Abstract
BackgroundUnderstanding and measuring mental health and wellbeing amongst teenagers has recently become a priority. The Warwick-Edinburgh Mental Well-being Scale (WEMWBS) is validated for measuring mental wellbeing in populations aged 16 years and over in the UK. We report here a study designed to establish the validity and reliability of WEMWBS in teenagers in the UK.MethodsWEMWBS and comparator scales, together with socio-demographic information and self-reported health, were incorporated into a self-administered questionnaire given to pupils aged 13 to 16 years in six schools in Scotland and England. Psychometric properties including internal consistency, correlations with comparator scales, test-retest stability and unidimensionality were investigated for WEMWBS. Twelve focus groups were undertaken to assess acceptability and comprehensibility of WEMWBS and were taped, transcribed and analysed thematically.ResultsA total of 1,650 teenagers completed the questionnaire (response rate 80.8%). Mean WEMWBS score was 48.8 (SD 6.8; median 49). Response scores covered the full range (from 14 to 70). WEMWBS demonstrated strong internal consistency and a high Cronbach's alpha of 0.87 (95% CI (0.85-0.88), n = 1517). Measures of construct validity gave values as predicted. The correlation coefficient for WEMWBS total score and psychological wellbeing domain of the Kidscreen-27 was 0.59 (95% CI [0.55; 0.62]); for the Mental Health Continuum Short Form (MHC-SF) was 0.65, 95% CI [0.62; 0.69]; and for the WHO (WHO-5) Well-being Index 0.57 (95% CI [0.53; 0.61]). The correlation coefficient for the Strengths and Difficulties Questionnaire (SDQ) was -0.44 (95% CI [-0.49; -0.40]) and for the 12-item General Health Questionnaire (GHQ12) -0.45 (95% CI [-0.49; -0.40]). Test-retest reliability was acceptable (Intraclass correlation coefficient (ICC) 0.66 (95% CI [0.59; 0.72] n = 212)). Confirmatory factor analysis demonstrated one underlying factor.WEMWBS was significantly associated with the Family Affluence Score (WEMWBS increased with increasing household socio-economic status) and had a positive association with the physical health dimension of the Kidscreen-27, but was unrelated to age, gender or location/school. Eighty students took part in focus groups. In general, although some students considered some items open to misunderstanding or misinterpretation, WEMWBS was received positively and was considered comprehensible, and acceptable.ConclusionsWEMWBS is a psychometrically strong population measure of mental wellbeing, and can be used for this purpose in teenagers aged 13 and over.
Highlights
Understanding and measuring mental health and wellbeing amongst teenagers has recently become a priority
Participants were predominantly white (78%), with 69% scoring 5 or higher on the Family Affluence Scale (FAS), indicating that they lived in households of middle or higher affluence
We found very little difference between age groups when correlations between Warwick-Edinburgh Mental Well-being Scale (WEMWBS) and General Health Questionnaire 12 item version (GHQ12), WHO-5, Strengths and Difficulties Questionnaire (SDQ), Mental Health Continuum Short Form (MHC-SF) and Kidscreen-27 were repeated for those aged years and younger versus those aged years and older. (Data available on request)
Summary
Understanding and measuring mental health and wellbeing amongst teenagers has recently become a priority. During the past 25 years, emotional and behavioural problems have been recognised as a major cause of ill health among adolescents in industrialised nations in addition to physical complaints [1,2,3]. Such problems are associated with an increased likelihood of poor later life outcomes such as depression [4], impaired social relationships [5] and substance misuse[6,7], as well as increased financial costs at the societal level due to criminal behaviour, extra educational support and social care [8]. Mental wellbeing has been found to be associated with higher educational attainment in childhood and adolescence, and with better occupational functioning in adulthood [1,2,3]
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