Factor structure and psychometric properties of the General Health Questionnaire (GHQ-12) among Ghanaian adolescents

Experience of psychosocial rehabilitation; perspectives of depressed adolescents

Given the multifaceted character of depression and its related symptoms, an adolescent living with it is at increased risk for a wide range of adverse events. This research aimed to understand and characterize the psychosocial rehabilitation experiences of depressed teenage participants in the Greater Accra Region of Ghana. A cross-sectional semi-structured interview design influenced by an interpretive phenomenological analysis (IPA) technique was adopted. We employed a nonprobability, purposeful sampling approach to recruit twenty-one adolescents (6 males, 15 females) diagnosed with depression from the community after one month of discharge from admission and undergoing psychosocial rehabilitation. Using separate interviews, we gathered and analyzed data using interpretive phenomenological analysis to produce themes and sub-themes. These were presented with the participants' direct quotations. We discovered that the perspectives of adolescents' psychosocial rehabilitation experience include hopelessness and suicide ideation, coping difficulties, undesirable attitudes from support networks, challenges related to school, and isolation. Participants suggested appropriate therapeutic environments, encouraging support systems, and the media's role in preventing and treating depression among young people as rehabilitation approaches that could assist adolescents to remain lucid for longer intervals. These results shed light on the tragic realities faced by depressed adolescents. There is an urgent need to put well-defined structures in place to aid their rehabilitation and develop coping strategies for a better life.

How to Measure the Mental Health of Teachers? Psychometric Properties of the GHQ-12 in a Large Sample of German Teachers

To improve the health status of teachers, there is a need for good and reliable instruments to continuously assess their mental health. The current study proposed the GHQ-12 questionnaire as an appropriate instrument for measuring the mental health of teachers. The GHQ-12 is a well-established screening instrument that has mostly been applied in non-teaching samples. In the current study, the psychometric properties of the questionnaire were analyzed using a large sample of German teachers (N = 3996). The data was collected yearly over an extended period of time (2012-2020). Results showed good to very good reliability, as well as high correspondence to burnout and life satisfaction scales. Principal axis factor analysis supported a two-factor structure: Factor 1 represents "depression/stress" and Factor 2 represents "loss of confidence". However, the mental health of the investigated teachers was worse than that of a representative sample in Germany. Consequently, this study highlighted the fact that the teaching profession is vulnerable to mental strain and underlined the importance of promoting prevention programs that could help to sustain and foster the mental health of teachers. In this context, the GHQ-12 could be proposed as a good and economic tool to assess and analyze mental health in German teachers. The presented norm could help practitioners and teachers to compare individual scores within a larger peer group.

Psychological distress in Spanish airline pilots during the aviation crisis caused by the COVID-19 pandemic and psychometric analysis of the 12-item general health questionnaire

The aim of this study was to evaluate the psychological distress of Spanish airline pilots, a group of professionals undergoing an unprecedented work situation as a result of the Covid-19 pandemic. To do so, we administered the General Health Questionnaire-12 (GHQ-12). A total of 342 questionnaires were obtained, with the largest respondent age group being 41-50 years. The psychometric properties of the instrument were also evaluated, with an exploratory factor analysis revealing a unidimensional structure that explained 59.23% of the variance. The total score on the standard GHQ-12 was 4.54 ± 3.31 very close to the cut-off point established to determine psychological distress. The score increased among those unemployed and was also higher among pilots on furlough compared to those whose work situation was relatively normal. Furthermore, the reliability measured by the total Cronbach's alpha was above 0.8 of each across all employment status considered. These results show the desirability of conducting periodic psychological distress assessments of pilots so that effective measures can be implemented to ensure their psychological and socio-emotional well-being. Practitioner summary: This article evaluates psychological distress in a group of professionals that has received scant attention in the field. Moreover, it does so against the background of an atypical situation, evaluating the psychological distress suffered by pilots in different employment categories during the current severe crisis in the aviation sector.Abbreviations: CFI: comparative fit index; COPAC: Official College of Commercial Aviation Pilots; ECA: European Cockpit Association; EFA: exploratory factor analysis; GHQ-12: general health questionnaire-12; IATA: International Air Transport Association; KMO: Kaiser-Meyer-Olkin test; PA: optimal implementation of parallel analysis; ULS: unweighted least squares.

Factorial validity of the Twi versions of five measures of mental health and well-being in Ghana

BACKGROUND

Mental health is considered an integral part of human health. Reliable and valid measurement instruments are needed to assess various facets of mental health in the native language of the people involved. This paper reports on five studies examining evidence for the factorial validity of the Twi versions of five mental health and well-being measurement instruments: Affectometer-2 (AFM-2); Automatic Thought Questionnaire-Positive (ATQ-P); Generalized Self-Efficacy Scale (GSEs); Patient Health Questionnaire-9 (PHQ-9); and Satisfaction with Life Scale (SWLS) in a rural Ghanaian adult sample.

METHOD

Measures were translated and evaluated using a research-committee approach, pilot-tested, and administered to adults (N = 444) randomly selected from four rural poor communities in Ghana. We applied confirmatory factor analysis (CFA), bifactor CFA, exploratory structural equation modeling (ESEM), and bifactor ESEM to the AFM-2, ATQ-P, and the PHQ-9, and CFA to the GSEs and the SWLS. The omega coefficient of composite reliability was computed for each measure.

RESULTS

A two-factor bifactor ESEM model displayed superior model fit for the AFM-2. The total scale and the Negative Affect subscale, but not the Positive Affect subscale, attained sufficient reliability. Two models (a four-factor 22-item bifactor ESEM model and a 5-factor 22-item ESEM model) fitted the data best for the ATQ-P. The bifactor ESEM model displayed a high reliability value for the total scale and satisfactory reliability values for three of its four subscales. For the GSEs, a one-factor CFA model (residuals of items 4 and 5 correlated) demonstrated superior model fit with a high reliability score for the total scale. A two-factor ESEM model outperformed all other models fitted for the PHQ-9, with moderate and satisfactory reliability scores for the subscales. A one-factor CFA model (residuals of item 4 and 5 correlated) demonstrated superior model fit for the SWLS, with a satisfactory reliability value for the total scale.

CONCLUSIONS

Findings established evidence for the factorial validity of the Twi versions of all five measures, with the global scores, but not all subscale scores, demonstrating satisfactory reliability. These validated measurement instruments can be used to assess mental health and well-being in the research and practice contexts of the current sample.

The Dimensionality of the 12-Item General Health Questionnaire (GHQ-12): Comparisons of Factor Structures and Invariance Across Samples and Time

Because of its brevity, the 12-item General Health Questionnaire (GHQ-12) has become one of the most popular and used measure for detecting psychological distress. Originally intended as a unidimensional measure, the majority of subsequent factor-analytic studies have failed to support GHQ-12 as a unitary construct and have instead proposed a plethora of multidimensional structures. In this study, we further examined the factor structure in two different military samples, one consisting of crewmembers from four different frigates deployed in anti-piracy operations and Standing NATO Maritime Group deployments (N = 591) and one consisting of crewmember from three different minehunters/sweepers serving in Standing NATO Mine Counter-Measures Group deployments (N = 196). Results from confirmatory factor analyses (CFA) performed in the first sample supported a bifactor model, consisting of a general factor representing communality among all items and two specific factors reflecting common variance due to wording effects (negatively and positively phrased items). A multi-group CFA further confirmed this structure to be invariant across our second sample. Structural equation modeling also showed that the general factor was strongly associated with symptoms of insomnia and mental health, whereas the specific factors were either non-significantly or considerably weaker associated with the criterion variables. Overall, our results are congruent with the notion that the multidimensionality demonstrated in many previous investigations is most likely an expression of method-specific variance caused by item wording. The explained unique variance associated with these specific factors was further relatively small. Ignoring the multidimensionality and treating GHQ-12 as a unitary construct will therefore most likely introduce minimal bias to most practical applications.

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

OBJECTIVE

Recent 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.

DESIGN

A 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.

SETTING

Representative sample of all employees living in Catalonia (Spain).

PARTICIPANTS

3050 participants (44.6% women) who responded the Second Catalonian Survey of Working Conditions.

RESULTS

A 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.

CONCLUSION

Individual 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.

Depressive symptomatology in adolescents in Ghana: Examination of psychometric properties of the Patient Health Questionnaire-9

BACKGROUND

The Patient Health Questionnaire (PHQ-9) has been used extensively in research and clinical settings. However, there is limited information regarding the psychometric properties of the PHQ-9 among adolescents, particularly in sub-Saharan Africa.

METHODS

Data were collected from 553 adolescents (girls = 322, 58.1%) using a cross-sectional survey design to investigate the factorial validity, construct validity and internal consistency of the PHQ-9 in Ghana.

RESULTS

Confirmatory factor analysis (CFA) and multi-group CFA support a one-factor structure of the PHQ-9 that was invariant across gender. The PHQ-9 correlates significantly with measures of anxiety, depression, mental wellbeing, and suicidal behavior. The internal consistency of the PHQ-9 was 0.71.

LIMITATION

The study did not include a gold standard measure of depression to assess the diagnostic properties (e.g., sensitivity and specificity) of the PHQ-9.

CONCLUSION

The results suggest that major depressive disorder, measured by the PHQ-9, is a homogeneous construct across gender and that the PHQ-9 can be used to screen for depressive symptoms in adolescent boys and girls in Ghana.

Psychoactive substance use among first-year students in a Botswana University: pattern and demographic correlates

BACKGROUND

Substance use amongst university students is a recognized problem worldwide. Few studies have been carried out in this group in Botswana. These studies have been mostly limited to the use of alcohol and tobacco. Therefore, this study was designed to investigate the pattern of general substance use, its association with psychological distress and common socio-demographic factors among first-year undergraduates in a Botswana University.

METHODS

A total of 401 students were interviewed using a modified W.H.O. student drug use questionnaire and the 12 item General Health Questionnaire (GHQ12) to assess the pattern of psychoactive substance use and its relationship with psychological distress amongst university students in Botswana.

RESULTS

Alcohol was the most (31.9%) commonly used psychoactive substance. Age of debut for most psychoactive substances was between the ages of 15-18 years. Current use of alcohol (p = 0.045), amphetamine-type stimulants (p = 0.004) and benzodiazepines (p = 0.021) were associated with significant psychological distress. A positive relationship was observed between low participation in religious activities and substance use (OR = 4.63, 95%CI: 2.03-10.51), while a negative association was observed between not having a friend who uses drugs and substance use (OR = 0.44, 95%CI: 0.19-0.99).

CONCLUSIONS

There is a significant substance abuse problem in the undergraduate population in Botswana. Our findings followed the global trend, with alcohol being the most commonly used substance. Religious participation demonstrates potential to be one of the solutions to this problem, but how to harness its seemingly protective influences is a field for further study.

Crowded living and its association with mental ill-health among recently-arrived migrants in Sweden: a quantitative study

Objective

Housing and neighbourhood conditions are widely acknowledged important social determinants of health and health inequalities that persist in developed countries despite general improvements in health outcomes across populations. Previous research has investigated what effect crowded living conditions have on mental health and concluded that women living in crowded conditions were more likely to suffer from depression. In contrast, men living in the same conditions responded with withdrawal or aggression. To the best of our knowledge, only a few studies have examined the association between recently-arrived migrants living in crowded conditions and poor mental health. The aim of this study was to investigate the association between crowded living conditions among recently-arrived migrants in Sweden and mental ill-health. The result is based on 681 migrants who completed and returned questionnaires in 2015–2016.

Results

The analyses, independent of gender, resulted in a significant unadjusted odds ratio of 1.46 (95% CI 1.05–2.03); even after adjustments were made, the association remained significant OR 1.47 (1.05–2.07). When adding stability in housing into the adjustment-model, the OR did not remain significant OR 1.40 (0.99–1.99), P-value 0.061.

Relationship Between Sexual Abuse in Childhood and the Occurrence of Mental Illness in Adulthood: A Matched Case-Control Study in Nigeria

This study aimed to examine the relationship between exposure to childhood sexual abuse (CSA) and the occurrence of mental illness in adulthood in Nigeria. An age- and gender-matched case-control study was conducted in the University of Port Harcourt Teaching Hospital, Nigeria, from January to March 2014. Cases were defined as individuals aged 18 to 60 years diagnosed with mental illness while controls were aged 18 to 60 years who did not have mental illness. The study had 304 subjects comprised of 152 case-control pairs. This case-control study showed a statistically significant association between exposure to CSA and occurrence of mental illness in adulthood (pair-matched odds ratio = 3.25, 95% CI = [1.70, 6.21]). The association between CSA and mental illness was still significant (adjusted odds ratio = 3.11, 95% CI = [1.67, 5.82]) after controlling for family functionality. A robust CSA prevention and treatment strategy that considers the victim and the perpetrator in Nigeria is hereby advocated. This could be achieved by the collaborative efforts of the government of Nigeria and non-governmental organizations.

Association between psychosomatic health symptoms and common mental illness in Ghanaian adolescents: Age and gender as potential moderators

Little is known about the role of age and gender in the association between psychosomatic symptoms and common mental illness in Ghanaian adolescents. This cross-sectional study examined age and gender as moderators between psychosomatic symptoms and common mental illness using data from a school-based survey ( N = 770). Males reported higher psychosomatic symptoms and common mental illness, while younger adolescents reported higher common mental illness only. Psychosomatic symptoms were positively associated with common mental illness, but age and gender did not moderate this association. Interventions aimed at reducing the prevalence rate in psychosomatic symptoms are crucial in decreasing common mental illness in Ghanaian adolescents.