Validation of the General Health Questionnaire in a young community sample

Area of Science:

• Psychometrics
• Adolescent Mental Health Assessment
• Screening Tools Validation

Background:

• The General Health Questionnaire (GHQ) is a widely used screening tool for detecting psychological distress.
• Assessing the validity of different GHQ versions in adolescent populations is crucial for accurate mental health screening.
• Previous validation studies have primarily focused on adult populations.

Purpose of the Study:

• To evaluate the validity of the 30-item, 28-item, and 12-item General Health Questionnaire (GHQ) versions.
• To compare the diagnostic accuracy (sensitivity and specificity) of different GHQ versions against the Present State Examination (PSE) in adolescents.
• To determine optimal cutting scores for each GHQ version in a 17-year-old sample.

Main Methods:

• A sample of 200 17-year-olds was assessed using the 30-item, 28-item, and 12-item GHQ versions.
• The Present State Examination (PSE) was used as the gold standard for case classification.
• Validity coefficients, misclassification rates, sensitivity, and specificity were calculated for various cutting scores.

Main Results:

• The Present State Examination (PSE) identified 3.5% of the sample as cases, with 47% classified as symptom-free.
• The GHQ-28 demonstrated superior validity, particularly with a cutting score of 5/6.
• The GHQ-12 also showed acceptable validity with a cutting score of 2/3.
• All GHQ versions exhibited high correlations with the PSE Index of Definition and total scores, supporting their use as continuous variables.
• Sub-scale analysis of the GHQ-28 indicated a general factor and relative independence of the social dysfunction sub-scale.

Conclusions:

• The GHQ-28 and GHQ-12 are valid instruments for screening psychological distress in 17-year-olds.
• Specific cutting scores (5/6 for GHQ-28, 2/3 for GHQ-12) are recommended for optimal performance.
• GHQ scores can be reliably treated as continuous variables in this population, reflecting a general psychological distress factor.