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The factor structure of the GHQ-12: the interaction between item phrasing, variance and levels of distress

Quality of Life Research volume 22, pages 145–152 (2013)Cite this article

Abstract

Purpose

The general health questionnaire-12 (GHQ-12) is a self-report instrument for measuring psychological morbidity. Previous work has suggested several multidimensional models for this instrument, although it has recently been proposed that these may be an artefact resulting from a response bias to negatively phrased items. The aim here was to explore the dimensionality of the GHQ-12.

Methods

Cluster analysis, exploratory factor analysis and confirmatory factor analysis were applied to waves of data from the English longitudinal study of ageing (ELSA Waves 1 and 3), in order to evaluate fit and factorial invariance over time of the GHQ-12.

Results

Two categories of respondents were identified: high and low scorers. Item variances were higher across all items for high scorers and higher for negatively phrased items (for both high and low scorers). The unidimensional model accounting for variance observed with negative phrasing (Hankins in Clin Pract Epidemiol Ment Health 4:10, 2008) was identified as having the best model fit across the two time points.

Conclusions

Item phrasing, item variance and levels of respondents’ distress affect the factor structure observed for the GHQ-12 and may perhaps explain why different factor structures of the instrument have been found in different populations.

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Abbreviations

GHQ-12:

General health questionnaire-12

ELSA:

English longitudinal study of ageing

BIC:

Bayesian information criterion

EFA:

Exploratory factor analysis

PCA:

Principal components analysis

CFA:

Confirmatory factor analysis

RMSEA:

Root-mean-square error of approximation

ECVI:

Expected cross-validation index

ANOVA:

Analysis of variance

ANCOVA:

Analysis of covariance

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Author information

Affiliations

  1. York Health Economics Consortium, University of York, York, UK

    Adam B. Smith

  2. Leeds Institute of Health Sciences, University of Leeds, Leeds, UK

    Yemi Oluboyede, Robert West, Jenny Hewison & Allan O. House

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  1. Adam B. Smith
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  2. Yemi Oluboyede
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  4. Jenny Hewison
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Correspondence to Adam B. Smith.

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Smith, A.B., Oluboyede, Y., West, R. et al. The factor structure of the GHQ-12: the interaction between item phrasing, variance and levels of distress. Qual Life Res 22, 145–152 (2013). https://doi.org/10.1007/s11136-012-0133-7

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  • DOI: https://doi.org/10.1007/s11136-012-0133-7

Keywords

  • GHQ-12
  • Factor structure
  • Factorial invariance
  • Cluster analysis
  • Confirmatory factor analysis
  • Community sample
  • Elderly population
  • ELSA