{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T14:00:52Z","timestamp":1785333652120,"version":"3.55.0"},"reference-count":61,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The 12-item General Health Questionnaire (GHQ-12) is widely used for assessing psychological distress, yet debates persist regarding its optimal factor structure, especially across different cultural contexts and demographic groups. While the bi-factor model has gained empirical support in Western populations, limited research has examined its validity in Chinese university students. This study aimed to evaluate the psychometric properties of the GHQ-12 in Chinese university students by examining its factor structure through Classical Test Theory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A cross-sectional study was conducted with a sample of Chinese university students (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f511). The dataset was randomly split into two samples, sample 1 (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f260) and sample 2 (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f251) for EFA and CFA, respectively. The study evaluated the construct validity of the GHQ-12 one-factor, two-factor, three-factor, and bi-factor models using CFA.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      EFA revealed a two-factor structure with strong fit. CFA results demonstrated that the bi-factor model showed the best overall numerical fit, whereas the two-factor model was retained as the preferred solution because it demonstrated strong and balanced factor loadings, conceptual interpretability, and greater parsimony (\n                      <jats:italic>\u03c7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      =\u202f83.3, df\u202f=\u202f53; CFI\u202f=\u202f0.989; TLI\u202f=\u202f0.986; RMSEA\u202f=\u202f0.048; SRMR\u202f=\u202f0.063). Internal consistency was excellent (\n                      <jats:italic>\u03b1<\/jats:italic>\n                      \u202f=\u202f0.838,\n                      <jats:italic>\u03c9<\/jats:italic>\n                      \u202f=\u202f0.842), and convergent validity was moderate with WHO-5 (\n                      <jats:italic>r<\/jats:italic>\n                      \u202f=\u202f\u22120.339) and SWEMWBS (\n                      <jats:italic>r<\/jats:italic>\n                      \u202f=\u202f\u22120.475).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The GHQ-12 demonstrates acceptable psychometric properties in Chinese university students. The two-factor model was retained as the preferred solution based on interpretability and parsimony, although the bi-factor model showed superior global fit indices. These findings support the use of the GHQ-12 for mental health screening and future psychometric research in Chinese youth populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1849577","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T04:25:44Z","timestamp":1785212744000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Psychometric evaluation of the factor structure of the General Health Questionnaire-12 in a sample of Chinese university students"],"prefix":"10.3389","volume":"14","author":[{"given":"Sai-fu","family":"Fung","sequence":"first","affiliation":[{"name":"Department of Social and Behavioural Science, City University of Hong Kong","place":["Kowloon, Hong Kong SAR, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cyrus Ngo Tin","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Social and Behavioural Science, City University of Hong Kong","place":["Kowloon, Hong Kong SAR, China"]},{"name":"Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong","place":["New Territories, Hong Kong SAR, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerf W. K.","family":"Yeung","sequence":"additional","affiliation":[{"name":"Department of Social and Behavioural Science, City University of Hong Kong","place":["Kowloon, Hong Kong SAR, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"ref1","volume-title":"World Mental Health Report: Transforming Mental Health for all","year":"2022"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"536","DOI":"10.1046\/j.1365-2648.2003.02938.x","article-title":"Psychological distress: concept analysis","volume":"45","author":"Ridner","year":"2004","journal-title":"J Adv Nurs"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1177\/1363459307077545","article-title":"The twain meet: distress, disorder and the continuing conundrum of categories (comment on Horwitz)","volume":"11","author":"Wheaton","year":"2007","journal-title":"Health (London, England: 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