Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2019 Nov 28;9(11):e031859.
doi: 10.1136/bmjopen-2019-031859.

Method effects associated with negatively and positively worded items on the 12-item General Health Questionnaire (GHQ-12): results from a cross-sectional survey with a representative sample of Catalonian workers

Maria F Rodrigo  1 , J Gabriel Molina  1 , Josep-Maria Losilla  2 , Jaume Vives  3 , José M Tomás  1
Affiliations
Observational Study

Method effects associated with negatively and positively worded items on the 12-item General Health Questionnaire (GHQ-12): results from a cross-sectional survey with a representative sample of Catalonian workers

Maria F Rodrigo et al. BMJ Open. .

Abstract

Objective: Recent studies into the factorial structure of the 12-item version of the General Health Questionnaire (GHQ-12) have shown that it was best represented by a single substantive factor when method effects associated with negatively worded (NW) items are considered. The purpose of the present study was to examine the presence of method effects, and their relationships with demographic covariates, associated with positively worded (PW) and/or NW items.

Design: A cross-sectional, observational study to compare a comprehensive set of confirmatory factor models, including method effects associated with PW and/or NW items with GHQ-12 responses.

Setting: Representative sample of all employees living in Catalonia (Spain).

Participants: 3050 participants (44.6% women) who responded the Second Catalonian Survey of Working Conditions.

Results: A confirmatory factor analysis showed that the best fitting model was a unidimensional model with two additional uncorrelated method factors associated with PW and NW items. Furthermore, structural equation modelling (SEM) revealed that method effects were differentially related to both the sex and age of the respondents.

Conclusion: Individual differences related to sex and age can help to identify respondents who are prone to answering PW and NW items differently. Consequently, it is desirable that both the constructs of interest as well as the effects of method factors are considered in SEM models as a means of avoiding the drawing of inaccurate conclusions about the relationships between the substantive factors.

Keywords: General Health Questionnaire (GHQ–12); confirmatory factor analysis; item wording effects; method effects; psychological health.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Competing models tested for the 12-item General Health Questionnaire. Underlined numbers identify negatively worded items. GPH: General Psychological Health; NW: method factor associated with negatively worded items; PW: method factor associated with positively worded items.
Figure 2
Figure 2
Bar charts of the response distributions for the 12-item General Health Questionnaire. Responses were given on a different four-point response scale for the positively worded items (0=better than usual, 1=same as usual, 2=less than usual, 3=much less than usual) and for the negatively worded items (0=not at all, 1=no more than usual, 2=more than usual, 3=much more than usual).
See this image and copyright information in PMC

References

    1. Goldberg DP. The detection of psychiatric illness by questionnaire. London: Oxford University Press, 1972.
    1. Goldberg DP, Williams P. A user’s guide to the General Health Questionnaire. Windsor, United Kingdom: NFER-Nelson, 1988.
    1. Bhui K, Bhugra D, Goldberg D. Cross-cultural validity of the Amritsar depression inventory and the general health questionnaire amongst English and Punjabi primary care attenders. Soc Psychiatry Psychiatr Epidemiol 2000;35:248–54. 10.1007/s001270050235 - DOI - PubMed
    1. 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;89:85–94. 10.2466/PR0.89.5.85-94 - DOI - PubMed
    1. Gelaye B, Tadesse MG, Lohsoonthorn V, et al. Psychometric properties and factor structure of the general health questionnaire as a screening tool for anxiety and depressive symptoms in a multi-national study of young adults. J Affect Disord 2015;187:197–202. 10.1016/j.jad.2015.08.045 - DOI - PMC - PubMed

Publication types

LinkOut - more resources