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Fung HW, Lam SKK, Chien WT, Ling HWH, Wu ZY, Ross CA, Chau AKC. Reliability and Mental Health Correlates of a Single-Item Measure of Self-Rated Mental Health (SRMH) in the Chinese Context. Healthcare (Basel) 2024; 12:122. [PMID: 38201026 PMCID: PMC10778785 DOI: 10.3390/healthcare12010122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/13/2023] [Accepted: 01/03/2024] [Indexed: 01/12/2024] Open
Abstract
The use of single-item measures of self-rated mental health (SRMH) has been increasingly valued in epidemiologic research. However, little is known about the reliability and mental health correlates of SRMH in Chinese populations. This study examined the reliability and mental health correlates of SRMH in three Chinese samples. We analyzed data collected from two convenience samples of Chinese adults from Hong Kong and/or Taiwan (Sample 1: N = 205; Sample 2: N = 377), and a random sample of Taiwan psychiatric inpatients (Sample 3: N = 100). Our results showed that the single-item measure of SRMH had moderate to good test-retest reliability (intraclass correlation [ICC] = 0.75) in Sample 1 and acceptable reliability between the self-report and interviewer-administered versions (ICC = 0.58) in Sample 3. It had a high positive correlation with self-esteem and a moderately high negative correlation with depression. It also had a consistently negative correlation with borderline personality disorder symptoms and post-traumatic stress disorder symptoms. The SRMH score was also associated with psychiatric service usage. These findings contribute to the body of knowledge regarding the use of a single-item measure of SRMH to assess overall self-perceived mental health in Chinese communities.
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Affiliation(s)
- Hong Wang Fung
- Department of Social Work, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, China
| | - Stanley Kam Ki Lam
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; (S.K.K.L.); (W.T.C.)
| | - Wai Tong Chien
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; (S.K.K.L.); (W.T.C.)
| | - Henry Wai-Hang Ling
- The Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China;
| | - Zi Yi Wu
- Yuli Hospital Ministry of Health and Welfare, Hualien 981, Taiwan;
| | - Colin A. Ross
- The Colin A. Ross Institute for Psychological Trauma, Richardson, TX 75080, USA;
| | - Anson Kai Chun Chau
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong SAR, China;
- Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong SAR, China
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Hanzlová R, Lynn P. Item response theory-based psychometric analysis of the Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS) among adolescents in the UK. Health Qual Life Outcomes 2023; 21:108. [PMID: 37773069 PMCID: PMC10540427 DOI: 10.1186/s12955-023-02192-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 09/19/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND Middle and late adolescence is the period in a person's life that is most vulnerable to mental health problems. To enable an evidence base that can support policies to prevent such problems, it is crucial to have good quality, reliable, and accurate measurement tools for mental well-being. One of them is the Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS). This study aimed to test the psychometric properties of the SWEMWBS on a large sample of adolescents aged 16 to 19 from the United Kingdom (UK) (N = 8,090). Data were from four waves of the longitudinal panel study Understanding Society. METHODS The analysis was conducted using Item Response Theory (IRT), which is the most appropriate method for testing psychometric properties. The Graded Response Model (GRM) was applied to the data. The reliability and criterion validity of the SWEMWBS were also examined. RESULTS The presented results confirm the very good psychometric properties of the SWEMWBS amongst adolescents aged 16 to 19 years. The assumptions for the use (unidimensionality, local non-independence, monotonicity) of IRT were met. The results of GRM showed very high discriminant power for all items. The five-category response scale performed optimally; however, differences were found between points on the response scale both between and within items. In general, the scale as a whole showed very good functioning, but particularly in the negative values of mental well-being. CONCLUSIONS The SWEMWBS was confirmed as a concise, reliable, and valid instrument for measuring mental well-being among older UK adolescents.
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Affiliation(s)
- Radka Hanzlová
- Institute of Sociology of the Czech Academy of Sciences, Prague, Czech Republic.
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Tsai CJ. Moving Away From Counting the Numbers: Leveraging a Sensible Clinical Trial Design for Oligometastatic Disease and Beyond. Int J Radiat Oncol Biol Phys 2022; 114:846-848. [DOI: 10.1016/j.ijrobp.2022.09.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 09/09/2022] [Accepted: 09/09/2022] [Indexed: 11/16/2022]
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Sun YH, Luo H, Lee K. A Novel Approach for Developing Efficient and Convenient Short Assessments to Approximate a Long Assessment. Behav Res Methods 2022; 54:2802-2828. [PMID: 35102519 PMCID: PMC9729327 DOI: 10.3758/s13428-021-01771-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2021] [Indexed: 12/16/2022]
Abstract
This paper describes a novel Long to Short approach that uses machine learning to develop efficient and convenient short assessments to approximate a long assessment. This approach is applicable to any assessments used to assess people's behaviors, opinions, attitudes, mental and physical states, traits, aptitudes, abilities, and mastery of a subject matter. We demonstrated the Long to Short approach on the Depression Anxiety Stress Scale (DASS-42) for assessing anxiety levels in adults. We first obtained data for the original assessment from a large sample of participants. We then derived the total scores from participants' responses to all items of the long assessment as the ground truths. Next, we used feature selection techniques to select participants' responses to a subset of items of the long assessment to predict the ground truths accurately. We then trained machine learning models that uses the minimal number of items needed to achieve the prediction accuracy similar to that when the responses to all items of the whole long assessment are used. We generated all possible combinations of minimal number of items to create multiple short assessments of similar predictive accuracies for use if the short assessment is to be done repeatedly. Finally, we implemented the short anxiety assessments in a web application for convenient use with any future participant of the assessment.
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Affiliation(s)
- Yuan Hong Sun
- Hangzhou Normal University Affiliated Hospital, Zhejiang, Hangzhou China
- Faculty of Applied Science & Engineering, University of Toronto, Toronto, ON Canada
| | - Hong Luo
- Hangzhou Normal University Affiliated Hospital, Zhejiang, Hangzhou China
| | - Kang Lee
- Institute of Child Study, University of Toronto, Toronto, ON Canada
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Lasater ME, Beebe M, Warren NE, Winch PJ, Soucko F, Keita M, Doumbia S, Murray SM. Reliability and validity of a perinatal depression screening instrument in rural Mali. SSM - MENTAL HEALTH 2022; 2:100059. [PMID: 36644110 PMCID: PMC9835090 DOI: 10.1016/j.ssmmh.2021.100059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Background In order to reduce the burden of perinatal depression in low- and middle-income countries, health systems must be able to identify and treat women suffering from depression. The objective of our study was to develop a locally valid and reliable screening instrument for use in identifying pregnant women and mothers of young children with a local depression syndrome, dusukasi, in rural Mali. Methods We administered a locally adapted screening instrument containing items from the Edinburgh Postpartum Depression Scale (EPDS) and Hopkins Symptom Checklist (HSCL-25) to 180 pregnant women and mothers of children under age 2 in Sélingué, Mali to assess the instrument's psychometric properties and validity. Item Response Theory was used to develop an abbreviated version of the measure and the validity and psychometric properties of this shortened version were compared with the full-length scale. Results The full 28-item scale exhibited a single factor structure with good internal consistency (Cronbach's alpha = 0.92). Women who self-identified as suffering from dusukasi (n = 87) in a known groups analysis to assess construct validity had significantly higher depression and anxiety symptom scores (p < 0.0001) and functional impairment scores (p < 0.0001) compared to women not reporting dusukasi (n = 93). The shortened 16-item scale performed as well as the full scale in identifying women with dusukasi. Conclusions Construct validity of our adapted screening instrument was supported for identifying dusukasi in rural Malian women. Our methodology can be applied in other settings to develop similarly valid screening instruments for perinatal depression.
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Affiliation(s)
- Molly E. Lasater
- Social and Behavioral Interventions Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, USA,Corresponding author. 615 N. Wolfe St, Baltimore, MD, USA, 21205. (M.E. Lasater)
| | - Madeleine Beebe
- Social and Behavioral Interventions Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, USA
| | - Nicole E. Warren
- School of Nursing, Johns Hopkins University, 525 N Wolfe St, Baltimore, MD, 21205, USA
| | - Peter J. Winch
- Social and Behavioral Interventions Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, USA
| | - Fatoumata Soucko
- Department of Public Health, Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technology of Bamako, Mali
| | - Mariam Keita
- Department of Public Health, Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technology of Bamako, Mali
| | - Seydou Doumbia
- Department of Public Health, Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technology of Bamako, Mali
| | - Sarah M. Murray
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Baltimore, MD, 21205, USA
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Sharma M, Koenen KC, Borba CPC, Williams DR, Deng DK. The measurement of war-related trauma amongst internally displaced men and women in South Sudan: Psychometric analysis of the Harvard Trauma Questionnaire. J Affect Disord 2022; 304:102-112. [PMID: 35151676 DOI: 10.1016/j.jad.2022.02.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 01/02/2022] [Accepted: 02/09/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Studies from armed conflict settings, including South Sudan, have revealed the deleterious mental health impact of exposure to war atrocities. However, there is little consensus on what is meant by war trauma, how it should be measured, and how levels of trauma vary across men and women. METHODS We used psychometric analyses to measure war trauma among 1178 internally displaced adults (mean age = 39 years, 50% women) in the Malakal region of South Sudan. We used cross-sectional survey data and applied classical test theory, factor analysis, item response theory, and differential item functioning with the war events subscale (17 items) of the Harvard Trauma Questionnaire (HTQ). RESULTS We found good validity and internal consistency reliability for the HTQ. We found evidence for unidimensionality using factor analyses, and item response theory models showed that some war events (like witnessing the killing of family or friends) were more sensitive to the underlying 'war-related trauma' trait than others (like abduction). Differential item functioning analyses revealed that the measure performed differently for men and women, indicating the need for sex-stratified analysis in the measurement of trauma. LIMITATIONS The use of self-report may lead to recall and response bias, and the study sample may not be representative of the broader population in South Sudan. CONCLUSION This study emphasizes the need for cultural adaptation and psychometric evaluation of commonly used measurement instruments, especially in humanitarian settings where survey data are used to set priorities for mental health and psychosocial support services.
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Affiliation(s)
- Manasi Sharma
- Harvard T. H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, United States.
| | - Karestan C Koenen
- Harvard T. H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, United States.
| | - Christina P C Borba
- Department of Psychiatry, Boston Medical Center, 850 Harrison Ave, Boston, MA 02118, United States.
| | - David R Williams
- Harvard T. H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, United States.
| | - David K Deng
- South Sudan Law Society, Atlabara C, Juba, South Sudan.
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Brooke-Sumner C, Petersen-Williams P, Wagener E, Sorsdahl K, Aarons GA, Myers B. Adaptation of the Texas Christian University Organisational Readiness for Change Short Form (TCU-ORC-SF) for use in primary health facilities in South Africa. BMJ Open 2021; 11:e047320. [PMID: 34921070 PMCID: PMC8689126 DOI: 10.1136/bmjopen-2020-047320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES The Texas Christian University Organisational Readiness for Change Scale (TCU-ORC) assesses factors influencing adoption of evidence-based practices. It has not been validated in low-income and middle-income countries (LMIC). This study assessed its psychometric properties in a South African setting with the aim of adapting it into a shorter measure. METHODS This study was conducted in 24 South African primary healthcare clinics in the Western Cape Province. The TCU-ORC and two other measures, the Organisational Readiness to Change Assessment (ORCA) and the Checklist for Assessing Readiness for Implementation (CARI) were administered. The questionnaire was readministered after 2 weeks to obtain data on test-retest reliability. Three hundred and ninety-five surveys were completed: 281 participants completed the first survey, and 118 recompleted the assessments. RESULTS We used exploratory factor analysis (EFA) to identify latent dimensions represented in the data. Cronbach's alpha for each subscale was assessed and we examined the extent to which the subscales and total scale scores for the first and retest surveys correlated. Convergent validity was assessed by the correlation coefficient between the TCU-ORC, ORCA and CARI total scale scores. EFA resulted in a three-factor solution. The three subscales proposed are Clinic Organisational Climate (8 items), Motivational Readiness for Change (13 items) and Individual Change Efficacy (5 items) (26 items total). Cronbach's alpha for each subscale was >0.80. The overall shortened scale had a test-retest correlation of r=0.80, p<0.01, acceptable convergent validity with the ORCA scale (r=0.56, p<0.05), moderate convergence with the CARI (r=39, p<0.05) and strong correlation with the original scale (r=0.79, p<0.05). CONCLUSIONS This study presents the first psychometric data on the TCU-ORC from an LMIC. The proposed shortened tool may be more feasible for use in LMICs. TRIAL REGISTRATION NUMBER Results stage. Project MIND trial. Pan-African Clinical Trials Registry. PACTR201610001825405.
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Affiliation(s)
- Carrie Brooke-Sumner
- Alcohol Tobacco and Other Drug Research Unit, South African Medical Research Council, Tygerberg, South Africa
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Petal Petersen-Williams
- Alcohol Tobacco and Other Drug Research Unit, South African Medical Research Council, Tygerberg, South Africa
- Division of Addiction Psychiatry, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Emma Wagener
- Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa
| | - Katherine Sorsdahl
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Gregory A Aarons
- Department of Psychiatry, University of California, La Jolla, San Diego, California, USA
- Child and Adolescent Services Research Center, San Diego, California, USA
| | - Bronwyn Myers
- Alcohol Tobacco and Other Drug Research Unit, South African Medical Research Council, Tygerberg, South Africa
- Division of Addiction Psychiatry, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
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Campo-Arias A, Blanco-Ortega JD, Pedrozo-Pupo JC. Brief Spanish Zung Self-Rating Anxiety Scale: Dimensionality, Internal Consistency, Nomological Validity, and Differential Item Functioning Among Chronic Obstructive Pulmonary Disease Patients in Colombia. J Nurs Meas 2021; 30:407-418. [PMID: 34518431 DOI: 10.1891/jnm-d-20-00125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSES The brief Spanish Zung Self-Rating Anxiety Scale is a tenitem tool available; however, there is little information about its psychometric performance. The study aimed to test the dimensionality, internal consistency, nomological validity, and gender differential item functioning of the scale in patients with chronic obstructive pulmonary disease (COPD) in Colombia. METHODS A psychometric study was designed. It participated in 408 COPD patients aged between 40 and 102 years. RESULTS The confirmatory factor analysis showed both one- and two-dimension structures with acceptable goodness-of-fit indicators. The brief Spanish Zung Self-Rating Anxiety Scale presented high internal consistency, acceptable nomological validity, and non-gender differential functioning. CONCLUSIONS The brief Spanish Zung Self-Rating Anxiety Scale presents some good indicators of validity and reliability, and it can be used in the measurement of anxiety in COPD patients.
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Lovero KL, Basaraba C, Khan S, Suleman A, Mabunda D, Feliciano P, dos Santos P, Fumo W, Mandlate F, Greene MC, Salem AF, Mootz JJ, Mocumbi AO, Duarte CS, Gouveia L, Oquendo MA, Wall MM, Wainberg ML. Brief Screening Tool for Stepped-Care Management of Mental and Substance Use Disorders. Psychiatr Serv 2021; 72:891-897. [PMID: 33993717 PMCID: PMC8328865 DOI: 10.1176/appi.ps.202000504] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Stepped mental health care requires a rapid method for nonspecialists to detect illness. This study aimed to develop and validate a brief instrument, the Mental Wellness Tool (mwTool), for identification and classification. METHODS Cross-sectional development and validation samples included adults at six health facilities in Mozambique. Mini International Neuropsychiatric Interview diagnoses were the criterion standard. Candidate items were from nine mental disorder and functioning assessments. Regression modeling and expert consultation determined best items for identifying any mental disorder and classifying positives into disorder categories (severe mental disorder, common mental disorder, substance use disorder, and suicide risk). For validation, sensitivity and specificity were calculated for any mental disorder (index and proxy respondents) and disorder categories (index). RESULTS From the development sample (911 participants, mean±SD age=32.0±11 years, 63% female), 13 items were selected-three with 0.83 sensitivity (95% confidence interval [CI]=0.79-0.86) for any mental disorder and 10 additional items classifying participants with a specificity that ranged from 0.72 (severe mental disorder) to 0.90 (suicide risk). For validation (453 participants, age 31±11 years, 65% female), sensitivity for any mental disorder was 0.94 (95% CI=0.89-0.97) with index responses and 0.73 (95% CI=0.58-0.85) with family proxy responses. Specificity for categories ranged from 0.47 (severe mental disorder) to 0.93 (suicide risk). Removing one item increased severe mental disorder specificity to 0.63 (95% CI=0.58-0.68). CONCLUSIONS The mwTool performed well for identification of any mental disorder with index and proxy responses to three items and for classification into treatment categories with index responses to nine additional items.
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Affiliation(s)
- Kathryn L. Lovero
- Department of Psychiatry, New York State Psychiatric Institute and Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | - Cale Basaraba
- Department of Psychiatry, New York State Psychiatric Institute and Columbia University Vagelos College of Physicians and Surgeons, New York, New York
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, New York
| | - Saida Khan
- Health Directorate of Maputo City, Ministry of Health, Maputo, Mozambique
- Universidade Eduardo Mondlane School of Medicine, Maputo, Mozambique
| | - Antonio Suleman
- Health Directorate of Nampula Province, Ministry of Health, Nampula, Mozambique
- Nampula Psychiatric Hospital, Nampula, Mozambique
| | - Dirceu Mabunda
- Health Directorate of Maputo City, Ministry of Health, Maputo, Mozambique
- Universidade Eduardo Mondlane School of Medicine, Maputo, Mozambique
| | - Paulino Feliciano
- Health Directorate of Nampula Province, Ministry of Health, Nampula, Mozambique
- Nampula Psychiatric Hospital, Nampula, Mozambique
| | - Palmira dos Santos
- Universidade Eduardo Mondlane School of Medicine, Maputo, Mozambique
- Department of Mental Health, Ministry of Health, Maputo, Mozambique
| | - Wilza Fumo
- Universidade Eduardo Mondlane School of Medicine, Maputo, Mozambique
- Department of Mental Health, Ministry of Health, Maputo, Mozambique
| | - Flavio Mandlate
- Universidade Eduardo Mondlane School of Medicine, Maputo, Mozambique
- Department of Mental Health, Ministry of Health, Maputo, Mozambique
| | - M. Claire Greene
- Department of Psychiatry, New York State Psychiatric Institute and Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | - Andre Fiks Salem
- Department of Psychiatry, New York State Psychiatric Institute and Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | | | - Ana Olga Mocumbi
- Universidade Eduardo Mondlane School of Medicine, Maputo, Mozambique
- National Institute of Health, Marracuene, Mozambique
| | - Cristiane S. Duarte
- Department of Psychiatry, New York State Psychiatric Institute and Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | - Lidia Gouveia
- Universidade Eduardo Mondlane School of Medicine, Maputo, Mozambique
- Department of Mental Health, Ministry of Health, Maputo, Mozambique
| | - Maria A. Oquendo
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Melanie M. Wall
- Department of Psychiatry, New York State Psychiatric Institute and Columbia University Vagelos College of Physicians and Surgeons, New York, New York
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, New York
| | - Milton L. Wainberg
- Department of Psychiatry, New York State Psychiatric Institute and Columbia University Vagelos College of Physicians and Surgeons, New York, New York
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