• PDF / 860,744 Bytes
• 11 Pages / 595.276 x 790.866 pts Page_size
• 41 Downloads / 190 Views

DOWNLOAD

REPORT

---

RESEARCH ARTICLE

Open Access

A Mokken scale analysis of the Kessler-6 screening measure among Chinese older population: findings from a national survey Lisong Zhang1 and Zhongquan Li2*

Abstract Background: The aging population increases rapidly across the world. Timely and effective screening of their mental-health problems is important to individuals, families, and the whole society. The Kessler-6 screening measure (K6) is a very popular instrument for non-specific psychological distress. However, few studies have focused on the psychometric properties of this instrument in the older population. Methods: The present study employed Mokken scale analysis to evaluate its dimensionality and structure. This study also used differential item functioning (DIF) to examine whether the same structure existed across sex in a national representative sample of old Chinese people. Data were drawn from a public data set, the 2010 China Family Panel Studies (CFPS2010), and responses from a total of 6450 participants aged 60 years old and above (3136 males and 3314 females) were included in the final analysis. Results: Mokken scale analysis supported the unidimensional structure of the K6. Differential item functioning (DIF) analysis revealed that two of the six items (“Hopeless” and “Everything was an effort”) were marked for DIF based on the Chi-square. However, their impacts were negligible in terms of McFadden’s pseudo R2. Conclusions: The K6 demonstrates adequate psychometric properties in the old Chinese population. The sum of all six items can be used as an indicator of non-specific psychological distress. Differences in the indicator across sex should be considered as a real difference in psychological distress between the female and the male. Keywords: Psychological distress, Mokken scale analysis, Dimensionality, Differential item functioning, Sex differences

Background The aging population increases rapidly across the world. Mental-health problems such as depression and anxiety are prevalent in this population. They have both shortterm and long-term consequences for individuals, families, and the whole society [1]. According to Report on National Mental Health Development in China (2017– 2018), in the past several years, prevalence estimate of * Correspondence: [email protected] 2 School of Social and Behavioral Sciences, Nanjing University, 163 Xianlin Avenue, Qixia District, Nanjing 210023, Jiangsu, China Full list of author information is available at the end of the article

depression disorder is ranged from 15 to 39.86%, and the prevalence rate of anxiety disorder is ranged from 11.51 to 22.02% among Chinese older population [2]. Another survey with a large nationally representative sample (the China Health and Retirement Longitudinal Study (CHARLS)) also indicated that about 33.09% of Chinese older adults suffered depression disorders [3]. In consideration of the largest population and fastest aging in China [4], timely and effective screening of psychological distress is vital to help those at risk for early in