Development and Psychometric Properties of the Mental Health Literacy Questionnaire (MHLQ) Among Young Iranian Soldiers

Erfan Soleimani-Sefat, Akram Parandeh, Fatemeh Rahmati, Tahereh Kamalikhah

Abstract


Background: Prevention of the incidences of mental disorders, psychological problems, or their rapid diagnosis is an important issue that has led to the creation of a mental health literacy concept and the development of standard tools for evaluating them. This study is the first step in the designing and psychometrics of the Mental Health Literacy Questionnaire (MHLQ) in Iran. The purpose of this study was to design the psychometric properties of the MHLQ in soldiers. Methods: This study is a methodological study that was designed in three phases: 1) Designing the instrument, 2) Assessing the items, and 3) Psychometric assessment. This study was conducted during 2017‑2018, and the soldiers were selected by using a convenience sampling method from different garrisons of Tehran, Iran. To evaluate the content validity of the questionnaire 10 experts, to evaluate the face validity 9 soldiers, and for the pilot study 103 soldiers formed the sample size. Finally, construct validity was assessed among 251 soldiers. Results: In the first phase, 78 items were collected and designed. Then, based on the experts’ opinions and preliminary studies, the items were reduced to 52 in the “Assessing the items phase” and then to 42 items in the psychometric phase. In the third phase, 31 items remained in the final version. The CVR and CVI scores of the 52 items were 0.91 and 0.94, respectively. Exploratory factor analysis revealed a 4‑factor structure with 31 items of special value that were higher than five that accounted for 55.04 of the total scale variance. The fit indices values indicated that the model is fit for the data. In the total scale, the test–retest reliability and Cronbach’s alpha were 0.81 and 0.76, respectively. Conclusion: The MHLQ of soldiers has appropriate psychometric properties and can be considered as a suitable tool for evaluation and screening as well as a basis for educational and research interventions.

Keywords


Literacy; mental health; military; psychometrics

Full Text:

PDF

References


Jorm A. Mental health literacy. public knowledge and beliefs

about mental disorders. Br J Psychiatry 2000;177:317‑27.

Jorm AF, Korten AE, Jacomb PA, Christensen H, Rodgers B,

Pollitt P. ‘Mental health literacy’: A survey of the public’s

ability to recognise mental disorders and their beliefs about the

effectiveness of treatment. Med J Aust 1997;166:182‑6.

Martin CR, Preedy VR, Patel VB, editors. Comprehensive

guide to post-traumatic stress disorders. Springer International

Publishing; 2016.

Bryan CJ, Butner JE, Sinclair S, Bryan AB, Hesse CM, Rose AE.

Predictors of emerging suicide death among military personnel on

social media networks. Suicide Life Threat Behav 2018;48:413‑30.

Rotenstein LS, Ramos MA, Torre M, Segal JB, Peluso MJ,

Guille C, et al. Prevalence of depression, depressive symptoms,

and suicidal ideation among medical students: A systematic

review and meta‑analysis. JAMA 2016;316:2214‑36.

Griffiths KM, Christensen H, Jorm AF, Evans K, Groves C.

Effect of web‑based depression literacy and cognitive–

behavioural therapy interventions on stigmatising attitudes to

depression. Br J Psychiatry 2004;185:342‑9.

Kronmüller K‑T, Saha R, Kratz B, Karr M, Hunt A, Mundt C,

et al. Reliability and validity of the knowledge about depression

and mania inventory. Psychopathology 2008;4:69‑76.

Kessler E‑M, Agines S, Bowen CE. Attitudes towards seeking

mental health services among older adults: Personal and

contextual correlates. Aging Ment Health 2015;19:182‑91.

Serra M, Lai A, Buizza C, Pioli R, Preti A, Masala C, et al.

Beliefs and attitudes among Italian high school students

toward people with severe mental disorders. J Nerv Ment Dis

;201:311‑8.

Madianos M, Economou M, Peppou LE, Kallergis G, Rogakou E,

Alevizopoulos G. Measuring public attitudes to severe mental

illness in Greece: Development of a new scale. Eur J Psychiatry

;26:55‑67.

Wang J, He Y, Jiang Q, Cai J, Wang W, Zeng Q, et al. Mental

health literacy among residents in Shanghai. Shanghai Arch

Psychiatry 2013;25:224‑35.

O’Connor M, Casey L. The Mental health literacy scale (MHLS):

A new scale‑based measure of mental health literacy. Psychiatry

Res 2015;229:511‑6.

Ghanbari S, Ramezankhani A, Montazeri A, Mehrabi Y. Health

literacy measure for adolescents (HELMA): Development and

psychometric properties. PLoS One 2016;11:e0149202.

Montazeri A, Tavousi M, Rakhshani F, Azin SA, Jahangiri K,

Ebadi M, et al. Health literacy for Iranian adults (HELIA):

Development and psychometric properties. Payesh

;13:589‑99.

Comrey AL, Lee HB. A First Course in Factor Analysis.

Psychology Press; 2013.

Swami V, Persaud R, Furnham A. The recognition of mental

health disorders and its association with psychiatric scepticism,

knowledge of psychiatry, and the Big Five personality factors:

An investigation using the overclaiming technique. Soc

Psychiatry Psychiatr Epidemiol 2011;46:181‑9.

Crabb J, Stewart RC, Kokota D, Masson N, Chabunya S,

Krishnadas R. Attitudes towards mental illness in Malawi:

A cross‑sectional survey. BMC Public Health 2012;12:541.

Mahfouz MS, Aqeeli A, Makeen AM, Hakami RM, Najmi HH,

Mobarki AT, et al. Mental health literacy among undergraduate

students of a Saudi tertiary institution: A cross‑sectional study.

Ment Illn 2016;8:35‑9.

Furnham A, Gee M, Weis L. Knowledge of mental illnesses:

Two studies using a new test. Psychiatry Res 2016;244:363‑9.

Lawshe CH. A quantitative approach to content validity 1. Pers

Psychol 1975;28:563‑75.

Waltz CF, Bausell BR. Nursing Research: Design Statistics and

Computer Analysis. Philadelphia: F.A. Davis Company; 1981.

Mulaik SA, James LR, Van Alstine J, Bennett N, Lind S,

Stilwell CD. Evaluation of goodness‑of‑fit indices for structural

equation models. Psychol Bull 1989;105:430.

Nunnally JC, Bernstein I. Psychometric Theory (McGraw‑Hill

Series in Psychology), vol. 3. New York: McGraw‑Hill; 1994.

Barrett P. Structural equation modelling: Adjudging model fit.

Pers Individ Differ 2007;42:815‑24.

Ghasemi V. Structural equation modeling in social researches

using Amos graphics"|Persian}. Tehran: Jameeshenasan

Publication; socialists, press; First Edition 2010.

Hooper D, Coughlan J, Mullen M. Structural Equation

Modelling: Guidelines for Determining Model Fit. Electron J

Bus Res Methods, 2008:653-60.

Wheaton B, Muthen B, Alwin DF, Summers GF. Assessing

reliability and stability in panel models. Sociol Methodol

;8:84‑136.

Ascher‑Svanum H. Development and validation of a measure

of patients’ knowledge about schizophrenia. Psychiatr Serv

;50:561‑3.

Hepperlen T, Clay D, Henly G, Barke C, Hehperlen TM,

Clay DL. Measuring teacher attitudes and expectations toward

students with ADHD. Development of the test of knowledge

about ADHD (KADD). J Atten Disord 2002;5:133‑42.

Bjørnsen HN, Ringdal R, Espnes GA, Moksnes UK. Positive

mental health literacy. development and validation of a measure

among Norwegian adolescents. BMC Public Health 2017;17:717.

Dias P, Campos L, Almeida H, Palha F. Mental health literacy

in young adults: Adaptation and psychometric properties of the

mental health literacy questionnaire. Int J Environ Res Public

Health 2018;15:1318.