Regression methods were used to select and score 12 items from the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) to reproduce the Physical Component Summary and Mental Component Summary scales in the general US population (n=2,333). The resulting 12-item short-form (SF-12) achieved multiple R squares of 0.911 and 0.918 in predictions of the SF-36 Physical Component Summary and SF-36 Mental Component Summary scores, respectively. Scoring algorithms from the general population used to score 12-item versions of the two components (Physical Components Summary and Mental Component Summary) achieved R squares of 0.905 with the SF-36 Physical Component Summary and 0.938 with SF-36 Mental Component Summary when cross-validated in the Medical Outcomes Study. Test-retest (2-week)correlations of 0.89 and 0.76 were observed for the 12-item Physical Component Summary and the 12-item Mental Component Summary, respectively, in the general US population (n=232). Twenty cross-sectional and longitudinal tests of empirical validity previously published for the 36-item short-form scales and summary measures were replicated for the 12-item Physical Component Summary and the 12-item Mental Component Summary, including comparisons between patient groups known to differ or to change in terms of the presence and seriousness of physical and mental conditions, acute symptoms, age and aging, self-reported 1-year changes in health, and recovery for depression. In 14 validity tests involving physical criteria, relative validity estimates for the 12-item Physical Component Summary ranged from 0.43 to 0.93 (median=0.67) in comparison with the best 36-item short-form scale. Relative validity estimates for the 12-item Mental Component Summary in 6 tests involving mental criteria ranged from 0.60 to 107 (median=0.97) in relation to the best 36-item short-form scale. Average scores for the 2 summary measures, and those for most scales in the 8-scale profile based on the 12-item short-form, closely mirrored those for the 36-item short-form, although standard errors were nearly always larger for the 12-item short-form.

Generic and disease-specific quality of life as a predictor of long-term mortality in heart failure.

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We describe the development of the Mental Health Inventory (MHI), a new 38item measure of psychological distress and well-being, developed for use in general populations. The MHI was fielded in four large samples having quite different characteristics (N = 5,089). One data set was used to explore the MHI's factor structure, and confirmatory factor analyses were used for cross-validation. Results support a hierarchical factor model composed of a general underlying psychological distress versus well-being factor; a higher order structure defined by two correlated factors-Psychological Distress and Well-Being; and five correlated lower order factors-Anxiety, Depression, Emotional Ties, General Positive Affect, and Loss of Behavioral Emotional Control. Summated rating scales produced high internalconsistency estimates and substantial stability over a 1-year interval. Our results provide strong psychometric support for a hierarchical model and scoring options ranging from five distinct constructs to reliance on one summary index. This tradeoff, which is between the unique information contained in the subscales versus the simplicity of a single score, should be evaluated further.A review of general population mentalhealth-survey instruments pointed out important trends in questionnaire content and conceptual issues that deserve empirical attention (Ware, Johnston, Davies-Avery, & Brook, 1979). Early instruments were very heterogeneous in content (Gurin, 1960;Langner, 1962;Macmillan, 1957). They included measures of physical and psychosomatic symptoms, functional status, other health problems or worries, and health habits, in addition to measures of more straightforward psychological constructs (e.g., symptoms of anxiety and depression). More recent instruments seem to focus almost exclusively on the more straightforward psychological constructs (Bradburn, 1969;Cleary, Goldberg, & Kessler, 1982;Dupuy, 1972). Whereas the more heterogeneous measures may be satisfactory for testing hypotheses about health status in general, they do not seem to do well in distinguishing changes in mental health from changes in physical health (Ware et al., 1979; Ware, Brook, Davies-Avery, et al., 1980b).Another characteristic of more recently developed mental health surveys is their focus Requests for reprints should be sent to

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