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

BMJ Open. 2019 Nov 28;9(11):e031859. doi: 10.1136/bmjopen-2019-031859.

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.

Publication types

  • Comparative Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Female
  • Health Status*
  • Humans
  • Language*
  • Male
  • Middle Aged
  • Occupational Health
  • Spain
  • Surveys and Questionnaires*
  • Young Adult