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Updated: Sep 17, 2025

A Modified Trier Social Stress Test for Vulnerable Mexican American Adolescents
Published on: July 10, 2017
Cross-cultural adaptation and validation of the GHQ-28 suicidal ideation index in Spain and Mexico
Lucía Fernández-Alba1, Cristina Rea-Rodríguez1, José Antonio Llosa2
1Faculty Padre Ossó, University of Oviedo, Oviedo, Spain.
Background:
Suicide is one of the leading causes of death globally and its early detection is key to prevention. The aim of this study was to adapt and validate the Suicidal Ideation Index of the GHQ-28 questionnaire in the general population in Spain and Mexico, evaluating its validity and psychometric reliability, as well as its usefulness for cross-cultural studies.
Results:
The research was developed with a total sample of 6377 people; 5573 in Spain and 804 in Mexico. The statistical analysis was divided into two studies: one to validate the index within each country and the other to assess its factorial invariance across countries. Factor analyses confirmed a unidimensional structure of the index, composed of four items related to suicidal thoughts. High levels of reliability were obtained and the invariance of the instrument by gender, psychotropic drug use and country was demonstrated, allowing its comparative use in cross-cultural research.
Conclusions:
Despite the frequent use of the GHQ-28 in mental health, there was no formal validation of its specific index for suicidal ideation in Spanish-speaking contexts. This study offers the first formal validation of the Suicidal Ideation Index of the GHQ-28 in Spanish-speaking populations. The index showed a unidimensional structure, high reliability, and measurement invariance across gender, psychotropic drug use, and country. These results support its use as a reliable tool for detecting suicidal ideation and for cross-cultural research in mental health.
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