Khumalo Itumeleng P, Appiah Richard, Wilson Fadiji Angelina
Department of Psychology, University of Johannesburg, Johannesburg, South Africa.
Department of Occupational Therapy, College of Health Sciences, University of Ghana, Accra, Ghana.
Front Psychol. 2022 Jun 20;13:885278. doi: 10.3389/fpsyg.2022.885278. eCollection 2022.
The dual-continua model of mental health provides a contemporary framework for conceptualising and operationalising mental health. According to this model, mental health is distinct from but related to mental illness, and not the opposite or merely the absence of psychopathology symptoms. To examine the validity of the dual-continua model, previous studies have either applied variable-based analysis such as confirmatory factor analysis (CFA), or used predetermined cut-off points for subgroup division. The present study extends this contribution by subjecting data from an African sample to both CFA and latent class analysis (LCA) to test the dual-continua model in Africa. We applied CFA separately for the Mental Health Continuum-Short Form (MHC-SF) and Patient Health Questionnaire-9 (PHQ-9); and LCA on combined item responses. College students ( = 892; average age = 22.74, = 4.92; female = 58%) from Ghana ( = 309), Kenya ( = 262), Mozambique ( = 232), and South Africa ( = 89) completed the MHC-SF and PHQ-9. With minor modifications to the measurement models, the CFA results of this study confirm the three-factor structure of the MHC-SF, and a unidimensional solution for the PHQ-9. LCA results show the presence of three distinct latent classes: languishing with moderate endorsement of depressive symptoms (25.9%), flourishing with low endorsement of depressive symptoms (63.7%), and moderate mental health with high endorsement of depressive symptoms (10.4%). These findings further contribute to affirming the evidence for the dual-continua model of mental health, with implications for the assessment of mental health, to inform policy, practise, and future research in community and clinical settings in Africa.
心理健康的双连续体模型为心理健康的概念化和操作化提供了一个当代框架。根据这个模型，心理健康与精神疾病不同但相关，并非精神病理学症状的对立面或仅仅是其不存在。为了检验双连续体模型的有效性，以往的研究要么应用基于变量的分析方法，如验证性因素分析（CFA），要么使用预先确定的临界点进行亚组划分。本研究通过对来自非洲样本的数据进行CFA和潜在类别分析（LCA），以检验非洲的双连续体模型，从而扩展了这一贡献。我们分别对心理健康连续体简表（MHC-SF）和患者健康问卷-9（PHQ-9）应用CFA；并对合并的项目反应进行LCA。来自加纳（n = 309）、肯尼亚（n = 262）、莫桑比克（n = 232）和南非（n = 89）的大学生（n = 892；平均年龄 = 22.74，标准差 = 4.92；女性 = 58%）完成了MHC-SF和PHQ-9。对测量模型进行了微小修改后，本研究的CFA结果证实了MHC-SF的三因素结构，以及PHQ-9的单维解决方案。LCA结果显示存在三个不同的潜在类别：抑郁症状中度认可的萎靡状态（25.9%）、抑郁症状低度认可的蓬勃状态（63.7%）和抑郁症状高度认可的中度心理健康状态（10.4%）。这些发现进一步有助于确认心理健康双连续体模型的证据，对心理健康评估具有启示意义，为非洲社区和临床环境中的政策制定、实践及未来研究提供参考。
