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Dimensionality and Internal Composition of the Twenty-Two Item Mental Health Inventory

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Dimensionality and Internal Composition of the Twenty-Two Item Mental Health Inventory Western Michigan University ScholarWorks at WMU Master's Theses Graduate College 8-1973 Dimensionality and Internal Composition of the Twenty-Two Item Mental Health Inventory John William Fox Follow this and additional works at: https://scholarworks.wmich.edu/masters_theses Part of the Sociology Commons Recommended Citation Fox, John William, "Dimensionality and Internal Composition of the Twenty-Two Item Mental Health Inventory" (1973). Master's Theses. 4646. https://scholarworks.wmich.edu/masters_theses/4646 This Masters Thesis-Open Access is brought to you for free and open access by the Graduate College at ScholarWorks at WMU. It has been accepted for inclusion in Master's Theses by an authorized administrator of ScholarWorks at WMU. For more information, please contact [email protected]. DIMENSIONALITY AND INTERNAL COMPOSITION OF THE TWENTY-TWO ITEM MENTAL HEALTH INVENTORY by Joh Willia Fox A Tesis Submitted to the Faculty of The Graduate College in partial fulfillment of the Degree of Master of Arts Western Michigan·university Kalamazoo, Michigan August 1973 ACKNOWLEDGEMENTS Many individuals have helped me in the preparation of this thesis. Dr. Martin Ross, my committee chairman until serious illness made it impossible for him to continue that role, provided endless patience and understanding as he guided the initial stages of this investigation. Dr. Michael Walizer assumed the role of being my com­ mittee chairman after Dr. Ross became ill. His knowledge, counsel and ability to blend persistence with patience have been invaluable in the completion of this thesis. Mr. Robert Wait challenged my in­ sights, provided me with new ones, helped me revise my old ones, and always insisted on my clear understanding of material. While the members of committee have guided the preparation of this thesis, they are not responsible for its final products. That responsibility is mine alone. Special thanks go to Mr. Sam Anerna of the Computer Center. His work and cousel on computer applications and programs have not only taught me a great deal, they have made some aspects of this thesis a reality. I must acknowledge a debt of continuing gratitude to the Sociol­ ogy Department for the financial support that I recieved during the preparation of this thesis. Lastly, I wish to thank my wife, Pattie. Without her support and continued sacrifices, this thesis would not have been completed. John William Fox ii TABLE OF CONTEN'l'S CHAPTER PAGE I INTRODUCTION • • • • • • • • • • • • • • • • • • • • • 1 II OVERVIEW OF THE MIDTCMN MANHATTAN STUDY AND THE 22 ITEM MENTAL HEALTH INVENTORY • • • • • • • • • • • • The Midtown Manhattan Study of Mental Disorder . • • 9 Background on the 22 Item Mental Health Inventory 12 Statistical criteria reported in the development of .the 22 Item Mental Health Inventory . • • • • 14 Content and scoring of the 22 Item Mental Health Inventory • • • • • • • • • • • • • • • • • • • 14 Cutting points on the 22 Item Mental Health Inven- tory •••• • • • • • • • • • • • • • • • • • • 18 Utilization of the 22 Item Mental Health Inventory in researcti • • • • • • • • • • • • • • • • • • 19 III Mental Health, Mental Illness AND THE 22 ITEM MENTAL HEALTH INVENTORY • • • • • • • • • • • • • • • • • • Homogeneous Scales and Inventories •• • • • • • • • 21 Theory and Practice of Mental Health and Mental Ill- ness in the Midtown Manhattan Study • • • • • • • 23 Theory and Practice of the 22 Item Mental Health In- ventory • • • • • • • • • • • • • • • • • • • • • 27 Subscales of the 22 Item Mental Health Inventory . • 30 IV STATISTICAL ANALYSES OF SCALES AND INVENTORIE.5 • • • • 36 Introduction ••• • • • • • • • • • • • • • • • • • 36 Factor Analysis • • • • • • • • • • • • • • • • • • 37 General description • • • • • • • • • • • • • • • 37 The basic indeterminacy of the common factor analysis model • • • • • • • • • • • • • • • • • 39 iii CHAPTER PAGE Factor analysis models • • • • • • • • • • • • • 40 1 Approximations to "true" communalities • • • • • • 42 Image factor analysis • • • • • • • • • • • • • • 43 Factor analytic technique • • • • • • • • • • • • 44 Rotation of factor solutions • • • • • • • • . 45 Correlation coefficients in factor analysis • • • 47 Item Analysis • • • • • • • • • • • • • • • • • • • 54 Internal Consistency • • • • • • • • • • • • • • • • 55 Factor Analysis and Hypothesis Testing • • • • • • • 57 Factor analytic hypotheses • • • • • • • • • • • • 64 V METHODOLOGY • • • • • • • • • • • • • • • • • • • • • 66 Introduction . • • • • • • • • • • • • • • • • • • • 66 Study Location • • • • • • • • • • • • • • • • • • • • 66 Sample • • • • • • • • • • • • • • • • • • • • • • • 67 The 22 Item Mental Health Inventory in the Kalamazoo County Study • • • • • • • • • • • • • • • • • • • 68 Scoring Procedure • • • • • • • • • • • • • • • • • 73 Correlation Matrices • • • • • • • • • • • • • • • • 75 Image Covariance Matrices • • • • • • • • • • • • • 78 Factor Analytic Procedures • • • • • • • • • • • • • 78 General procedures ••• • • • • • • • • • • • • • 78 Factor analytic procedures for testing unidimen- ality • • • • • • • • • • • • • • • • • • • • • 81 Factor analytic procedures for testing a pattern of relationships • • • • • • • • • • • • • • • • 82 VI RESULTS AND CONCLUSIONS • • • • • • • • • • • • • • • 84 iv CHAPTER PAGE Factor Analytic Results and Conclusions • • • • • • 84 Factor analysis tables ••• • • • • • • • • • • • Factor analytic results in testing the hypothesis of unidimensionality . • • • • • • • • • • • • • 86 Factor analytic results in testing the hypothesis of a specific pattern of relationships . • • • • 91 Internal Consistency of the 22 Item Mental Health Inventory ••••••• • • • • • • • • • • • • • 103 Item-Total Score Correlations • • • • • • • • • • • 105 Swmnary of Findings and Conclusions • • • • • • • • 106 VII LIMITATIONS • • • • • • • .. • . .... • • • • • • • 108 Limitations of the Data • • • • • • • • • • • • • • 108 Limitations of the Analysis • • • • • • • • • • • • 109 VIII IMPLICATIONS • • • • • • • • • • • • • • • • • • • • • 114 BIBLIOGRAPHY • • • • • • • • • • • • • • • • • • • • • • • • • 123 V CHAPTER I INTRODUCTION Social scientists have long been concerned with the relation­ ships between mental disorder and various sociocultural factors, such as, social economic status, ethnic background, sex, age, and marital status. Until quite recently, the majority of studies that have investigated these relationships have defined cases of mental disorder solely in terms of whether or not an individual was in psychiatric treatment (see Faris and Dunham, 1939J Rose and Stub, 1955; Hollingshead and Redlich, 1958). The utilization of psychiatric treatment as the only criterion of mental disorder, however, has been criticized by a number of researchers. Felix and Bowers (1948), Plunkett and Gordon (1960), and Mechanic (1970) have suggested that the availability of psy­ chiatric treatment and public attitudes toward their use are related to psychiatric treatment rates. Dohrenwend and Dohrenwend (1965:52) have suggested that either of these factors could result in spur­ ious interpretations being given to the observed relationships between various social factors (e.g., social economic status) and rates of mental disorder as based on the number of individuals in psychiatric treatment. Clausen and Yarrow (1955), Cumming and Cumrmning (1957), Schwartz (1957) and Scheff (1966) have suggested that most behavior indicative of mental disorder is either unrecognized, denied or rationalized 1 2 within community populations. Their findings suggest that the rates of mental disorder based on the number of individuals in psychiatric treatment in a community are likely to underestimate the actual rate of both treated and untreated cases of mental disorder in the community. A growing recognition of the limitations imposed by the operational definition of mental disorder as being in psychiatric treatment coupled with the increasing concern for community mental health (see Srole et al., 1962:6-7) has prompted attempts by social scientists to study both treated and untreated mental dis­ order in community populations. Due to time-costs factors and the fact that data only needs to be collected at one time, the largest number of these studies have been concerned with the total pre­ 1 valence of mental disorder in community populaJions. Dohrenwend and Dohrenwend (1969) have summarized the rates of mental disorder for over forty studies that have attempted to count both treated and untreated cases of mental disorder in community populations. Studies that compared both treated and untreated mental disorder in the same populations have consistently found that the rates of untreated mental disorder far exceed the rates of mental disorder based on treatment records (see Srole et al., 1962; Manis et al., 1 Prevalence is defined as the number of cases in a population at a given time. Incidence is defined as the number of new cases that occur in a population during a given time period. For critiques of the use of prevalence data in epidemiology studies of mental disorder, see Kramer (1957), Kleiner and Parker (1963), Lapouse (1967), Mishler and Scotch (1967). 3 1964). Over the years, epidemiological studies of the prevalence of untreated mental disorder have increasingly relied on question­ naires, structured interviews and symptom inventories to stand­ ardize their data collection techniques. In several instances, social scientists have attempted to develop mental health inven­ tories and rating
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