Abstract
The Mental Health Inventory-18 (MHI-18) is an 18-item self-report psychometric scale that assesses mental health among general populations. There are several adapted and translated mental health assessment scales in Bangladesh. However, none of these assess the complete state of mental health that the MHI assesses. Consequently, the present study assessed the psychometric properties of the MHI-18 in the Bangladesh context (N = 571). Confirmatory factor analysis confirmed the four-factor structure of the Bangla MHI-18 (i.e., anxiety, depression, behavior control, and positive affect). Second-order tests of measurement invariance suggested that the Bangla MHI-18 assessed the same construct among both male and female groups. The instrument had acceptable levels of internal consistency reliability, test–retest reliability, composite reliability, average variance extracted, standard error of measurement, discrimination power, convergent validity, and concurrent validity. The tests relating to differential item functioning suggested lack of item response bias. Accepted levels of infit and outfit MnSqs, item and person separation, and reliabilities in rating scale model suggested that the Bangla MHI-18 had satisfactory psychometric properties. This will be helpful to Bangladeshi mental health practitioners to assess the complete mental state of young clients and contribute in formulating necessary therapeutic intervention for ensuring sound mental health.
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Abbreviations
- CFI:
-
Comparative Fit Index
- CTT:
-
Classical Test Theory
- COX Z:
-
Standardized Cox’s Noncentrality Parameter
- DIF:
-
Differential item functioning
- GFI:
-
Goodness-of-Fit Index
- GHQ:
-
General Health Questionnaire
- IRT:
-
Item Response Theory
- ITC:
-
International Test Commission
- LOR Z:
-
Standardized Liu-Agresti Cumulative Common Log-Odds Ratio
- MHI:
-
Mental Health Inventory
- MnSq:
-
Mean Square
- MSQLI:
-
Multiple Sclerosis Quality of Life Inventory
- RMSEA:
-
Root Mean Square Error of Approximation
- RSM:
-
Rating Scale Model
- SDQ:
-
Strengths and Difficulties Questionnaire
- SRMR:
-
Standardized Root Mean Square Residual
- TLI:
-
Tucker–Lewis Index
- WEMWBS:
-
Warwick-Edinburgh Mental Well-being Scale
- WHO:
-
World Health Organization
References
Alva, S. A., & Reyes, Rd. L. (1999). Psychosocial stress, internalized symptoms, and the academic achievement of Hispanic adolescents. Journal of Adolescent Research, 14(3), 343–358. https://doi.org/10.1177/0743558499143004
Andresen, R., Caputi, P., & Oades, L. (2010). Do clinical outcome measures assess consumer-defined recovery? Psychiatry Research, 177(3), 309–317. https://doi.org/10.1016/j.psychres.2010.02.013
Bagozzi, R. P., & Yi, Y. (1988). On the evaluation of structural equation models. Journal of the Academy of Marketing Science, 16(1), 74–94. https://doi.org/10.1007/BF02723327
Banoo, N. (2001). The translated Bangla version of GHQ-28. University of Dhaka.
Boden, J. M., Fergusson, D. M., & Horwood, L. J. (2008). Does adolescent self-esteem predict later life outcomes? A test of the causal role of self-esteem. Development and Psychopathology, 20(1), 319–339. https://doi.org/10.1017/S0954579408000151
Bollen, K. A. (1989). Structural equations with latent variables. Wiley.
Bond, T. G., & Fox, C. M. (2007). Applying the Rasch model: Fundamental measurement in the human sciences (2nd ed.). Lawrence Erlbaum.
Browne, M. W., & Cudeck, R. (1993). Alternative ways of assessing model fit. In K. A. Bollen & J. S. Long (Eds.), Testing structural equation models (pp. 136–162). Sage.
Byrne, B. M. (2010). Structural equation modeling with AMOS: Basic concepts, applications, and programming (2nd ed.). Routledge.
Byrne, B. M. (2016). Structural equation modeling with AMOS: Basic concepts, applications, and programming (3rd ed.). Routledge.
Chang, K.-C., Wang, J.-D., Tang, H.-P., Cheng, C.-M., & Lin, C.-Y. (2014). Psychometric evaluation, using Rasch analysis, of the WHOQOL-BREF in heroin-dependent people undergoing methadone maintenance treatment: Further item validation. Health and Quality of Life Outcomes, 12(1), 148. https://doi.org/10.1186/s12955-014-0148-6
Chen, F. F. (2007). Sensitivity of goodness of fit indexes to lack of measurement invariance. Structural Equation Modeling, 14(3), 464–504. https://doi.org/10.1080/10705510701301834
Cheung, G. W., & Rensvold, R. B. (2002). Evaluating goodness-of-fit indexes for testing measurement invariance. Structural Equation Modeling, 9(2), 233–255. https://doi.org/10.1207/S15328007SEM0902_5
Cunningham, M., Hurley, M., Foney, D., & Hayes, D. (2002). Influence of perceived contextual stress on self-esteem and academic outcomes in African American adolescents. Journal of Black Psychology, 28(3), 215–233. https://doi.org/10.1177/0095798402028003003
Dimitrov, D. M. (2012). Statistical methods for validation of assessment scale data in counseling and related fields. American Counseling Association.
Field, A. (2017). Discovering statistics using SPSS (5th ed.). Sage Publications.
Floyd, F. J., & Widaman, K. F. (1995). Factor analysis in the development and refinement of clinical assessment instruments. Psychological Assessment, 7(3), 286–299. https://doi.org/10.1037/1040-3590.7.3.286
Furr, R. M. (2011). Scale construction and psychometrics for social and personality psychology. Sage Publication Ltd.
Goldberg, D. (1978). Manual of the General Health Questionnaire. NFER-Nelson.
Goodman, R. (1997). The strengths and difficulties questionnaire: A research note. Journal of Child Psychology and Psychiatry, 38(5), 581–586. https://doi.org/10.1111/j.1469-7610.1997.tb01545.x
Gustavson, K., Knudsen, A. K., Nesvåg, R., Knudsen, G. P., Vollset, S. E., & Reichborn-Kjennerud, T. (2018). Prevalence and stability of mental disorders among young adults: Findings from a longitudinal study. BMC Psychiatry, 18(1), 65. https://doi.org/10.1186/s12888-018-1647-5
Hagen, K. A., Myers, B. J., & Machintosh, V. H. (2005). Hope, social support, and behavioral problems in at-risk children. American Journal of Orthopsychiatry, 75(2), 211–219. https://doi.org/10.1037/0002-9432.75.2.211
Headey, B. W., Kelley, J., & Wearing, A. J. (1993). Dimensions of mental health: Life satisfaction, positive affect, anxiety and depression. Social Indicators Research, 29(1), 63–82. https://doi.org/10.1007/BF01136197
Hennessy, M. J., Patrick, J. C., & Swinbourne, A. L. (2018). Improving mental health outcomes assessment with the Mental Health Inventory-21. Australian Psychologist, 53(4), 313–324. https://doi.org/10.1111/ap.12330
Heubeck, B. G., & Neill, J. T. (2000). Confirmatory factor analysis and reliability of the Mental Health Inventory for Australian adolescents. Psychological Reports, 87(2), 431–440. https://doi.org/10.2466/pr0.2000.87.2.431
Hu, L. T., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6(1), 1–55. https://doi.org/10.1080/10705519909540118
Ilyas, Q. S. M., & Aeysha, M. (2001). Bangali version of the Goldberg General Health Questionnaire (GHQ). Unpublished Manuscript. Department of Psychology: University of Dhaka.
International Test Committee (ITC). (2018). The ITC guidelines for translating and adapting tests (second edition). International Journal of Testing, 18(2): 101–134. https://doi.org/10.1080/15305058.2017.1398166
Jaser, S. S., Langrock, A. M., Keller, G., Merchant, M. J., Benson, M. A., Reeslund, K., Champion, J. E., & Compas, B. E. (2005). Coping with the stress of parental depression II: Adolescent and parent reports of coping and adjustment. Journal of Clinical Child and Adolescent Psychology, 34(1), 193–205. https://doi.org/10.1207/s15374424jccp3401_18
Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 593–602. https://doi.org/10.1001/archpsyc.62.6.593
Keyes, C. L. M. (2007). Promoting and protecting mental health as flourishing. American Psychologist, 62(2), 95–108. https://doi.org/10.1037/0003-066X.62.2.95
Kim, H.-Y. (2013). Statistical notes for clinical researchers: Assessing normal distribution (2) using skewness and kurtosis. Restorative Dentistry and Endodontics, 38(1), 52–54. https://doi.org/10.5395/rde.2013.38.1.52
Kline, P. (1999). The handbook of psychological testing (2nd ed.). Routledge.
Kline, P. (2015). A handbook of test Construction: Introduction to psychometric design. Routledge.
Kook, S. H., & Varni, J. W. (2008). Validation of the Korean version of the pediatric quality of life inventory™ 4.0 (PedsQL™) generic core scales in school children and adolescents using the Rasch model. Health and Quality of Life Outcomes, 6(1), 41. https://doi.org/10.1186/1477-7525-6-41
Langner, T. S. (1962). A twenty-two item screening score of psychiatric symptoms indicating impairment. Journal of Health and Human Behavior, 3(4), 269–276. https://doi.org/10.2307/2948599
Linacre, J. M. (2012). A user’s guide to WINSTEPS and ministep Rasch model computer programs: Program manual. 3.75. Retrieved from https://www.winsteps.com/manuals.htm
Loge, J. H., & Kaasa, S. (1998). Short form 36 (SF-36) health survey: Normative data from the general Norwegian population. Scandinavian Journal of Social Medicine, 26(4), 250–258. https://doi.org/10.1177/14034948980260040401
MacCallum, R. C., Roznowski, M., & Necowitz, L. B. (1992). Model modifications in covariance structure analysis: The problem of capitalization on chance. Psychological Bulletin, 111(3), 490–504. https://doi.org/10.1037/0033-2909.111.3.490
Macmillan, A. M. (1957). The Health opinion survey: Technique for estimating prevalence of psychoneurotic and related types of disorder in communities. Psychological Reports, 3(2), 325–339. https://doi.org/10.2466/PR0.3.325-339
Mandersheid, R. W., Ryff, C. D., Freeman, E. J., McKnight, L. R., Dhingra, S., & Strine, T. W. (2010). Evolving definitions of mental illness and wellness. Prevention of Chronic Disease, 7(1), 1–6.
Manne, S., & Schnoll, R. (2001). Measuring cancer patients’ psychological distress and well-being: A factor analytic assessment of the Mental Health Inventory. Psychological Assessment, 13(1), 99–109. https://doi.org/10.1037/1040-3590.13.1.99
Marsh, H. W., Hau, K. T., & Wen, Z. (2004). In search of golden rules: Comment on hypothesis testing approaches to setting cutoff values for fi t indexes and dangers in over-generalizing findings. Structural Equation Modeling, 11(3), 320–341. https://doi.org/10.1207/s15328007sem1103_2
Marsh, H. W., & Hocevar, D. (1988). A new, more powerful approach to multitrait-multimethod analyses: Application of second-order confirmatory factor analysis. Journal of Applied Psychology, 73(1), 107–117. https://doi.org/10.1037/0021-9010.73.1.107
Martin, R. A., Kazarian, S. S., & Breiter, H. J. (1995). Perceived stress, life events, dysfunctional attitudes, and depression in adolescent psychiatric inpatients. Journal of Psychopathology and Behavioral Assessment, 17(1), 81–95. https://doi.org/10.1007/BF02229205
McKnight, C. G., Huebner, E. S., & Suldo, S. (2002). Relationships among stressful life events, temperament, problem behavior, and global life satisfaction in adolescents. Psychology in the Schools, 39(6), 677–687. https://doi.org/10.1002/pits.10062
Meybodi, F. A., Saeedi, Z., Behjati, Z., Noorbala, F., Dastbaravardec, A., & Enjedany, E. (2011). Reliability and validity of a Farsi version of 18-item mental health inventory. Procedia - Social and Behavioral Sciences, 30, 1425–1429. https://doi.org/10.1016/j.sbspro.2011.10.277
Meyer, J. P. (2014). Applied Measurement with jMetrik. Routledge.
Mullick, M. S. I., & Goodman, R. (2001). Questionnaire screening for mental health problem in Bangladeshi children: A preliminary analysis. Social Psychiatry and Psychiatric Epidemiology, 36(2), 94–99. https://doi.org/10.1007/s001270050295
National Institute of Mental Health (2019). National Mental Health Survey of Bangladesh, 2018–19: Provisional fact sheet. National Institute of Mental Health.
Nunnally, J. C. (1978). Psychometric Theory (2nd ed.). McGraw-Hill.
Ostroff, J. S., Woolverton, K. S., Berry, C., & Lesko, L. M. (1996). Use of the mental health inventory with adolescents: A secondary analysis of the Rand Health Insurance study. Psychological Assessment, 8(1), 105–107. https://doi.org/10.1037/1040-3590.8.1.105
Penfiled, R. D. (2013). DIFAS 5.0. Differential Item Functioning Analysis System. Users’s Manual. Retrieved May 21, 2019, from: https://soe.uncg.edu/wp-content/uploads/2015/12/DIFASManual_V5.pdf
Rahman, S. T., & Imran, M. A. (2013). Bangladeshi adaptation of Warwick-Edinburgh Mental Well-being scale. The Dhaka University Journal of Psychology, 37, 49–60.
Ritvo, P. G., Fischer, J. S., Miller, D. M., Andrews, H., Paty, D. W., & LaRocca, N. G. (1997). Multiple sclerosis quality of life inventory: A user’s manual. National Multiple Sclerosis Society.
Schroever, M. J., Ranchor, A. V., & Sanderman, R. (2003). Depressive symptoms in cancer patients compared with people from the general population: The role of sociodemographic and medical factors. Journal of Psychosocial Oncology, 21(1), 1–26. https://doi.org/10.1300/J077v21n01_01
Snyder, C. R., Hoza, B., Pelham, W. E., Rapoff, M., Ware, L., Danovsky, M., & HighbergerRibinsteiStahl, L. H. K. J. (1997). The development and validation of the Children’s Hope Scale. Journal of Pediatric Psychology, 22(3), 399–421. https://doi.org/10.1093/jpepsy/22.3.399
Stedman, T., Yellowlees, P., Drake, S., Chant, D., Clarke, R., & Chapple, B. (2000). The perceived utility of six selected measures of consumer outcomes proposed for routine use in Australian mental health services. Australian and New Zealand Journal of Psychiatry, 34, 842–849. https://doi.org/10.1080/j.1440-1614.2000.00803.x
Strand, B. H., Dalgard, O. S., Tambs, K., & Rognerud, M. (2003). Measuring the mental health status of the Norwegian population: A comparison of the instruments SCL-25, SCL-10, SCL-5 and MHI-5 (SF-36). Nordic Journal of Psychiatry, 57(2), 113–118. https://doi.org/10.1080/08039480310000932
Sullivan, M., & Karlsson, J. (1998). The Swedish SF-36 Health Survey III. Evaluation of criterion-based validity: Results from normative population. Journal of Clinical Epidemiology, 51(11), 1105–1113. https://doi.org/10.1016/S0895-4356(98)00102-4
Tanaka, J. S., & Huba, G. J. (1984). Structures of psychological distress: Testing confirmatory hierarchical models. Journal of Consulting and Clinical Psychology, 52(4), 719–721. https://doi.org/10.1037/0022-006X.52.4.719
Tennant, R., Hiller, L., Fishwick, R., Platt, S., Joseph, S., & WeichParkinsonSeckerStewart-Brown, S. J. J. S. (2007). The Warwick-Edinburgh mental well-being scale (WEMWBS): Development and UK validation. Health and Quality of Life Outcomes, 5(63), 114212. https://doi.org/10.1186/1477-7525-5-63
Valle, M. F., Huebner, E. S., & Suldo, S. M. (2004). Further evaluation of the Children’s Hope Scale. Journal of Psychoeducational Assessment, 22(4), 320–337. https://doi.org/10.1177/073428290402200403
Veit, C. T., & Ware, J. E. (1983). The structure of psychological distress and well-being in general populations. Journal of Consulting and Clinical Psychology, 51(5), 730–742. https://doi.org/10.1037/0022-006X.51.5.730
Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54(6), 1063–1070. https://doi.org/10.1037/0022-3514.54.6.1063
Westerhof, G. J., & Keyes, C. L. M. (2010). Mental illness and mental health: The two continua model across the lifespan. Journal of Adult Development, 17(2), 110–119. https://doi.org/10.1007/s10804-009-9082-y
World Health Organization. (2004). Promoting mental health: Concepts, emerging evidence, practice: Summary report. World Health Organization.
World Health Organization. (2014). Basic documents (48th ed.). World Health Organization.
Wuang, Y. P., Su, C. Y., & Huang, M. H. (2012). Psychometric comparisons of three measures for assessing motor functions in preschoolers with intellectual disabilities. Journal of Intellectual Disability Research, 56(6), 567–578. https://doi.org/10.1111/j.1365-2788.2011.01491.x
Yuvaraj, Y., Poornima, S., & Rashmi, S. (2016). Screening for overall mental health status using mental health inventory amongst medical students of a government medical college in North Karnataka India. International Journal of Community Medicine and Public Health, 3(12), 3308–3312. https://doi.org/10.18203/2394-6040.ijcmph20164026
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All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Oli Ahmed. The first draft of the manuscript was written by Oli Ahmed and all authors commented on previous versions of the manuscript and revised accordingly. All authors read and approved the final manuscript.
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Ahmed, O., Griffiths, M.D. & Hossain, M.A. Psychometric Assessment of the 18-Item Bangla Mental Health Inventory (Bangla MHI-18). Psychol Stud 67, 110–122 (2022). https://doi.org/10.1007/s12646-022-00645-y
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DOI: https://doi.org/10.1007/s12646-022-00645-y