Measurement Invariance of the General Health Questionnaire GHQ 12-Item Version (GHQ-12)
A Large UK Longitudinal Study Across Students and Non-Students
Abstract
Abstract: Understanding how levels, patterns, predictors, and outcomes of mental health issues differs in students relative to non-students can inform more effective and better tailored prevention and intervention for mental health in higher education contexts. However, comparisons of mental health in student and non-student groups depend on the critical but seldom-tested assumption of measurement invariance. In this study, we use data from the UK household longitudinal study (UKLS) to evaluate the measurement invariance of the scores from a commonly used mental health measure: the General Health Questionnaire 12-item version (GHQ-12) across students and non-students. Using a bifactor model to take account of wording factors we found measurement invariance up to the scalar level for students and non-student groups. This provides support for the use of instruments for comparing mental health issue levels and candidate risk factors and outcomes across students and non-students.
References
2021). The student mental health crisis: Assessing psychiatric and developmental explanatory models. Journal of Adolescence, 86, 101–114. https://doi.org/10.1016/j.adolescence.2020.12.004
(1982). Unemployment and risk of minor psychiatric disorder in young people: Cross-sectional and longitudinal evidence. Psychological Medicine, 12(4), 789–798. https://doi.org/10.1017/s0033291700049096
(2008). Mental health of college students and their non-college-attending peers: Results from the national epidemiologic study on alcohol and related conditions. Archives of General Psychiatry, 65(12), 1429–1437. https://doi.org/10.1001/archpsyc.65.12.1429
(2003). Confirmatory factor analysis of the GHQ-12: Can I see that again? Australian & New Zealand Journal of Psychiatry, 37(4), 475–483. https://doi.org/10.1046/j.1440-1614.2003.01208.x
(2007). Sensitivity of goodness of fit indexes to lack of measurement invariance. Structural Equation Modeling: A Multidisciplinary Journal, 14(3), 464–504. https://doi.org/10.1080/10705510701301834
(2021). University student well-being in the United Kingdom: A scoping review of its conceptualisation and measurement. Journal of Mental Health, 30(3), 375–387. https://doi.org/10.1080/09638237.2021.1875419
(2003). Factor structure of the 12-item General Health Questionnaire in the Japanese general adult population. Psychiatry and Clinical Neurosciences, 57(4), 379–383. https://doi.org/10.1046/j.1440-1819.2003.01135.x
(2009). Stigma and help seeking for mental health among college students. Medical Care Research and Review, 66(5), 522–541. https://doi.org/10.1177/1077558709335173
(2013). Factorial validity and invariance of the GHQ-12 among clinical and nonclinical samples. Assessment, 20(2), 219–229. https://doi.org/10.1177/1073191112465768
(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. https://doi.org/10.2989/17280583.2015.1007867
(2018). The structure of the General Health Questionnaire (GHQ-12): Two meta-analytic factor analyses. Health Psychology Review, 12(2), 179–194. https://doi.org/10.1080/17437199.2018.1426484
(1972). The detection of psychiatric illness by questionnaire. Maudsley Monograph. https://doi.org/10.1192/bjp.122.4.483
(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, 1–8. https://doi.org/10.1186/1745-0179-4-10
(2018). Higher education student statistics: UK, 2016/17. HESA https://www.hesa.ac.uk/news/11-01-2018/sfr247-higher-education-student-statistics/numbers
. (2020). The dimensionality of the 12-item General Health Questionnaire (GHQ-12): Comparisons of factor structures and invariance across samples and time. Frontiers in Psychology, 11, Article
(1300 . https://doi.org/10.3389/fpsyg.2020.013002004). A confirmatory factor analysis of the General Health Questionnaire-12. Stress and Health: Journal of the International Society for the Investigation of Stress, 20(1), 11–20. https://doi.org/10.1002/smi.993
(2020). Factor structure of the 12-item General Health Questionnaire (GHQ-12) among Korean university students. Psychiatry Clinical Psychopharmacology, 30(1), 248–253. https://doi.org/10.5455/PCP.20200518112914
(2021). Higher education and mental health: Analyses of the LSYPE cohorts: Research report: May 2021. UK Department of Education. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/996975/Higher_education_and_mental_health__analyses_of_the_LSYPE_cohorts.pdf
(2018). Longitudinal measurement non-invariance with ordered-categorical indicators: How are the parameters in second-order latent linear growth models affected? Structural Equation Modeling: A Multidisciplinary Journal, 25(5), 762–777. https://doi.org/10.1080/10705511.2017.1419353
(2016). Validity of the 12-item version of the General Health Questionnaire in detecting depression in the general population. Public Health, 136, 66–74. https://doi.org/10.1016/j.puhe.2016.03.005
(2010). Stigma and student mental health in higher education. Higher Education Research & Development, 29(3), 259–274. https://doi.org/10.1080/07294360903470969
(2021). Measuring antenatal depressive symptoms across the world: A validation and cross-country invariance analysis of the Patient Health Questionnaire – 9 (PHQ-9) in eight diverse low resource settings. https://doi.org/10.31234/osf.io/kbf2h
(2013). The limitations of model fit in comparing the bi-factor versus higher-order models of human cognitive ability structure. Intelligence, 41(5), 407–422. https://doi.org/10.1016/j.intell.2013.06.004
(2017). Evaluating longitudinal invariance in dimensions of mental health across adolescence: An analysis of the Social Behavior Questionnaire. Assessment, 26(7), 1234–1245. https://doi.org/10.1177/1073191117721741
(2022). A longitudinal and gender invariance analysis of the Strengths and Difficulties Questionnaire across ages 3, 5, 7, 11, 14, and 17 in a large UK-representative sample. Assessment, 29(6), 1248–1261. https://doi.org/10.1177/10731911211009312
(2019). A Monte Carlo simulation study to assess the appropriateness of traditional and newer approaches to test for measurement invariance. Structural Equation Modeling: A Multidisciplinary Journal, 26(5), 724–744. https://doi.org/10.1080/10705511.2018.1561293
(1994). Reliability, validity and factor structure of the 12-item General Health Questionnaire among young males in Italy. Acta Psychiatrica Scandinavica, 90(6), 432–437. https://doi.org/10.1111/j.1600-0447.1994.tb01620.x
(2012). Lavaan: An R package for structural equation modeling and more. Version 0.5-12 (BETA). Journal of Statistical Software, 48(2), 1–36. https://doi.org/10.18637/jss.v048.i02
(2020). The potential impact of an anti-stigma intervention on mental health help-seeking attitudes among university students. BMC Psychiatry, 20(1), 1–14. https://doi.org/10.1186/s12888-020-02960-y
(2021). Prevalence and risk factors for mental health problems in university undergraduate students: A systematic review with meta-analysis. Journal of Affective Disorders, 287, 282–292. https://doi.org/10.1016/j.jad.2021.03.054
(2020). Multiple-group invariance with categorical outcomes using updated guidelines: An illustration using M plus and the lavaan/semTools packages. Structural Equation Modeling: A Multidisciplinary Journal, 27(1), 111–130. https://doi.org/10.1080/10705511.2019.1602776
(2021). Mental health in higher education students and non-students: Evidence from a nationally representative panel study. Social Psychiatry and Psychiatric Epidemiology, 56(5), 879–882. https://doi.org/10.1007/s00127-021-02032-w
(2003). Validity and psychometric properties of the General Health Questionnaire-12 in Young Australian Adolescents. Australian & New Zealand Journal of Psychiatry, 37(3), 374–381. https://doi.org/10.1046/j.1440-1614.2003.01133.x
(2023, June 16). Measurement invariance of the General Health Questionnaire GHQ 12 item version (GHQ-12) across students and non-students based on a large UK longitudinal study. https://osf.io/jr6um/
(1989). The General Health Questionnaire: Reliability and validity for Australian youth. Australian and New Zealand Journal of Psychiatry, 23(1), 53–58. https://doi.org/10.3109/00048678909062592
(2016). Identification of confirmatory factor analysis models of different levels of invariance for ordered categorical outcomes. Psychometrika, 81(4), 1014–1045. https://doi.org/10.1007/s11336-016-9506-0
(2012). Validity and factor structure of the General Health Questionnaire (GHQ-12) in university students. International Journal of Behavioral Sciences, 6(2), 153–160.
(2016). Measurement invariance via multigroup SEM: Issues and solutions with chi-square-difference tests. Psychological Methods, 21(3), 405–426. https://doi.org/10.1037/met0000080
(2010). Using the 12-item General Health Questionnaire (GHQ-12) to assess the psychological health of Malaysian college students. Global Journal of Health Science, 2(1), 73–80. https://doi.org/10.5539/gjhs.v2n1p73
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