Development and validation of the Rapid Positive Mental Health Instrument (R-PMHI) for measuring mental health outcomes in the population

Janhavi Ajit Vaingankar,Hwee Lin Wee,Esmond Seow,Wei Yen Lim,Siow Ann Chong,Robertus Martinus Van Dam,Mythily Subramaniam,Rajeswari Sambasivam,Edimansyah Abdin,Boon Yiang Chua,Linda Wei Lin Tan

doi:10.1186/s12889-020-08569-w

Abstract

BackgroundThe multidimensional Positive Mental Health Instrument (PMHI) has 47 items and six subscales. This study aimed to develop and validate a short unidimensional version of the PMHI among Singapore’s adult resident population.MethodsUsing pooled data from three earlier studies (n = 1050), PMHI items were reduced by Partial Credit Rasch Model (PCRM) runs in a random split-half sample, while psychometric properties of the resulting measure were tested through confirmatory factor analysis (CFA), item response theory-graded response model and internal consistency reliability in the other half. Its reliability, construct and concurrent validity, agreement with the original scale, floor and ceiling effect, and scale estimates were further investigated in an external representative general population sample (n = 1925).ResultsThe average age of the participants was around 41 years. Four PCRM re-runs for item selection resulted in a 6-item unidimensional Rapid PMHI (R-PMHI). CFA confirmed the unidimensional structure of the R-PMHI in the internal (RMSEA = 0.075, CFI = 0.985, TLI = 0.974) and external (RMSEA = 0.051, CFI = 0.992, TLI = 0.987) validation samples. In the external validation sample, the R-PMHI met concurrent validity criteria, showing high agreement with the 47-item version with intra-class correlation coefficient of 0.872 (95% CI: 0.861 to 0.882) and low floor and ceiling effects. Weight-adjusted mean (SE, 95% CI) R-PMHI score in the population was 4.86 (0.2, 4.82–4.90).ConclusionThe unidimensional 6-item R-PMHI offers brevity over the original multidimensional measure while appropriately representing the positive mental health construct. Prospective studies are needed to assess its responsiveness and test-retest reliability.

Highlights

The multidimensional Positive Mental Health Instrument (PMHI) has 47 items and six subscales
A study conducted among mental health professionals found that employee positive mental health was associated with their life satisfaction and profession compared to allied health employees, psychiatrists had lower scores on spirituality and nurses had higher scores on personal growth and autonomy [16]
Except for the first study where completing the study questionniare was treated as an implied consent, written informed consent was obtained from all participants

Summary

Introduction

The multidimensional Positive Mental Health Instrument (PMHI) has 47 items and six subscales. The multidimensional scale has 47 items representing six domains of positive mental health - general coping, emotional support, spirituality, interpersonal skills, personal growth and autonomy, and global affect. Studies in clinical populations have found gender differences in positive mental health of patients with schizophrenia [14] and positive association of positive mental health with life satisfaction and general functioning, and inverse relation with depressive symptom severity among patients with mental disorders [15]. Current studies with the PMHI involve associations with negative aspects of mental health, lifestyle and behavioral factors (Unpublished) These findings have important practice and policy implications for mental health promotion in the general population, clinical settings and workplace

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