{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T13:19:25Z","timestamp":1785417565750,"version":"3.56.0"},"reference-count":56,"publisher":"AOSIS","issue":"0","license":[{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>This study evaluated the psychometric validity and clinical utility of the 12-item General Health Questionnaire (GHQ-12) in isolated, confined and unusual or extreme (ICUE) work environments in South Africa. Two occupational health surveillance cohorts (N\u00a0= 730 and\u00a0N\u00a0= 128) representing diverse occupational fields completed the GHQ-12 together with validated measures of common mental disorders, psychological resilience, emotional wellbeing and mental toughness. Confirmatory factor analyses supported a bifactor model comprising a strong general factor with minimal unique variance attributable to the positive and negative item subfactors. Internal consistency was high across samples. The GHQ-12 total scores correlated positively with depression, anxiety and adjustment disorder symptoms, and negatively with psychological resilience, emotional wellbeing and mental toughness, supporting convergent validity. Test\u2013retest reliability was moderately strong, with a minority showing marked deterioration of mental health under more stressful operational conditions, indicating the tool\u2019s potential sensitivity to environmental stressors. The GHQ-12 total scores differentiated between individuals with and without common mental disorders, and receiver operating characteristic analyses indicated acceptable sensitivity and specificity at optimal thresholds. Introducing a \u2018grey-zone\u2019 approach with lower and upper thresholds enhanced its practical application for surveillance and triage, by improving risk identification and decision-making for occupational health practitioners.\nContribution:\u00a0This study provides the first large-scale evaluation of the GHQ-12 in ICUE occupational environments in southern Africa. By combining psychometric evaluation with a clinically oriented grey-zone approach, it offers evidence to support how brief mental health tools can be applied to high-risk workplaces such as offshore vessels, submarines and polar research stations.<\/jats:p>","DOI":"10.4102\/ajopa.v8i0.195","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T07:33:21Z","timestamp":1784792001000},"update-policy":"https:\/\/doi.org\/10.4102\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Psychometric validity and clinical utility of the GHQ-12 for screening psychological health in isolated, confined and unusual or extreme environments"],"prefix":"10.4102","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4793-417X","authenticated-orcid":false,"given":"Charles H.","family":"van Wijk","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05bk57929","id-type":"ROR","asserted-by":"publisher"}],"name":"Stellenbosch University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0942-3478","authenticated-orcid":false,"given":"Chris J.B.","family":"Muller","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05bk57929","id-type":"ROR","asserted-by":"publisher"}],"name":"Stellenbosch University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2580","published-online":{"date-parts":[[2026,7,24]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"Andrich, D., & Van Schoubroeck, L. 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