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Original Article

An Integrated Approach to Bias in the Spanish Version of the General Health Questionnaire (GHQ-12)

Published Online:https://doi.org/10.1027/1015-5759/a000395

Abstract. The aim of the paper is to illustrate a comprehensive approach to bias in an application of the General Health Questionnaire (GHQ-12) among native Spanish people and immigrants in Spain. A comprehensive evaluation of bias can detect combined effects of different types of bias and their causes. The GHQ-12, administered as part of the 2006 Spanish National Health Survey, was used for evaluating bias. The entire sample of 1,251 participants was composed of Spanish and immigrants from Morocco, Ecuador, Romania, and Colombia. Construct, method, and items bias were evaluated, using analyses of measurement invariance, response styles, and Differential Item Functioning (DIF), respectively. Integrating the results of the bias analyses, we found that the presence of bias was related to items asking about symptoms, notably dealing with feelings and personal perceptions. Furthermore, colloquialisms in the items led to bias in the comparison of Spanish speakers from Spain and South America (all of whom had Spanish as mother tongue). The comprehensive approach to bias showed the value of examining various forms of bias in an integrated manner.

References

  • Abubakar, A., Van de Vijver, F. J. R., Fischer, R., Alonso-Arbiol, I., He, J., Adams, B., … Suryani, A. O. (2016). Invariance of Factorial Structure of the General Health Questionnaire-12 across 19 Cultural Contexts. Manuscript submitted for publication. First citation in articleGoogle Scholar

  • American Psychological Association, American Educational Research Association, National Council on Measurement in Education (2014). Standards for Educational and Psychological Testing. Washington, DC: American Psychological Association. First citation in articleGoogle Scholar

  • Arbuckle, J. L. (2010). IBM SPSS Amos 19 User’s Guide. Crawfordville, FL: Amos Development Corporation. First citation in articleGoogle Scholar

  • Goldberg, D. (1972). The detection of psychiatric illness by questionnaire. London, UK: Oxford University Press. First citation in articleGoogle Scholar

  • Graetz, B. (1991). Multidimensional properties of the General Health Questionnaire. Social Psychiatry and Psychiatric Epidemiology, 26, 132–138. First citation in articleCrossrefGoogle Scholar

  • He, J., & Van de Vijver, F. J. R. (2013). A general response style factor: Evidence from a multi-ethnic study in the Netherlands. Personality and Individual Differences, 55, 794–800. doi: 10.1016/j.paid.2013.06.017 First citation in articleCrossrefGoogle Scholar

  • IBM Corp. (2010). IBM SPSS Statistics for Windows, Version 19.0. Armonk, NY: IBM Corp. First citation in articleGoogle Scholar

  • International Test Commission. (2010). International Test Commission guidelines for translating and adapting tests, Retrieved from http://www.intestcom.org/upload/sitefiles/40.pdf First citation in articleGoogle Scholar

  • Kline, R. B. (2015). Principles and practice of structural equation modeling (4th ed.). New York, NY: Guilford. First citation in articleGoogle Scholar

  • Mellenbergh, G. J. (1982). Contingency table models for assessing item bias. Journal of Educational Statistics, 7, 105–118. doi: 10.2307/1164960 First citation in articleCrossrefGoogle Scholar

  • Miller, T. R., & Spray, J. A. (1993). Logistic Discriminant Function Analysis for DIF identification of polytomously scored items. Journal of Educational Measurement, 30, 107–122. doi: 10.1111/j.1745-3984.1993.tb01069.x First citation in articleCrossrefGoogle Scholar

  • Millsap, R. E., & Everson, H. T. (1993). Methodology review: Statistical approaches for assessing measurement bias. Applied Psychological Measurement, 17, 297–334. doi: 10.1177/014662169301700401 First citation in articleCrossrefGoogle Scholar

  • Morren, M., Gelissen, J. P. T. M., & Vermunt, J. K. (2012). Response strategies and response styles in cross-cultural surveys. Cross-Cultural Research, 46, 255–279. doi: 10.1177/1069397112440939 First citation in articleCrossrefGoogle Scholar

  • Muthén, B. O., & Muthén, L. K. (2004–2008). Mplus user manual, Los Angeles, CA: Muthén & Muthén. First citation in articleGoogle Scholar

  • 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, 1291–1298. doi: 10.1007/s11136-011-0038-x First citation in articleCrossrefGoogle Scholar

  • 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, 1021–1030. doi: 10.1037/a0036468 First citation in articleCrossrefGoogle Scholar

  • Romppel, M., Braehler, E., Roth, M., & Glaesmer, H. (2013). What is the General Health Questionnaire-12 assessing? Dimensionality and psychometric properties of the General Health Questionnaire-12 in a large scale German population sample. Comprehensive Psychiatry, 54, 406–413. doi: 10.1016/j.comppsych.2012.10.010 First citation in articleCrossrefGoogle Scholar

  • Sánchez-López, M. P., & Dresch, V. (2008). The 12-Item General Health Questionnaire (GHQ-12): Reliability, external validity and factor structure in the Spanish population. Psicothema, 20, 839–843. First citation in articleGoogle Scholar

  • 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, 1–10. doi: 10.1186/1477-7525-8-45 First citation in articleCrossrefGoogle Scholar

  • Spanish Ministry of Health and Consume. (2006). Encuesta Nacional de Salud de España 2006 [National Health Survey in Spain 2006]. Madrid, Spain: Ministerio de Sanidad y Consumo. First citation in articleGoogle Scholar

  • Van de Vijver, F. J. R. (2011). Capturing bias in structural equation modeling. In E. DavidovP. SchmidtJ. BillietEds., Cross-cultural analysis: Method and applications (pp. 3–34). New York, NY: Routledge. First citation in articleGoogle Scholar

  • Van de Vijver, F. J. R., & Leung, K. (2011). Equivalence and bias: A review of concepts, models, and data analytic procedures. In D. MatsumotoF. J. R. Van de VijverEds., Cross-cultural research methods in psychology (pp. 17–45). New York, NY: Cambridge University Press. First citation in articleGoogle Scholar

  • Van de Vijver, F. J. R., & Matsumoto, D. (2011). Introduction to the methodological issues associated with Cross-Cultural Research. In D. MatsumotoF. J. R. van de VijverEds., Cross-cultural research methods in psychology (pp. 1–14). New York, NY: Cambridge University Press. First citation in articleGoogle Scholar

  • Zumbo, B. D. (1999). A handbook on the theory and methods of differential item functioning (DIF): Logistic regression modeling as a unitary framework for binary and Likert-type (ordinal) item scores. Ottawa, ON: Directorate of Human Resources Research and Evaluation, Department of National Defense. First citation in articleGoogle Scholar

  • Zumbo, B. D., & Thomas, D. R. (1997). A measure of effect size for a model-based approach for studying DIF. Prince George, Canada: University of Northern British Columbia, Edgeworth Laboratory for Quantitative Behavioral Science. First citation in articleGoogle Scholar