The positive mental health instrument: development and validation of a culturally relevant scale in a multi-ethnic asian population

Abstract

BackgroundInstruments to measure mental health and well-being are largely developed and often used within Western populations and this compromises their validity in other cultures. A previous qualitative study in Singapore demonstrated the relevance of spiritual and religious practices to mental health, a dimension currently not included in exiting multi-dimensional measures. The objective of this study was to develop a self-administered measure that covers all key and culturally appropriate domains of mental health, which can be applied to compare levels of mental health across different age, gender and ethnic groups. We present the item reduction and validation of the Positive Mental Health (PMH) instrument in a community-based adult sample in Singapore.MethodsSurveys were conducted among adult (21-65 years) residents belonging to Chinese, Malay and Indian ethnicities. Exploratory and confirmatory factor analysis (EFA, CFA) were conducted and items were reduced using item response theory tests (IRT). The final version of the PMH instrument was tested for internal consistency and criterion validity. Items were tested for differential item functioning (DIF) to check if items functioned in the same way across all subgroups. Results: EFA and CFA identified six first-order factor structure (General coping, Personal growth and autonomy, Spirituality, Interpersonal skills, Emotional support, and Global affect) under one higher-order dimension of Positive Mental Health (RMSEA = 0.05, CFI = 0.96, TLI = 0.96). A 47-item self-administered multi-dimensional instrument with a six-point Likert response scale was constructed. The slope estimates and strength of the relation to the theta for all items in each six PMH subscales were high (range:1.39 to 5.69), suggesting good discrimination properties. The threshold estimates for the instrument ranged from -3.45 to 1.61 indicating that the instrument covers entire spectrums for the six dimensions. The instrument demonstrated high internal consistency and had significant and expected correlations with other well-being measures. Results confirmed absence of DIF.ConclusionsThe PMH instrument is a reliable and valid instrument that can be used to measure and compare level of mental health across different age, gender and ethnic groups in Singapore.

Positive Mental Well-being in Australian Adolescents: Evaluating the Warwick-Edinburgh Mental Well-being Scale

“…The issue of less than perfect model fit has arisen in a number of studies employing CFA and Rasch model analysis, but these studies were with adult populations in different countries (Gremigni, & Stewart-Brown, 2011;Lloyd & Devine, 2012;López et al, 2013;Tennant et al, 2007a). Taken together, these studies demonstrate the importance of examining the psychometric properties of an instrument in different populations and in different settings (see Vaingankar et al, 2011).…”

“…For a description of its development see Tennant et al (2007a;2007b). However, the data supporting its use come almost exclusively from adults: Cronbach alphas of = 0.87 -0.93 and significant correlations with other scales measuring components of affect or wellbeing Lloyd & Devine, 2012;Tennant et al, 2007a) including using the shorted 7 item version (Vaingankar, Subramaniam, Chong, Abdin, Edelen, Picco et al, 2011); significant age and gender effects (Tennant et al, 2007a); and test-retest reliability 0.66 -0.83 Tennant et al, 2007a). Two studies employing the Rasch model (Rasch, 1960(Rasch, , 1980 have also found support for the unidimensionality of the WEMWBS, but in the form of a shortened 7-item version (Bartram, Sinclair, & Baldwin, 2012;Stewart-Brown et al, 2009).…”

The Singaporean public beliefs about the causes of mental illness: results from a multi-ethnic population-based study

“…Indeed, 7.6% of people with mental illness in Singapore reported seeking help from religious/spiritual advisors or other healers (Chong et al 2012b) -a significant proportion, which could not be captured with the causal beliefs scale. As spirituality is a key aspect of positive mental health in the local population (Vaingankar et al 2011), engaging traditional healers and religious leaders to increase mental health literacy is important (Bhikha et al 2015). Engaging these key avenues may not only reduce the treatment gap but also reduce stigma and provide social support for those with mental illness.…”

Systematic Review about Personal Growth Initiative

“…Studies that investigated psychological well-being as a single-factor dimension also evidenced the positive relationship between this and PGI (Kashubeck-West & Meyer, 2008;Lasun & Odufowokan, 2012;Negovan, 2010;Robitschek, 1999;Shorey et al, 2007) Higher levels of PGI were associated with the presence of higher indices of emotional well-being, social well-being (Negovan, 2010) 2009; Stevic & Ward, 2008); positive mental health (Ogunyemi & Mabekoje, 2007;Vaingankar et al, 2011); and positive affect (Hardin et al, 2007;Robitschek & Keyes, 2009). Consequently, people who had higher levels of PGI were more likely to possess lower levels of negative affect (Hardin et al, 2007), stress (Hardin et al, 2007;Shorey et al, 2007), lower levels of perceived stigma (Sultan, 2011) and more chance of healthily recovering from traumatic experiences (Borja & Callahan, 2009;Callahan et al, 2013).…”