The Factor Structure of the Twelve Items General Health Questionnaire (GHQ-12): a Population Based Study

Motamed, Nima; Zakeri, Shiva Edalatian; Rabiee, Behnam; Maadi, Mansooreh; Khonsari, Mahmood Reza; Keyvani, Hossein; Hosseini, Seyed Hamzeh; Zamani, Farhad

doi:10.1007/s11482-017-9522-y

Cited by 9 publications

(10 citation statements)

References 41 publications

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“…Moreover, in disagreement with some studies [ 14 , 16 – 18 ], findings of the present study showed although the unidimensional model with adjusting wording effects associated with negatively and positively phrased items considerably improved fit indices compared to the One-Dimensional model, it did not give a suitable fit compared to Three and Four-Dimension models in our population. Following these findings in our study, similar results were observed in some studies [ 50 ].…”

Section: Discussioncontrasting

confidence: 99%

“…Our findings of the current study showed One-Dimensional model had a worst fit than the alternative models. In agreement with our results, many studies are available in favor of the multidimensional compared to the unidimensional structure of GHQ-12 around the world among various populations such as the employee population [ 17 ], diseases-specific populations [ 28 , 49 ], and adolescents and general populations [ 16 , 22 , 50 ].…”

Section: Discussionsupporting

confidence: 92%

“…In contrast with our findings, some studies among the Iranian population in other areas of the country have achieved different latent structures of GHQ-12 among young people aged 18 to 25 years old [ 23 ], university students [ 24 ], and the elderly population [ 25 ]. Findings of the recent study of Northern Iran on participants aged ten years and older revealed the model with the best fit was one-dimensional model adjusting negative statement items effect, followed by the three-dimensional model (social dysfunction (items 1–6), A/D (items 7–10), and loss of confidence (items 11–12)) [ 16 ]. In this regard, it was suggested that the underlying latent structure might depend on the population under study [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

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How different domains of quality of life are associated with latent dimensions of mental health measured by GHQ-12

Nouri

Feizi

Roohafza

et al. 2021

Health Qual Life Outcomes

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Background and objectives A short form of the General Health Questionnaire (GHQ-12) is a useful screening instrument for assessing mental health. Furthermore, Quality of life (QoL) is a critical treatment outcome in many clinical and health care research settings. This study aimed to reassess the dimensionality of GHQ-12 using Multidimensional Graded Response Model (MGRM) and evaluate how its extracted dimensions are associated with the QoL's domains. Methods Isfahan Cohort Study 2 (ICS2) is a population-based, ongoing prospective cohort study among adults aged 35 years and older who were free of cardiovascular diseases (CVDs) at the beginning of the study in 2013. A total of 1316 participants, all living in urban and rural areas of Isfahan and Najafabad, Iran was completed the GHQ-12 and WHO QoL-brief version at baseline. Five competing MGRMs with different latent structures were specified for GHQ-12. Factor scores derived from the best fitted model were used to associate with various domains of QoL. Results: The Three-Dimensional model for GHQ-12 was the best-fitted model explaining the Social Function (SF), Self Confidence (SC), and Anxiety/Depression (A/D) as three correlated yet different latent dimensions of mental health. Our findings in full adjusted multivariate regression models showed that a one-SD increase in dimensions of SC and SF was associated with a 38- to 48%-SD and 27- to 38%-SD increase in the domains scores of QoL, respectively. Moreover, for each one‐SD increase in score of A/D dimension, the domains scores of QoL decreased by 29- to 40%-SD. The highest to the lowest standardized coefficients for all latent dimensions of mental health were respectively related to the psychological, physical health, social relationships, and environmental condition domains of QoL. Furthermore, SC, A/D, and SF dimensions of GHQ-12 showed the highest to the lowest degree of association with all domains of QoL. Conclusions Our findings confirm that the GHQ-12 as a multidimensional rather than unitary instrument measures distinct dimensions of mental health. Furthermore, all aspects of QoL changed when the intensity of latent dimensions of mental health increased. Moreover, the psychological domain of QoL is the most affected by all latent dimensions of mental health, followed by physical health, social relationships, and environmental condition domains. It seems that in an attempt to full recovery as assessed by improved QoL outcomes, treatment of clinical symptoms may not be sufficient. Identifying and differentiating the structures of mental health in each community as well as implementing intervention programs aimed at focusing on specific dimensions may help in the prevention of further deterioration of mental health and improved QoL in the community.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

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How different domains of quality of life are associated with latent dimensions of mental health measured by GHQ-12

Nouri

Feizi

Roohafza

et al. 2021

Health Qual Life Outcomes

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“…Hankins31 found that, after modelling the wording effects for the NW items, the unidimensional model fitted better than both the two-factor model (NW vs PW items) and Graetz’s three-factor model. Other studies have called into question the substantive meaning of the GHQ-12 multifactor solutions, suggesting that they might just be an artefact due to the wording effects associated with NW items 29 30 34–40. See Molina et al 36 for a deeper review about the dimensionality of GHQ-12.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, another source of variability in the results about the factor structure of the GHQ-12 could come from the statistical control of method biases, which has been mainly achieved through the correlated traits–correlated methods (CTCM) and the correlated traits–correlated uniquenesses (CTCU) confirmatory factor analysis models. Both procedures have been used in GHQ-12, to deal with method effects applying the CTCM model,30 44 the CTCU model29 31 39 40 or both CTCM and CTCU models 34–37…”

Section: Introductionmentioning

confidence: 99%

Method effects associated with negatively and positively worded items on the 12-item General Health Questionnaire (GHQ-12): results from a cross-sectional survey with a representative sample of Catalonian workers

et al. 2019

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ObjectiveRecent studies into the factorial structure of the 12-item version of the General Health Questionnaire (GHQ-12) have shown that it was best represented by a single substantive factor when method effects associated with negatively worded (NW) items are considered. The purpose of the present study was to examine the presence of method effects, and their relationships with demographic covariates, associated with positively worded (PW) and/or NW items.DesignA cross-sectional, observational study to compare a comprehensive set of confirmatory factor models, including method effects associated with PW and/or NW items with GHQ-12 responses.SettingRepresentative sample of all employees living in Catalonia (Spain).Participants3050 participants (44.6% women) who responded the Second Catalonian Survey of Working Conditions.ResultsA confirmatory factor analysis showed that the best fitting model was a unidimensional model with two additional uncorrelated method factors associated with PW and NW items. Furthermore, structural equation modelling (SEM) revealed that method effects were differentially related to both the sex and age of the respondents.ConclusionIndividual differences related to sex and age can help to identify respondents who are prone to answering PW and NW items differently. Consequently, it is desirable that both the constructs of interest as well as the effects of method factors are considered in SEM models as a means of avoiding the drawing of inaccurate conclusions about the relationships between the substantive factors.

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Factorial validity of the 12-item general health questionnaire in patients with psychological disorders

Zhong

et al. 2022

Curr Psychol

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The Factor Structure of the Twelve Items General Health Questionnaire (GHQ-12): a Population Based Study

Cited by 9 publications

References 41 publications

How different domains of quality of life are associated with latent dimensions of mental health measured by GHQ-12

How different domains of quality of life are associated with latent dimensions of mental health measured by GHQ-12

Method effects associated with negatively and positively worded items on the 12-item General Health Questionnaire (GHQ-12): results from a cross-sectional survey with a representative sample of Catalonian workers

Factorial validity of the 12-item general health questionnaire in patients with psychological disorders

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