The Cultural Fairness of the 12-Item General Health Questionnaire Among Diverse Adolescents

The 12-item general health questionnaire (GHQ-12) was used in the Longitudinal Study of Young People in England (LSYPE; N = 15,770) to collect measures on adolescent mental health. Given the debate in current literature regarding the dimensionality of the GHQ-12, this study examined the cultural sensitivity of the instrument at the item level for each of the 7 major ethnic groups within the database. This study used a hybrid approach of ordinal logistic regression and item response theory (IRT) to examine the presence of differential item functioning (DIF) on the questionnaire. Results demonstrated that uniform, nonuniform, and overall DIF were present on items between White and Asian adolescents (7 items), White and Black Caribbean adolescents (1 item), and White and Black African adolescents (7 items), however all McFadden's pseudo R-2 effect size estimates indicated that the DIF was negligible. Overall, there were cumulative small scale level effects for the Mixed/Biracial, Asian, and Black African groups, but in each case the bias was only marginal. Findings demonstrate that the GHQ-12 can be considered culturally sensitive for adolescents from diverse ethnic groups in England, but follow-up studies are necessary. Implications for future education and health policies as well as the use of IR-based approaches for psychological instruments are discussed.