Abstract
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.
Highlights
Increased focus on mental health problems and its impact on the population have resulted in development of screening programs for different sub-groups at risk for developing severe psychopathologies
Among the five alternative models tested, a bifactor structure with one general factor and two specific factors proved to be the best representation of the data from a statistical perspective
A larger proportion of the variance associated with the specific factors could be attributed to the general factor than to what was unique to these two factors
Summary
Increased focus on mental health problems and its impact on the population have resulted in development of screening programs for different sub-groups at risk for developing severe psychopathologies. The diversity in programs range from screening for mental health in women with risk of transferring HIV to their children (Iheanacho et al, 2015) to mental health evaluation. Mental health screening in the military domain is parallel to community screening programs and has long historical roots (Wright et al, 2002). In order to be able to process large amount of data in brief periods of time, short self-report inventories are preferable. Credé et al (2012) reported lower internal consistency estimates and lower predictive power across a range of outcomes for short versus long scales
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