The structure of mental health:: Higher-order confirmatory factor analyses of psychological distress and well-being measures

This paper addresses the question of whether psychological distress and subjective well-being are the opposite poles of the same axis of mental health or independent constructs that should be measured on two independent axes. The measures used in this study originate from a preliminary ethnosemantic study and the content analysis of narratives of psychological distress and well-being episodes experienced by a random sample of francophone Quebecers (Canada). Two scales were produced: a Psychological Distress Manifestation Scale (PDMS) based on 23 items and four factors (Anxiety/Depression, Irritability, Self-Depreciation, and Social Disengagement), and a Psychological Well-Being Manifestation Scale with 25 items and six factors (Self-Esteem, Social Involvement, Mental Balance, Control of Self and Events, Sociability, and Happiness). Structural equation modeling analyses confirm that these 10 factors can be viewed as components of two correlated dimensions (psychological distress and well-being) (r = -0.65) of a two-dimensional latent construct which reflects a higher-order concept of mental health. We conclude that assessment of mental health in general populations should use concomitant measures of psychological distress and well-being.