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Confirmatory factor analysis of the General Health Questionnaire (GHQ-12) in Spanish adolescents

Abstract

Purpose

To evaluate the factor structure of the 12-item General Health Questionnaire (GHQ-12) in a population of Spanish adolescents.

Methods

Cross-sectional study among 4,146 individuals (mean age 16.3 years). The students completed a health questionnaire that included the GHQ-12. A confirmatory factor analysis (CFA) was conducted with four factor structure models. Three of the models were theory-driven: unidimensional, two-dimensional (positive and negative questions), model proposed by Graetz (anxiety and depression, social dysfunction, loss of confidence); and the fourth model was based on our exploratory factor analysis (EFA).

Results

The Cronbach’s alpha for internal consistency was 0.82. A three-dimensional structure was identified in the EFA. The first factor included items 1, 2, 5, 6, 7, and 9 of the GHQ-12; the second, items 3, 10, and 11; and the third, items 4, 8, and 12. The three factors together explained 53.7% of the variance. The model with the best fit in the CFA was the three-dimensional model proposed by Graetz, followed by the three-dimensional model derived from the EFA. These two models had acceptable goodness-of-fit indices.

Conclusions

In an adolescent population from Southern Europe, the GHQ-12 showed high internal consistency. The factor structure that best fitted the data was the Graetz three-dimensional model. However, the high correlations observed between factors suggest that the GHQ-12 should be used as a unidimensional scale, as currently done.

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Fig. 1

Abbreviations

GHQ:

General Health Questionnaire

CFA:

Confirmatory Factor Analysis

EFA:

Exploratory Factor Analysis

RMSEA:

Root Mean Square Error of Approximation

CFI:

Comparative Fit Index

GFI:

Goodness-of-Fit Index

ECVI:

Expected Cross-Validation Index

AIC:

Akaike Information Criterion

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Acknowledgments

This work was funded by the Madrid Regional Authority for Health, Spain. We thank the interviewers and respondents as well as Miguel de la Fuente for the fieldwork support.

Conflict of interest

None.

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Correspondence to Iñaki Galán.

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Padrón, A., Galán, I., Durbán, M. et al. Confirmatory factor analysis of the General Health Questionnaire (GHQ-12) in Spanish adolescents. Qual Life Res 21, 1291–1298 (2012). https://doi.org/10.1007/s11136-011-0038-x

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Keywords

  • Mental health
  • Confirmatory factor analysis
  • Adolescents
  • Health survey
  • Spain