The factor structure of the twelve item General Health Questionnaire (GHQ-12): the result of negative phrasing?
The factor structure of the twelve item General Health Questionnaire (GHQ-12): the result of negative phrasing?
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DOI：
10.1186/1745-0179-4-10
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发表时间：
2008-04-24
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影响因子：
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通讯作者：
Hankins, Matthew
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作者：
Hankins, Matthew
背景：由12个条目组成的一般健康问卷(GHQ-12)通常被用作心理发病率的单一维度测量。许多因素分析研究报告说，GHQ-12有两个或三个维度，威胁到它的有效性。这些“维度”可能是GHQ-12措辞的结果，即它分为关于情绪状态的积极短语(PP)和消极短语(NP)陈述。方法：GHQ-12数据来自2004年英国健康调查队列(N=3705)。在探索性因素分析(EFA)之后，使用结构方程模型(SEM)比较了单因素模型、双因素模型和三因素模型与一维模型的拟合优度。这些假设是：(1)由于回答偏差，NP项目的回答方差将显著高于PP项目，以及(2)反应偏差的建模将提供最好的数据拟合。结果：与以往的报道一致，全民教育建议了一个双因素解决方案，将项目分为NP和PP项目。对NP项目的回答方差显著高于PP项目。考虑反应偏差的模型对所有指标的拟合效果最好(RMSEA=0.068，90%CL=0.064，0.073)。对反应频率的分析表明，反应偏向源于没有负面情绪状态的反应选项的模糊性。结论：该数据与GHQ-12是一个一维量表是一致的，负性短语的项目有很大程度的反应偏向。报告GHQ-12是多维的研究，没有考虑这种反应偏差，将人工因素结构解释为表示“真实”结构的风险，犯了具体化的方法论错误。尽管GHQ-12看起来像预期的那样是单维的，但在分析GHQ-12数据时应考虑到存在如此大的响应偏差。
BACKGROUND: The 12-item General Health Questionnaire (GHQ-12) is used routinely as a unidimensional measure of psychological morbidity. Many factor-analytic studies have reported that the GHQ-12 has two or three dimensions, threatening its validity. It is possible that these 'dimensions' are the result of the wording of the GHQ-12, namely its division into positively phrased (PP) and negatively phrased (NP) statements about mood states. Such 'method effects' introduce response bias which should be taken into account when deriving and interpreting factors.METHODS: GHQ-12 data were obtained from the 2004 cohort of the Health Survey for England (N = 3705). Following exploratory factor analysis (EFA), the goodness of fit indices of one, two and three factor models were compared with those of a unidimensional model specifying response bias on the NP items, using structural equation modelling (SEM). The hypotheses were (1) the variance of the responses would be significantly higher for NP items than for PP items because of response bias, and (2) that the modelling of response bias would provide the best fit for the data.RESULTS: Consistent with previous reports, EFA suggested a two-factor solution dividing the items into NP and PP items. The variance of responses to the NP items was substantially and significantly higher than for the PP items. The model incorporating response bias was the best fit for the data on all indices (RMSEA = 0.068, 90%CL = 0.064, 0.073). Analysis of the frequency of responses suggests that the response bias derives from the ambiguity of the response options for the absence of negative mood states.CONCLUSION: The data are consistent with the GHQ-12 being a unidimensional scale with a substantial degree of response bias for the negatively phrased items. Studies that report the GHQ-12 as multidimensional without taking this response bias into account risk interpreting the artefactual factor structure as denoting 'real' constructs, committing the methodological error of reification. Although the GHQ-12 seems unidimensional as intended, the presence of such a large response bias should be taken into account in the analysis of GHQ-12 data.