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Gepubliceerd in: Quality of Life Research 1/2013

01-02-2013

The factor structure of the GHQ-12: the interaction between item phrasing, variance and levels of distress

Auteurs: Adam B. Smith, Yemi Oluboyede, Robert West, Jenny Hewison, Allan O. House

Gepubliceerd in: Quality of Life Research | Uitgave 1/2013

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Abstract

Purpose

The general health questionnaire-12 (GHQ-12) is a self-report instrument for measuring psychological morbidity. Previous work has suggested several multidimensional models for this instrument, although it has recently been proposed that these may be an artefact resulting from a response bias to negatively phrased items. The aim here was to explore the dimensionality of the GHQ-12.

Methods

Cluster analysis, exploratory factor analysis and confirmatory factor analysis were applied to waves of data from the English longitudinal study of ageing (ELSA Waves 1 and 3), in order to evaluate fit and factorial invariance over time of the GHQ-12.

Results

Two categories of respondents were identified: high and low scorers. Item variances were higher across all items for high scorers and higher for negatively phrased items (for both high and low scorers). The unidimensional model accounting for variance observed with negative phrasing (Hankins in Clin Pract Epidemiol Ment Health 4:10, 2008) was identified as having the best model fit across the two time points.

Conclusions

Item phrasing, item variance and levels of respondents’ distress affect the factor structure observed for the GHQ-12 and may perhaps explain why different factor structures of the instrument have been found in different populations.
Literatuur
1.
go back to reference Goldberg, D. P., & Hillier, V. F. (1979). A scaled version of the General Health Questionnaire. Psychological Medicine, 9, 139–145.PubMedCrossRef Goldberg, D. P., & Hillier, V. F. (1979). A scaled version of the General Health Questionnaire. Psychological Medicine, 9, 139–145.PubMedCrossRef
2.
go back to reference Werneke, U., Goldberg, D. P., Yalcin, I., & Üstün, B. T. (2000). The stability of the factor structure of the General Health Questionnaire. Psychological Medicine, 30, 823–829.PubMedCrossRef Werneke, U., Goldberg, D. P., Yalcin, I., & Üstün, B. T. (2000). The stability of the factor structure of the General Health Questionnaire. Psychological Medicine, 30, 823–829.PubMedCrossRef
3.
go back to reference Politi, P. L., Piccinelli, M., & Wilkinson, G. (1994). Reliability, validity & factor structure of the 12-item General Health Questionnaire among young males in Italy. Acta Psychiatrica Scandinavica, 90, 432–437.PubMedCrossRef Politi, P. L., Piccinelli, M., & Wilkinson, G. (1994). Reliability, validity & factor structure of the 12-item General Health Questionnaire among young males in Italy. Acta Psychiatrica Scandinavica, 90, 432–437.PubMedCrossRef
4.
go back to reference Kiliç, C., Rezaki, M., Rezaki, B., Kaplan, I., & Özgen, G. (1997). General Health Questionnaire (GHQ12 & GHQ28): psychometric properties and factor structure of the scales in a Turkish primary care sample. Social Psychiatry and Psychiatric Epidemiology, 32, 327–331.PubMedCrossRef Kiliç, C., Rezaki, M., Rezaki, B., Kaplan, I., & Özgen, G. (1997). General Health Questionnaire (GHQ12 & GHQ28): psychometric properties and factor structure of the scales in a Turkish primary care sample. Social Psychiatry and Psychiatric Epidemiology, 32, 327–331.PubMedCrossRef
5.
go back to reference Schmitz, N., Kruse, J., & Tress, W. (1999). Psychometric properties of the General Health Questionnaire (GHQ-12) in a German primary care sample. Acta Psychiatrica Scandinavica, 100, 462–468.PubMedCrossRef Schmitz, N., Kruse, J., & Tress, W. (1999). Psychometric properties of the General Health Questionnaire (GHQ-12) in a German primary care sample. Acta Psychiatrica Scandinavica, 100, 462–468.PubMedCrossRef
6.
go back to reference Martin, A. J. (1999). Assessing the multidimensionality of the 12-item General Health Questionnaire. Psychological Reports, 84, 927–935.PubMedCrossRef Martin, A. J. (1999). Assessing the multidimensionality of the 12-item General Health Questionnaire. Psychological Reports, 84, 927–935.PubMedCrossRef
7.
go back to reference Picardi, A., Abeni, D., & Pasquini, P. (2001). Assessing psychological distress in patients with skin diseases: reliability, validity and factor structure of the GHQ-12. European Academy of Dermatology and Venereology, 15, 410–417.CrossRef Picardi, A., Abeni, D., & Pasquini, P. (2001). Assessing psychological distress in patients with skin diseases: reliability, validity and factor structure of the GHQ-12. European Academy of Dermatology and Venereology, 15, 410–417.CrossRef
8.
go back to reference Campbell, A., Walker, J., & Farrell, G. (2003). Confirmatory factor analysis of the GHQ12: Can I see that again? Australian and New Zealand Journal of Psychiatry, 37, 475–483.PubMedCrossRef Campbell, A., Walker, J., & Farrell, G. (2003). Confirmatory factor analysis of the GHQ12: Can I see that again? Australian and New Zealand Journal of Psychiatry, 37, 475–483.PubMedCrossRef
9.
go back to reference Worsely, A., & Gribbin, C. C. (1977). A factor analytic study of the twelve-item General Health Questionnaire. Australian and New Zealand Journal of Psychiatry, 11, 269–272.CrossRef Worsely, A., & Gribbin, C. C. (1977). A factor analytic study of the twelve-item General Health Questionnaire. Australian and New Zealand Journal of Psychiatry, 11, 269–272.CrossRef
10.
go back to reference Graetz, B. (1991). Multidimensional properties of the 12-item General Health Questionnaire. Social Psychiatry and Psychiatric Epidemiology, 26, 132–138.PubMedCrossRef Graetz, B. (1991). Multidimensional properties of the 12-item General Health Questionnaire. Social Psychiatry and Psychiatric Epidemiology, 26, 132–138.PubMedCrossRef
11.
go back to reference Cheung, Y. B. (2002). A confirmatory factor analysis of the 12-item General Health Questionnaire among older people. International Journal of Geriatric Psychiatry, 17, 739–744.PubMedCrossRef Cheung, Y. B. (2002). A confirmatory factor analysis of the 12-item General Health Questionnaire among older people. International Journal of Geriatric Psychiatry, 17, 739–744.PubMedCrossRef
12.
go back to reference Gao, F., Luo, N., Thumboo, J., Fones, C., Li, S. C., & Cheung, Y. B. (2004). Does the 12-item General Health Questionnaire contain multiple factors and do we need them? Health and Quality of Life Outcomes, 2, 63.PubMedCrossRef Gao, F., Luo, N., Thumboo, J., Fones, C., Li, S. C., & Cheung, Y. B. (2004). Does the 12-item General Health Questionnaire contain multiple factors and do we need them? Health and Quality of Life Outcomes, 2, 63.PubMedCrossRef
13.
go back to reference Shevlin, M., & Adamson, G. (2005). Alternative factor models and factorial invariance of the GHQ-12: A large sample analysis using confirmatory factor analysis. Psychological Assessment, 17, 231–236.PubMedCrossRef Shevlin, M., & Adamson, G. (2005). Alternative factor models and factorial invariance of the GHQ-12: A large sample analysis using confirmatory factor analysis. Psychological Assessment, 17, 231–236.PubMedCrossRef
14.
go back to reference Mäkikangas, A., Feldt, T., Kinnunen, U., Tolvanen, A., Kinnunen, M. L., & Pulkkinen, L. (2006). The factor structure and factorial invariance of the 12-item General Health Questionnaire (GHQ-12) across time: Evidence from two community-based samples. Psychological Assessment, 18, 444–451.PubMedCrossRef Mäkikangas, A., Feldt, T., Kinnunen, U., Tolvanen, A., Kinnunen, M. L., & Pulkkinen, L. (2006). The factor structure and factorial invariance of the 12-item General Health Questionnaire (GHQ-12) across time: Evidence from two community-based samples. Psychological Assessment, 18, 444–451.PubMedCrossRef
15.
go back to reference Penninkilampi-Kerola, V., Miettunen, J., & Ebeling, H. (2006). 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. Scandanavian Journal of Psychology, 47, 431–440.CrossRef Penninkilampi-Kerola, V., Miettunen, J., & Ebeling, H. (2006). 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. Scandanavian Journal of Psychology, 47, 431–440.CrossRef
16.
go back to reference Andrich, D., & van Schoubroeck, L. (1989). The General Health Questionnaire: A psychometric analysis using latent trait theory. Psychological Medicine, 19, 469–485.PubMedCrossRef Andrich, D., & van Schoubroeck, L. (1989). The General Health Questionnaire: A psychometric analysis using latent trait theory. Psychological Medicine, 19, 469–485.PubMedCrossRef
17.
go back to reference Kalliath, T. J., O’Driscoll, M. P., & Brough, P. (2004). A confirmatory factor analysis of the General Health Questionnaire-12. Stress and Health, 20, 11–20.CrossRef Kalliath, T. J., O’Driscoll, M. P., & Brough, P. (2004). A confirmatory factor analysis of the General Health Questionnaire-12. Stress and Health, 20, 11–20.CrossRef
18.
go back to reference Smith, A. B., Fallowfield, L. J., Stark, D. P., Velikova, G., & Jenkins, V. (2010). A Rasch and confirmatory factor analysis of the General Health Questionnaire (GHQ)-12. Health and Quality of Life Outcomes, 8, 45.PubMedCrossRef Smith, A. B., Fallowfield, L. J., Stark, D. P., Velikova, G., & Jenkins, V. (2010). A Rasch and confirmatory factor analysis of the General Health Questionnaire (GHQ)-12. Health and Quality of Life Outcomes, 8, 45.PubMedCrossRef
19.
go back to reference Hankins, M. (2008). The factor structure of the twelve item General Health Questionnaire (GHQ-12): The result of negative phrasing? Clinical Practice & Epidemiology in Mental Health, 4, 10.CrossRef Hankins, M. (2008). The factor structure of the twelve item General Health Questionnaire (GHQ-12): The result of negative phrasing? Clinical Practice & Epidemiology in Mental Health, 4, 10.CrossRef
20.
go back to reference Ye, S. (2009). Factor structure of the General Health Questionnaire (GHQ-12): The role of wording effects. Personality and Individual Differences, 46, 197–201.CrossRef Ye, S. (2009). Factor structure of the General Health Questionnaire (GHQ-12): The role of wording effects. Personality and Individual Differences, 46, 197–201.CrossRef
21.
go back to reference Clark, S. A. (1992). Mental illness among new residents to residential care. International Journal of Geriatric Psychiatry, 7, 59–64.CrossRef Clark, S. A. (1992). Mental illness among new residents to residential care. International Journal of Geriatric Psychiatry, 7, 59–64.CrossRef
22.
go back to reference Harrison, R., Savla, N., & Kafetz, K. (1990). Dementia, depression and physical disability in a London borough: A survey of elderly people in and out of residential care and implications for future developments. Age and Ageing, 19, 97–103.PubMedCrossRef Harrison, R., Savla, N., & Kafetz, K. (1990). Dementia, depression and physical disability in a London borough: A survey of elderly people in and out of residential care and implications for future developments. Age and Ageing, 19, 97–103.PubMedCrossRef
23.
go back to reference Marmot, M., Banks, J., Blundell, R., Lessof, C., & Nazroo, J. (2003). Health, wealth and lifestyles of the older population in England: The 2002 English Longitudinal Study of Ageing. London: The Institute for Fiscal Studies. Marmot, M., Banks, J., Blundell, R., Lessof, C., & Nazroo, J. (2003). Health, wealth and lifestyles of the older population in England: The 2002 English Longitudinal Study of Ageing. London: The Institute for Fiscal Studies.
24.
go back to reference Goldberg, D., & Williams, P. (1988). A user’s guide to the General Health Questionnaire. Windsor: NFER-Nelson. Goldberg, D., & Williams, P. (1988). A user’s guide to the General Health Questionnaire. Windsor: NFER-Nelson.
25.
go back to reference Campbell, A., & Knowles, S. (2007). A confirmatory factor analysis of the GHQ12 using a large Australian sample. European Journal of Psychological Assessment, 23, 2–8.CrossRef Campbell, A., & Knowles, S. (2007). A confirmatory factor analysis of the GHQ12 using a large Australian sample. European Journal of Psychological Assessment, 23, 2–8.CrossRef
26.
go back to reference Bentler, P. M. (1990). Comparative fit indices in structural models. Psychological Bulletin, 107, 238–246.PubMedCrossRef Bentler, P. M. (1990). Comparative fit indices in structural models. Psychological Bulletin, 107, 238–246.PubMedCrossRef
27.
go back to reference Bollen, K. A. (1989). Structural equations with latent variables. New York: Wiley. Bollen, K. A. (1989). Structural equations with latent variables. New York: Wiley.
28.
go back to reference Steiger, J. H. (1990). Structural model evaluation and modification: An interval estimation approach. Multivariate Behavioural Research, 25, 173–180.CrossRef Steiger, J. H. (1990). Structural model evaluation and modification: An interval estimation approach. Multivariate Behavioural Research, 25, 173–180.CrossRef
29.
go back to reference Jöreskog, K., & Sörbom, D. (1981). LISREL V: Analysis of linear structural relationships by the method of maximum likelihood. Chicago: National Educational Resources. Jöreskog, K., & Sörbom, D. (1981). LISREL V: Analysis of linear structural relationships by the method of maximum likelihood. Chicago: National Educational Resources.
30.
go back to reference Brosan, L., Hoppitt, L., Shelfer, L., Sillence, A., & Mackintosh, B. (2011). Cognitive bias modification for attention and interpretation reduces trait and state anxiety in anxious patients referred to an out-patient service: Results from a pilot study. Journal of Behavior Therapy and Experimental Psychiatry, 42(3), 258–264.PubMedCrossRef Brosan, L., Hoppitt, L., Shelfer, L., Sillence, A., & Mackintosh, B. (2011). Cognitive bias modification for attention and interpretation reduces trait and state anxiety in anxious patients referred to an out-patient service: Results from a pilot study. Journal of Behavior Therapy and Experimental Psychiatry, 42(3), 258–264.PubMedCrossRef
31.
go back to reference Macleod, C., Mathews, A., & Tata, P. (1986). Attentional bias in emotional disorders. Journal of Abnormal Psychology, 95(1), 15–20.PubMedCrossRef Macleod, C., Mathews, A., & Tata, P. (1986). Attentional bias in emotional disorders. Journal of Abnormal Psychology, 95(1), 15–20.PubMedCrossRef
32.
go back to reference Gilbody, S., House, A., & Sheldon, T. (2001). Routinely administered questionnaires for depression and anxiety: Systematic review. British Medical Journal, 332, 406–409.CrossRef Gilbody, S., House, A., & Sheldon, T. (2001). Routinely administered questionnaires for depression and anxiety: Systematic review. British Medical Journal, 332, 406–409.CrossRef
33.
go back to reference Harwood, R. H., Prince, M. J., Mann, A. H., & Ebrahim, S. (1998). The prevalence of diagnoses, impairments, disabilities and handicaps in a population of elderly people living in a defined geographical area: The Gospel Oak project. Age and Ageing, 27, 707–714.PubMedCrossRef Harwood, R. H., Prince, M. J., Mann, A. H., & Ebrahim, S. (1998). The prevalence of diagnoses, impairments, disabilities and handicaps in a population of elderly people living in a defined geographical area: The Gospel Oak project. Age and Ageing, 27, 707–714.PubMedCrossRef
Metagegevens
Titel
The factor structure of the GHQ-12: the interaction between item phrasing, variance and levels of distress
Auteurs
Adam B. Smith
Yemi Oluboyede
Robert West
Jenny Hewison
Allan O. House
Publicatiedatum
01-02-2013
Uitgeverij
Springer Netherlands
Gepubliceerd in
Quality of Life Research / Uitgave 1/2013
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-012-0133-7

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