Psychometric evaluation of the factor structure of the General Health Questionnaire-12 in a sample of Chinese...

The 12-item General Health Questionnaire (GHQ-12) is widely used for assessing psychological distress, yet debates persist regarding its optimal factor structure, especially across different cultural contexts and demographic groups. While the bi-factor model has gained empirical support in Western populations, limited research has examined its validity in Chinese university students. This study aimed to evaluate the psychometric properties of the GHQ-12 in Chinese university students by examining its factor structure through Classical Test Theory.

A cross-sectional study was conducted with a sample of Chinese university students (n = 511). The dataset was randomly split into two samples, sample 1 (n = 260) and sample 2 (n = 251) for EFA and CFA, respectively. The study evaluated the construct validity of the GHQ-12 one-factor, two-factor, three-factor, and bi-factor models using CFA.

EFA revealed a two-factor structure with strong fit. CFA results demonstrated that the bi-factor model showed the best overall numerical fit, whereas the two-factor model was retained as the preferred solution because it demonstrated strong and balanced factor loadings, conceptual interpretability, and greater parsimony (χ ² = 83.3, df = 53; CFI = 0.989; TLI = 0.986; RMSEA = 0.048; SRMR = 0.063). Internal consistency was excellent (α = 0.838, ω = 0.842), and convergent validity was moderate with WHO-5 (r = -0.339) and SWEMWBS (r = -0.475).

The GHQ-12 demonstrates acceptable psychometric properties in Chinese university students. The two-factor model was retained as the preferred solution based on interpretability and parsimony, although the bi-factor model showed superior global fit indices. These findings support the use of the GHQ-12 for mental health screening and future psychometric research in Chinese youth populations.