Psychometric Analysis of the General Health Questionnaire with Chilean Inmates
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Abstract
Introduction. Chilean prisons face various issues that not only are detrimental to human rights but also public safety. The mental health of inmates appears to be one of the most pressing, invisible aspects of incarceration. Nevertheless, this topic remains largely invisible as there are no assessments of mental health on admission or instruments adapted to the prison context, preventing assessment and intervention.
Objective. to analyze the psychometric properties of the 12-item Goldberg General Health Questionnaire (GHQ-12) in a sample of 1,022 inmates at 20 facilities across Chile.
Method. we conducted a descriptive cross-sectional study and evaluated the internal structure of the GHQ-12 with both exploratory and confirmatory factor analysis. We also analyzed invariance by length of incarceration to determine the reliability of the instrument.
Results. our results showed the multidimensionality of the instrument, with a three-factor model. Invariance was demonstrated considering length of incarceration; and a similar factor structure to other studies was obtained: anxiety, social dysfunction, and loss of confidence.
Discussion and conclusion. Chilean prisons should have higher standards of dignity and effectiveness, including measures to improve their approach to mental health. A critical step to achieving this is ensuring timely detection of cases. The GHQ-12 appears to be a brief, simple, and inexpensive instrument that could be used as a reliable screening test to identify potential cases of mental disorders for subsequent referral and clinical treatment, as well as for prevalence studies of minor mental disorders.
References
Araya, R., Wynn, R., & Lewis, G. (1992). Comparison of two self administered psychiatric questionnaires (GHQ-12 and SRQ-20) in primary care in Chile. Social Psychiatry and Psychiatric Epidemiology, 27(4), 168–173. https://doi.org/10.1007/bf00789001
Baier, A., Fritsch, R., Ignatyev, Y., Priebe, S., & Mundt, A. P. (2016). The course of major depression during imprisonment – A one year cohort study. Journal of Affective Disorders, 189, 207–213. https://doi.org/10.1016/j.jad.2015.09.003
Boothby, M. R. K., Mulholland, I., Cases, A., Carrington, K., & Bolger, T. (2010). Towards mental health promotion in prisons: the role of screening for emotional distress. Procedia - Social and Behavioral Sciences, 5, 90–94. https://doi.org/10.1016/j.sbspro.2010.07.056
Bruna, D., Pérez, M., Bustos, C., & Núñez, J. (2017). Psychometric Properties of the Self-Regulated Learning Inventory in Chilean University Students. Revista Iberoamericana de Diagnóstico y Evaluación – e Avaliação Psicológica. RIDEP, 44(2), 77–91. https://doi.org/10.21865/RIDEP44.2.07
Burrone, M. S., Abeldaño, A., Lucchese, M., Susser, L., Enders, J., Alvarado, R., Valencia, E., & Fernandez, R. (2016). Evaluación psicométrica y estudio de fiabilidad del cuestionario general de salud (GHQ-12) en consultantes adultos del primer nivel de atención en Córdoba - Argentina. Revista de la Facultad de Ciencias Médicas de Córdoba, 72(4), 236–242. https://doi.org/10.31053/1853.0605.v72.n4.13827
Campbell, A., Walker, J., & Farrell, G. (2003). Confirmatory Factor Analysis of the GHQ-12: Can I See that Again?. Australian & New Zealand Journal of Psychiatry, 37(4), 475–483. https://doi.org/10.1046/j.1440-1614.2003.01208.x
Ceballos-Espinoza, F., Chávez-Hernández, A. M., Padilla-Gallegos, G. M., & Leenaars, A. A. (2016). Suicidio en las cárceles de Chile durante la década 2006-2015. Revista Criminalidad, 58(3), 101–118. http://www.scielo.org.co/pdf/crim/v58n3/v58n3a09.pdf
Chahín-Pinzón, N. (2014). Aspectos a tener en cuenta cuando se realiza una adaptación de test entre diferentes culturas. Psychologia. Avances de la disciplina, 8(2), 109–112.
Cova, F., Bustos, C., Rincón, P., Grandón, P., Saldivia, S., & Inostroza, C. (2019). Propiedades Psicométricas de una Forma Breve del Cuestionario de Parentalidad Alabama en Familias de Preescolares Chilenos. Revista Iberoamericana de Diagnóstico y Evaluación – e Avaliação Psicológica, 51(2). https://doi.org/10.21865/ridep51.2.03
Chen, F. F. (2007). Sensitivity of Goodness of Fit Indexes to Lack of Measurement Invariance. Structural Equation Modeling: A Multidisciplinary Journal, 14(3), 464–504. https://doi.org/10.1080/10705510701301834
Daradkeh, T. K., Ghubash, R., & El-Rufaie, O. E. F. (2001). Reliability, Validity, and Factor Structure of the Arabic Version of the 12-Item General Health Questionnaire. Psychological Reports, 89(1), 85–94. https://doi.org/10.2466/pr0.2001.89.1.85
Escobar, J., González, B., Quiroz, M., & Rodríguez, G. (2008). Decesos en el sistema penitenciario: una descripción preliminar por tipo de muertes. Revista de Estudios Criminológicos y Penitenciarios, 13, 35–54.
Espinoza, O., Martínez, F., & Sanhueza, G. (2014). El Sistema penitenciario y su Impacto en los Derechos Humanos de las Personas Privadas de Libertad (pp. 245–289). En Informe sobre Derechos Humanos en Chile. Ediciones Universidad Diego Portales.
Fasce H, E., Pérez V, C., Ortiz M, L., Parra P, P., & Matus B, O. (2011). Estructura factorial y confiabilidad de la escala de aprendizaje autodirigido de Fisher, King & Tague en alumnos de medicina chilenos. Revista médica de Chile, 139(11), 1428–1434. https://doi.org/10.4067/s0034-98872011001100006
Figueroa, F. (2018). Discapacidad psicosocial, salud mental y prisión en Chile. Aproximaciones hacia una sensibilización con enfoque de derechos humanos. Revista de Derecho, 35(2), 11–26. https://doi.org/10.21703/issn0717-0599/2018.n35-01
Gnambs, T., & Staufenbiel, T. (2018). The Structure of the General Health Questionnaire (GHQ-12): Two Meta-Analytic Factor Analyses. Health Psychology Review, 12(2), 179–194. https://doi.org/10.1080/17437199.2018.1426484
Goldberg, D. P., & Williams, P. (1988). A users’ guide to the general health questionnaire. GL Assessment.
Graetz, B. (1991). Multidimensional properties of the General Health Questionnaire. Social Psychiatry and Psychiatric Epidemiology, 26(3), 132–138. https://doi.org/10.1007/bf00782952
Griffith, G. J., & Jones, K. (2019). Understanding the population structure of the GHQ-12: Methodological considerations in dimensionally complex measurement outcomes. Social Science & Medicine, 243, Article 112638. https://doi.org/10.1016/j.socscimed.2019.112638
Horn, J. L. (1965). A Rationale and Test for the Number of Factors in Factor Analysis. Psychometrika, 30(2), 179–185. https://doi.org/10.1007/bf02289447
Hu, L., & Bentler, P. M. (1999). Cutoff Criteria for Fit Indexes in Covariance Structure Analysis: Conventional Criteria versus New Alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6(1), 1–55. https://doi.org/10.1080/10705519909540118
Ledesma, R., Ferrando, P., & Tosi, J. (2019). Uso del análisis factorial exploratorio en RIDEP. Recomendaciones para autores y revisores. Revista Iberoamericana de Diagnóstico y Evaluación – e Avaliação Psicológica, 52(3). https://doi.org/10.21865/ridep52.3.13
Lewis, G., & Araya, R. I. (1995). Is the General Health Questionnaire (12 item) a culturally biased measure of psychiatric disorder? Social Psychiatry and Psychiatric Epidemiology, 30(1), 20–25. https://doi.org/10.1007/bf00784430
López-Castedo, A., & Domínguez, J. (2010). Exploratory Factor Analysis and Psychometric Properties of the General Health Questionnaire in Spanish Adolescents. Psychological Reports, 107(1), 120–126. https://doi.org/10.2466/06.08.13.pr0.107.4.120-126
McGilloway, S., & Donnelly, M. (2004). Mental illness in the UK criminal justice system: A police liaison scheme for Mentally Disordered Offenders in Belfast. Journal of Mental Health, 13(3), 263–275. https://doi.org/10.1080/09638230410001700899
Ministerio de Salud (2013). Guía Clínica AUGE Depresión en personas de 15 años y más (2ª ed.). https://diprece.minsal.cl/wrdprss_minsal/
Ministerio de Justicia y Derechos Humanos (2025). Caracterización de Personas Privadas de Libertad. Gendarmería de Chile. https://www.gendarmeria.gob.cl/car_personas_pp.html
Mundt, A. P., Alvarado, R., Fritsch, R., Poblete, C., Villagra, C., Kastner, S., & Priebe, S. (2013). Prevalence Rates of Mental Disorders in Chilean Prisons. PLoS ONE, 8(7), e69109. https://doi.org/10.1371/journal.pone.0069109
Osses-Paredes, C., & Riquelme-Pereira, N. (2013). Situación de salud de reclusos de un centro de cumplimiento penitenciario, Chile. Revista Española de Sanidad Penitenciaria, 15(3), 98–104.
Pevalin, D. J. (2000). Multiple applications of the GHQ-12 in a general population sample: an investigation of long-term retest effects. Social Psychiatry and Psychiatric Epidemiology, 35(11), 508–512. https://doi.org/10.1007/s001270050272
Sanhueza, G., Candia, J., & Zúñiga, L. (2025). Mental Health in the Chilean Incarcerated Population: A Screening Approach. International Journal of Environmental Research and Public Health, 22(2), Article 268. https://doi.org/10.3390/ijerph22020268
Sanhueza, G. E. (2023). Human Rights in Chilean Prisons: Advances and Pending Challenges from a Social Work Perspective. Journal of Human Rights and Social Work, 8(4), 439–448. https://doi.org/10.1007/s41134-023-00276-x
Smith, C., & Borland, J. (1999). Minor psychiatric disturbance in women serving a prison sentence: The use of the General Health Questionnaire in the estimation of the prevalence of non‐psychotic disturbance in women prisoners. Legal and Criminological Psychology, 4(2), 273–284. https://doi.org/10.1348/135532599167905
Rivas-Diez, R., & Sánchez-López, M. d. P. (2014). Propiedades psicométricas del Cuestionario de Salud General (GHQ-12) en población femenina chilena. Revista Argentina de Clínica Psicológica, 23(3), 251–260.
Ruiz, F. J., García-Beltrán, D. M., & Suárez-Falcón, J. C. (2017). General Health Questionnaire-12 validity in Colombia and factorial equivalence between clinical and nonclinical participants. Psychiatry Research, 256, 53–58. https://doi.org/10.1016/j.psychres.2017.06.020
Villa G., I. C., Zuluaga Arboleda, C. & Restrepo Roldán, L. F. (2013). Psychometric Properties of the General Health Goldberg GHQ-12 Questionnaire Applied at a Hospital Facility in the City of Medellin. Avances en Psicología Latinoamericana, 31(3), 532–545. https://revistas.urosario.edu.co/index.php/apl/article/viewFile/1656/2206
Werneke, U., Goldberg, D. P., Yalcin, I., & Üstün, B. T. (2000). The Stability of the Factor Structure of the General Health Questionnaire. Psychological Medicine, 30(4), 823–829. https://doi.org/10.1017/s0033291799002287
