The Mental Health Scale: Development, Reliability, And Validity

Objective: The aim of this study was to: (1) explore the intra-structure of mental health, (2) develop a new Mental Health Scale (MRS) for using in general populations over 15 years in our country, and (3) examine the reliability and validity of the scale.Methods: The samples consisted of 1000 general populations, and 100 patients with mental disorders that met CCMD-3 criteria. Exploratory and confirmatory factor analytic approaches were used to develop and evaluate the intra-structure of the scale. The reliability analysis included the mean inter-item correlation (Mnc), Cronbach's a, split-half reliability, and test-retest reliability. The validity analysis included content, construct, and criterion-related validity.Results: (1) The MHS consists of 104 items. (2) Exploratory principal component analysis of the items identified that the scale had thirteen first-order factors and three second-order factors, explaining 52% and 63% of the total variance respectively. Thirteen first-order factors were labeled as follows: Fl: happiness, F2: impulsion/anger, F3: health concern, F4: suspicion, F5: anxiety/depression, F6: trust/friendship, F7: subjective cognitive ability, F8: inferiority, F9: mental deviate, F10: self-control ability, F11: loss of emotional control, F12: distrust, and F13: self-confidence. Three second-order factors were labeled as follows: FI: psychological problem or disorder [PDJ, FII: positive affect [PA], and Fill: health and cognitive concerns [HCC]. (3) Internal consistency analyses showed that the mean inter-item correlation (Mnc) coefficients ranged from 0.20 to 0.47 for the first- and second-order factors and the total MHS. The Cronbach's a coefficient, split-half and test-retest correlation coefficients ranged from 0.62 to 0.91, 0.59 to 0.88 and 0.681 to 0.902 respectively for the first-order factors, from 0.90 to 0.95, 0.73 to 0.85 and 0.912 to 0.932 respectively for the second-order factors, and were 0.96, 0.92 and 0.948 respectively for the total scale. (4) Interscale correlations studies showed that the correlations among all the first-order and second-order factor scores ranged from 0.120 to 0.877, the correlations between the first- and second-order factor scores and total scores ranged from 0.509 to 0.904. All the first-order factors had a highercorrelation with their corresponding second-order factors than with the other second-order factors. (5) Using structural equation modeling, confirmatory factor analyses were conducted to assess the measurement of first- and second-order factor structure of the scale. On the first-order level, The results supported 13-factor model of the scale. The results of the second-order analysis indicated also good fit. (6) The correlations between the first- and second-order factors and total scores of the MHS and predicted self-assessed mental health, psychological distress, psychological well-being, happiness, and physical health scales were significant, ranging from 0.226 to 0.564, 0.202 to 0.511, 0.069 to 0.537, 0.099 to 0.520, and 0.080 to 0.584 respectively. The correlations with similar scales were higher than those with disaffinity scales. (7) Sex difference studies showed that the scores of anxiety/depression, inferiority, self-control ability, and loss of emotional control in men were significantly lower than those in women. Significant higher score of suspicion was found in men than those in women. (8) Age difference studies showed that scores of impulsion/anger, suspicion, anxiety/depression, trust/friendship, inferiority, mental deviate, and loss of emotional control of the first-order factors in the elderly were significantly lower than those in the non-elderly. Significant higher scores of health concern, subjective cognitive ability and self-confidence were found in the elderly than those in the non-elderly. The score of psychological problem or disorder of the second-order factor in the elderly was significantly lower than those in the non-elderly. Significant higher score of health and cognitive concerns was found in the eld...