Multidimensional item response theory to assess psychometric properties of GHQ-12 in parents of school children
Abstract
Background: The multidimensional item response theory (MIRT) model provides an ideal foundation for assessing the psychological properties of a questionnaire designed with multidimensional structure. This study aimed to present the first use of MIRT models to investigate the psychometric properties of general health questionnaire (GHQ-12) in parents of school-aged children.
Methods: A total of 1104 parents of school children-aged completed the Persian version of GHQ-12 questionnaire. The unidimensional IRT model and MIRT models with two and three factors were applied to model the observed scores for each GHQ-12 item as a function of the subject’s latent traits while taking the correlation among dimensions of the questionnaire into account. Goodness of fit indices were reported for the three models, and the fits of items were assessed for the best model. Individual items were described in detail through item characteristic curves, and the amount of information carried by different items was presented using information curves.
Results: The MIRT analysis with three factors corresponding with anxiety depression, social dysfunction and loss of confidence provided the best account of the GHQ-12 data. The model showed that all items were fitted adequately. Items varied in their discrimination ranged from 0.94 to 2.13, 1.31 to 2.74, and 2.87 to 3.57 for social dysfunction, anxiety depression, and loss of confidence, respectively. Moreover, items 8 and 2 provided the least information in social dysfunction and anxiety depression dimensions, respectively. Items in the loss of confidence dimension carried the most information among all items of the GHQ-12.
Conclusions: The developed framework for evaluating the psychometric properties of GHQ-12 can be a suitable alternative to traditional approaches as well as unidimensional IRT models, the use of which has been restricted due to the multidimensional structure of the questionnaire.
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2. Goldberg DP, Hillier VF. A scaled version of the General Health Questionnaire. Psychological Medicine. 2009;9(1):139-45. Epub 07/09.
3. Romppel M, Braehler E, Roth M, Glaesmer H. What is the General Health Questionnaire-12 assessing?: Dimensionality
and psychometric properties of the General Health Questionnaire-12 in a large scale German population sample. Comprehensive Psychiatry. 2013 2013/05/01/;54(4):406-13.
4. Salama-Younes M, Montazeri A, Ismaïl A, Roncin C. Factor structure and internal consistency of the 12-item General HealthدQuestionnaire (GHQ-12) and the Subjective Vitality Scale (VS), and the relationship between them: a study from France. Health Qual Life Outcomes [Internet]. 2009 2009; 7:[22 p.]. Available from: http://europepmc.
org/abstract/MED/19265516 http://www.biomedcentral.com/1477- 7525/7/22/abstract http://www.biomedcentral.com/content/ pdf/1477-7525-7-22.pdf http://www.biomedcentral.com/1477-
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5. Rahmati Najarkolaei F, Raiisi F, Rahnama P, Gholami Fesharaki M, Zamani O, Jafari MR, et al. Factor structure of the Iranian version of 12-item general health questionnaire. Iran Red Crescent Med J. 2014;16(9):e11794-e. PubMed PMID: 25593708. eng.
6. Liang Y, Wang L, Yin X. The factor structure of the 12-item general health questionnaire (GHQ-12) in young Chinese
civil servants. Health Qual Life Outcomes. 2016;14(1):136-. PubMed PMID: 27669741.eng.
7. Politi PL, Piccinelli M, Wilkinson G.Reliability, validity and factor structure of the 12-item General Health Questionnaire
among young males in Italy. Acta Psychiatrica Scandinavica. 1994 1994/12/01;90(6):432-7.
8. Daradkeh TK, Ghubash R, el-Rufaie OE. Reliability, validity, and factor structure of the Arabic version of the 12-item General Health Questionnaire. Psychol Rep. 2001 2001/08//;89(1):85-94. PubMed PMID:11729557. eng.
9. Quek KF, Low WY, Razack AH, Loh CS. Reliability and validity of the General Health Questionnaire (GHQ-12) among urological patients: a Malaysian study. Psychiatry Clin Neurosci. 2001 2001/10//;55(5):509-13. PubMed PMID: 11555347. eng.
10. Kilic C, Rezaki M, Rezaki B, Kaplan I, Ozgen G, Sağduyu A, et al. General Health Questionnaire (GHQ12 & GHQ28):
psychometric properties and factor structure of the scales in a Turkish primary care sample. Soc Psychiatry Psychiatr Epidemiol. 1997 1997/08//;32(6):327-31. PubMed PMID:9299926. eng.
11. Chan DW. The Chinese General Health Questionnaire in a psychiatric setting: the development of the Chinese scaled version. Soc Psychiatry Psychiatr Epidemiol. 1993 1993/07//;28(3):124-9. PubMed PMID:8378807. eng.
12. Sánchez-López MdP, Dresch V. The 12- Item General Health Questionnaire (GHQ-12): reliability, external validity and factor structure in the Spanish population. Psicothema. 2008 2008/11//;20(4):839-43. PubMed PMID:18940092. eng.
13. Montazeri A, Harirchi AM, Shariati M, Garmaroudi G, Ebadi M, Fateh A. The 12-item General Health Questionnaire (GHQ- 12): translation and validation study of the Iranian version. Health Qual Life Outcomes. 2003;1:66-. PubMed PMID: 14614778. eng.
14. Namjoo S, Shaghaghi A, Sarbaksh P, Allahverdipour H, Pakpour AH. Psychometric properties of the General Health Questionnaire (GHQ-12) to be applied for the Iranian elder population. Aging & Mental Health. 2017 2017/10/03;21(10):1047-51.
15. Fernandes HM, Vasconcelos-Raposo J. Factorial validity and invariance of the GHQ-12 among clinical and nonclinical samples. Assessment. 2013 2013/04//;20(2):219-29. PubMed PMID: 23118267. eng.
16. Hahn D, Reuter K, Härter M. Screening for affective and anxiety disorders in medical patients - comparison of HADS, GHQ-12 and Brief-PHQ. Psychosoc Med [Internet]. 20062006; 3:[Doc09 p.]. Available from: http://
europepmc.org/abstract/MED/19742274https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/19742274/?tool=EBI
https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/19742274/pdf/?tool=EBIhttps://europepmc.org/articles/PMC2736509
h t t p s : / / e u r o p e pmc . o r g / a r t i c l e s /PMC2736509?pdf=render.
17. Vanheule S, Bogaerts S. The factorial structure of the GHQ‐12. Stress and Health: Journal of the International Society for theInvestigation of Stress. 2005;21(4):217-22.
18. Toyabe S-i, Shioiri T, Kobayashi K,Kuwabara H, Koizumi M, Endo T, et al. Factor structure of the General Health Questionnaire (GHQ-12) in subjects who had suffered from the 2004 Niigata-Chuetsu Earthquake in Japan:
a community-based study. BMC Public Health. 2007;7(1):175.
19. Schmitz N, Kruse J, Tress W. Improving screening for mental disorders in the primary care setting by combining the GHQ-12 and SCL-90-R subscales. Comprehensive psychiatry. 2001 2001 Mar-Apr;42(2):166-73. PubMed PMID: 11244154. eng.
20. Picardi A, Abeni D, Pasquini P. Assessing psychological distress in patients with skin diseases: reliability, validity and
factor structure of the GHQ-12. J Eur Acad Dermatol Venereol. 2001 2001/09//;15(5):410- 7. PubMed PMID: 11763380. eng.
21. Kalliath TJ, O'Driscoll MP, Brough P. A confirmatory factor analysis of the General Health Questionnaire-12. Stress and Health. 2004 2004/02/01;20(1):11-20.
22. Gureje O. Reliability and the factor structure of the Yoruba version of the 12-item General Health Questionnaire. Acta Psychiatrica Scandinavica. 1991 1991/08/01;84(2):125-9.
23. Campbell A, Walker J, Farrell G. Confirmatory factor analysis of the GHQ-12: can I see that again? Aust N Z J Psychiatry. 2003 2003/08//;37(4):475-83. PubMed PMID: 12873334. eng.
24. French DJ, Tait RJ. Measurement invariance in the General Health Questionnaire-12 in young Australianadolescents. Eur Child Adolesc Psychiatry.2004 2004/02//;13(1):1-7. PubMed PMID:14991426. eng.
25. Shevlin M, Adamson G. Alternative factor models and factorial invariance of the GHQ-12: a large sample analysis using confirmatory factor analysis. Psychol Assess. 2005 2005/06//;17(2):231-6. PubMed PMID: 16029110. eng.
26. Graetz B. Multidimensional propertiesof the General Health Questionnaire. Soc Psychiatry Psychiatr Epidemiol. 1991
1991/05//;26(3):132-8. PubMed PMID: 1887291. eng.
27. Goetz C, Ecosse E, Rat A-C, Pouchot J, Coste J, Guillemin F. Measurement properties of the osteoarthritis of knee and hip quality of life OAKHQOL questionnaire: an item response theory analysis. Rheumatology(Oxford). 2011 2011/03//;50(3):500-5. PubMed PMID: 21071480. eng.
28. Depaoli S, Tiemensma J, Felt JM. Assessment of health surveys: fitting a multidimensional graded response model.
Psychology, Health & Medicine. 2018 2018/12/14;23(sup1):1299-317.
29. Haem E, Doostfatemeh M, Firouzabadi N, Ghazanfari N, Karlsson MO. A longitudinal item response model for Aberrant Behavior Checklist (ABC) data from children with autism. J Pharmacokinet Pharmacodyn. 2020
2020/04//. PubMed PMID: 32285302. eng.
30. Doostfatemeh M, Taghi Ayatollah SM, Jafari P, Jafari P. Power and Sample Size Calculations in Clinical Trials with Patient Reported Outcomes under Equal and Unequal Group Sizes Based on Graded Response
Model: A Simulation Study. Value Health. 2016 2016 Jul-Aug;19(5):639-47. PubMed PMID: 27565281. eng.
31. Smith AB, Fallowfield LJ, Fallowfield LJ, Stark DP, Velikova G, Jenkins V. A Rasch and confirmatory factor analysis of the general health questionnaire (GHQ)--12. Health Qual Life Outcomes [Internet]. 2010 2010/04//; 8:[45 p.]. Available from: http://europepmc. org/abstract/MED/20433690 https://www.ncbi.nlm.nih.gov/pmc/articles/ pmid/20433690/?tool=EBI
https://www.ncbi.nlm.nih.gov/pmc/articles/ pmid/20433690/pdf/?tool=EBI http://www.biomedcentral.com/content/
pdf/1477-7525-8-45.pdf http://www.biomedcentral.com/1477-7525/8/45http://www.biomedcentral.com/1477-
7525/8/45/abstracthttps://doi.org/10.1186/1477-7525-8-45https://europepmc.org/articles/PMC2873594
h t t p s : / / e u r o p e pmc . o r g / a r t i c l e s / PMC2873594?pdf=render.
32. Doyle F, Watson R, Morgan K, McBride O. A hierarchy of distress and invariant item ordering in the General Health
Questionnaire-12. Journal of Affective Disorders. 2012 2012/06/01/;139(1):85-8.
33. Mayhew E, Stuttard L, Beresford B.An Assessment of the Psychometric Properties of the GHQ-12 in an English Population of Autistic Adults Without Learning Difficulties. J Autism Dev Disord. 2020 2020/07//. PubMed
PMID: 32653976. eng.
34. Alexandrowicz RW, Friedrich F, Jahn R, Soulier N. Using Rasch-models to compare the 30-, 20-, and 12-items version of the general health questionnaire taking four recoding schemes into account. Neuropsychiatr. 2015
2015;29(4):179-91. PubMed PMID: 26512001. eng.
35. Stochl J, Böhnke JR, Pickett KE, Croudace TJ. An evaluation of computerized adaptive testing for general
psychological distress: combining GHQ- 12 and Affectometer-2 in an item bank for public mental health research. BMC Med Res Methodol [Internet]. 2016 2016/05//; 16:[58 p.]. Available from: http://europepmc.org/abstract/MED/27206714
https://doi.org/10.1186/s12874-016-0158-7 https://europepmc.org/articles/PMC4875708 h t t p s : / / e u r o p e pmc . o r g / a r t i c l e s / PMC4875708?pdf=render.
36. Böhnke JR, Croudace TJ. Calibrating well-being, quality of life and common mental disorder items: psychometric epidemiology in public mental health research. Br J Psychiatry. 2016 2016/08//;209(2):162-8. PubMed PMID:
26635327. eng.
37. Doostfatemeh M, Ayatollahi SMT, Jafari P, Jafari P. Testing parent dyad interchangeability in the parent proxy-report of PedsQL™ 4.0: a differential item functioning analysis. Qual LifeRes. 2015 2015/08//;24(8):1939-47. PubMed
PMID: 25645741. eng.
38. Christine E, Morse R. Can Parents Rate Their Child's Health-Related Quality of Life? Results of a Systematic Review. Quality of Life Research. 2001;10(4):347-57.
39. Varni JW, Limbers CA, Burwinkle TM.Parent proxy-report of their children's healthrelated quality of life: an analysis of 13,878 parents' reliability and validity across age subgroups using the PedsQL 4.0 Generic Core Scales. Health Qual Life Outcomes. 2007;5:2-. PubMed PMID: 17201923. eng.
40. te Marvelde JM, Glas CA, Van Landeghem G, Van Damme J. Application of multidimensional item response theory
models to longitudinal data. Educational and Psychological Measurement. 2006;66(1):5-34.
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| Files | ||
| Issue | Vol 8 No 1 (2022) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/jbe.v8i1.10405 | |
| Keywords | ||
| Multidimensional item response theory general health questionnaire psychometrics properties psychological distress | ||
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How to Cite
1.
Haem E, Doostfatemeh M. Multidimensional item response theory to assess psychometric properties of GHQ-12 in parents of school children. JBE. 2022;8(1):45-60.
