Background: The scientific study of well-being has expanded as researchers extend the definition of mental health beyond the absence of mental illness to also include the presence of positive psychological factors. Well-being refers to individuals’ perceptions and appraisals of their own lives in terms of their affect – i.e., how they are feeling (hedonic perspective), as well as their psychological and social functioning – i.e., how they are doing (eudaimonic perspective) (Keyes, 2002). The Mental Health Continuum-Short Form (MHC-SF; Keyes, 2008) is a well-established validated 14-item questionnaire that measures emotional, psychological, and social components of well-being. To date, psychometric studies of the MHC-SF have only examined non-clinical samples (e.g., Lamers et al., 2011, De Bruin & Du Plessis, 2015, Petrillo et al., 2014, etc.). To address this gap, we examined the factor structure, internal consistency, and convergent validity of the MHC-SF in a clinical sample of patients receiving brief intensive CBT for acute psychiatric symptoms in a partial hospital setting.
Methods: This study included 708 patients receiving treatment at the Behavioral Health Partial Hospital Program at McLean Hospital. Upon admission to the program, as part of routine clinical monitoring, patients completed the MHC-SF, the Patient Health Questionnaire (PHQ-9) to assess depressive symptoms, and the Motivation and Pleasure Scale-Self Report (MAP-SR) to assess anhedonia.
Results: We conducted exploratory and confirmatory factor analyses (EFA and CFA) by randomly splitting the sample in half. EFA using promax rotation revealed a 3-factor structure, similar but not identical to the one previously documented in other studies (Factor 1 = Psychological/Social Well-Being; Factor 2 = Positive Affect; Factor 3 = Beliefs about Society, all αs>.80). This structure was replicated using CFA, with multiple fit indices indicating the appropriateness of the model, χ2(51) = 121.76, p < .001, RMSEA = .06, CFI = .97, SRMR = .04. The factor structure provided a significantly better fit than the structure found in previous studies, ∆ χ2(23)=181.92, p < .001, ∆AIC=1993.43, ∆BIC=2016.65. Covergent validity analyses showed that the subscales of the MHC-SF negatively correlated with measures of depression and anhedonia. Conclusion: Results of this psychometric investigation revealed that the MHC-SF presents a somewhat different factor structure in a clinical sample than previously found in nonclinical populations. In particular, in the present sample, individual social functioning appeared to be more closely related to psychological functioning than to beliefs about society. Overall, these results suggest that the MHC-SF reliably provides important information about positive psychological factors at play in the lives of individuals experiencing acute psychiatric symptoms.
Alexandra Silverman– Clinical Research Coordinator, McLean Hospital, Belmont, Massachusetts
Marie Forgeard– Postdoctoral Fellow, McLean Hospital and Harvard Medical School, Belmont, Massachusetts
Courtney Beard– Assistant Professor, McLean Hospital/Harvard Medical School, Belmont, Massachusetts
Thröstur Björgvinsson– Director, Behavioral Health Partial Program, McLean Hospital
Clinical Research Coordinator
McLean Hospital and Harvard Medical School
McLean Hospital/Harvard Medical School