King Nathan, Davison Colleen M, Pickett William
Department of Public Health Sciences, Queen's University, Kingston, ON, Canada.
Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada.
Front Psychol. 2022 Aug 12;13:918894. doi: 10.3389/fpsyg.2022.918894. eCollection 2022.
According to the Dual-factor Model, mental health is comprised of two related constructs: subjective well-being and psychopathology. Combining these constructs can provide a more accurate and comprehensive assessment of adolescent mental health than considering either on its own. The model suggests the need to group mental health into four distinct categories, which does not recognize its potential continuum and adds statistical complexity. In this study, we developed a continuous measure inspired by, and as a complement to, the Dual-factor Model. Our goal was to demonstrate a novel approach to developing a valid measure for use in public health research that captures varying mental health states more accurately than traditional approaches and has advantages over the categorical version.
Self-report data are from the 2014 Canadian Health Behavior in School-aged Children study ( = 21,993). Subjective well-being was measured by combining indicators of life satisfaction, positive affect, and negative affect. Internalized and externalized symptoms scales were combined to measure psychopathology. The continuous dual-factor measure was created by subtracting standardized psychopathology scores from standardized subjective well-being scores. Construct validity was assessed using multivariable linear regression by examining associations between factors known to be associated with adolescent mental health status (demographic characteristics, social and academic functioning, and specific indicators of mental health) and average mental health scores.
The average age was 14.0 (SD = 1.41) years. The continuous mental health score ranged from 5 to 67 [Mean (SD): 50.1 (9.8)], with higher scores indicating better overall mental health. The nature and direction of the associations examined supported construct validity. Being from a more affluent family, and having more supportive relationships with family, peers, teachers, and classmates was associated with greater mental health (Cohen's d: 0.65 to 1.63). Higher average marks were also associated with better mental health. Average mental health scores were much lower if students reported feeling hopeless or rated their health as fair or poor.
A continuous measure of mental health based on the Dual-factor Model appears to be a comprehensive and valid measure with applications for research aimed at increasing our understanding of adolescent mental health.
根据双因素模型，心理健康由两个相关的构念组成：主观幸福感和精神病理学。将这些构念结合起来，比单独考虑其中任何一个，能更准确、全面地评估青少年心理健康。该模型建议将心理健康分为四个不同类别，但这并未认识到其潜在的连续性，还增加了统计复杂性。在本研究中，我们开发了一种受双因素模型启发并作为其补充的连续性测量方法。我们的目标是展示一种新方法，以开发一种有效的测量方法用于公共卫生研究，该方法能比传统方法更准确地捕捉不同的心理健康状态，且优于分类版本。
自我报告数据来自2014年加拿大学龄儿童健康行为研究（n = 21,993）。主观幸福感通过结合生活满意度、积极情感和消极情感指标来测量。内化和外化症状量表相结合以测量精神病理学。连续性双因素测量通过从标准化主观幸福感分数中减去标准化精神病理学分数来创建。通过检查已知与青少年心理健康状况相关的因素（人口统计学特征、社会和学业功能以及心理健康的特定指标）与平均心理健康分数之间的关联，使用多变量线性回归评估结构效度。
平均年龄为14.0（标准差 = 1.41）岁。连续性心理健康分数范围为5至67 [均值（标准差）：50.1（9.8）]，分数越高表明整体心理健康状况越好。所检查的关联的性质和方向支持结构效度。来自更富裕的家庭，以及与家人、同龄人、教师和同学有更多支持性的关系与更好的心理健康相关（科恩d值：0.65至1.63）。更高的平均成绩也与更好的心理健康相关。如果学生报告感到绝望或将自己的健康评为一般或较差，平均心理健康分数会低得多。
基于双因素模型的心理健康连续性测量似乎是一种全面且有效的测量方法，适用于旨在增进我们对青少年心理健康理解的研究。
