Reliability, Validity, and Factor Structure of the Arabic Version of the 12-Item General Health Questionnaire

Abstract

The aim was to examine the psychometric properties of the Arabic 12-item General Health Questionnaire in a sample of university students. A sample of 157 university students was screened using this questionnaire and the Hopkins Symptom Checklist-90. A standardized clinical interview using SCID was conducted on a subset of screened students. Reliability, validity, and factor analysis of the questionnaire were evaluated. Using factor score discrimination between cases and noncases was also evaluated. The Arabic version of the GHQ-12 proved to be reliable as indicated by Cronbach alpha of .86. The best balance between sensitivity and specificity was found at the General Health Questionnaire cut-off point of 15/16: at this threshold, sensitivity was .88 and was paired with a specificity of .84. Principal component analysis with varimax rotation identified three factors, namely, Factor A (general dysphoria), Factor B (lack of enjoyment), and Factor C (social dysfunction). Factors A and C discriminated between clinically distressed and clinically nondistressed subjects. The General Health Questionnaire-12 as a whole is a reliable and valid screening tool in university settings.

The factor structure of the general health questionnaire (GHQ12) in Saudi Arabia

“…These 3 factors explained 55% of the overall variance. Our findings were similar to that of previous factor analytic studies of GHQ-12 that have found three-factor solution [20,35,44]. In conformity, Martin and Newell [45] in their factor analysis of Graetz three-factor solution utilizing likert scoring revealed three factors: Anxiety, social dysfunction, and loss of confidence.…”

“…The findings were supported and verified by several other studies. Some of the research studies for example, Martin [44], and Daradkeh [20] revealed that the GHQ-12 was 3-dimensional, nonetheless, it utilized wide-ranging names from those proposed and used by Graetz [27]. In our study, factors designated as anxiety, social dysfunction, and loss of confidence, were subject to variation possibly due to being more under the influence of the socio-cultural norms and values that govern the population under study.…”

“…Validated GHQ-12 for Arab population [20,41] contains an equal number of positive and negative items and Likert method of scoring was used for rating scale in this study. Likert method of scoring ranges from 0 to 3: where zero represents the healthiest and 3 representing poor healthy/ illness and total score can range from 0 to 36.…”

“…In different segments of the populations across countries, psychometric properties of this questionnaire in a variety of studies has also been appraised [14][15][16][17][18]. The GHQ-12 tends to have good specificity, reliability, and reasonably high sensitivity [19,20]. Since its development by Goldberg [9], the GHQ has now being used in many different countries/cultures and has been translated into 38 languages; a testament to the validity and reliability of the questionnaire [21][22][23][24][25].…”

“…An in-depth study of factor structures would be valuable [39] because certain psychological domains can be a focus for targeting interventions to prevent further psychological deterioration within the population. Furthermore, in Saudi Arabia, to date, only one study successfully assessed the psychometric properties of the Arabic version GHQ-12 in university students [20]. However, no exploratory factor analysis (EFA) has been performed to assess the GHQ-12 factor structure.…”