

The 12-item Disgust Propensity and Sensitivity Scale – Revised (DPSS-12) is widely used to assess the tendency for an individual to respond with disgust (i.e., disgust propensity) and how bothered an individual is by the experience of disgust (i.e., disgust sensitivity). However, heterogeneous items included in the DPSS-12 call into question the adequacy of its two-factor structure. The current study examined the factor structure of the DPSS-12 using two large, nonclinical student samples. Exploratory factor analyses revealed three lower order factors: (1) disgust propensity, (2) disgust sensitivity, and (3) self-focused/ruminative disgust. Confirmatory factor analyses supported the three-factor solution and demonstrated that the model fit better than a unidimensional or two-factor model. Further, a modified two-factor model that excluded the third factor provided a better fit than the original two-factor model. Additionally, the third domain explained a significant portion of the total variance, and evidenced a distinctive pattern of association with relevant constructs including obsessional symptoms. These data suggest the need to refine our knowledge about the latent structure of disgust reflected by this measure.     

A psychometric study of the Drug Use Disorders Identification Test-Extended in a Norwegian sample

Motivation is a widely used concept in substance use treatment, and is commonly seen as a premise for change during treatment. Different measures of motivation have been suggested. A relatively new instrument is the Drug Use Disorders Identification Test-Extended (DUDIT-E), developed in Sweden. This instrument has recently been introduced in Norway. The present study examined the Motivational Index of the Norwegian version of the Drug Use Disorders Identification Test-Extended (DUDIT-E). We tested whether the three-factor model ("Positive aspects of substance abuse"; "Negative aspects of substance abuse"; and "Treatment readiness") suggested by previous studies could be replicated in a sample of Norwegian inpatients. Responses to the DUDIT-E were obtained from 105 patients admitted to inpatient substance abuse treatment in Northern Norway. Exploratory common factor analyses were used to compare the factor structure from the current sample with the Swedish sample of mainly detoxification patients and prison inmates. The current sample did not include prison inmates, and it consisted of more women than the Swedish sample. The samples did not differ according to age or substance dependency. The analyses suggested that six primary factors was the most efficient way of combining the item scores, and not 11 as in the Swedish sample. A second-order factor analysis found best support for a two-factor solution, and hence, did not replicate the previously suggested three-factor model either. Several regression analyses comparing the efficiency of the different ways of combining the DUDIT scores in primary or secondary factor scores indicated that the model involving six sum scores had best merit and should be explored further.     

Confirmatory factor analysis of the antisocial process screening device with a clinical inpatient population

Research linking psychopathic tendencies to childhood behavior problems is predicated on the assumption that the findings are based on using psychometrically sound measures of psychopathic tendencies. Although evaluated with community samples, the psychometric properties of such measures have not been evaluated with inpatient clinical populations thereby limiting conclusions. Hence, the goal of the present study was to evaluate the factor structure of a widely used measure-the Antisocial Process Screening Device (APSD)-with an inpatient population. Parents of 328 children (M age = 8.90 years) completed the APSD at the time of their child's admission for treatment. Although confirmatory factor analyses supported the three- and two-factor solutions proposed by the authors of the measure, the two-factor structure was more parsimonious. Factors of the two-factor model were also related to symptoms of childhood behavior disorders. The findings extend current research on the APSD's factor structure to an inpatient population.     

Risk and protective factors for pre- and postnatal bonding

Since disturbances in the mother–child bond increase the risk of negative consequences for child development, it is important to identify risk and protective factors for bonding as well as longitudinal associations. Previous research has used different bonding instruments during pregnancy and the postnatal phase, leading to inconsistent results. In the current study, the same instrument was used during the various phases. In a large, community-based sample (N = 793), general information, feelings of pre- and postnatal bonding (Pre- and Postnatal Bonding Scale), depressive symptoms (Edinburgh Postnatal Depression Scale), and partner support (subscale Tilburg Pregnancy/Postnatal Distress Scale) were measured at both 32 weeks of pregnancy and 8 months postnatally. Partner support was found to be a protective factor for suboptimal pre- and postnatal bonding, as was the engagement with fetal movements for prenatal bonding. High maternal educational level was a risk factor for suboptimal prenatal bonding, as were depressive symptoms for suboptimal postnatal bonding. The associations between most prenatal determinants and postnatal bonding were mediated by prenatal bonding, which underlines the importance of promoting prenatal bonding. Professionals in clinical practice should be aware of partner support, engagement with fetal movements, and postnatal depressive symptoms: All these factors offer opportunities for improving the bonding processes.     

French translation and validation of the Karitane Parenting Confidence Scale

IntroductionPerceived parental self-efficacy (PSE) is thought to play a crucial role in parental well-being, the parent-infant relationship, and other aspects of infant development, particularly in the early postnatal period. The Karitane Parenting Confidence Scale (KPCS) is a 15-item self-report questionnaire designed for parents with infants aged 0–12 months.ObjectiveTo explore the factor structure of a French translation of the KPCS and assess its psychometric qualities.MethodUsing a French-language translation of the KPCS (KPCS-F), 257 parents of children aged 0–12 months were recruited via childcare structures (e.g. nurseries, community centers, mother and child protection centers). Confirmatory factor analyses (CFA) were conducted to examine 2- and 3-factor solutions for the KPCS-F scale. Internal reliability and convergent validity were evaluated.ResultsThe best model was a two-factor solution (PSE “infant care” and PSE “parental role”) restricted to 12 items. Sound internal consistency was indicated, with a Cronbach's alpha coefficient of 0.80 and a McDonald's omega coefficient of 0.80. Test-retest reliability was good. KPCS-F score was correlated with social support and psychological well-being scores.ConclusionThe KPCS-F showed substantial validity and reliability for this sample. The translated scale should therefore improve assessment and intervention processes for professionals working with parents of young children.     

Subjective Well-Being in Midlife: The Role of Involvement of and Closeness to Parents in Childhood

This study used data from the British National Child Development Study to examine the role of parenting in later subjective well-being (SWB). Parenting was defined as mother involvement and father involvement (measured at age 7) and as closeness to mother and closeness to father (measured at age 16). SWB was measured at age 42 and was defined as life satisfaction, psychological functioning (measured with the GHQ-12), and absence of psychological distress (measured with the Malaise Inventory). Control factors were parental social class at birth, parental family structure throughout childhood, domestic tension in the parental home, parental ill mental health in early childhood, psychological maladjustment in adolescence, financial difficulties throughout childhood, educational attainment, self-rated health in early adulthood, and current socio-demographic correlates of SWB (labour force participation, religion and being partnered). It was found that even after adjusting for these factors closeness to mother at age 16 predicted life satisfaction at age 42 in both men and women, whereas mother involvement at age 7 predicted life satisfaction at age 42 in men. Closeness to mother at age 16 was also negatively related to poor psychological functioning at age 42 in women.     

Ersch?pfung und Depression in der Schwangerschaft

For women pregnancy represents a condition of intense physical and psychological changes which subject the pregnant women to a number of potentially stressful situations. Hormonal changes during pregnancy predispose to exhaustion and therefore to an increased vulnerability to affective disorders. Depression is one of the most commonly diagnosed psychiatric disorders in the female population with an increased incidence during the reproductive years. Recent studies showed that approximately 10?C13% of patients suffer from a depressive episode in the perinatal period requiring specialized treatment including psychotherapy and/or pharmacotherapy. Underestimation of this condition and a lack of proper management can hinder normal mother-child bonding leading to impaired cognitive and emotional long-term development of the child. In this article the medical literature related to the prevalence and clinical presentation of depression during the perinatal period and its association to maternal exhaustion is reviewed. The clinical implications and therapeutic options are discussed.