Abstract
BackgroundThe Positive Mental Health (PMH) instrument was developed and validated to assess the level of PMH and its six dimensions in a multi-ethnic general population sample. This cross-sectional study examines the psychometric properties of the instrument for assessing the level of PMH among help-seeking patients with mental disorders.MethodsThe PMH instrument was tested among 360 out-patients with schizophrenia, depression or anxiety spectrum disorders, seeking treatment at a tertiary psychiatric hospital and its affiliated clinics in Singapore. All participants completed the PMH instrument along with measures of life satisfaction, mental and overall health and happiness. Reliability (internal consistency), construct (Exploratory Structural Equation Modeling (ESEM)) and criterion (convergent and divergent) validity of the PMH instrument were tested in this population. Items were also tested for item response theory and differential item functioning (IRT-DIF).ResultsESEM on the PMH instrument showed good fit with the model reflecting six factors (general coping, personal growth and autonomy, spirituality, interpersonal skills, emotional support, and global affect). Internal consistency was high (Cronbach’s alpha >0.85) for the instrument and its six subscales. The PMH instrument fulfilled expected correlations with related constructs and demonstrated adequate item discrimination and difficulty estimates; however, significant DIF was noted for few items for age, gender and ethnicity groups.ConclusionsThe PMH instrument is a reliable and valid instrument for measuring PMH dimensions in patients with mental disorders. Further studies in larger samples are needed to assess the impact of DIF on PMH scores. The implications for the shift in focus from just the negative aspects of mental disorders to including positive components in the assessment of patients with mental disorders are immense, and can be applied in routine mental health practice and policy making.
Highlights
The Positive Mental Health (PMH) instrument was developed and validated to assess the level of PMH and its six dimensions in a multi-ethnic general population sample
The current study aimed to explore the psychometric properties of the PMH instrument among patients with mental disorders who were seeking treatment at a tertiary psychiatric hospital and its affiliated clinics in Singapore
Nonresidents and patients belonging to other ethnic groups, with poor English literacy and those who were physically or mentally unable to provide consent and/or complete the self-administered PMH instrument were excluded from the study
Summary
The Positive Mental Health (PMH) instrument was developed and validated to assess the level of PMH and its six dimensions in a multi-ethnic general population sample. Assessing well-being at the national level has gained momentum with politicians, economists, policy makers, and health professionals, with efforts being made towards understanding the concept of mental well-being and how this relates to happiness, life satisfaction and productivity of citizens and countries around the world. This growing interest in mental well-being poses two important conceptual challenges. Ryan and Deci first proposed a composite theory that granted equal importance to subjective (transient) and psychological (eudemonic) wellbeing for optimal functioning in form of the ‘self-determination theory model of health behavior change’ This model linked autonomy, competence and relatedness with mental and physical health, and suggested that mental health and affect were associated with individual’s satisfaction and psychological needs [2]. Well-being experts have applied several combinations of these constructs in the study of mental health and well-being; positive mental health (PMH) is one of them
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