Measuring mental wellbeing in clinical and non-clinical adolescents using the COMPAS-W Wellbeing Scale

Abstract

Introduction: Adolescence is a key period of vulnerability for poor mental health as the brain is still developing and may be more sensitive to the negative impacts of stress and adversity. Unfortunately, few measures comprehensively assess wellbeing in adolescents.

Methods: The 26-item COMPAS-W Wellbeing Scale for adults was validated in a sample of 1,078 adolescents aged 13-17 years old (51.67% male, 79.13% non-clinical vs 20.87% psychiatric or developmental clinical cases). The six COMPAS-W sub-scales and total scale were examined in this sample using second-order confirmatory factor analysis, and psychometric testing.

Results: The 23-item COMPAS-W demonstrated the best fit for this sample according to goodness-of-fit indices (χ ² (220, 1078) = 1439.395, p < 0.001, CFI = 0.893, TLI = 0.877, RMSEA = 0.070, SRMR = 0.095). Internal reliability for the confirmed 23-item COMPAS-W model was run for the total scale (α = 0.912) and sub-scales (Composure, α = 0.735; Own-worth, α = 0.601; Mastery, α = 0.757; Positivity, α = 0.721; Achievement, α = 0.827; and Satisfaction, α = 0.867). Test-retest reliability over 6 weeks was also good for the total scale at r = 0.845 and the sub-scales: Composure (r = 0.754), Own-worth (r = 0.743), Mastery (r = 0.715), Positivity (r = 0.750), Achievement (r = 0.750), and Satisfaction (r = 0.812). Compared with non-clinical participants' wellbeing (M = 90.375, SE = 0.400), those with clinical diagnoses reported lower wellbeing, both for those with developmental diagnoses (M = 85.088, SE = 1.188), or psychiatric diagnoses (M = 78.189, SE = 1.758), or combined developmental and psychiatric diagnoses (M = 77.079, SE = 2.116). Yet, when wellbeing category scores were considered by diagnosis group, both non-clinical and clinical groups demonstrated incidence across all three categories of languishing, moderate and flourishing wellbeing, in support of the dual-continua model of mental health. On average, younger adolescents' (13-14 years) wellbeing did not differ from older adolescents' (15-17 years) wellbeing; however, for sex, males scored 1.731 points significantly higher in wellbeing compared with females (p = 0.028); and American participants scored 3.042 points significantly higher in wellbeing compared with Australian participants (p < 0.001).

Discussion: In conclusion, the 23-item COMPAS-W is a reliable measure of wellbeing for adolescents, both for those with and without developmental and psychiatric diagnoses.

Keywords: adolescence; developmental disorders; mental health; psychiatric disorders; psychometric testing; reliability; validity; well-being.

Figure 1

COMPAS-W Final Model (Model 4) derived from Second-Order Confirmatory Factor Analysis. Items 10, 14 and 26 (in red) were removed from the total scale for optimal fit in this adolescent sample. Items removed from the sub-scales are indicated by the dotted red lines. See Table 2 for model estimates.

Figure 2

COMPAS-W wellbeing scores by sex. Boxplots of COMPAS-W (23 items) scores by sex showing means (large centre dots), medians (mid-lines), interquartile ranges, minimum and maximum values; overlayed with corresponding distribution of group values. On average, compared to females, males scored significantly higher in wellbeing.

Figure 3

COMPAS-W wellbeing scores by country. Boxplots of COMPAS-W (23 items) scores by country showing means (large centre dots), medians (mid-lines), interquartile ranges, minimum and maximum values; overlayed with corresponding distribution of group values. On average, compared to Australians, Americans scored significantly higher in wellbeing.

Figure 4

COMPAS-W wellbeing scores by diagnosis group. Boxplots of COMPAS-W (23 items) scores by diagnosis group, showing means (large centre dots), medians (mid-lines), interquartile ranges, minimum and maximum values; overlayed with corresponding distribution of group values. The means of the developmental diagnosis group, psychiatric diagnosis group, and both developmental and psychiatric diagnoses group all differed significantly to the mean of the no diagnoses (non-clinical) group.

Figure 5

Histogram of COMPAS-W (23 items) scores by diagnosis group. No Diagnoses (non-clinical) = no developmental or psychiatric diagnoses reported; Developmental Diagnoses = at least one developmental diagnosis reported; Psychiatric Diagnoses = at least one psychiatric diagnosis reported; and Both Diagnoses = at least one developmental and one psychiatric diagnosis reported.