RESUMEN
While the General Health Questionnaire, 12-item version (GHQ-12) has been widely used in cross-cultural comparisons, rigorous tests of the measurement equivalence of different language versions are still lacking. Thus, our study aims at investigating configural, metric and scalar invariance across the German and the Spanish version of the GHQ-12 in two population samples. The GHQ-12 was applied in two large-scale population-based samples in Germany (N = 1,977) and Colombia (N = 1,500). To investigate measurement equivalence, confirmatory factor analyses were conducted in both samples. In the German sample mean GHQ-12 total scores were higher than in the Colombian sample. A one-factor model including response bias on the negatively worded items showed superior fit in the German and the Colombian sample; thus both versions of the GHQ-12 showed configural invariance. Factor loadings and intercepts were not equal across both samples; thus GHQ-12 showed no metric and scalar invariance. As both versions of the GHQ-12 did not show measurement equivalence, it is not recommendable to compare both measures and to conclude that mental distress is higher in the German sample, although we do not know if the differences are attributable to measurement problems or represent a real difference in mental distress. The study underlines the importance of measurement equivalence in cross-cultural comparisons.
Asunto(s)
Síntomas Conductuales/diagnóstico , Comparación Transcultural , Escalas de Valoración Psiquiátrica/normas , Psicometría/normas , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Síntomas Conductuales/etnología , Colombia/etnología , Femenino , Alemania/etnología , Humanos , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
PURPOSE: The objective of this study was to generate normative values and to test psychometric properties of the Hospital Anxiety and Depression Scale (HADS) for the general population of Colombia. While there are several normative studies in Europe, Latin American normative values are missing. The identification of people with mental distress requires norms obtained for the specific country. METHODS: A representative face-to-face household study (n = 1,500) was conducted in 2012. The survey questionnaire contained the HADS, several other questionnaires, and sociodemographic variables. RESULTS: HADS mean values (anxiety: M = 4.61 ± 3.64, depression: M = 4.30 ± 3.91) were similar to those reported from European studies. Females were more anxious and depressed than males. The depression scale showed a nearly linear age dependency with increasing scores for old people. Mean scores and percentiles (75 and 90%) are presented for each age decade for both genders. Both anxiety and depression correlated significantly with the total score of the multidimensional fatigue inventory and with the mental component summary score of the quality of life questionnaire SF-8. Internal consistency coefficients of both scales were satisfying, but confirmatory factorial analysis results only partially supported the two-dimensional structure of the questionnaire. CONCLUSION: This study supports the reliability of the HADS in one Latin American country. The normative scores can be used to compare a patient's score with those derived from a reference group. However, the generalizability to other Latin American regions requires further research.