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Social Psychiatry and Psychiatric Epidemiology

, Volume 51, Issue 6, pp 895–906

First Online: 21 December 2015Received: 08 June 2015Accepted: 13 November 2015


PurposeGoldberg’s General Health Questionnaire GHQ items are frequently used to assess psychological distress but no study to date has investigated the GHQ-30’s potential for adaptive administration. In computerized adaptive testing CAT items are matched optimally to the targeted distress level of respondents instead of relying on fixed-length versions of instruments. We therefore calibrate GHQ-30 items and report a simulation study exploring the potential of this instrument for adaptive administration in a longitudinal setting.

MethodsGHQ-30 responses of 3445 participants with 2 completed assessments baseline, 7-year follow-up in the UK Health and Lifestyle Survey were calibrated using item response theory. Our simulation study evaluated the efficiency of CAT administration of the items, cross-sectionally and longitudinally, with different estimators, item selection methods, and measurement precision criteria.

ResultsTo yield accurate distress measurements marginal reliability at least 0.90 nearly all GHQ-30 items need to be administered to most survey respondents in general population samples. When lower accuracy is permissible marginal reliability of 0.80, adaptive administration saves approximately 2-3 of the items. For longitudinal applications, change scores based on the complete set of GHQ-30 items correlate highly with change scores from adaptive administrations.

ConclusionsThe rationale for CAT-GHQ-30 is only supported when the required marginal reliability is lower than 0.9, which is most likely to be the case in cross-sectional and longitudinal studies assessing mean changes in populations. Precise measurement of psychological distress at the individual level can be achieved, but requires the deployment of all 30 items.

KeywordsComputerized adaptive testing Item response theory Bifactor model Measurement invariance General Health Questionnaire  Download fulltext PDF

Autor: Jan Stochl - Jan R. Böhnke - Kate E. Pickett - Tim J. Croudace


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