The Warwick-Edinburgh Mental Well-being Scale (WEMWBS): development and UK validation

Ruth Tennant, Louise Hiller, Ruth Fishwick, Stephen Platt, Stephen Joseph, Scott Weich, Jane Parkinson, Jenny Secker, Sarah Stewart-Brown, Ruth Tennant, Louise Hiller, Ruth Fishwick, Stephen Platt, Stephen Joseph, Scott Weich, Jane Parkinson, Jenny Secker, Sarah Stewart-Brown

Abstract

Background: There is increasing international interest in the concept of mental well-being and its contribution to all aspects of human life. Demand for instruments to monitor mental well-being at a population level and evaluate mental health promotion initiatives is growing. This article describes the development and validation of a new scale, comprised only of positively worded items relating to different aspects of positive mental health: the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS).

Methods: WEMWBS was developed by an expert panel drawing on current academic literature, qualitative research with focus groups, and psychometric testing of an existing scale. It was validated on a student and representative population sample. Content validity was assessed by reviewing the frequency of complete responses and the distribution of responses to each item. Confirmatory factor analysis was used to test the hypothesis that the scale measured a single construct. Internal consistency was assessed using Cronbach's alpha. Criterion validity was explored in terms of correlations between WEMWBS and other scales and by testing whether the scale discriminated between population groups in line with pre-specified hypotheses. Test-retest reliability was assessed at one week using intra-class correlation coefficients. Susceptibility to bias was measured using the Balanced Inventory of Desired Responding.

Results: WEMWBS showed good content validity. Confirmatory factor analysis supported the single factor hypothesis. A Cronbach's alpha score of 0.89 (student sample) and 0.91 (population sample) suggests some item redundancy in the scale. WEMWBS showed high correlations with other mental health and well-being scales and lower correlations with scales measuring overall health. Its distribution was near normal and the scale did not show ceiling effects in a population sample. It discriminated between population groups in a way that is largely consistent with the results of other population surveys. Test-retest reliability at one week was high (0.83). Social desirability bias was lower or similar to that of other comparable scales.

Conclusion: WEMWBS is a measure of mental well-being focusing entirely on positive aspects of mental health. As a short and psychometrically robust scale, with no ceiling effects in a population sample, it offers promise as a tool for monitoring mental well-being at a population level. Whilst WEMWBS should appeal to those evaluating mental health promotion initiatives, it is important that the scale's sensitivity to change is established before it is recommended in this context.

Figures

Figure 1
Figure 1
WEMBS question responses: student and population samples.
Figure 2
Figure 2
Cronbach's alphas of 10 randomly generated versions of WEMWBS: student and population samples.
Figure 3
Figure 3
Score distribution for student and population samples.
Figure 4
Figure 4
WEMWBS score vs. GHQ-12 score, scatter plot and box and 90% CI whisker plot: population sample.

References

    1. World Health Organisation . Promoting Mental Health; Concepts emerging evidence and practice Summary report. Geneva; World Health Organisation; 2004.
    1. World Health Organisation . Strengthening mental health promotion. Geneva; World Health Organisation; 2001.
    1. Ryan RM, Deci EL. On happiness and human potential: a review of research on hedonic and eudaimonic well-being. Annu Rev Psychol. 2001;52:141–166. doi: 10.1146/annurev.psych.52.1.141.
    1. Goldberg DP, Williams P. A user's guide to the General Health Questionnaire. Windsor, UK: NFER-Nelson; 1988.
    1. Compton WC, Smith ML, Cornish KA, Qualls DL. Factor structure of mental health measures. J Pers Soc Psychol. 1996;71:406–413. doi: 10.1037/0022-3514.71.2.406.
    1. Keyes CLM, Shmotkin D, Ryff CD. Optimizing well-being: The empirical encounter of two traditions. J Pers Soc Psychol. 2002;82:1007–1022. doi: 10.1037/0022-3514.82.6.1007.
    1. Waterman AS. Two conceptions of happiness: Contrasts of personal expressiveness (eudaimonia) and hedonic enjoyment. J Pers Soc Psych. 1993;64:678–691. doi: 10.1037/0022-3514.64.4.678.
    1. Huppert FA, Wittington JE. Positive mental health in individuals and populations. In: Huppert FA, Baylis N, editor. The Science of Well-being. Keverne Oxford: Oxford University Press; 2004. pp. 307–340.
    1. Linley PA, Joseph S, (Eds.) Positive psychology in practice. Hoboken, NJ: Wiley; 2004.
    1. Fava GA. Well-being therapy. Psychother Psychosom. 1999;68:171–178. doi: 10.1159/000012329.
    1. Fava GA, Rafanelli C, Cazzarro M, Conti S, Grandi S. Well-being therapy: A novel psychotherapeutic approach for residual symptoms of affective disorders. Psychol Med. 1998;28:475–480. doi: 10.1017/S0033291797006363.
    1. Joseph S, Linley PA. Positive therapy: a meta-theory for positive psychological practice. Routledge; 2006.
    1. Hu Y, Stewart-Brown S, Twigg L, Weich S. Can the 12 item General Health Questionnaire be used to measure positive mental health? Psychol Med. 2007;37:1005–13. doi: 10.1017/S0033291707009993.
    1. Watson D, Clark LA, Tellegen A. Development and validation of brief measures of positive and negative affect: the PANAS scales. J Pers Soc Psych. 1988;6:1063–70. doi: 10.1037/0022-3514.54.6.1063.
    1. Diener E, Emmons RA, Larsen RJ, Griffin S. The Satisfaction with Life Scale. J Pers Assess. 1985;49:71–75. doi: 10.1207/s15327752jpa4901_13.
    1. Ryff CD, Keyes CLM. The structure of psychological well-being revisited. J Pers Soc Psychol. 1995;69:719–727. doi: 10.1037/0022-3514.69.4.719.
    1. Joseph S, Linley PA, Harwood J, Lewis CA, McCollam P. Rapid assessment of well-being: the Short Depression-Happiness Scale (SDHS) Psychol Psychother. 2004;77:463–478. doi: 10.1348/1476083042555406.
    1. Bech P. Measuring the dimensions of psychological general well-being by the WHO-5. QoL Newsletter. 2004;32:15–16.
    1. Kammann R, Flett R. A scale to measure current level of general happiness. Aust Psychol. 1983;35:259–265. doi: 10.1080/00049538308255070.
    1. Stewart-Brown S. Measuring parts most measures do not reach: a necessity for evaluation in mental health promotion. J Mental Health Promotion. 2002;1:4–9.
    1. Tennant R, Fishwick R, Platt S, Joseph S, Stewart-Brown S. Monitoring positive mental health in Scotland: validating the Affectometer 2 scale and developing the Warwick-Edinburgh Mental Well-being Scale for the UK. Edinburgh, NHS Health Scotland; 2006.
    1. Tennant R, Joseph S, Stewart-Brown S. The Affectometer 2: a measure of positive mental health in UK populations. Qual Life Res. 2007;16:687–695. doi: 10.1007/s11136-006-9145-5.
    1. Singleton HLG, (Ed) Better or worse: a longitudinal study of adults living in private households in Great Britain. London: The Stationery Office; 2003.
    1. NHS Health Scotland . Glasgow: NHS Health Scotland (in preparation) [database on the Internet] Colchester: UK Data Archive; 2007. Health Education Population Survey: Update from 2006 survey.
    1. Braunholtz S, Davidson S, Myant K, O'Connor R. Well? What do you think? (2006) The third national Scottish survey of public attitudes to mental health, mental wellbeing and mental health problems. Scottish Executive: Edinburgh; 2007. To access the dataset contact Angela Hallam .
    1. Singleton N, Bumpstead R, O'Brien M, Lee A, Meltzer H. Psychiatric morbidity among adults living in private households. Office for National Statistics: London. 2001.
    1. Eurobarometer Life Satisfaction
    1. Schutte NS, Malouff JM, Hall LE, Haggerty DJ, Cooper JT, Golden CJ, Dornheim L. Development and validation of a measure of emotional intelligence. Pers Ind Diff. 1998;25:167–177. doi: 10.1016/S0191-8869(98)00001-4.
    1. Brooks R, Robin R, de Charro F, (Eds.) The measurement and valuation of health status using EQ5-D: a European perspective. Kluwer Academic Publishers; 2003.
    1. Paulhus DL, Reid DB. Enhancement and denial in socially desirable responding. J Pers Soc Psychol. 1991;60:307–317. doi: 10.1037/0022-3514.60.2.307.
    1. Bentler PM. Comparative fit indexes in structural models. Psychol Bull. 1990;107:238–246. doi: 10.1037/0033-2909.107.2.238.
    1. Cole DFA. Utility of confirmatory factor analysis in test validation research. J Consul Clin Psychol. 1987;55:584–594. doi: 10.1037/0022-006X.55.4.584.
    1. Hu L, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling. 1999;1:1–55.
    1. Bentler PM, Bonnet DG. Significance tests and goodness of fit in the anlaysis of covariance structures. Psychol Bull. 1980;88:58. doi: 10.1037/0033-2909.88.3.588.
    1. Nunnally JC. Psychometric Theory. 2. McGraw-Hill, London; 1978.
    1. Cheung WY, Garratt AM, Russell IT, Williams JG. The UK IBDQ – A British version of the inflammatory bowel disease questionnaire: development and validation. J Clin Epidemiol. 2000;53:297–306. doi: 10.1016/S0895-4356(99)00152-3.
    1. Goldberg DP, Gater R, Sartorius N, Ustun TB, Piccinelli M, Gureje O, Rutter C. The validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychol Med. 1997;27:191–197. doi: 10.1017/S0033291796004242.

Source: PubMed

スポンサーと協力者

医学的状態

薬物療法

3
購読する