The structure of the General Health Questionnaire (GHQ-12): two meta-analytic factor analyses.
The General Health Questionnaire (GHQ-12) is a popular measure of psychological distress. Despite its widespread use, an ongoing controversy pertains to its internal structure. Although the GHQ-12 was originally constructed to capture a unitary construct, empirical studies identified different factor structures. Therefore, this study examined the dimensionality of the GHQ-12 in two independent meta-analyses. The first meta-analysis used summary data published in 38 primary studies (total N = 76,473). Meta-analytic exploratory factor analyses identified two factors formed by negatively and positively worded items. The second meta-analysis included individual responses of 410,640 participants from 84 independent samples. Meta-analytic confirmatory factor analyses corroborated the two-dimensional structure of the GHQ-12. However, bifactor modelling showed that most of the variance was explained by a general factor. Therefore, subscale scores reflected rather limited unique variance. Overall, the two meta-analyses demonstrated that the GHQ-12 is essentially unidimensional. It is not recommended to use and interpret subscale scores because they primarily reflect general mental health rather than distinct constructs.
['Gnambs|Timo|T|0000-0002-6984-1276', 'Staufenbiel|Thomas|T|']
D000328:Adult D005163:Factor Analysis, Statistical D005260:Female D006306:Health Surveys D006801:Humans D008297:Male D011594:Psychometrics D012680:Sensitivity and Specificity D013315:Stress, Psychological
distress meta-analysis Mental health factor analysis wording effects