A measurement issue in the assessment of social dysfunction and dysphoria in the third trimester of pregnancy

Objective

Screening for psychological disturbance during pregnancy is clinically desirable, however the current battery of brief screening instruments have limited utility in this group. A short-version of the General Health Questionnaire (GHQ), the GHQ-8 comprising two sub-scales has recently been developed. The current investigation sought to determine if common covariates (age and level of education) impacted on item responsiveness within the two GHQ-8 sub-scales.

Design

A cross sectional design was used with GHQ-8 item scores, age and level of education as dependent variables evaluated within a structural equation model.

Setting

Women in the third trimester of pregnancy recruited from one obstetric out-patient clinic of a public teaching hospital in Hong Kong.

Main outcome measure

The 8-item GHQ-8 [Kalliath, T.J., O’Driscoll, M.P., Brough, P., 2004. A confirmatory factor analysis of the General Health Questionnaire-12. Stress and Health 20, 11–20].

Results

The GHQ-8 was shown to have good factorial validity, however, one of the GHQ-8 items in the social dysfunction sub-scale was found to be differentially influenced by age.

Conclusions

The GHQ-8 may have to be revised, or age-normed cut-off scores developed, in order to prevent screening accuracy of a clinically-applied version of the instrument being compromised by the age of the individual being screened.