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Cited by 245Psychometric Methodologies and TestingAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesMental Health Research Topics

The DOI matches its Crossref record; 87 of the 88 references it cites were found in a registry or an index.

The WHO-5 well-being index – validation based on item response theory and the analysis of measurement invariance across 35 countries

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Sischka, Philipp E., Costa, Andreia P., Steffgen, Georges, Schmidt, Alexander F.·2020·Journal of Affective Disorders Reports
DOI 10.1016/j.jadr.2020.100020
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Abstract

The five-item World Health Organization Well-Being Index (WHO-5) is a frequently used brief standard measure in large-scale cross-cultural clinical studies. Despite its frequent use, some psychometric questions remain that concern the choice of an adequate item response theory (IRT) model, the evaluation of reliability at important cutoff points, and most importantly the assessment of measurement invariance across countries. Data from the 6th European Working Condition survey (2015) were used that collected nationally representative samples of employed and self-employed individuals (N = 43,469) via computer-aided personal interviews across 35 European countries. An in-depth IRT analysis was conducted for each country, testing different IRT assumptions (e.g., unidimensionality), comparing different IRT-models, and calculating reliabilities. Furthermore, measurement invariance analysis was conducted with the recently proposed alignment procedure. The graded response model fitted the data best for all countries. Furthermore, IRT assumptions were mostly fulfilled. The WHO-5 showed overall and at critical points high reliability. Measurement invariance analysis revealed metric invariance but discarded scalar invariance across countries. Analysis of the test characteristic curves of the aligned graded response model indicated low levels of differential test functioning at medium levels of the WHO-5, but differential test functioning increased at more extreme levels. The current study has no external criterion (e.g., structured clinical interviews) to assess sensitivity and specificity of the WHO-5 as a depression screening-tool. The WHO-5 is a psychometrically sound measure. However, large-scale cross-cultural studies should employ a latent variable modeling approach that accounts for non-invariant parameters across countries (e.g., alignment).

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Image 1
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Image 2
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Fig. 2 Item parameter for the GRM.
Fig. 2 Item parameter for the GRM.CC-BY-NC-ND · From the PDF
Image 4
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Fig. 4 Item parameter for the GRM after alignment.
Fig. 4 Item parameter for the GRM after alignment.CC-BY-NC-ND · From the PDF
Fig. 5 Test characteristic curves for the GRM after alignment.
Fig. 5 Test characteristic curves for the GRM after alignment.CC-BY-NC-ND · From the PDF
Fig. 6 Differential test functioning for the GRM after alignment (Reference group: GBR).
Fig. 6 Differential test functioning for the GRM after alignment (Reference group: GBR).CC-BY-NC-ND · From the PDF
Image 8
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Research works printed but not linked: 1

  1. Eurofound (Ed.)., 2017. European quality of life survey 2016: quality of life, quality of public services, and quality of society. Publications Office of the European Union, Luxembourg.

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Metadata

Authors
Sischka, P. E., Costa, A. P., Steffgen, G., & Schmidt, A. F.
Affiliations
  • University of Luxembourg (LU)
  • Johannes Gutenberg University Mainz (DE)
Corresponding author
Sischka, Philipp E.
ORCID
Venue
Journal of Affective Disorders Reports
Publisher
Elsevier BV
Published
2020-12
Volume
1
Pages
100020
ISSN
2666-9153 (ISSN-L)
DOI
10.1016/j.jadr.2020.100020
OpenAlex
W3094404984
Cited by
245
References
88
Citations by year
2026: 50 · 2025: 55 · 2024: 61 · 2023: 35 · 2022: 28 · 2021: 13 · 2020: 3
FWCI
12.56
Type
journal article
Language
en
Update notices
erratum (2022-12-01)
Open access
Licence
Locations
  • Journal of Affective Disorders Reports (publishedVersion, cc-by-nc-nd)
  • Open Repository and Bibliography (University of Luxembourg) (submittedVersion, cc-by-nc-sa)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • OSF Preprints (OSF Preprints) (submittedVersion)
Topics
  • Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
Keywords
WHO-5, well-being index, measurement invariance, graded response model, alignment procedure, differential item functioning, depression screening, psychometric validation, cross-cultural measurement, European Working Conditions Survey, reliability statistics, unidimensionality

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