Psychometric properties of the GHQ-28 in opiate-dependent patients
DOI:
https://doi.org/10.20882/adicciones.216Keywords:
GHQ-28, factorial structure, opiate-dependent patients, screeningAbstract
Objective: To know the psychometric properties of the GHQ-28 when it is applied to a sample of opiate-dependent patients. Method: Participants were 138 opiate-dependent patients. Reliability was estimated by means of the Cronbach’s alpha and Spearman-Brown coefficients. Confirmatory Factor Analysis was applied to check the four-factor structure proposed by Goldberg and Hillier. The sensitivity and specificity of the instrument for the detection of possible psychiatric cases were measured using ROC (Receiver Operating Characteristic) analysis, using as criterion the DSMIV diagnosis from the Mini International Neuropsychiatric Interview. Results: Reliability estimation was adequate. Validity results could not confirm the four-factor structure of GHQ-28 proposed by Goldberg and Hillier. The sensitivity and specificity parameters show optimum values of 60.7 % and 73.7 %, respectively, 65.9 % of the participants being correctly classified. Conclusions: GHQ-28 shows adequate reliability and appropriate sensitivity and specificity parameters when it is applied to opiate-dependent patients. However, the original factorial structure could not be confirmed. Given these results and those from other validity studies in which the relationships with Severity of Dependence, Physical Health and Health-Related Quality of Life were shown, the GHQ-28 can be considered a useful instrument for screening in clinical practice.References
American Educational Research Association, American Psychological
Association, y National Council on Measurement in Education. (2002). Standards for educational and psychological testing. Washington DC: American Educational Research Association.
Andersen, H. S., Sestoft, D., Lillebaek, T., Gabrielsen, G. y Hemmingsen,
R. (2002). Validity of the General Health Questionnaire (GHQ-28) in a prison population: data from a randomized sample of prisoners on remand. International Journal of Law and Psychiatry, 25, 573-580.
Bentler, P. M. (2005). EQS 6 Structural equations program manual.
Encino, CA: Multivariate Software.
Bentler, P. M. (1990). Comparative fit indexes in structural models.
Psychological Bulletin, 107, 238-246.
Bentler, P. M. y Bonnet, D. G. (1980). Significance test and goodness
of fit in the analysis of covariance structures. Psychological Bulletin, 88, 588-606.
Bollen, K. A. (1989). A new incremental fit index for general structural
equation models. Sociological Methods & Research, 17, 303-316.
Browne, M. W. y Cudeck, R. (1993). Alternative ways of assessing model fit. En K.A. Bollen y J.S. Long (Eds.), Testing structural equation models (pp. 136-162). Newbury Park: Sage.
Byrne, B. M. (2001). Structural equation modeling with AMOS: basic
concepts, applications, and programming. Mahwah, New Jersey: Lawrence Erlbaum Associates.
Carmines, E. G. y McIver, J. P. (1981). Analyzing models with unobserved variables. En G. W. Bohrnstedt y E. F. Borgatta (Eds.).
Social measurement: Current issues (pp. 122-133). Beverly Hills: Sage.
Charney, D. A., Palacios-Boix, J., Negrete, J. C., Dobkin, P. L. y Gill, K. J.
(2005). Association between concurrent depression and anxiety and six-month outcome of addiction treatment. Psychiatric Services, 56, 927-933.
Darke, S., Hall, W., Wodak, A., Heather, N. y Ward, J. (1992). Development and validation of a multidimensional instrument for assessing
outcome of treatment among opiate users: the Opiate Treatment Index. British Journal of Addictions, 87, 733-742
Derogatis L. R. (1998). SCL-90-R: administration scoring and procedures manual. Towson: Clinical Psychometric Research.
Fernández-Montalvo, J., López, J. J., Landa, N., Illescas, C., Lorea, I. y
Zarzuela, A. (2004). Trastornos de personalidad y abandonos terapéuticos en pacientes adictos: resultados en una comunidad terapéutica. International Journal of Clinical and Health Psychology, 4, 271-283.
Forman, R., Svikis, D., Montoya, I. D. y Blaine, J. (2004). Selection of a
substance use disorder diagnostic instrument by the National Drug Abuse Treatment Clinical Trials Networks. Journal of Substance Abuse Treatment, 27, 1-8
García, O., Secades, R., Fernandez, J. R., Carballo, J. L., Errasti, J. M. y
Al-Halabi, S. (2005). Comparación de pacientes cocainómanos y heroinómanos en el EuropASI. Adicciones, 17, 33-42
Gibbons, P., Flores de Arévalo, H., y Mónico, M. (2004). Assessment of the
factor structure and reliability of the 28 item version of the General Health Questionnaire (GHQ-28) in El Salvador. International Journal of Clinical and Health Psychology, 4, 389-398.
Goldberg, D. P. (1972). The detection of psychiatric illness by questionnaire. London: Oxford University Press.
Goldberg, D. P., Gater, R., Sartorius, N., Ustun, T. B., Piccinelli, M., Gureje, O. y Rutter, C. (1997). Validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychological Medicine, 27, 191-197.
Goldberg, D. P. y Hillier, V. F. (1979). A scaled version of the General
Health Questionnaire. Psychological Medicine, 9, 139-145.
Goldberg, D.P. y Williams, P. (1991). A user’s guide to the General Health Questionnaire. NFER-Nelson: Windsor.
Herbeck, D. M., Hser, Y., Lu, T. H., Stark, M. E. y Paredes, A. (2006). A
-year follow-up study of psychiatric symptomatology among cocaine-dependent men. Addictive Behaviors, 31, 1974-1987.
Iraurgi, I. (2002). Instrumentos de Evaluación de la Calidad de Vida Relacionada con la Salud en Toxicomanías. En I. Iraurgi y F. González-Saiz (Eds.). Instrumentos de evaluación en drogodependencias (pp. 481-511). Madrid: Aula Médica.
Jöreskog, K. G. y Sörbom, D. (1989). LISREL 7 User’s Reference Guide.
Chicago: Scientific Software, Inc.
Kokkevi, A., y Hartgers, C. (1995). European Adaptation of a multidimensional assessment instrument for drug and alcohol dependence. European Addiction Research, 1, 208-210
Kranzler, H., Del Boca, F. y Rousanville, B. (1995). Comorbid psychiatric
predicts three-year outcomes in alcoholics: A posttreatment natural history study. Journal of Studies on Alcohol, 3, 619-626.
Le Bon, O., Basiaux, P., Streel, E., Tecco, J., Hanak, C., Hansenne, M., et
al. (2004). Personality profile and drug of choice; a multivariate analysis using Cloninger’s TCI on heroin addicts, alcoholics and a random population group. Drug and Alcohol Dependence, 73, 175-182
Lobo, A., Pérez-Echevarria, M. J. y Artal, J. (1986). Validity of the scaled
version of the General Health Questionnaire (GHQ-28) in a Spanish population. Psychological Medicine, 16, 135-140.
Lozano, O. M., Rojas, A. J., Pérez, C., González-Sáiz, F., Ballesta, R. y Bilbao, A. (2008). Evidencias de validez del test para la evaluación de la calidad de vida en adictos a sustancias psicoactivas a partir del modelo biaxial de la adicción. Psicothema, 20, 311-317.
Likouras, L., Adrachta, D., Kalfakis, N., Oulis, P., Voulgari, A., Christodoulou, G. N., et al. (1996). GHQ-28 as an aid to detect mental disorders in neurological inpatients. Acta Psychiatrica Scandinava, 93, 212-216.
Malakouti, S. K., Fatollahi, P., Mirabzadeh, A. y Zandi, T. (2006). Reliability,
validity and factor structure of the GHQ-28 used among elderly Iranians. International Psychogeriatrics, 19, 623-634.
Mateu, G., Astals, M. y Torrens, M. (2005). Comorbilidad psiquiatrica y trastorno por dependencia de opiaceos: del diagnostic al tratamiento. Adicciones, 17, 111-121
Moggi, F., Hirsbrunner, H. P., Brodbeck, J. y Bachmann, K. M. (1999).
One-year outcome of an integrative inpatient treatment for dual diagnosis patients. Addictive Behaviors, 24, 589-592.
Molina, J. D., Andrade-Rosa, C., González-Parra, S., Blasco-Fontecilla, H., Real, M. A. y Pintor, C. (2006). The factor structure of the General Health Questionnaire (GHQ): a scaled version for general practice in Spain. European Psychiatry, 21, 478-486.
Muñoz, P. E., Vázquez, J. L., Pastrana, E., Rodríguez, F. y Oneca, C. (1978). Study of the validity of Goldberg’s 60-item GHQ in its Spanish version. Social Psychiatry, 13, 99-104.
Observatororio Español sobre Drogas. (2007). Informe 2007 del Observatorio Español sobre Drogas. Situación y tendencias de los problemas de drogas en España. Madrid: Ministerio de Sanidad y Consumo
Raju, N. S. (1977). A generalization of Alpha Coefficient. Psychometrika,
, 549-565.
Sáiz, P. A., García-Portilla, P. Mª., Bascarán, Mª. T., Paredes, Mª. B.,
Martínez, S., Jiménez, L. y Bobes, J. (2005). Instrumentos de evaluación de la dependencia de heroína. Adicciones, 17 (supl. 2), 81-94
San, G. I., Gutiérrez, E., Sáiz, P.A., González, Mª.P., Bascarán, Mª. T. y
Bobes, J. (2000). Evaluación de trastornos de la personalidad en pacientes heroinómanos mediante el International Disorders Examination (IPDE). Adicciones, 12, 43-56
Satorra, A. y Bentler, P. M. (1994). Corrections to test statistics and standard errors in covariance structure analysis. In A.V. Eye y C.C. Clogg (Eds.). Latent variables analysis: Applications for developmental research, 399-419. Thousand Oaks, CA: Sage.
Sheehan, D. V., Lecrubier, Y., Sheehan, K. H., Amorim, P., Janavs, J.,
Weiller, E., et al. (1998). The Mini-International Neuropsychiatric Interview (M.I.N.I.): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry, 59 (suppl. 20), 22–33.
Seva, A., Magallón, R., Sarasola, A. y Merino, J. A. (1992). GHQ-28
validation in a Spanish general urban population. European Journal of Psychiatry, 6, 147-153.
Steiger, J. H. (1990). Structural model evaluation and modification: an
interval estimation approach. Multivariate Behavioral Research, 25, 173-180.
Taylor, A., Del Grande, E. y Parsons, J. (1997). Mental Health Status of
South Australians. South Australia: National Library of Australia Cataloging Publication.
Torrens, M. (2008). Patología dual: situación actual y retos del futuro.
Adiciones, 20, 315-320
Werneke, U., Goldberg, D. P., Yalcin, I. y Üstün, B. T. (2000). The stability
of the factor structure of the General Health Questionnaire. Psychological Medicine, 30, 823-829.
