GHQ-12 in adolescents: contributions to the controversial factorial validity

  • Eduardo J. Pedrero Pérez Unidad Técnica de Formación e Investigación. Departamento de Evaluación y Calidad. Madrid Salud. Ayuntamiento de Madrid. https://orcid.org/0000-0002-3940-5609
  • Carlos Mora-Rodríguez Madrid Salud
  • Rosana Rodríguez Gómez Unidad Técnica de Formación e Investigación. Departamento de Evaluación y Calidad. Madrid Salud. Ayuntamiento de Madrid.
  • María Teresa Benítez-Robredo Unidad Técnica de Formación e Investigación. Departamento de Evaluación y Calidad. Madrid Salud. Ayuntamiento de Madrid.
  • Ana Ordóñez-Franco
  • Lidio González-Robledo Facultad de Psicología. Universidad Camilo José Cela. Madrid.
  • Susana Méndez-Gago Facultad de Psicología. Universidad Camilo José Cela. Madrid.
Keywords: GHQ-12, mental health, adolescence, screening, factorial analysis, early detection, questionnaire

Abstract

Objective: The GHQ-12 is one of the most widely used questionnaires in the adult population, but there are not as many studies exploring its applicability in adolescents. The main problem is the diversity of results on its factorial structure, as different studies have shown one, two or three dimensions. The purpose of this study was to explore the GHQ-12 factorial structure for adolescents. Method: An observational multicenter cross-sectional descriptive study was designed for schools in the city of Madrid. A random sample of n=2,171, 14-16-year-olds was stratified by the school’s development level and funding (public, private or mixed). Unrestricted factor analysis was applied based on the polychoric or tetrachoric correlations matrix (depending on the test scoring method). Results: The optimized parallel analysis provided an unequivocal one-factor structure, confirmed by unidimensionality assessment. Around 30% of male and 42% of female adolescents were found to be at risk of developing mental health problems. Conclusions: The GHQ-12 is a one-dimensional test for screening psychological distress, with excellent psychometric properties for its application in an adolescent population. The use of adequate statistical methods can overcome old controversies and promote proper application and interpretation of the results provided by the test.

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References

Baksheev, G. N., Robinson, J., Cosgrave, E. M., Baker, K., & Yung, A. R. (2011). Validity of the 12-item General Health Questionnaire (GHQ-12) in detecting depressive and anxiety disorders among high school students. Psychiatry Research, 187(1-2), 291-296. DOI: 10.1016/j.psychres.2010.10.010
Bansal, V., Goyal, S., & Srivastava, K. (2009). Study of prevalence of depression in adolescent students of a public school. Industrial Psychiatry Journal, 18(1), 43-46. DOI: 10.4103/0972-6748.57859
Barsky, A. J., Peekna, H. M., & Borus, J. F. (2001). Somatic symptom reporting in women and men. Journal of General Internal Medicine, 16(4), 266-275. DOI: 10.1046/j.1525-1497.2001.016004266.x
Blakemore, S. J., & Choudhury, S. (2006). Development of the adolescent brain: implications for executive function and social cognition. Journal of Child Psychology and Psychiatry, 47(3-4), 296-312. DOI: 10.1111/j.1469-7610.2006.01611.x
Bowe, A. (2017). The cultural fairness of the 12-item General Health Questionnaire among diverse adolescents. Psychological Assessment, 29(1), 87-97. DOI: 10.1037/pas0000323
Crutzen, R., & Peters, G. J. Y. (2017). Scale quality: alpha is an inadequate estimate and factor-analytic evidence is needed first of all. Health Psychology Review, 11(3), 242-247. DOI: 10.1080/17437199.2015.1124240
Davis, M. C., Matthews, K. A., & Twamley, E. W. (1999). Is life more difficult on Mars or Venus? A meta-analytic review of sex differences in major and minor life events. Annals of Behavioral Medicine, 21(1), 83-97. DOI: 10.1007/BF02895038.
Díaz-Olalla, J. M., & Benítez-Robredo, T., eds. (2017). Estudio de Salud de la Ciudad de Madrid 2014. Madrid: Madrid Salud, Ayuntamiento de Madrid. Disponible URL:
Ferrando, P.J. & Lorenzo-Seva, U. (2013). Unrestricted item factor analysis and some relations with item response theory. Technical Report. Department of Psychology, Universitat Rovira i Virgili, Tarragona. Document available at: http://psico.fcep.urv.cat/utilitats/factor/
Ferrando, P. J., & Lorenzo-Seva, U. (2017). Assessing the quality and appropriateness of factor solutions and factor score estimates in exploratory item factor analysis. Educational and Psychological Measurement, Article first published online: July 7, 2017, DOI: 10.1177/0013164417719308
French, D. J., & Tait, R. J. (2004). Measurement invariance in the General Health Questionnaire-12 in young Australian adolescents. European Child & Adolescent Psychiatry, 13(1), 1-7. DOI: 10.1007/s00787-004-0345-7
Glozah, F. N., & Pevalin, D. J. (2015). Factor structure and psychometric properties of the General Health Questionnaire (GHQ-12) among Ghanaian adolescents. Journal of Child & Adolescent Mental Health, 27(1), 53-57. DOI: 10.2989/17280583.2015.1007867
Goldberg, D. P. (1972). The detection of psychiatric illness by questionnaire. London. Oxford University Press.
Goldberg, D. P., & Williams, P. (1998). A user’s guide to the General Health Questionnaire. Londres: Nfer-Nelson.
Hankins, M. (2008). The factor structure of the twelve item General Health Questionnaire (GHQ-12): the result of negative phrasing?. Clinical Practice and Epidemiology in Mental Health, 4(1), 10. DOI: 10.1186/1745-0179-4-10
Hankins, M. (2008). The reliability of the twelve-item general health questionnaire (GHQ-12) under realistic assumptions. BMC Public Health, 8(1), 355. DOI: 10.1186/1471-2458-8-355
Li, W. H., Chung, J. O., Chui, M. M., & Chan, P. S. (2009). Factorial structure of the Chinese version of the 12-item General Health Questionnaire in adolescents. Journal of Clinical Nursing, 18(23), 3253-3261. DOI: 10.1111/j.1365-2702.2009.02905.x
Lobo, A., & Muñoz, P. E. (1996). General Health Questionnaire. Guide for the use of the different validated versions in Spanish language [Cuestionario de Salud General GHQ. Guía para el usuario de las distintas versiones en lengua española validadas]. Barcelona: Masson.
Lopez-Castedo, A., & Fernandez, L. (2005). Psychometric properties of the Spanish version of the 12-item General Health Questionnaire in adolescents. Perceptual and Motor Skills, 100(3), 676-680. DOI: 10.2466/pms.100.3.676-680
Lorenzo-Seva, U., & Ferrando, P.J. (2013). FACTOR 9.2 A Comprehensive Program for Fitting Exploratory and Semiconfirmatory Factor Analysis and IRT Models. Applied Psychological Measurement, 37(6), 497-498. DOI: 10.1177/0146621613487794
Makowska, Z., Merecz, D., Moscicka, A., & Kolasa, W. (2002). The validity of general health questionnaires, GHQ-12 and GHQ-28, in mental health studies of working people. International Journal of Occupational Medicine and Environmental Health, 15(4), 353-362.
Padrón, A., Galán, I., Durbán, M., Gandarillas, A., & Rodríguez-Artalejo, F. (2012). Confirmatory factor analysis of the General Health Questionnaire (GHQ-12) in Spanish adolescents. Quality of Life Research, 21(7), 1291-1298. DOI: 10.1007/s11136-011-0038-x
Paus, T., Keshavan, M., & Giedd, J. N. (2008). Why do many psychiatric disorders emerge during adolescence?. Nature Reviews Neuroscience, 9(12), 947-957. DOI: 10.1038/nrn2513
Rey, J. J., Abad, F. J., Barrada, J. R., Garrido, L. E., & Ponsoda, V. (2014). The impact of ambiguous response categories on the factor structure of the GHQ–12. Psychological Assessment, 26(3), 1021-1030. DOI: 10.1037/a0036468
Romppel, M., Braehler, E., Roth, M., & Glaesmer, H. (2013). What is the General Health Questionnaire-12 assessing?. Comprehensive Psychiatry, 54(4), 406-413. DOI: 10.1016/j.comppsych.2012.10.010
Ruscio, J., & Roche, B. (2012). Determining the number of factors to retain in an exploratory factor analysis using comparison data of known factorial structure. Psychological Assessment, 24(2), 282-292. doi:10.1037/a0025697
Sánchez-López, M. D. P., & Dresch, V. (2008). The 12-Item General Health Questionnaire (GHQ-12): reliability, external validity and factor structure in the Spanish population. Psicothema, 20(4), 839-843.
Sarkova, M., Nagyová, I., Katreniaková, Z., Geckova, A. M., Orosová, O., Middel, B.,... & van den Heuvel, W. (2006). Psychometric evaluation of the General Health Questionnaire-12 and Rosenberg Self-esteem Scale in Hungarian and Slovak early adolescents. Studia Psychologica, 48(1), 69-79.
Sheldrick, R. C., Benneyan, J. C., Kiss, I. G., Briggs‐Gowan, M. J., Copeland, W., & Carter, A. S. (2015). Thresholds and accuracy in screening tools for early detection of psychopathology. Journal of Child Psychology and Psychiatry, 56(9), 936-948. DOI: 10.1111/jcpp.12442
Timmerman, M. E., & Lorenzo-Seva, U. (2011). Dimensionality assessment of ordered polytomous items with parallel analysis. Psychological Methods, 16(2), 209-220. DOI: 10.1037/a0023353
Trizano-Hermosilla, I., & Alvarado, J. M. (2016). Best alternatives to Cronbach's alpha reliability in realistic conditions: congeneric and asymmetrical measurements. Frontiers in Psychology, 7, 769. DOI: 10.3389/fpsyg.2016.00769
Yang, Y., & Green, S. B. (2011). Coefficient alpha: A reliability coefficient for the 21st century?. Journal of Psychoeducational Assessment, 29(4), 377-392. DOI: 10.1177/0734282911406668
Published
09-04-2020
How to Cite
Pedrero Pérez, E. J., Mora-Rodríguez, C., Rodríguez Gómez, R., Benítez-Robredo, M. T., Ordóñez-Franco, A., González-Robledo, L., & Méndez-Gago, S. (2020). GHQ-12 in adolescents: contributions to the controversial factorial validity. Anales De Psicología / Annals of Psychology, 36(2), 247-253. https://doi.org/10.6018/analesps.372721
Section
Clinical and Health Psychology