Measuring general mental health in early‐mid adolescence: A systematic meta‐review of content and psychometrics

Abstract

Background Adolescent mental health is a major concern and brief general self‐report measures can facilitate insight into intervention response and epidemiology via large samples. However, measures' relative content and psychometrics are unclear. Method A systematic search of systematic reviews was conducted to identify relevant measures. We searched PsycINFO, MEDLINE, EMBASE, COSMIN, Web of Science, and Google Scholar. Theoretical domains were described, and item content was coded and analysed, including via the Jaccard index to determine measure similarity. Psychometric properties were extracted and rated using the COSMIN system. Results We identified 22 measures from 19 reviews, which considered general mental health (GMH) (positive and negative aspects together), life satisfaction, quality of life (mental health subscales only), symptoms, and wellbeing. Measures were often classified inconsistently within domains at the review level. Only 25 unique indicators were found and several indicators were found across the majority of measures and domains. Most measure pairs had low Jaccard indexes, but 6.06% of measure pairs had >50% similarity (most across two domains). Measures consistently tapped mostly emotional content but tended to show thematic heterogeneity (included more than one of emotional, cognitive, behavioural, physical and social themes). Psychometric quality was generally low. Conclusions Brief adolescent GMH measures have not been developed to sufficient standards, likely limiting robust inferences. Researchers and practitioners should attend carefully to specific items included, particularly when deploying multiple measures. Key considerations, more promising measures, and future directions are highlighted. PROSPERO registration: CRD42020184350 https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020184350.

Mental Health and Well-being Measures for Mean Comparison and Screening in Adolescents: An Assessment of Unidimensionality and Sex and Age Measurement Invariance

“…Nevertheless, psychometric fitness for purpose of self-report measures must be examined. Indeed, evidence is mounting that poor development practices may contribute to noisiness in adolescent mental health and well-being data ( Bentley et al, 2019 ; Black et al, 2020 ; Black, Panayiotou, & Humphrey, 2022 ; Wolpert & Rutter, 2018 ). There is therefore a need to interrogate existing measures further from a psychometric standpoint to ensure these can be robustly used.…”

“…Some studies use well-being interchangeably with symptoms or mental health difficulties (e.g., Fuhrmann et al, 2021 ; Orben & Przybylski, 2019 ), while others argue they are distinct constructs ( Iasiello & Agteren, 2020 ). Furthermore, proposed domains within general mental health and well-being frameworks, including for example, hedonic, eudaimonic, and complete state models ( Ryff et al, 2021 ; Westerhof & Keyes, 2010 ), are often conceptually similar ( Alexandrova & Haybron, 2016 ; Black, Panayiotou, & Humphrey, 2022 ). For instance, hedonic/subjective well-being is defined as the combination of life satisfaction and affect ( Diener et al, 2018 ), thus sharing content with internalizing symptoms ( Alexandrova & Haybron, 2016 ).…”

“…Several authors have suggested the additional insights afforded by positive approaches, compared to measuring only symptoms, may support early identification of poor mental health outcomes ( Bartels et al, 2013 ; Black et al, 2021 ; Greenspoon & Saklofske, 2001 ; Iasiello & Agteren, 2020 ). However, psychometric insight to support this, including into the comparability of outcomes, is typically missing ( Bentley et al, 2019 ; Black, Panayiotou, & Humphrey, 2022 ). We, therefore, set out to address this issue in the current paper.…”

“…Given these issues, we adopt a broad, inclusive approach that reflects all the domains of mental health and well-being proposed by the young people who were consulted in the development of the #BeeWell survey, a major well-being project ( #BeeWell Research Team, 2021 ; BeeWell Youth Steering Group Members, 2021 ). We prioritized including all #BeeWell well-being domains because there has been a historic tendency not to involve young people in the development of mental health and well-being measures, meaning face (and therefore also content) validity is often unclear ( Black, Panayiotou, & Humphrey, 2022 ). Our approach, rather than, for instance, omitting potentially more proximal domains such as autonomy, sought to somewhat mitigate this problem and provide wide-ranging insights.…”

“…The domains included map onto a range of theoretical domains, including hedonic (e.g., life satisfaction), eudaimonic (e.g., autonomy) and complete state (e.g., internalizing symptoms) models of well-being. Our approach also reflects work that has considered such domains together under broad approaches (i.e., non-disorder-specific) in systematic reviews of brief self-report measures ( Bentley et al, 2019 ; Black, Panayiotou, & Humphrey, 2022 ; Deighton et al, 2014 ).…”