Psychometric Properties of the Mental Health Continuum-Short Form (MHC-SF) in Iranian Adolescents

doi:10.21203/rs.3.rs-1236021/v2

Download PDF

Research Article

Psychometric Properties of the Mental Health Continuum-Short Form (MHC-SF) in Iranian Adolescents

https://doi.org/10.21203/rs.3.rs-1236021/v2

This work is licensed under a CC BY 4.0 License

Version 2

posted

You are reading this older preprint version

Read the latest preprint version →

Background

Psychological tests are necessary to assess and assess the mental state of individuals. Mental health is one of the important psychological indicators and is increasingly considered as having various aspects of well-being. The Mental Health Continuum-Short Form (MHC-SF) is a 14-item instrument that assesses mental health, focusing on emotional, psychological, and social well-being. The present study examined the psychometric properties of the Persian version of the MHC-SF among adolescents, focusing on its factor structure, internal consistency, construct validity, and gender measurement invariance.

Methods

Results

The results of confirmatory factor analysis supported the 3-factor structure of MHC-SF (emotional, psychological, and social well-being). Reliability was confirmed by Cronbach's alpha method and composite reliability (>.7). Measurement invariance were confirmed among girls and boys. Convergent and divergent validity were also evaluated and confirmed by correlating the test score with similar and different tests.

Conclusion

This study examined and confirmed the psychometric properties of GHQ in the Iranian adolescent community. This instrument can be used in psychological research and diagnostic evaluations.

Adolescence is a critical period for increasing vulnerability and the onset of mental illness (1-2). Mental health problems during adolescence impose psychological, social and economic challenges on any society (2-4). Epidemiological studies have shown the prevalence of adolescent mental illness from 10 to 20% worldwide (3). About 15% of Iran's population is between 10 and 20 years old and adolescents (5). Based on epistemological data in Iran, behavioral and mental health problems are common in this group (6-8). Research reports show that unmet needs in children and adolescents are even greater than in adults (9).

The relationship between mental health and mental illness has evolved in recent decades, and this has influenced the conceptualization of mental health. For example, The World Health Organization defined mental health as being free from mental illness (10-11). However, focusing solely on the prevention and treatment of mental illness was not successful in reducing the prevalence of mental illness (12).In particular, Weisz et al (13) showed that in the last fifty years, psychological interventions in children and adolescents have not led to much improvement. On the other hand, the pathological view of mental health did not help to distinguish adolescents with educational and behavioral problems (14).

With the development of positive psychology, a new approach to mental health was formed. In the latest definition of the World Health Organization (15) mental health is defined as “A state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community”. This approaches emphasize the role of positive functioning, worthwhile goals, meaningful activity and optimistic growth in mental well-being. Thus, elements of positive mental health and symptoms of mental illness can coexist. In this view, the strengths and weaknesses of the individual are seen together and must be combined to fully assess the mental state.

Various models have been proposed for conceptualizing and evaluating mental health. In Keyes's theory (16), human beings are embedded in social structures, face various social challenges, and have numerous interpersonal interactions, thus addressing the social aspect of mental health. Keyes (16-17) developed two distinct but related continuum model, Instead of a single continuum with mental well-being and illness at both ends. This mental health continuum distinguishes three levels of positive mental health: flourishing, moderate, and languishing mental health (18).People with flourishing mental health have enjoyable and positive performance. In contrast, people with languishing mental health experience low pleasure and positive performance. Individuals who are neither flourishing nor languishing are known as moderate mental health. Given the importance of measuring the mental health of the population, epidemiological studies focusing on flourishing - such as MHC-SF - have been shown to be associated with superior physical, mental, and psychosocial functions (19).

Most instruments designed to measure adolescent mental well-being either have many questions or measure limited dimensions of mental health (20). Due to the many countries have adopted MHC-SF, considering evidence supporting the utility, validity and reliability of its. The 14 item Continuum-short form of mental health (MHC-SF) (25) is a short questionnaire that corresponds to the 40 item Continuum mental health form (26). Psychometric properties of the MHC-SF were confirmed in adolescents and adults of different cultures, including Argentina (21), Canada (22), China (23), Egypt (24), India (25), Ireland (26), Italy (27), Korea (28), Poland (29), South Africa (30), USA (31, 32), Dutch(20). In Iran, too, Joshanloo reported the psychometric properties of this tool well. But his research sample was university students (33).

As mentioned, adolescents are a special group and the structure obtained from adults about them may not be valid. Given that the field of planning and exercise is increasingly focused on mental health among adolescents, an appropriate instrument to this age group is needed to considering the variance in well-being. The aim of this study was to adapt MHC-SF to a sample of adolescents in Iranian society. For this purpose, the factor structure and psychometric properties such as its Reliability and validity have been evaluated. Most previous research has confirmed the three-factor structure for MHC-SF. In order to investigate the psychometric properties of MHC-SF, first, its reliability is evaluated based on internal consistency and test-retest, second, determining the factor structure by assuming three underlying factors, and third, evaluating convergent validity of the MHC-SF-A, correlating the PANAS-C, and Kidscreen-2 and RCADS-25. As well as, this study aimed to obtain evidence for the two-continuum model.

Participants

The population of this study was Iranian adolescents between 11 and 18 years old who were enrolled in the seventh to twelfth grades. A convenience sample of 822 Adolescents from four large cities in the Iran (Tehran, Zanjan, Hamedan and Ghazvin) participated in the present study. They were relatively proportional distributed by sex: 430 girls (52%) and 392 boys (48%). The mean age was 16.33 years old (SD = 8.80). The highest percentage of the participants (38.6%; n = 317) lived in Tehran province, 20% (n = 165) lived in Zanjan province, 22% (n = 179) lived in Hamedan province 18.7% (n = 154) lived in Ghazvin province and only 7 cases did not report their residence. Concerning their socioeconomic status, the majority (68.1%, n = 560) described itself as belonging to the middle class, 19.9% (n = 164) to middle-low or lower class, 9.2% (n = 76) to high or middle-high class, and 2.6% (n = 22) did not report their class. In the Iranian educational system, the first and second secondary education are included from the seventh to the eleventh grade. Most of the participants (58%, n=479) were enrolled in the second secondary, compared to 42% (n=345) who were enrolled in the first secondary education. In terms of educational grade the sample consisted 95 7th graders (11.5%), 115 8th graders (13.9%), 135 9th graders (36.5%), 164 10th graders (36.5%), 195 11th graders (36.5%), and 120 12th graders (36.5%).

Procedure

The executive process of this research has been approved by the Ethics Committee of Kermanshah University of Medical Sciences under No. IR.KUMS.REC.1400.608 all procedures were carried out an adequate understanding and each participant provided their informed consent prior to the study. Data was collected through non-random and voluntary sampling. Iranian adolescents were asked to complete online questionnaires. Questionnaires were provided for online implementation and administered from November 28th 2020 to February 16th 2021. Before completing the questionnaires, the participants were explained the purposes and significance of research and their informed consent was obtained. For participants under 16 years, parental consent was also obtained

MHC-SF-A

The original 14-item Mental Health Continuum–Short Form (MHC-SF) (30) is a self-report questionnaire, measuring three basic subjective well-being domains: emotional (3 items), psychological (6 items) and social (5 items) of well-being. Respondents rated the frequency of every feeling in the past month on a 6-point Likert scale. Respondents thought about their past month and rated the frequency of each feeling on a 6-point Likert-type scale from never (0) to every day (5). The Iranian version of this questionnaire has already been used and validate by Rafiey et al. (34) in the adult population. The original English MHC-SF (30) for adolescent is just like the adult version, with only one helpful change to better fit the adolescent population. Specially, Examples of the community in the item “How often did you feel that you belonged to a community?” which in the adult version was “(like a social group, your neighborhood, or your city)” were given in the adolescent version as “(like a group of friends, at school, or in the neighborhood)”.

PANAS-C

The positive affect (PA) dimension of the 10-item PANAS-C (35) was selected to evaluate emotional well-being, as referred to the degree to which people feel is vitality and enthusiastic. The PA dimension was evaluated five adjective by five items: happy, lively, happy, energetic, and proud. The items have a 5-point Likert response format with answers ranging from 1 („very little) to 5 („a lot’). The sum of the item scores gives the total health score. The PA dimension has been shown to measure PA markers well among 6–18-year-olds. Ebesutani et al. (35) showed that PANAS-C is valid and reliable for the age group of 18-18 years. Lotfi (36) reported the psychometric properties of this questionnaire very well in Iran. In the present study, the Cronbach’s alpha of the PANAS-C was 0.76.

Kidscreen-27

Kidscreen-27 (37) is a brief screening measure to evaluate the behavioral and emotional problems of children and adolescents by 27 items measuring five scales, physical well-being, psychological well-being, autonomy and parents, peers and social support, and school environment. Items are scored on a 5-point Likert scale. The higher the total score indicates greater quality of life.Nik-Azin, Naeinian and Shairi (38) reported the psychometric properties of this questionnaire in Iran suitable for the age group of 11 to 19 years. The results of this study supported the five-factor structure of the original version. In the present study, the Cronbach’s alpha of the Kidscreen-27 was 0.73.

DASS-21

The DASS-21 (39) is a short form of DASS-42, well‐established instrument for measuring depression, anxiety, and stress with good reliability and validity reported in different cultural context (40). DASS-21 is a set of three self-report 7-item scales for assessing negative mental states in anxiety, depression, and stress. All 21 items are scored on a 4-point Likert scale from 0) did not apply to me at all) to 3 (applied to me very much, or most of the time). Asghari (41), examining the psychometric properties of this questionnaire in Iran, reported it as valid and reliable. A high score indicates psychological distress on each scale. In the present study, the Cronbach’s alpha of the DASS‐21 was 0.75.

The results of the analysis are reported separately for different areas of psychometrics.

Reliability

Table 1 shows the descriptive statistics (means, standard deviations, skewness, and kurtosis), Cronbach alphas and composite reliabilities for latent MHC-SF-A subscales. The results support the reliability of the scales in both Cronbach's alpha methods and the composite reliability (>0.70(that indicates the MHC-SF is a reliable measure, therefore it can be accepted.

Table 1

Descriptive Statistics for MHC-SF dimensions and reliability indices
Dimension	M	SD	Skewness	Kurtosis	CR	α
Emotional	10.31	3.17	.38	.70	0.87	0.84
Social	14.82	3.94	.74	.67	0.85	0.85
Psychological	18.13	4.26	.43	.69	0.86	0.82
MHC-SF Total	43.27	12.48	.51	.33	0.88	0.87

Factorial Validity

Confirmatory factor analysis was used to determine the factor structure of the questionnaire. LISREL10.2 was used to evaluate the factor structure. The method of estimating the weighted least squares with data from polychoric matrix and asymptotic covariance matrix was used in data analysis. The least squares method was preferred because the Likert response options were five-choice and the polychoric matrix had to be calculated instead of the Pearson correlation (42). Confirmatory factor analysis was performed by comparing four models of one-factor, two-factor, three-factor first-order and three-factor second-order. According to the information in Table 2, the first-order three-factor model has the best fit. Table 3 reports the standard estimates and the t-value based on the best fit of the factor model.

Table 2

Results of the Confirmatory Factor Analyses
model	X²	df	IFI	CFI	NFI	RMSEA	90% CI RMSEA
Single factor	727.22	77	0.823	0.818	0.813	0.131	0.126-0.136
Two factor	498.09	75	0.872	0.868	0.867	0.111	0.106-0.116
Three factor	222.35	73	0.938	0.943	0.941	0.061	0.055-0.066
Second order (three factor)	315.74	68	0.910	0.901	0.903	0.082	0.074-0.087
Notes. χ²: Chi Squared test, df: degrees of freedom, IFI: Incremental Fit Index, CFI: comparative fit index, NFI: Normed-of-Fit Index, RMSEA: root mean square error of approximation, CI: confidence interval. Criteria for interpreting model fit are: RSMEA < .08, IFI, CFI and NFI > .90.

Table 3

Standard estimate and t-value for the relationship between the item and the factor in the three-factor model
Factor	item	Factor loading	t-value
Emotional Wellbeing	1. Happy	.65	7.31
	2. Interested in life	.58	6.25
	3. Satisfied	.55	6.04
Social Wellbeing	4. That you had something important to contribute to society	.61	7.09
	5. That you belonged to a community (like a group of friends, at school or in the neighborhood)	.51	5.87
	6. That our society is becoming a better place for people	.57	6.16
	7. That people are basically good	.58	6.20
	8. That the way our society works makes sense to you	.59	6.29
Psychological Wellbeing	9. That you liked most parts of your personality	.63	7.24
	10. Good at managing the responsibilities of your daily life	.57	6.18
	11. That you had warm and trusting relationships with others	.60	6.34
	12. That you have experiences that challenge you to grow and become a better person	.64	7.28
	13. Confident to think or express your own ideas and opinions	.49	5.53
	14. That your life has a sense of direction or meaning to it	.63	7.20

Cross-Validation

Cross-validation was used to assess whether the three-factor model determined in the two groups of boys (n = 366) and girls (n = 366) had a similar fit. The model fit indices for the two groups are reported in Table 4. The results show that the three-factor measurement model fits well in both girls and boys.

Table 4

Results of cross-validation analysis in two groups of girls and boys
group	X²	df	IFI	CFI	NFI	RMSEA	90% CI RMSEA
Males	219.38	73	0.942	0.941	0.933	0.065	0.060-0.071
Females	224.84	72	0.945	0.941	0.925	0.065	0.060-0.071

Measurement Invariance

Table 5 shows the values for comparing models and measurement variability. Chi-square difference, CFI difference and RMSEA difference are the comparison criteria. According to the results of the Table, none of the indicators are significant (p>0.05). Therefore, Strong invariance was supported between males and females.

Table 5

Measurement Invariance across Gender
model	X²	df	CFI	RMSEA	Model comparison	ΔX²	Δdf	p	ΔCFI	ΔRMSEA
Model 1 No constraints	339.33	149	0.942	0.062	-	-	-		-	-
Model 2 Factor loadings constrained	352.85	160	0.940	0.061	2 vs 1	13.52	11	0.260	0.002	0.001
Model 3 Factor loadings and covariances constrained	362.19	164	0.942	0.060	3 vs 1	22.86	15	0.087	0.000	0.002

Construct validity

To evaluate the construct validity, the relationship between the score obtained from MHC-SF-A and several other measures was examined. According to Keyes’ (17) conceptualization, MHC-SF-A is expected to be negatively related to anxiety and depression (convergent validity), Also has a positive relationship with Kidscreen-27 positive affect tests (divergent validity). The results of Pearson correlation coefficient for convergent and divergent validity are reported in Table 6. This table also shows the relationship between MHC-SF-A subscales to evaluate the internal homogeneity of the test. According to these results, there is both convergent validity, divergent validity and internal validity between MHC-SF-A subscales.

Table 6

Pearson Correlation Coefficients for Construct Validity
measure		MHC-SF subscale			MHC-SF total
measure		Emotional	Psychological	Social	MHC-SF total
convergent validity
anxiety		-0.40^***	-0.33^***	-0.29^***	-0.37^***
depression		-0.43^***	-0.37^***	-0.36^***	-0.40^***
divergent validity
Kidscreen-27		0.48^***	0.47^***	0.40^***	0.45^***
Positive affect		0.50^***	0.43	0.38^***	0.44^***
Internal Consistency
MHC-SF subscale	Emotional	-
	Psychological	0.62^***	-
	Social	0.50^***	0.55^***	-
***p < .001

Reliability

Table 7 shows the descriptive statistics (means, standard deviations, skewness, and kurtosis), Cronbach alphas and composite reliabilities for latent MHC-SF-A subscales. The results support the reliability of the scales in both Cronbach's alpha methods and the composite reliability (>0.70(that indicates that the MHC-SF is a reliable measure, therefore it can be accepted.

Table 7

Descriptive statistics, composite reliabilities and Cronbach alpha coefficients for MHC-SF-A subscales
scale	M	SD	Skewness	Kurtosis	CR	α
Emotional	3.41	0.92	0.69	0.78	0.87	0.84
Psychological	3.32	1.04	0.46	0.31	0.85	0.85
Social	3.01	1.13	0.70	0.89	0.86	0.82
MHC-SF total	3.20	0.95	0.44	0.40	0.88	0.87

The aim of this study was to examine at the structure and psychometric features of data collected for teenagers using the Mental Health Continuum-Short Form version (30) in Iranian adolescences, its internal consistency and reliability, its invariance across gender, and plausibility of the two continua model proposing that mental health and illness are distinct yet related constructs. The Mental Health Continuum, or MHC, provides a clinical approach towards the ongoing evaluation and categorical identification of positive mental health states (30,17). The 14-item short form of the MHC scale is one of the most extensively used measures to assess well-being around the world (21). As a result, the primary goal of this research would have been to verify the MHC–SF in an Iranian adolescent population. The present results confirm that the MHC-SF is a valid and reliable tool that can be taken advantage of evaluating the health of Iranian adolescents.

The results of study prove that the multidimensional structure of well-being (emotional, social and psychological). The three-factor model showed an acceptable goodness-of-fit index and was relatively superior to the one- and two-factor models. These findings are consistent with a growing body of research suggesting that the MHCSF measures three specific factors that correspond to major components of overall well-being and subscales of emotional, social, and psychological well-being (27, 29, 33, 43-45).

MHCSF emotional and psychometric scales in this population displayed high internal consistency and reliability, as assessed by Cronbach's alpha. The internal consistency and reliability coefficients of the social well-being subscale were acceptable, but low compared to the other subscales. Similar results have been detected in preceding studies (27,29,30,46). All Cronbach alphas were superior to those seen in studies in South Africa, the Netherlands and Italy (29,30,46).

Confirmatory Factor Analysis (CFA) was calculated to determine the factor structure of MHC-SF. A second-order CFA was performed to test whether these three factors reveal the same dimension. The CFA provides a fairly good level of support for the MHC-SF tripartite structure (29,47). Unique cross-culture study of MHC-SF factor structure is Joshanloo et al.’s (47) study using CFA, displaying that the three-dimensional model of the MHC-SF corresponded to the data well in Iran, South Africa, and the Netherlands. The overall Iranian MHC-SF and the three sub-dimensions were more internally consistent than other studies. In addition, our results confirmed strong invariance of the three MHC-SF elements by gender. These results suggest that MHC-SF is similarly measured in males and females using a three-factor model, allowing comparisons between genders.

The convergent validity of the MHCSF was good in the present study, implying that the MHC-SF is a valid instrument. The Pearson Correlation Coefficient results for convergent and divergent validity showed the relationship between the MHC-SF-A subscales for assessing the internal homogeneity of the test. Between anxiety and depression, depression covered a broader conceptualization of well-being. This means that depression on a health-affirming measure, for example, is most strongly correlated with the total score of the MHC-SF, a measure of general well-being. According to Keyes’ conceptualization (16), MHC-SF-A is expected to be negatively related to anxiety and depression. Previous studies have also demonstrated the convergent validity of the emotional, social, and psychological aspects of mental well-being (18,46).

In addition to convergent validity, the MHC–SF was found to have divergent and discriminant validity in the current investigation. Mental illness and mental health, according to the two-continua concept, are connected but separate dimensions. The current study demonstrates that mental health measures are connected to, but separate from, mental illness measures. This obviously means that the lack of mental illness does not always imply the existence of mental health, requiring the development of a mental health assessment tool.

Generally, the MHC-SF is a beneficial, short self-report questionnaire for evaluating of mental health. Consequently, Research helps fill knowledge gaps about the authenticity and usefulness of the MHC-SF in national cultures around the world for positive mental health measures.

There are some limitations that need to be taken into account in this study. Weak correlations are statistically significant due to the large sample size. As a result, we applied an alpha of .001 instead of the common .05 as a margin of significance in the validation analyses. Due to the extremely limiting assumptions of the CFA approach and resulting inflation of the interrelationships, the future studies are capable of applying Exploratory Structural Equation Modeling (ESEM) to illustrate the factor structure of multidimensional constructs such as mental well-being. What is more, future research will be able to discover the validity of the Iranian MHC–SF, and the three categorizations for positive mental health and people in different sorting.

According to results, there are some vital implications for mental health policy and care. Recently, mental health care concentrates mostly on psychopathology in either diagnostics or treatment. Nevertheless, with mental health and mental illness being two detached indices of mental health, it may be useful to concentrates also on boosting of positive mental health. It is hoped that this study will cover the path for more knowledgeable and inclusive conceptualization and assessment of mental well-being in different age groups.

In this research, in relation to the level of mental health, we conducted the Mental Health Continuum-Short Form (30) to a large Iranian sample (aged from 11 to 18 years) to examine its factor structure, psychometrics, and benefit in determining the level of functioning among Keyes’ (16) model. Consequently, to our knowledge, the present study is among the first to confirm a measure of Iranian adolescences’ positive mental health and presents primary confirmation that the MHC-SF can be applied to younger participants. These results support the findings of prior research in terms of adolescents (31,48) implying that this conceptualization of mental health can be appropriate from immaturity to maturity. To sum up, we deliberate the MHC-SF to be a psychometrically sound questionnaire for general mental well-being in relation to Iranian adolescents.

Ethics approval and consent to participate

All participants gave informed written consent with the right to withdraw at any time. In the first part of the questionnaire, there was a paragraph introducing the study aim and assuring confidentiality of data by anonymous questionnaires. Participants did not experience any harm and they were allowed to stop their participation during the data collection process. All methods were carried out in accordance with relevant guidelines and regulations. The executive process of this research has been approved by the Ethics Committee of Kermanshah University of Medical Sciences under No. IR.KUMS.REC.1400.608.

Consent for publication

Not applicable

Availability of data and materials

The datasets during and/or analyzed during the current study available from the corresponding author on reasonable request.

Competing interests

The authors declare that they have no competing interests

Funding

The authors received no specific funding for this work.

Acknowledgements

We sincerely thank all the participants and their families who participated in this study. We also thank the officials of the schools who cooperated well with us.

Authors' Contributions

MYA conceived and designed the research; MYA collected, organized and analyzed the dada; MYA wrote the paper. MYA read and approved the final manuscript.

Health for the world’s adolescents: a second chance in the second decade; 2014.
Heizomi H, Allahverdipour H, Jafarabadi MA, Bhalla D, Nadrian H. Effects of a mental health promotion intervention on mental health of Iranian female adolescents: a school-based study. Child and Adolescent Psychiatry and Mental Health. 2020 Dec;14(1):1-0.
Kieling C, Baker-Henningham H, Belfer M, Conti G, Ertem I, Omigbodun O, Rohde LA, Srinath S, Ulkuer N, Rahman A. Child and adolescent mental health worldwide: evidence for action. The Lancet. 2011 Oct 22;378(9801):1515-25.
Sharifi V, Mojtabai R, Shahrivar Z, Alaghband-Rad J, Zarafshan H, Wissow L. Child and adolescent mental health care in Iran: Current status and future directions. Archives of Iranian medicine. 2016 Nov 1;19(11):0-.
Statistical Center of Iran. Population and housing census. 2018; Available from: http://www.amar.org.ir/Default.aspx?1. Statistical Center of Iran. Population and housing census [Internet]. Iran: Statistical Center of Iran: 2018. Available from: http://www.amar.org.ir/Default.aspx?tabid=1190.
R, Hefazi M, et al. Twelve–month prevalence and correlates of psychiatric disorders in Iran: The iranian mental health survey, 2011. Arch Iran Med. 2015; 18(2): 76 – 84.
Radgoodarzi R, Hefazi M, et al. Iranian Mental Health Survey: Design and Field Procedures. Iran J Psychiatry. 2014; 9(2): 96 – 109.
Mohammadi MR, Salmanian M, Ghanizadeh A, Alavi A, Malek A, Fathzadeh H, et al. Psychological problems of Iranian children questionnaire. J Ment Health. 2014; 23(6): 287 – 291.
World Health Organization. The World Health Report 2001: Mental health: new understanding, new hope.
Fen CM, Isa I, Chu CW, Ling C, Ling SY. Development and validation of a mental wellbeing scale in Singapore. Psychology. 2013 Jun 24;4(07):592.
Snyder CR, Lopez SJ. Handbook of positive psychology. Eds. New York: Oxford University Press; 2002.
Insel T, Scolnick E. Cure therapeutics and strategic prevention: raising the bar for mental health research. Mol Psychiatry. 2006;11:11–7.Return
Weisz JR, Kuppens S, Ng MY, Eckshtain D, Ugueto AM, Vaughn-Coaxum R, et al. What five decades of research tells us about the effects of youth psychological therapy: a multilevel meta-analysis and implications for science and practice. Am Psychol. 2017;72:79–117.
Antaramian SP, Scott Huebner E, Hills KJ, Valois RF. A dual-factor model of mental health: toward a more comprehensive understanding of youth functioning. Am J Orthopsychiatry. 2010;80:462–72.
World Health Organisation. Promoting mental health: concepts, emerging evidence, practice (summary report). Geneva, Switzerland: WHO Press; 2004. p. 69.
Keyes CL. The mental health continuum: From languishing to flourishing in life. Journal of health and social behavior. 2002 Jun 1:207-22.
Keyes CL. Promoting and protecting mental health as flourishing: A complementary strategy for improving national mental health. American psychologist. 2007 Feb;62(2):95.
Keyes CL, editor. Mental well-being: International contributions to the study of positive mental health. Springer Science & Business Media; 2012 Nov 8.
Keyes CL. Mental illness and/or mental health? Investigating axioms of the complete state model of health. Journal of consulting and clinical psychology. 2005 Jun;73(3):539.
Luijten CC, Kuppens S, van de Bongardt D, Nieboer AP. Evaluating the psychometric properties of the mental health continuum-short form (MHC-SF) in Dutch adolescents. Health and quality of life outcomes. 2019 Dec;17(1):1-0.
Perugini MLL, de la Iglesia G, Solano AC, Keyes CL. The mental health continuum–short form (MHC–SF) in the Argentinean context: confirmatory factor analysis and measurement invariance. Eur J Psychol. 2017;13:93–108.Return
Doré I, O’Loughlin JL, Sabiston CM, Fournier L. Psychometric evaluation of the mental health continuum–short form in French Canadian Young adults. Can J Psychiatry. 2017;62:286–94.
Guo C, Tomson G, Guo J, Li X, Keller C, Söderqvist F. Psychometric evaluation of the mental health continuum-short form (MHC-SF) in Chinese adolescents–a methodological study. Health Qual Life Outcomes. 2015;13:198–206.
Salama-Younes M. Validation of the mental health continuum short form and subjective vitality scale with Egyptian adolescent athletes. In: Brdar I, editor. The human pursuit of well-being. Dordrecht: Springer; 2011. p. 221–34.
Singh K, Bassi M, Junnarkar M, Negri L. Mental health and psychosocial functioning in adolescence: an investigation among Indian students from Delhi. J Adolesc. 2015;39:59–69.
Donnelly A, O’Reilly A, Dolphin L, O’Keeffe L, Moore J. Measuring the performance of the mental health continuum-short form (MHC-SF) in a primary care youth mental health service. Ir J Psychol Med. 2019:1–5.
Petrillo G, Capone V, Caso D, Keyes CL. The mental health continuum–short form (MHC–SF) as a measure of well-being in the Italian context. Soc Indic Res. 2015;121:291–312.
Lim YJ. Psychometric characteristics of the Korean mental health continuum–short form in an adolescent sample. J Psychoeduc Assess. 2014;32:356–64.
Karaś D, Cieciuch J, Keyes CL. The polish adaptation of the mental health continuum-short form (MHC-SF). Personal Individ Differ. 2014;69:104–9.
Keyes CL, Wissing M, Potgieter JP, Temane M, Kruger A, Van Rooy S. Evaluation of the mental health continuum–short form (MHC–SF) in setswana-speaking south Africans. Clin Psychol Psychother. 2008;15:181–92.
Keyes CL. The subjective well-being of America's youth: toward a comprehensive assessment. Adolescent Family Health. 2006;4:3–11.
Keyes CL, Eisenberg D, Perry GS, Dube SR, Kroenke K, Dhingra SS. The relationship of level of positive mental health with current mental disorders in predicting suicidal behavior and academic impairment in college students. J Am Coll Heal. 2012;60:126–33.
Joshanloo M. A new look at the factor structure of the MHC‐SF in Iran and the United States using exploratory structural equation modeling. Journal of clinical psychology. 2016 Jul;72(7):701-13.
Rafiey H, Alipour F, LeBeau R, Amini Rarani M, Salimi Y, Ahmadi S. Evaluating the psychometric properties of the Mental Health Continuum-Short Form (MHC-SF) in Iranian earthquake survivors. International Journal of Mental Health. 2017 Jul 3;46(3):243-51.
Ebesutani C, Regan J, Smith A, Reise S, Higa-McMillan C, Chorpita BF. The 10-item positive and negative affect schedule for children, child and parent shortened versions: application of item response theory for more efficient assessment. J Psychopathol Behav Assess. 2012;34:191–203.Return to ref 40 in article
Lotfi M, Bahrampoori L, Amini M, Fatemitabar R, Birashk B, Shiasi Y. Developing the Persian version of positive and negative affect scale for children (Original and short form) and assessing its psychometric properties. Iranian Journal of Psychiatry and Clinical Psychology. 2020;25(4):440-53.
Ravens-Sieberer U, Auquier P, Erhart M, Gosch A, Rajmil L, Bruil J, Power M, Duer W, Cloetta B, Czemy L, Mazur J. The KIDSCREEN-27 quality of life measure for children and adolescents: psychometric results from a cross-cultural survey in 13 European countries. Quality of Life Research. 2007 Oct;16(8):1347-56.
Nik-Azin A, Naeinian M R, Shairi M R. Validity and Reliability of Health Related Quality of Life Questionnaire “KIDSCREEN-27” in a Sample of Iranian Students . IJPCP. 2013; 18 (4) :310-321.
Antony MM, Bieling PJ, Cox BJ, Enns MW, Swinson RP. Psychometric properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales in clinical groups and a community sample. Psychological assessment. 1998 Jun;10(2):176.
Oei TP, Sawang S, Goh YW, Mukhtar F. Using the depression anxiety stress scale 21 (DASS‐21) across cultures. International Journal of Psychology. 2013 Dec; 48(6):1018-29.
Asghari A, Saed F, Dibajnia P. Psychometric properties of the Depression Anxiety Stress Scales-21 (DASS-21) in a non-clinical Iranian sample. Int J psychol. 2008;2(2):82-102.
Keyes, C. L. M. (1998). Social well-being. Social Psychology Quarterly, 61(2), 121-140. doi:10.2307/2787065
Echeverría, G., Torres, M., Pedrals, N., Padilla, O., Rigotti, A., and Bitran, M. (2017). Validation of a Spanish version of the mental health continuum-short form questionnaire. Psicothema 29, 96–102. doi: 10.7334/psicothema2016.3
Rogoza, R., Truong Thi, K. H., Rózycka-Tran, J., Piotrowski, J., and ZemojtelPiotrowska, M. (2018). Psychometric properties of the MHC-SF: an integration of the existing measurement approaches. J. Clin. Psychol. 74, 1742–1758. doi: 10.1002/jclp.22626
Longo, Y., Jovanovic, V., Sampaio de Carvalho, J., and Kara ´ ´s, D. (2020). The general factor of well-being: multinational evidence using bifactor ESEM on the Mental Health Continuum–Short Form. Assessment 27, 596–606. doi: 10.1177/1073191117748394
Lamers S, Westerhof GJ, Bohlmeijer ET, ten Klooster PM, Keyes CL. Evaluating the psychometric properties of the Mental Health Continuum–Short Form (MHC-SF). J Clin Psychol. 2011;67(1):99-110.
Joshanloo M, Wissing MP, Khumalo IP, Lamers SM. Measurement invariance of the Mental Health Continuum–Short Form (MHC-SF) across three cultural groups. Pers Individual Differences. 2013;55(7):755-75
Matos, A. P., Andre´, R. S., Cherpe, S., Rodrigues, D., Figueira, C., & Pinto, A. M. (2010). Preliminary psychometric study of the Mental Health Continuum—Short Form—for youth, in a sample of Portuguese adolescents. Psychologica, 53, 131–156. doi:10. 14195/1647-8606_53_7.

No competing interests reported.

Download PDF

Version 2

posted

You are reading this older preprint version

Read the latest preprint version →

Psychometric Properties of the Mental Health Continuum-Short Form (MHC-SF) in Iranian Adolescents

Status:

Version 2

Abstract

Background

Methods

Results

Conclusion

Introduction

Methods

Participants

Procedure

Results

Reliability

Factorial Validity

Cross-Validation

Measurement Invariance

Construct validity

Reliability

Discussion

Conclusion

Declarations

References

Additional Declarations

Status:

Version 2